Released: November 16, 2007
Hajj, a spiritual gathering of over 2 million Muslims from all over the world, takes place in Mecca, Saudi Arabia, from the eighth to the twelfth day of Dhul Hijjah, the twelfth month of the Islamic lunar calendar. This year the Hajj season will take place between December 18th and 23rd, 2007.
Due to the close proximity of pilgrims during this period, public health officials agree that certain diseases and respiratory viruses such as meningococcal infections, influenza, tuberculosis and gastrointestinal infections may be more easily transmitted. Non-communicable health risks such as heat exhaustion, heat stroke and physical injuries may also be increased. In addition, individuals with pre-existing medical conditions may be more at risk. A travel health clinic or your family doctor would be best positioned to provide you with individual advice. You are advised to seek medical attention at least 6 weeks prior to your departure date.
The Public Health Agency of Canada recommends that the Canadian Traveller:
1. Follow the requirements as outlined by the Ministry of Health of Saudi Arabia.
The requirements have been published in detail in the World Health Organization's Weekly Epidemiological Record:
Health Conditions for Travelers to Saudi Arabia for the Pilgrimage to Mecca
All travellers are required to provide proof of vaccination with the meningococcal quadravalent (serogroups A/C/Y/W135) vaccine administered no less than 10 days before arrival in Saudi Arabia and not more than 3 years ago.
Proof of yellow fever vaccination is required at port of entry in Saudi Arabia if you are coming through a country where yellow fever is known to occur - see requirements by Saudi Arabia Ministry of Health.
Vaccines generally used for the prevention and control of meningococcal disease within Canada only offer protection against serogroup C and are therefore insufficient for entry to Saudi Arabia.
2. Ensure immunization against certain vaccine preventable diseases
In addition to the quadravalent meningococcal meningitis vaccine, travellers to Saudi Arabia should consider the following vaccines:
Routine childhood vaccines: (Tetanus, diphtheria, polio, pertussis, hemophilus influenza type B, measles, mumps, rubella, varicella, pneumococcal conjugate). (Reference: Immunization Schedules Recommendations from the National Advisory Committee on Immunization (NACI) Immunization Schedules for Infants and Children)
Adult boosters:(Reference: Immunization Schedules Recommendations from the National Advisory Committee on Immunization (NACI) Immunizations Recommended for Adults Table 5. Adult Immunization Schedule - Routinely for All)
Tetanus, diphtheria and polio (every 10 years)
Pertussis (if never received a booster)
Others:
Hepatitis A
Hepatitis B
Measles, mumps, rubella (if second dose not received and born on or after 1970)
Influenza
Quadrivalent meningococcal meningitis
Typhoid
Rabies
3. Protect yourself against food- and water-borne diseases
Hepatitis A, typhoid fever, cholera and other diseases can be transmitted when you consume contaminated food or water. Other infections can sometimes be transmitted in public bathing facilities.
To protect yourself from contaminated food and water:
"Boil it, cook it, peel it or leave it!"
Always wash your hands before eating or drinking.
Eat only food that's been well cooked and is still hot when served. Avoid uncooked foods - especially shellfish - and salads. Fruits and vegetables that can be peeled are usually a good choice.
Drink only purified water that's been boiled or disinfected with chlorine or iodine, or commercially-bottled water in sealed containers. Drinking carbonated drinks, including beer, is usually safe.
Avoid ice, unless it's been made with purified water.
Avoid unpasteurized dairy products and ice cream.
Avoid food from street vendors.
Avoid swimming in fresh water.
Hand washing is one of the most important practices in preventing illness while travelling. Wash your hands often with soap and water or use an alcohol-based hand sanitizer.
For further information see: Statement On Persistent Diarrhea In The Returned Traveller Committee to Advise on Tropical Medicine and Travel (CATMAT) ACS-1 vol 32,15 February 2006
4. Protect yourself against insect- and tick-borne diseases
Mosquitoes transmit a variety of serious infections. Malaria does occur in Saudi Arabia outside of the urban areas of Jeddah, Mecca, Medina, and Ta'if.
Your first line of protection against any insect- or tick-borne disease is not to get bitten. To reduce your exposure to insects:
Stay in well-screened or completely enclosed air-conditioned rooms and sleep under an insecticide-treated bed net.
Wear light-coloured, long-sleeved, tucked-in shirts, long pants, shoes (not sandals), and a hat to cover exposed skin.
Use insect repellent on exposed skin. Of the insect repellents registered in Canada, those containing DEET are the most effective. Use as directed by the manufacturer. When using sunscreen, apply the sunscreen first and then the repellent. Repellent should be washed off at the end of the day, before going to bed.
Inspect your body and clothing for ticks during outdoor activity and at the end of the day. Wear light-coloured or white clothing so that ticks can be more easily seen.
Apply a permethrin insecticide to your outerwear and shoes, and to tents and bed nets for greater protection. Use only products manufactured for clothing and gear, and don't use them directly on skin. Permethrin-treated clothing is effective for up to two weeks or six washings. While permethrin isn't available in Canada, travel health clinics can advise you how to purchase permethrin and pre-treated gear before you travel or en route.
Comprehensive information on protective measures against insects can be found on the Travel Health website at www.travelhealth.gc.ca.
As malaria transmission does occur in certain areas of Saudi Arabia, it is recommended that you consult your doctor or travel health clinic for individualized advice. If anti-malarial preventative medications are recommended for you, be sure to take them as prescribed, and don't stop taking them until you finish the full course. If you have a reaction or illness when taking the medication, see a doctor immediately to get another method of malaria prevention.
5. Protect yourself against animal-borne diseases
You can become ill from animal bites or from simple contact with animal fluids or feces, or by eating food made from contaminated animals, particularly meat and dairy products. Rabies, avian influenza (bird flu), leptospirosis, brucellosis and certain viral hemorrhagic fevers (e.g. Rift Valley fever) are all spread through contact with animals or animal products.
Reduce your risk of infection by avoiding close contact with wild, captive or domestic animals in any area where infection is being reported or is likely. Be particularly careful to prevent children from approaching and handling animals.
6. Upon Your Return
Travellers who become sick or feel unwell on their return to Canada should seek a medical assessment with their personal physician. Travellers should inform their physician, without being asked, that they have been travelling or living outside of Canada, and where they have been.
7. For more information...
For a list of travel-medicine clinics across Canada, see: Travel Health Clinics
For more information on meningitis, see: Meningococcal Disease
CATMAT Statement on Meningococcal Vaccination for Travellers
For more information on travel health risks, see General Travel Health Advice
