Given the characteristics of the Spanish Health System, pediatricians and nurses, particularly those working at a primary care level, should be encouraged to provide basic advice to travelers. Furthermore, easy

free access to the reference International Health Units buy MDV3100 could be a key tool for high-risk children to face the new challenges raised by the emergent population of CVFR. The authors state that they have no conflicts of interest to declare. “
“Background. Every year millions of pilgrims from around the world gather under extremely crowded conditions in Mecca, Saudi Arabia to perform the Hajj. In 2009, the Hajj coincided with influenza season during the midst of an influenza A (H1N1) pandemic. After the Hajj, resource-limited countries with large numbers of traveling pilgrims could be vulnerable, given their

limited ability to purchase H1N1 vaccine and capacity to respond to a possible wave of H1N1 introduced via returning pilgrims. Methods. We studied the worldwide migration of pilgrims traveling to Mecca to perform the Hajj in 2008 using data from the Saudi Ministry of Health and international air compound screening assay traffic departing Saudi Arabia after the 2008 Hajj using worldwide airline ticket sales data. We used gross national income (GNI) per capita as a surrogate marker of a country’s ability to mobilize an effective response to H1N1. Results. PJ34 HCl In 2008, 2.5 million pilgrims from 140 countries performed the Hajj. Pilgrims (1.7 million) were of international (non-Saudi) origin, of which 91.0% traveled to Saudi Arabia

via commercial flights. International pilgrims (11.3%) originated from low-income countries, with the greatest numbers traveling from Bangladesh (50,419), Afghanistan (32,621), and Yemen (28,018). Conclusions. Nearly 200,000 pilgrims that performed the Hajj in 2008 originated from the world’s most resource-limited countries, where access to H1N1 vaccine and capacity to detect and respond to H1N1 in returning pilgrims are extremely limited. International efforts may be needed to assist resource-limited countries that are vulnerable to the impact of H1N1 during the 2009 to 2010 influenza season. The Muslim ritual of pilgrimage to Mecca, known as the Hajj, has been occurring every year for more than 14 centuries and is an obligation of all Muslims who are physically able to perform at least once in their lifetime.