Healthcare | Sunday 12 June, 2016 4:04 pm |

Mass gatherings have long been associated with the spread of infectious diseases. In 1992, two outbreaks of meningococcal disease occurred among residents and Umrah visitors in Mecca and Jeddah.2  In 1997, during the month of Ramadan in the Umrah season, an increase in the number of cases of the disease was noted with over 70% of the cases being religious visitors.2  Pneumococcal disease can also be a serious threat, with individuals who carry S. pneumoniae in their nasal passages, potentially exposing others to the risk of developing the disease through close contact via respiratory droplets that are sneezed, coughed, or exhaled containing S. pneumoniae bacteria.5 

To reduce the health burden associated with these diseases for pilgrims, and to prevent these infections from spreading, experts in KSA have advised early vaccination for Ramadan Umrah travelers as a necessary measure. 

The epidemiology of meningococcal disease in MENA is affected by the proximity of the region to the African meningitis belt. The dry season in some MENA countries and parts of the meningitis belt is characterized by dust winds and cold nights. These conditions, combined with upper respiratory tract infections that damage the nasopharyngeal tract (upper part of the throat), are thought to lead to an increased risk of meningococcal disease. Age is a primary risk factor for pneumococcal disease, and as the world’s population ages, the number of people at risk for pneumococcal infection grows5,. Pneumonia is the most common cause of hospital admission during Hajj as it easily spreads from person to person in a mass gathering5. 

 “There is an increasing need in KSA to create awareness on infectious diseases that travelers may be exposed to while undertaking Umrah. People need to proactively undertake preventive measures like vaccination to reduce the risk of contracting these serious diseases. Due to the seriousness of these diseases, its disabling health risks, and the potential for epidemic spread, any occurrence of these requires an urgent public health response”, said Dr. Mohammed Zeitouni, Consultant, Section of Pulmonary Medicine at the King Faisal Specialist Hospital and Research Center. 

 

People who should be vaccinated against meningococcal disease

• All Umrah and Hajj pilgrims (especially when Umrah is performed in peak times such as Ramadan);
• Travelers to the extended African meningitis belt;
• Travelers to countries where outbreaks are known to occur or with epidemic risk;
• Military and national guard;
• Health-care workers in countries with a high burden of disease (especially those working in intensive care units, laboratories, paediatric ward);
• Health-care workers, policemen and other personnel in the Makkah and Madinah area as well as in airports and seaports that receive pilgrims;
• Participants of exchange programmes (pupils, students, au-pairs, expatriate workers) before long-term stays in countries with recommended meningococcal immunization, if required by host institution;
• High-risk groups are elderly adults over the age of 65, adults with comorbidities like type 2 diabetes mellitus, hematological malignancy, organ and bone marrow transplantation or chronic kidney or lung diseases.5 

 

“The preventive potential of adult vaccination is under-recognized. Being knowledgeable about the benefits of immunization, and overall increase in awareness on the burden of meningococcal disease and pneumococcal disease is very essential,” added Dr. Adel Alothman, Head of Infectious Diseases Division at the King Abdulaziz Medical City, Riyadh.

 

The Ministry of Health and Ministry of Hajj in Saudi Arabia provide regular updates about Hajj travel advice and health regulations for pilgrims and these are posted on the Ministry of Health’s website. They also disseminate this advice through liaising closely with international public health agencies including WHO, Public Health England, the Centers for Disease Control and Prevention, and the European Centre for Disease Prevention and Control, and many religious groups, organizations, and travel agencies that provide Hajj and Umrah services1.

Meningococcal meningitis can cause severe brain damage and is fatal in 50% of cases if untreated. Center for Disease Control and Prevention (CDC) recommends adult vaccination to help prevent pneumococcal disease, among other infectious diseases.  According to WHO’s facts on immunization, it is one of the most successful and cost-effective of public health interventions, preventing between 2 million and 3 million deaths every year in people of all ages.