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1. A widespread family of phage-inducible chromosomal islands only steals bacteriophage tails to spread in nature

Author

Rousset, François, Depardieu, Florence, Miele, Solange, Dowding, Julien, Laval, Anne-Laure, Lieberman, Erica, Garry, Daniel, Rocha, Eduardo P.C., Bernheim, Aude, Bikard, David, Génomique évolutive des Microbes / Microbial Evolutionary Genomics, Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), This work was supported by grants MR/M003876/1, MR/V000772/1, and MR/S00940X/1 from the Medical Research Council (UK), BB/N002873/1, BB/V002376/1, BB/V009583/1, and BB/S003835/1 from the Biotechnology and Biological Sciences Research Council (BBSRC, UK), ERC-ADG-2014 Proposal no. 670932 Dut-signal (from EU), and Wellcome Trust 201531/Z/16/Z to J.R.P., and grants INCEPTION project (PIA/ANR-16-CONV-0005), Equipe FRM (Fondation pour la Recherche Médicale): EQU201903007835, Laboratoire d’Excellence IBEID Integrative Biology of Emerging Infectious Diseases (ANR-10-LABX-62-IBEID), and SALMOPROPHAGE ANR-16-CE16-0029 to E.P.C.R. L.M.-R. was the recipient of a Spanish postdoctoral fellowship from the Fundación Ramón Areces (2018–2020). A.F.-S. is the recipient of a fellowship from Imperial College., ANR-16-CONV-0005,INCEPTION,Institut Convergences pour l'étude de l'Emergence des Pathologies au Travers des Individus et des populatiONs(2016), ANR-10-LABX-0062,IBEID,Integrative Biology of Emerging Infectious Diseases(2010), ANR-16-CE12-0029,Salmo_prophages,Co-évolution des génomes bactériens et de leurs prophages: cooptation des prophages et conversion lysogenique chez Salmonella(2016), European Project: 670932,H2020,ERC-2014-ADG,DUT-signal(2015), University of Glasgow, King Saud Bin Abdulaziz University for Health Sciences [Riyadh] (KSAU-HS), Imperial College London, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), National University of Singapore (NUS), This work was supported by grants MR/M003876/1, MR/V000772/1 and MR/S00940X/1 from the Medical Research Council (UK), BB/N002873/1, BB/V002376/1 and BB/S003835/1 from the Biotechnology and Biological Sciences Research Council (BBSRC, UK), ERC-ADG-2014 Proposal n° 670932 Dut-signal (from EU), and Wellcome Trust 201531/Z/16/Z to JRP, and grants INCEPTION project (PIA/ANR-16-CONV-0005), Equipe FRM (Fondation pour la Recherche Médicale): EQU201903007835, Laboratoire d’Excellence IBEID Integrative Biology of Emerging Infectious Diseases [ANR-10-LABX-62-IBEID], and SALMOPROPHAGE ANR-16-CE16-0029 to EPCR., and ANR-05-GANI-0001,GenOvul,Exploitation de la variabilité génétique intra et inter-espèces pour l'étude du déterminisme génétique du taux d'ovulation(2005)

Subjects
small capsid formation, [SDV.BID.EVO]Life Sciences [q-bio]/Biodiversity/Populations and Evolution [q-bio.PE], [SDV]Life Sciences [q-bio], packaging, [SDV.BID.SPT]Life Sciences [q-bio]/Biodiversity/Systematics, Phylogenetics and taxonomy, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Microbiology, tail, bacteriophage, Virology, Parasitology, convergent evolution, pathogenicity islands, gene transfer, PICI
Abstract

Phage satellites interfere with helper phage packaging through the production of small-capsids, where only satellites can be packaged. So far, in all the analysed systems, the satellite-sized capsids are composed of phage proteins. Here we report the first demonstration that a family of phage-inducible chromosomal island (PICIs), a type of satellites, encodes all the proteins required for both the production of the small-sized capsids and the exclusive packaging of the PICIs into these capsids. Therefore, this new family, that we have named cf-PICIs (capsid forming PICIs), only requires phage tails to generate infective PICI particles. Remarkably, the representative cf-PICI reproduces without cost for their helper phages, suggesting that the relationship between these elements is not parasitic but commensalistic. Finally, our phylogenomic studies indicate that cf-PICIs are present both in Gram-positive and Gram-negative bacteria and have evolved at least three times independently to spread widely into the satellite universe.

Published
2022
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2. A Homozygous Missense Variant in PPP1R1B/DARPP‐32 Is Associated With Generalized Complex Dystonia

Author

Anne Molitor, Gaoqun Zhang, Bruno Rinaldi, Sepand Rastegar, Muhammad Umair, Seiamak Bahram, Sylvie Friant, Mathieu Anheim, Sylvain Mayeur, Benoit Lhermitte, Stefan T. Arold, Amjad Khan, Béatrice Lannes, Raphael Carapito, Immuno-Rhumatologie Moléculaire, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), GENOMAX [plateforme], Fédération Hospitalo-Universitaire OMICARE, Fédération Hospitalo-Universitaire (OMICARE), Centre de Recherche d’Immunologie et d’Hématologie [Strasbourg], LabEx Transplantex [Strasbourg], Université de Strasbourg (UNISTRA), Fédération de Médecine Translationnelle de Strasbourg (FMTS), CHU Strasbourg, Karlsruher Institut für Technologie (KIT), Génétique moléculaire, génomique, microbiologie (GMGM), Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), King Saud Bin Abdulaziz University for Health Sciences [Riyadh] (KSAU-HS), Centurion University of Technology and Management [India], King Abdullah University of Science and Technology (KAUST), Centre de Biologie Structurale [Montpellier] (CBS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Nouvel Hôpital Civil de Strasbourg, Les Hôpitaux Universitaires de Strasbourg (HUS), univOAK, Archive ouverte, Institut de biologie moléculaire des plantes (IBMP), Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA), Université Louis Pasteur - Strasbourg I-Centre National de la Recherche Scientifique (CNRS), Institut de génétique et biologie moléculaire et cellulaire (IGBMC), Université Louis Pasteur - Strasbourg I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)

Subjects
Dopamine and cAMP-Regulated Phosphoprotein 32, autosomal recessive generalized dystonia, Movement disorders, Substantia nigra, Sciences du Vivant [q-bio]/Médecine humaine et pathologie, [SDV.GEN.GH] Life Sciences [q-bio]/Genetics/Human genetics, 03 medical and health sciences, 0302 clinical medicine, medicine, Missense mutation, Animals, Humans, Generalized epilepsy, Zebrafish, Exome sequencing, PPP1R1B, 030304 developmental biology, Dystonia, Genetics, 0303 health sciences, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, biology, Homozygote, medicine.disease, biology.organism_classification, 3. Good health, DARPP-32, Neurology, [SDV.GEN.GH]Life Sciences [q-bio]/Genetics/Human genetics, Dystonic Disorders, Neurology (clinical), medicine.symptom, exome sequencing, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Background: The dystonias are a heterogeneous group of hyperkinetic disorders characterized by sustained or intermittent muscle contractions that cause abnormal movements and/or postures. Although more than 200 causal genes are known, many cases of primary dystonia have no clear genetic cause.Objectives: To identify the causal gene in a consanguineous family with three siblings affected by a complex persistent generalized dystonia, generalized epilepsy, and mild intellectual disability.Methods: We performed exome sequencing in the parents and two affected siblings and characterized the expression of the identified gene by immunohistochemistry in control human and zebrafish brains.Results: We identified a novel missense variant (c.142G>A (NM_032192); p.Glu48Lys) in the protein phosphatase 1 regulatory inhibitor subunit 1B gene (PPP1R1B) that was homozygous in all three siblings and heterozygous in the parents. This gene is also known as dopamine and cAMP-regulated neuronal phosphoprotein 32 (DARPP-32) and has been involved in the pathophysiology of abnormal movements. The uncovered variant is absent in public databases and modifies the conserved glutamate 48 localized close to the serine 45 phosphorylation site. The PPP1R1B protein was shown to be expressed in cells and regions involved in movement control, including projection neurons of the caudate-putamen, substantia nigra neuropil, and cerebellar Purkinje cells. The latter cells were also confirmed to be positive for PPP1R1B expression in the zebrafish brain.Conclusions: We report the association of a PPP1R1B/DARPP-32 variant with generalized dystonia in man. It might be relevant to include the sequencing of this new gene in the diagnosis of patients with otherwise unexplained movement disorders. © 2021 International Parkinson and Movement Disorder Society.

Published
2022
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3. The ectomycorrhizal basidiomycete Laccaria bicolor releases a GH28 polygalacturonase that plays a key role in symbiosis establishment

Author

Feng Zhang, Aurore Labourel, Mireille Haon, Minna Kemppainen, Emilie Da Silva Machado, Nicolas Brouilly, Claire Veneault‐Fourrey, Annegret Kohler, Marie‐Noëlle Rosso, Alejandro Pardo, Bernard Henrissat, Jean‐Guy Berrin, Francis Martin, Lanzhou University, Interactions Arbres-Microorganismes (IAM), Université de Lorraine (UL)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Biodiversité et Biotechnologie Fongiques (BBF), Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Consejo Nacional de Investigaciones Científicas y Técnicas [Buenos Aires] (CONICET), Institut de Biologie du Développement de Marseille (IBDM), Aix Marseille Université (AMU)-Collège de France (CdF (institution))-Centre National de la Recherche Scientifique (CNRS), Architecture et fonction des macromolécules biologiques (AFMB), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), King Saud Bin Abdulaziz University for Health Sciences [Riyadh] (KSAU-HS), National Natural Science Foundation of China (NSFC) 1901279Natural Science Foundation of Gansu Province20JR5RA276, ANR-14-CE06-0020,FUNTUNE,Cocktails enzymatiques inspirés de modèles fongiques pour la déconstruction contrôlée de la biomasse végétale(2014), and ANR-11-LABX-0002,ARBRE,Recherches Avancées sur l'Arbre et les Ecosytèmes Forestiers(2011)

Subjects
Laccaria, [SDV.BIO]Life Sciences [q-bio]/Biotechnology, Polygalacturonase, Physiology, Basidiomycota, Mycorrhizae, fungi, Plant Science, Symbiosis, Plant Roots, apoplastic effectorcarbohydrate-active enzymescell-wall-modifying enzymesectomycorrhizaLaccaria bicolorpectinspolygalacturonase
Abstract

International audience; In ectomycorrhiza, root penetration and colonization of the intercellular space by symbiotic hyphae is thought to rely on the mechanical force that results from hyphal tip growth, enhanced by the activity of secreted cell-wall-degrading enzymes. Here, we characterize the biochemical properties of the symbiosis-induced polygalacturonase LbGH28A from the ectomycorrhizal fungus Laccaria bicolor. The transcriptional regulation of LbGH28A was measured by quantitative PCR (qPCR). The biological relevance of LbGH28A was confirmed by generating RNA interference (RNAi)-silenced LbGH28A mutants. We localized the LbGH28A protein by immunofluorescence confocal and immunogold cytochemical microscopy in poplar ectomycorrhizal roots. Quantitative PCR confirmed the induced expression of LbGH28A during ectomycorrhiza formation. Laccaria bicolor RNAi mutants have a lower ability to establish ectomycorrhiza, confirming the key role of this enzyme in symbiosis. The purified recombinant LbGH28A has its highest activity towards pectin and polygalacturonic acid. In situ localization of LbGH28A indicates that this endopolygalacturonase is located in both fungal and plant cell walls at the symbiotic hyphal front. These findings suggest that the symbiosis-induced pectinase LbGH28A is involved in the Hartig net formation and is an important determinant for successful symbiotic colonization.

Published
2021
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4. Expert consensus statements for the management of COVID-19-related acute respiratory failure using a Delphi method

Author

Ognjen Gajic, Samuel M. Galvagno, Elie Azoulay, Adam M. Deane, Jan Bakker, Massimo Antonelli, Sangeeta Mehta, Pauline K. Park, Yaseen M. Arabi, David Pilcher, Krishnaswamy Sundararajan, Gopi C. Khilnani, Paolo Pelosi, Suveer Singh, Laurent Brochard, Younsuck Koh, Bin Du, Massimiliano Sorbello, Waleed Alhazzani, Jason Phua, Lise Piquilloud, John Victor Peter, Prashant Nasa, Sachin Gupta, Armand Mekontso-Dessap, Manu L N G Malbrain, Sharon Einav, Michael T. McCurdy, Manu Shankar-Hari, Claude Guérin, Yash Javeri, Jean-Baptiste Lascarrou, Samir Jaber, Ashish Khanna, Jordi Mancebo, Pradeep Rangappa, Deven Juneja, Andrés Esteban, Sheila Nainan Myatra, Marcus J. Schultz, Ravindranath Tiruvoipati, Andrew A. Udy, Brendan McGrath, Flávia Ribeiro Machado, Michael Nurok, Tobias Welte, Mervyn Mer, Ravi Jain, Peter Schellongowski, NMC Specialty Hospital, Al Nahda, Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Wake Forest School of Medicine [Winston-Salem], Wake Forest Baptist Medical Center, Mahatma Gandhi Hospital, Narayana Super Speciality Hospital, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, King Saud Bin Abdulaziz University for Health Sciences [Riyadh] (KSAU-HS), New York University School of Medicine (NYU), New York University School of Medicine, NYU System (NYU)-NYU System (NYU), Erasmus University Medical Center [Rotterdam] (Erasmus MC), Pontificia Universidad Católica de Chile (UC), Keenan Research Centre of the Li Ka Shing Knowledge Institute [Toronto], The Royal Melbourne Hospital, Peking Union Medical College Hospital [Beijing] (PUMCH), Shaare Zedek Medical Center [Jerusalem, Israel], CIBER de Epidemiología y Salud Pública (CIBERESP), Mayo Clinic, University of Maryland School of Medicine, University of Maryland System, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), University of Ulsan, Centre hospitalier universitaire de Nantes (CHU Nantes), Federal University of Sao Paulo (Unifesp), International Fluid Academy, Vrije Universiteit Brussel [Bruxelles] (VUB), Hospital Universitari Sant Pau, Barcelona, Manchester University NHS Foundation Trust (MFT), Manchester Academic Health Sciences Centre [Manchester, UK], Mount Sinai Health System, Hôpital Henri Mondor, Groupe de recherche clinique CARMAS (Cardiovascular and Respiratory Manifestations of Acute lung injury and Sepsis) (CARMAS), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Henri Mondor, University of the Witwatersrand [Johannesburg] (WITS), Cedars-Sinai Medical Center, University of Michigan Medical School [Ann Arbor], University of Michigan [Ann Arbor], University of Michigan System-University of Michigan System, Ospedale Policlinico San Martino [Genoa], Università degli studi di Genova = University of Genoa (UniGe), Christian Medical College and Hospital Ludhiana [Punjab, India] (CMCHL), National and Kapodistrian University of Athens (NKUA), Monash University [Melbourne], Lausanne University Hospital, Medizinische Universität Wien = Medical University of Vienna, VU University Medical Center [Amsterdam], Mahidol University [Bangkok], University of Oxford [Oxford], Guy's and St Thomas' Hospital [London], King‘s College London, Royal Brompton Hospital, Chelsea and Westminster Hospital, Monash College [Melbourne], German Center for Lung Research - DZL [Munich, Germany], Tata Memorial Centre, Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, ACS - Pulmonary hypertension & thrombosis, Intensive Care Medicine, AII - Infectious diseases, ACS - Diabetes & metabolism, ACS - Microcirculation, and Epidemiology

Subjects
medicine.medical_specialty, ARDS, COVID-19 acute respiratory distress syndrome, Consensus, Delphi Technique, medicine.medical_treatment, education, Delphi method, Critical Care and Intensive Care Medicine, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Prone ventilation, 03 medical and health sciences, 0302 clinical medicine, Respiratory Insufficiency/therapy, COVID-19 high flow nasal oxygen, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, COVID-19 respiratory management, medicine, Humans, COVID-19/complications, Respiratory Insufficiency/virology, COVID 19 invasive mechanical ventilation, COVID-19 ventilatory management, Respiratory distress syndrome adult, Intensive care medicine, Personal protective equipment, Positive end-expiratory pressure, 11 Medical and Health Sciences, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, business.industry, Research, Tracheal intubation, lcsh:Medical emergencies. Critical care. Intensive care. First aid, COVID-19, 030208 emergency & critical care medicine, lcsh:RC86-88.9, medicine.disease, Emergency & Critical Care Medicine, COVID-19 high fow nasal oxygen, 3. Good health, 030228 respiratory system, Respiratory failure, Breathing, business, Respiratory Insufficiency
Abstract

Background Coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented pressure on healthcare system globally. Lack of high-quality evidence on the respiratory management of COVID-19-related acute respiratory failure (C-ARF) has resulted in wide variation in clinical practice. Methods Using a Delphi process, an international panel of 39 experts developed clinical practice statements on the respiratory management of C-ARF in areas where evidence is absent or limited. Agreement was defined as achieved when > 70% experts voted for a given option on the Likert scale statement or > 80% voted for a particular option in multiple-choice questions. Stability was assessed between the two concluding rounds for each statement, using the non-parametric Chi-square (χ2) test (p Results Agreement was achieved for 27 (73%) management strategies which were then used to develop expert clinical practice statements. Experts agreed that COVID-19-related acute respiratory distress syndrome (ARDS) is clinically similar to other forms of ARDS. The Delphi process yielded strong suggestions for use of systemic corticosteroids for critical COVID-19; awake self-proning to improve oxygenation and high flow nasal oxygen to potentially reduce tracheal intubation; non-invasive ventilation for patients with mixed hypoxemic-hypercapnic respiratory failure; tracheal intubation for poor mentation, hemodynamic instability or severe hypoxemia; closed suction systems; lung protective ventilation; prone ventilation (for 16–24 h per day) to improve oxygenation; neuromuscular blocking agents for patient-ventilator dyssynchrony; avoiding delay in extubation for the risk of reintubation; and similar timing of tracheostomy as in non-COVID-19 patients. There was no agreement on positive end expiratory pressure titration or the choice of personal protective equipment. Conclusion Using a Delphi method, an agreement among experts was reached for 27 statements from which 20 expert clinical practice statements were derived on the respiratory management of C-ARF, addressing important decisions for patient management in areas where evidence is either absent or limited. Trial registration: The study was registered with Clinical trials.gov Identifier: NCT04534569.

Published
2021
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5. Acquisition of respiratory and gastrointestinal pathogens among health care workers during the 2015 Hajj season

Author

Philippe Gautret, Hail M. Al-Abdely, Laura Pezzi, Abdulaziz Mushi, Rémi N. Charrel, Yara Yassin, Samir Benkouiten, Fuad Maashi, Badriah Alotaibi, Hanan H. Balkhy, Saber Yezli, Didier Raoult, Ministry of Health [Riyadh], King Saud Bin Abdulaziz University for Health Sciences [Riyadh] (KSAU-HS), Unité des Virus Emergents (UVE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), COMBE, Isabelle, Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées (IRBA), and King Saud Bin Abdulaziz University for Health Sciences

Subjects
Male, Epidemiology, health care facilities, manpower, and services, Cohort Studies, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Health care, 030212 general & internal medicine, Respiratory system, Respiratory Tract Infections, Aged, 80 and over, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, 0303 health sciences, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Transmission (medicine), Health Policy, Middle Aged, Gastroenteritis, 3. Good health, Religion, Infectious Diseases, Carrier State, Cohort, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Respiratory, Respiratory virus, Female, Adult, medicine.medical_specialty, Gastrointestinal, Infectious Disease Transmission, Patient-to-Professional, Health Personnel, education, Saudi Arabia, Gastrointestinal pathogens, Article, Young Adult, 03 medical and health sciences, Occupational Exposure, medicine, Humans, Aged, Carriage, 030306 microbiology, business.industry, Public Health, Environmental and Occupational Health, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Crowding, Emergency medicine, Hajj, [SDV.MP.BAC] Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, business, Multiplex Polymerase Chain Reaction
Abstract

International audience; Background: Data on the risk of transmission of infection to health care workers (HCWs) serving ill pilgrims during the Hajj is scarce.Methods: Two cohorts of HCWs, the first serving Hajj pilgrims in Mecca and the second serving patients in Al-Ahsa, were investigated for respiratory and gastrointestinal symptoms and pathogen carriage using multi-plex polymerase chain reaction before and after the 2015 Hajj.Results: A total of 211 HCWs were enrolled of whom 92 were exposed to pilgrims (Mecca cohort), whereas 119 were not exposed (Al-Ahsa cohort). Symptoms were observed only in HCWs from the Mecca cohort, with 29.3% experiencing respiratory symptoms during the Hajj period or in the subsequent days and 3.3% having gastrointestinal symptoms. Acquisition rates of at least 1 respiratory virus were 14.7% in the Mecca cohort and 3.4% in the Al-Ahsa cohort (P = .003). Acquisition rates of at least 1 respiratory bacterium were 11.8% and 18.6% in the Mecca and Al-Ahsa cohorts, respectively (P = .09). Gastrointestinal pathogens were rarely isolated in both cohorts of HCWs and acquisition of pathogens after the Hajj was documented in only a few individuals.Conclusions: HCWs providing care for pilgrims both acquire pathogens and present symptoms (especially respiratory symptoms) more frequently than those not working during Hajj.

Published
2019
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