Bracing for the Hajj during a global pandemic

The upcoming 2009 Hajj pilgrimage -- the world’s largest and densest gathering of people -- presents a serious public health challenge in the face of a global H1N1 pandemic. However, the Kingdom of Saudi Arabia (KSA) and the World Health Organization worked together this past summer in Jeddah to produce a list of prevention efforts and medical strategies that could help to stem the transmission of H1N1 virus around the world during this global event, researchers report in the Oct. 29 issue of Science. In a Policy Forum, Shahul Ebrahim from the U.S. Centers for Disease Control, along with colleagues from that agency and the KSA government, discuss the challenges of meeting these recommendations, as well as the most recent plans to help minimize transmission of the H1N1 virus. Pilgrims who are particularly at risk of developing complications from the H1N1 virus (pregnant women, those with chronic diseases, and children under 12 years of age and over 65 years of age) are urged to voluntarily abstain from the 2009 Hajj. Common prevention measures, such as face masks and hand sanitizers, are strongly recommended to all pilgrims, but experts caution that religious beliefs might detract from their use and effectiveness. The KSA Ministry of Health says that thermal screening equipment is in place at KSA airports in order to identify individuals with high fevers, and it asks that receiving airports make room for as many as 200 to 300 pilgrims who might be symptomatic with influenza-like illness and need to be isolated in order to evaluate them on the spot. They will help pilgrims who are separated from their Hajj groups to rejoin them when it is safe to do so. Since it takes a full 14 days for the H1N1 vaccine to start protecting individuals from the virus, it is unlikely that most pilgrims will receive their vaccination in time to enjoy the benefits of protection on their journey. So, once the global availability of H1N1 vaccines has been announced, the KSA government is requesting official correspondence from each of the countries sending pilgrims regarding the availability of H1N1 vaccines there. If they receive official notice that vaccines are available in a certain country early enough, then proof of vaccination may be required for pilgrims traveling from that particular country. In addition, the KSA government has secured adequate amounts of antiviral agents, and will offer them free of charge to any pilgrims in need, regardless of their national origin. The authors suggest that Islamic politicians and religious entities could help to minimize global transmission of the H1N1 virus by endorsing these recommendations and safety measures.

Article #20: "Pandemic H1N1, the 2009 Hajj, and global health security," by S.H. Ebrahim; T.M. Uyeki; N. Marano; S.N.J. McNabb at Centers for Disease Control and Prevention in Atlanta, GA; Z.A. Memish at Assistant Deputy Minister for Preventative Medicine in Saudi Arabia; T.A.M. Khoja at Health Ministers’ Council for Cooperation Council of Gulf States in Saudi Arabia.