Travel Health Information Sheets
General advice for Hajj and Umrah Pilgrims:
(This information has been updated in line with the Kingdom of Saudi Arabia’s requirements and recommendations for the 2013/1434 Hajj season).
Hajj, the yearly pilgrimage to Makkah (Mecca), in the Kingdom of Saudi Arabia (KSA), is the largest annual mass gathering in the world, with over two million Muslims worldwide going on this pilgrimage every year.
The Hajj pilgrimage occurs between the 8th and 12th day of the twelfth month of the Islamic calendar and the dates change each year. This year’s Hajj (2013/1434 season) is estimated to fall between 13 and 15 October. Umrah is a shorter pilgrimage that can be completed at any time.
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.
Hajj and Umrah vaccine requirements:
Meningitis outbreaks have occurred during previous Hajj pilgrimages, with cases spreading to other countries, including the United Kingdom. Proof of meningitis ACWY vaccine is therefore 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.
Pilgrims arriving from the following countries: Benin, Burkina Faso, Cameroon, Chad, Central African Republic, Côte d’Ivoire, Eritrea, Ethiopia, Gambia, Guinea, Guinea-Bissau, Mali, Niger, Nigeria, Senegal and the Sudan will be given antibiotic tablets, called ciprofloxacin (500 mg) when they arrive in KSA. This is in addition to the requirement for proof of vaccination against meningococcal meningitis ACW135Y.
All travellers from countries with a risk of polio (Afghanistan, Chad, Nigeria and Pakistan) must provide proof of polio vaccination (given at least six weeks prior to departure). These travellers will also receive a dose of oral polio vaccine (OPV) when they arrive in KSA.
This requirement also applies to all travellers from recently endemic countries at high risk of re-importation of polio, such as India.
All visitors aged under 15 years travelling to KSA from countries reporting polio following importation or due to circulating vaccine-derived polio in the past 12 months (Chad, Kenya, Niger, Somalia and Yemen) should be vaccinated against polio with the OPV.
Proof of polio vaccination with either OPV or inactivated polio vaccine (IPV) is required 6 weeks prior to the application for entry visa.
For babies and children up to the age of 15 years, a record of polio vaccine is also required. Irrespective of previous immunisation history, all visitors under 15 years of age arriving in KSA will receive an additional dose of OPV when they arrive in KSA.
For adults, 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). Maps showing countries with a risk of yellow fever are available in a yellow fever information leaflet from NaTHNaC. Yellow fever is not a risk in Britain.
Hajj and Umrah general 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 by KSA Ministry of Health.
Certain travellers are at particular risk of complications, including older people (65 years and above), pregnant women, anyone with a pre-existing medical problem (like a heart or chest condition), diabetes, kidney or liver problems or anyone who does not have a spleen.
These travellers are usually given an influenza vaccine every year by their GP, as part of their routine UK vaccines. If you are not in one of these higher risk categories, you should ask about availability of influenza vaccine at 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 disease. It is found in blood and body fluids and can be spread by 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.
There is a risk of rabies in KSA. Avoid contact with all wild or domestic animals and get immediate medical treatment if you are bitten, licked or scratched by an animal, or if an animal spits in your face.
There is a vaccination course you can have prior to travel, and while this will not eliminate the need for post-exposure medical evaluation and more vaccine doses, it does simplify rabies treatment and removes the need for a blood product called rabies immunoglobulin, which is in short supply worldwide.
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.
Drugs 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.
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 personal, food and water hygiene advice, and carry a supply of re-hydration powders (such as Dioralyte® or Electrolade®) for mixing with clean drinking water to replace lost minerals and salts. If suitable for you, anti-diarrhoea medicines, like loperamide (available from high street chemists), which temporarily stops diarrhoea will be useful. If you have a medical condition that might be made worse by diarrhoea, ask your GP or hospital specialist if it is appropriate for you to carry a supply of self-treatment antibiotics.
Hajj and Umrah pilgrims are not allowed to bring fresh food into KSA. Only properly canned or sealed food or food stored in containers with easy access for inspection is allowed in small quantities, sufficient for one person for the duration of their trip.
Insect spread illnesses
Insect-borne diseases, including dengue fever, are present in KSA, so you should follow insect bite avoidance advice to reduce your risk. 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.
Make sure you have adequate travel health insurance, remember to declare all your medical conditions to your insurance company and carry a copy of your policy.
All pilgrims should take a basic medical kit that includes dressings, plasters and basic pain relief.
Many pilgrims suffer from respiratory infections due to viruses (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 helps reduce your risk of respiratory infections (See KSA Ministry of Health advice below).
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.
Middle East respiratory syndrome coronavirus
Since September 2012, a small number of people have caught a respiratory illness, caused by a new virus in some Middle Eastern countries, including Jordan, KSA, Qatar and the United Arab Emirates. This virus, now called Middle East respiratory syndrome coronavirus (MERS-CoV), has in some cases, caused severe illness and death.
The risk of contracting MERS-CoV during travel is very low.
However, KSA’s Ministry of Health recommends that the following groups postpone their performance of the Hajj and Umrah this year for their own safety:
Elderly people - above 65 years of age
Anyone with chronic diseases such as cancer, heart, kidney, respiratory problems, diabetes, or immune deficiency and terminal illnesses
Children under 12 years old
Wash hands with soap and water or disinfectant, especially after coughing and sneezing.
Use disposable tissues when coughing or sneezing and dispose it in the waste basket.
Try as much as possible to avoid hand contact with the eyes, nose and mouth.
Avoid direct contact with people with symptoms such as cough, sneeze, expectoration, vomiting, and diarrhoea.
Wear masks, especially when in crowded places.
Maintain good personal hygiene.
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 allow time to get adapt to high temperatures.
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 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.
Updated October 2013
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