Persistent Extended-Spectrum β-Lactamase Urinary Tract Infection

the use of masks, considering compliance with this advice unlikely because many Muslims believe that covering the face during the Hajj is prohibited and because masks need to be of high quality and changed at least every 6 hours to remain effective (7). Recent studies demonstrated that surgical and N95 masks were equally effective in preventing spread of PCR-detectable infl uenza virus when used by infected patients. These masks also were potentially effective at preventing respiratory virus acquisition by household contacts of infected persons when worn by healthy persons. However, effectiveness depended largely on adherence to mask use (8,9). Maintenance of good hand hygiene is also effective in reducing spread of respiratory infection. The World Muslim League has issued a fatwa allowing use of alcohol-based hand-rubs on skin as a disinfectant (10). The demonstration of high acceptability of simple physical measures to prevent ARI encourages the education of pilgrims during the pretravel encounter. The results also support conclusion that masks, hand-rubs, and disposable handkerchiefs should be provided to pilgrims, along with strong advice about the risk for ARI, to increase adherence to prevention measures.