Guarding Against Disease Among Pilgrims to Mecca

http://www.nytimes.com/2014/05/27/health/guarding-against-disease-among-pilgrims-to-mecca.html

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Going all the way back to a malaria epidemic in A.D. 632, the annual Muslim pilgrimage to Mecca has been vulnerable to infectious disease. Last year the number of pilgrims fell below two million, from the expected three million, because of fears over the Middle East respiratory syndrome virus, or MERS.

Preventing outbreaks during the hajj is a major focus of the new field of “mass gathering medicine,” and last week in The Lancet, Saudi and European scientists affiliated with the new Global Center for Mass Gathering Medicine, based in the Saudi health ministry, outlined the protective steps the kingdom will take.

This year’s hajj is expected to start in early October. To prevent gastrointestinal illness, pilgrims will be barred from bringing in fresh food; kitchen workers across the country will be swabbed for pathogens; and water chlorination will be monitored.

Mosquito spraying will be intensified, especially in housing for pilgrims from countries with dengue virus. Proof of vaccinations against polio, yellow fever and meningitis will be required. Those lacking proof for yellow fever will be vaccinated and quarantined for 10 days.

Arrivals from Africa’s “meningitis belt” will get antibiotics, and those from countries with polio will be revaccinated; 500,000 polio vaccine doses are given annually to pilgrims.

The country has 25 hospitals with 5,000 beds for pilgrims and an Internet health surveillance system based in Mecca.

There was no transmission of MERS during the 2012 or 2013 hajj, the report said, though it did not mention that new cases have surged past 500 since spring, especially in Jeddah, where most pilgrims land.