Staying safe during Hajj and Umrah: How to protect yourself from meningococcal disease
By Hammam Haridy, Vaccines & Antiviral Medical Lead MERA, Pfizer
At this time of year, families and friends are planning their trips to go on the Umrah and Hajj pilgrimages. It is a great time to reconnect with our loved ones, but it also comes with the responsibility to stay safe and healthy, and keep others safe, as well. These mass gatherings bring together up to seven million people from more than 184 countries. While this occasion is one of fulfillment, it can come with risk factors for meningococcal disease, which can be severe and deadly to patrons and their families.
The Hajj and Umrah pilgrimages have historically been associated [1] with both local and international outbreaks for meningococcal disease. It is a serious bacterial infection caused [2] by the bacterium Neisseria meningitidis. Meningococcal disease can result in meningitis, which is the infection of the brain’s lining and the spinal cord. The disease is considered very serious. It has the ability to turn deadly in as little as 24 hours, with 10 percent of those infected likely dying and 20 percent survivors experiencing long-term disabilities, including brain damage, hearing loss, learning disabilities or limb amputations.
As pilgrims come from every corner of the world, it is incredibly critical to take preventive measures like vaccines to make sure that communities around the world are protected from the disease. It can make the potential difference between life and death for many people, even if they do not attend these pilgrimages.
Impact of immunization on meningococcal outbreaks during Hajj and Umrah pilgrimages
There are already several protective measures in place to protect pilgrims during the Hajj and Umrah seasons from meningococcal disease. In 1987, a meningococcal serogroup A outbreak occurred [3] across the continent associated with the Hajj. It triggered the introduction of mandatory vaccination against groups A and C for pilgrims from meningitis belt countries from Africa. A little more than a decade later, in 2000 and 2001, another global outbreak of meningococcal serogroup W led [3] to the implementation of broader vaccine coverage for all pilgrims entering the Kingdom of Saudi Arabia. Unfortunately, these outbreaks led to substantial pilgrim mortality [4]. In tandem with the external pilgrimage policy, immunization activities for all KSA citizens and residents with pilgrim interactions were also introduced. Since then, the number of meningococcal disease cases as well as the case fatality ratios declined, suggesting a potential positive effect of the current Hajj vaccination policy, among other factors.
While these policies are considered a tremendous success, there remain limitations [5] in current immunization approaches and an ongoing risk for future outbreaks associated with Hajj and Umrah. Some data suggests [6] that not everyone who attends the Hajj and Umrah have received the vaccine. This is a major challenge as vaccines are one of the best ways to get protected from the disease. It’s why it’s important for healthcare providers and the general public to stay on top of vaccinations against meningococcal disease to ensure that people can make the most of their time with friends and family during these sacred moments.
How pilgrims can protect themselves from meningococcal disease
As we approach a season of mass gatherings, it’s important for patrons to be as prepared as possible so their pilgrimage remains uninterrupted by health issues. There are many ways they can protect themselves from meningococcal disease:
- Get vaccinated: The top of the list should be to get the right vaccine before they travel. Vaccines are one of the greatest public health advances of all time, helping to effectively prevent illness, disability and death worldwide
- Practice good hygiene: Pilgrims should wash their hands frequently with soap and water, and avoid touching their face or mouth with their hands. They should also cover their mouth and nose when coughing or sneezing, and dispose of any used tissues properly.
- Avoid close contact with sick people: Pilgrims should avoid close contact with anyone who has symptoms of meningococcal disease, such as fever, headache, and neck stiffness.
- Wear a mask: Wearing a mask can help prevent the spread of meningococcal disease, especially in crowded and communal spaces.
- Stay in well-ventilated areas: Pilgrims should stay in well-ventilated areas and avoid crowded and enclosed spaces as much as possible.
- Seek medical attention if you develop symptoms: If pilgrims develop symptoms of meningococcal disease, such as fever, headache, and neck stiffness, they should seek medical attention immediately.
With a greater awareness of meningococcal disease, people from all over the world can protect themselves from getting sick. We all deserve to enjoy our time with families and friends – whether it is during the Hajj and Umrah, or anywhere else. Especially after experiencing hard times during the pandemic lockdown, it’s important for us to take the right preventative steps in order to make the most of our time with our loved ones.
References
1. Yezli, Saber, et al. “Meningococcal Disease during the Hajj and Umrah Mass Gatherings.” International Journal of Infectious Diseases, vol. 47, 2016, pp. 60–64., https://doi.org/10.1016/j.ijid.2016.04.007.
2. “Meningococcal Disease.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 7 Feb. 2022, https://www.cdc.gov/meningococcal/index.html:~:text=Meningococcal%20disease%20refers%20to%20any,cord%20(meningitis)%20and%20bloodstream.
3. Badur, Selim et al. “Meningococcal Disease and Immunization Activities in Hajj and Umrah Pilgrimage: a review.” Infectious diseases and therapy vol. 11,4 (2022): 1343-1369. doi: https://doi.org/10.1007/s40121-022-00620-0
4. Memish, Z et al. “Laboratory-confirmed invasive meningococcal disease: effect of the Hajj vaccination policy, Saudi Arabia, 1995 to 2011.” Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin vol. 18,37 20581. 12 Sep. 2013, doi: https://doi.org10.2807/1560-7917 .es2013.18.37.20581
5. Tobaiqy, Mansour et al. “Assessment of Preventative Measures Practice among Umrah Pilgrims in Saudi Arabia, 1440H-2019.” International journal of environmental research and public health vol. 18,1 257. 31 Dec. 2020, doi: https://doi.org/10.3390/ijerph18010257
6. Alasmari, Abrar et al. “Meningococcal carriage among Hajj pilgrims, risk factors for carriage and records of vaccination: a study of pilgrims to Mecca.” Tropical medicine & international health : TM & IH vol. 26,4 (2021): 453-461. doi: https://doi.org/10.1111/tmi.13546
