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Mass gatherings allow infectious diseases to spread easily due to the large numbers of people gathering together. Mass gatherings that attract people from all over the world bring the risk of people being exposed to infectious diseases that they normally would not come in contact with; therefore they are at risk.

The annual Hajj, or pilgrimage to Mecca in Saudi Arabia, is among the largest mass gatherings in the world. In 2019, the Hajj will take place between August 9th and 14th. Over two million pilgrims travel annually to perform Hajj in Saudi Arabia and approximately 75% of these are foreign pilgrims.

The risk for European citizens (including Irish citizens) to become ill with infectious diseases during the Hajj 2019 is considered low due to the vaccination requirements for travelling to Makkah (Mecca) and the Saudi Arabian preparedness plans that address the management of health risks during and after Hajj according to a Rapid Risk Assessment published by the European Centre for Disease Prevention and Control on July 2nd.

Before Hajj

Vaccination
According to Saudi Arabian authorities, pilgrims are required to provide proof of vaccination with the conjugated quadrivalent meningococcal ACW135Y vaccine administered no less than ten days prior to arrival in Saudi Arabia in order to obtain an entry visa. Pilgrims should be up to date with immunisations routinely administered in Ireland including vaccinations for measles, mumps and rubella (MMR) and diphtheria-tetanus-polio (DTP). Additional vaccinations such as hepatitis A, hepatitis B and influenza may be indicated. See National immunisation guidelines, Chapter 5.

Pre-existing medical conditions
Pilgrims with pre-existing medical conditions are recommended by Saudi Arabian authorities to consult a healthcare provider to review the risk before deciding to make the pilgrimage and identify a trusted healthcare facility prior to travel in the case of a health emergency during their stay.

During Hajj

  • The main risk of infectious disease outbreaks is through food, water, and respiratory sources, therefore people should pay extra attention to hand and respiratory hygiene. Tips on food and water illness prevention are outlined by the Saudi Arabian authorities.
  • The risk of vaccine-preventable (immunisation) diseases such as measles and vector-borne diseases such as Dengue Fever is considered low if preventive measures are applied, such as mosquito bite prevention.
  • The Middle East Respiratory Syndrome coronavirus (MERS-CoV) remains an active risk on the Arabian Peninsula which includes Saudi Arabia. MERS-CoV can be picked up from infected people in a healthcare setting and contact with dromedary camels. Sick dromedary camels can pass on the infection without having any symptoms themselves. To reduce the risk of picking up the infection, people should avoid close contact with these camels, drinking camel milk or urine, or eating undercooked camel meat.
  • Last but not least  –  Dont forget to download Salaam Haji Mobile App that will provide you a feature called ‘Online Doctor’, A live doctor will assist you and help you remediate the infection.

After Hajj
People should seek immediate medical advice, according to ECDC:

  • if they experience symptoms that suggest any type of infection such as gastrointestinal or respiratory infections and inform the healthcare provider of their travel history to Hajj
  • if they have a fever (38°C and over), cough or difficulties breathing, even within 14 days of their return to rule out the possibility of having an infection with MERS-CoV.

Within a year of returning from Hajj, if medical care is required for any reason, inform the healthcare provider of the travel history and/or a previous hospitalisation while performing Hajj to rule out the possibility of an infection due to bacteria with antimicrobial resistance.

Additional information on prevention measures:

  1. The ECDC rapid risk assessment outlines in full preventive measures for pilgrims during and after the Hajj. To read the ECDC Rapid Risk Assessment go to: https://ecdc.europa.eu/en/publications-data/rapid-risk-assessment-public-health-risks-related-communicable-diseases-during-1
  2. For Health Requirements and Recommendations for Travellers to Saudi Arabia for Hajj and Umrah 2019 from the Ministry of Health of the Kingdom of Saudi Arabia: https://www.moh.gov.sa/en/Hajj/HealthGuidelines/HealthGuidelinesBeforeHajj/Pages/default.aspx and https://www.moh.gov.sa/en/Hajj/HealthGuidelines/HealthGuidelinesDuringHajj/Pages/HealthRequirements.aspx