WHO / Health conditions for travellers to Saudi Arabia for the pilgrimage to Mecca (Hajj)

In accordance with the International Health Regulations 2005, all travellers arriving from countries or areas at risk of yellow fever must present a valid yellow fever vaccination certificate showing that the person was vaccinated at least 10 days previously and not more than 10 years before arrival at the border. In the absence of such a certificate, the individual will be placed under strict surveillance for 6 days from the date of vaccination or the last date of potential exposure to infection, whichever is earlier.

Visitors from all over the world arriving for the purpose of Umra or pilgrimage or for seasonal work are required to produce a certificate of vaccination with the quadrivalent (ACYW135) vaccine against meningitis issued not more than 3 years previously and not less than 10 days before arrival in Saudi Arabia. The responsible authorities in the visitor’s country of origin should ensure that adults and children over the age of 2 years are given 1 dose of the quadrivalent polysaccharide (ACYW135) vaccine.

For arrivals from countries in the African meningitis belt, namely Benin, Burkina Faso, Cameroon, Chad, Central African Republic, Côte d’Ivoire, Eritrea, Ethiopia, Gambia, Guinea, Guinea-Bissau, Mali, Niger, Nigeria, Senegal and Sudan.In addition to the above stated requirements, chemoprophylaxis will be administered at port of entry to all arrivals from these countries to lower the carriers rate among them. Adults will receive ciprofloxacin tablets(500 mg), children will receive rifampicin, and pregnant women will receive ceftriaxone injections.

All visitors aged under 15 years travelling to Saudi Arabia from countries with imported cases of poliomyelitis or circulating vaccine-derived polioviruses (see list below) in the past 12 months (as of mid-February 2012) should be vaccinated against poliomyelitis with the OPV or inactivated poliovirus vaccine (IPV). Proof of OPV or IPV vaccination is required 6 weeks prior the application for entry visa. Irrespective of previous immunization history, all visitors under 15 years arriving in Saudi Arabia will also receive 1 dose of OPV at border points.

Polio cases related to wild poliovirus importation or to circulating vaccine-derived poliovirus have been registered during the past 12 months in the following countries: China, Central African Republic, Côte d’Ivoire, Kenya, Mali, Niger, Somalia and Yemen.

The Ministry of Health of Saudi Arabia recommends that international pilgrims be vaccinated against seasonal influenza before arrival into the kingdom of Saudi Arabia, particularly those at increased risk of severe complications (e.g. the elderly over 65 years of age, people with pre-existing medical conditions such as people with chronic respiratory or heart diseases, hepatic or renal failure, neuromuscular or metabolic  diseases including diabetes or immunocompromised conditions due to various reasons such as HIV infection or immunosuppressive therapy). Pregnant women can also be considered for vaccination.

In Saudi Arabia, seasonal influenza vaccine is recommended for internal pilgrims, particularly those with pre-existing health conditions, and all health staff working in the Hajj premises.

Updating immunization against vaccine-preventable diseases in all travellers is strongly recommended. With the recent resurgence of measles and rubella cases, special attention is needed for both of these vaccines to avoid widespread outbreaks with this virus during this year Hajj and Umra.

Preparation for international travel provides opportunity to review the immunization status of travellers. Incompletely immunized travellers can be offered routine vaccinations recommended in national immunization schedules (these usually include diphtheria, tetanus, pertussis, polio, measles and mumps), in addition to those needed for the specific travel (e.g. meningococcal vaccination for Hajj).

In InternationalTravel and Health 2012, WHO recommends that travelers ensure immunity against measles by having at least 2 doses of vaccine and against rubella by 1 dose of vaccine.

Commentary: Given that we have a lot of Hajjis going to Mecca, Indian pilgrims need to take all these vaccinations and designated government or private centers to ensure their health and avoid getting in to problems in Saudi Arabia.