Travel Health Information Sheets
Updated 21 May 2013
General advice for Hajj and Umrah Pilgrims:
(This information will be updated when the Kingdom of Saudi Arabia publish requirements and recommendations for the 2013/1434 Hajj season)
Hajj, the yearly pilgrimage to Makkah, in the Kingdom of Saudi Arabia (KSA), is the largest mass gathering in the world, with over two million Muslims worldwide going on this annual pilgrimage. Every year, the KSA publishes specific entry requirements for Hajj and Umrah pilgrims. These requirements are usually posted a few months before the Hajj season starts.
The Hajj pilgrimage occurs from the 8th and 12th day of the twelfth month of the Islamic calendar. This year’s Hajj (2013/1434 season) is estimated to fall between 13 and 15 October. Umrah is a shorter pilgrimage (also performed as part of Hajj) that can be completed at any time, although the same entry requirements apply.
Hajj and Umrah vaccine requirements:
Meningitis outbreaks have occurred during previous Hajj pilgrimages, with cases spreading to other countries, including United Kingdom. Proof of meningitis ACWY vaccine is a requirement for entry and is also advised for personal protection of all pilgrims, including children under two years.
All Hajj and Umrah pilgrims aged two years and older must provide proof of vaccination against meningitis ACW135Y in order to get a Hajj or Umrah pilgrimage visa. You must receive the vaccine not more than three years, and not less than ten days, before you arrive in KSA. It should be recorded in a vaccine book showing your full name (as it appears in your passport). Ask your GP, practice nurse or travel clinic about this vaccine as soon as you decide to travel.
For babies and children up to the age of 15 years, a record of polio vaccine is also required. If your last dose of polio vaccine was over ten years ago, ask your GP, practice nurse or travel clinic for a booster dose with the combined tetanus, diphtheria and polio vaccine.
All Hajj and Umrah pilgrims arriving from countries with a risk of yellow fever must present a valid International Certificate of Vaccination or Prophylaxis showing that they have received yellow fever vaccine in accordance with International Health Regulations (2005). Yellow fever is not a risk in Britain.
Hajj and Umrah Vaccine Advice:
Check NaTHNaC’s Country Information Page for Saudi Arabia for specific health and vaccine advice. You should also make sure you are up-to-date with all your routine immunisations including measles, mumps and rubella (MMR) before you travel.
Flu (influenza) spreads in the same way as a cold (via coughs, sneezes and respiratory contact) and is easy to catch in a crowd, so influenza vaccine is recommended for all pilgrims. Certain travellers are at particular risk of complications, including: older people (65 years and above), pregnant women and anyone with a pre-existing medical problem, like a heart or chest condition, diabetes, kidney or liver problems or who does not have a spleen. These travellers have usually have a yearly influenza vaccine from their GP as part of their routine UK vaccines. If you are not in one of these higher risk categories, you can arrange an influenza vaccine from a high street chemist, private GP service or travel clinic. (See NaTHNaC’s Influenza information for more advice).
Hepatitis B virus can cause serious liver problems. It is found in blood and body fluids and can be spread by emergency medical or dental treatment, or if your blood and body fluids come into direct contact with an infected person’s blood or body fluids. All pilgrims should consider hepatitis B vaccine.
One of the Hajj rites is male head shaving. Licensed barbers, with a new blade for each pilgrim are present. However, unlicensed barbers may not follow this standard. Take a disposable razor and avoid sharing razors or shaving with previously used blade, as this could put you at risk of hepatitis B and other blood borne infections like HIV.
Other health issues:
Accidents and injuries
Minor injuries are common, particularly to the feet. You are also at risk of more serious injuries, particularly a result of stampedes or as pilgrims undertake the stoning rite or other mass activities. Avoid peak times whenever possible. Also, if you are elderly or infirm, you can appoint a proxy to perform the stoning rite on your behalf.
During the winter, it can get very cold at night, even when it’s hot during the day. Take warm clothes and appropriate bedding, such as blankets and sleeping bags.
Food and water hygiene
Diarrhoea and stomach upsets are spread by contaminated food or water. Dehydration is a risk, particularly in hot weather. Babies, young children, older pilgrims and anyone with long term health problems are more vulnerable to dehydration.
Follow good food and water hygiene advice and carry a supply of diarrhoea medicines, like loperamide, which temporarily stops diarrhoea (available from high street chemists) and re-hydration powders, such as Dioralyte® or Electrolade® for mixing with clean drinking water to replace lost minerals and salts. If you have a serious medical condition, ask your GP or hospital specialist if it is appropriate for you to carry a supply of self-treatment antibiotics.
Insect spread diseases
Malaria is not found in Medina or Makkah, but is a risk in south-western, rural parts of KSA. If you are planning to travel before or after Hajj or Umrah to malaria risk areas in KSA or other regions, such as Asia, Africa and Latin America, get advice about malaria prevention from your doctor or nurse. Follow insect bite avoidance advice to reduce your risk of other insect diseases, like dengue fever.
Make sure you have adequate travel health insurance, remember to declare all you medical conditions to your insurance company and carry a copy of your policy.
Medication and medical history
If you take regular medicines, make sure you have a good supply, carry copies of prescriptions and a doctor’s letter detailing your medical history. Your GP's details may be required if you need emergency medical care.
All pilgrims should take a basic medical kit that includes dressings, plasters and basic pain relief.
Many pilgrims suffer from a respiratory virus (called Hajj cough). Symptoms range from a mild inconvenience to severe illness - which can interfere with performing the rites. Following simple precautions, known as cough hygiene; which includes using tissues when coughing/sneezing, disposing of used tissues carefully and washing you hands frequently, all help reduce your risk of any respiratory infections.
Severe respiratory illness is a risk worldwide and can spread rapidly in crowds. Again, following cough hygiene helps reduce your risk. If you return with mild respiratory symptoms, you have probably just caught a common illness, like a cold. However, if your symptoms get worse or you experience any breathing problems, get urgent advice from am urgent care centre, your GP or NHS Direct – remember to mention the countries you’ve visited.
Sun and heat
Daytime temperatures in KSA, even during the winter, can get very high. Risks include sunburn, dehydration, heat exhaustion, and heat stroke. If possible, try to travel before Hajj starts to give yourself time to get use to the high temperature.
Drink plenty of clean water (preferably bottled or boiled and cooled) to avoid dehydration. Apply high protection sunscreen (at least SPF 15) regularly. Male pilgrims are not allowed to cover their heads, but can use umbrellas.
Sand can reach very high temperatures - wear comfortable, good quality shoes and carry a shoe bag for the times you need to be barefoot.
It is important to make sure you are physically fit as the Hajj is demanding and includes walking long distances in hot conditions.
If you want to avoid your period during Hajj, speak to your GP or family planning clinic about the suitability of hormone medication to delay menstruation. The KSA government advises against undertaking wither pilgrimages if you are pregnant. If you are determined to travel whilst pregnant, discuss your plans with your midwife and see you GP or practice nurse for advice and vaccines.