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Health conditions for travellers to Saudi Arabia for the pilgrimage to Mecca (Hajj) (WHO WER, 11/13/09, edited)
Health conditions for travellers to Saudi Arabia for the pilgrimage to Mecca (Hajj) (WHO WER, 11/13/09, edited)
[Source PDF Document: LINK. EDITED.]
Weekly epidemiological record - 13 NOVEMBER 2009, 84th YEAR - No. 46, 2009, 84, 477?484 - http://www.who.int/wer
Health conditions for travellers to Saudi Arabia for the pilgrimage to Mecca (Hajj)
Editorial note
This publication in the Weekly Epidemiological Record is to inform visitors of the full requirements for entry into Saudi Arabia; it does not imply an endorsement by WHO of all measures stipulated.
The Ministry of Health of Saudi Arabia has issued the following requirements and recommendations for entry visas for the Hajj and Umra seasons in 2009.
I. Pandemic influenza A (H1N1) 2009 virus
(A) Individuals with certain chronic diseases (such as cardiac, renal, respiratory or neurological diseases and diabetes mellitus) and acquired or congenital immunodeficiency, pregnant women and extremely overweight individuals are more likely to experience complicated forms of pandemic influenza A (H1N1) 2009 virus infection. It is therefore recommended that people with the above-mentioned conditions defer from performing the Hajj this year (2009).
(B) It is further recommended that individuals aged less than 12 years or more than 65 years defer from performing the Hajj this year (2009). The health authorities in the pilgrim?s country of origin are responsible for adherence to this recommendation. Pilgrims who arrive in Saudi Arabia for the purpose of performing the Hajj will be allowed to do so regardless of their age.
(C) For seasonal influenza vaccine and pandemic (H1N1) 2009 vaccine, Saudi Arabian embassies will address health authorities in all countries about the availability of vaccines for this year?s pilgrimage to Hajj. Where the vaccines are available in countries, proof of both vaccinations will be required by competent authorities before issuing visas. Where vaccines are not available, visas will be issued to pilgrims by the responsible health authority of each country.
(D) Health authorities in pilgrims? countries of origin are responsible for educating and advising pilgrims about simple public health measures to prevent the spread of respiratory infections, especially pandemic (H1N1) 2009. Emphasis should be placed on adherence to good personal hygiene measures, including cough etiquette, use of antiseptic hand gels, wearing of masks when in crowded areas or public places while experiencing symptoms of upper respiratory tract infection, avoiding close contact with sick people, and frequent hand-washing with soap and water.
II. Yellow fever
(A) In accordance with the revised International Health Regulations (2005),1 all travellers arriving from countries or areas at risk of yellow fever transmission must present a valid certificate of yellow fever vaccination showing that the individual was vaccinated at least 10 days previously and not more than 10 years before arrival at the border. The following countries or areas are at risk of yellow fever transmission (as defined by International travel and health2):
Africa: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo, C?te d?Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Mali, Mauritania, Niger, Nigeria, Rwanda, Sao Tome and Principe, Senegal, Sierra Leone, Somalia, Sudan, Togo, Uganda, United Republic of Tanzania.
Americas: Argentina, Bolivarian Republic of Venezuela, Brazil, Colombia, Ecuador, French Guyana, Guyana, Panama, Paraguay, Peru, Plurinational State of Bolivia, Suriname, Trinidad and Tobago.
(B) Aircraft arriving from areas at risk for yellow fever transmission must be disinsected in accordance with methods recommended by WHO and a completed Health Part of the Aircraft General Declaration including the details of the disinsection submitted to the competent authority on arrival in accordance with the International Health Regulations (2005).1
In accordance with the International Health Regulations (2005), all arriving ships will be requested to provide to the competent authority a valid Ship Sanitation Certificate. Ships arriving from areas at risk for yellow fever transmission may also be required to submit to inspection to ensure they are free of yellow fever vectors, or disinsected, as a condition of granting free pratique (including permission to enter a port, to embark or disembark and to discharge or load cargo or stores).
III. Bubonic plague
In addition to providing a valid Ship Sanitation Certificate, arriving ships may also be required to submit to inspection to ensure they are free of plague vectors and reservoirs or be subjected to health control measures, as a condition of granting free pratique (including permission to enter a port, to embark or disembark and to discharge or load cargo or stores).
IV. Meningococcal meningitis
(A) For all arrivals Visitors arriving from around the world to participate in the ?Umra?, the pilgrimage or for seasonal work are required to produce a certifi cate of vaccination with the quadrivalent (ACYW135) vaccine against meningitis issued not more than 3 years previously and at least 10 days before arrival in Saudi Arabia. The responsible authorities in the visitor?s country of origin should ensure that vaccination has been carried out as follows:
(B) For arrivals from countries of the African meningitis belt (namely Benin, Burkina Faso, Cameroon, Chad, Central African Republic, Chad, C?te d?Ivoire, Eritrea, Ethiopia, Gambia, Guinea, Guinea-Bissau, Mali, Niger, Nigeria, Senegal, Sudan).
(C) Interior pilgrims and the Hajj workers Vaccination with quadrivalent (ACYW135) vaccine is required for:
− all citizens and residents of Mecca and Medina who have not been vaccinated during the past 3 years;
− all citizens and residents undertaking the Hajj;
− all Hajj workers who have not been vaccinated in the past 3 years;
− any individual working at entry points in Saudi Arabia.
V. Poliomyelitis
(A) All visitors aged under 15 years travelling to Saudi Arabia from countries reinfected with poliomyelitis (see list below) should be vaccinated against poliomyelitis with oral poliovirus vaccine (OPV). Proof of OPV vaccination is required 6 weeks prior to application for an entry visa. Irrespective of previous vaccination history, all visitors aged under 15 years arriving in Saudi Arabia will also receive 1 dose of OPV at border points. The following countries are considered to be reinfected with poliomyelitis (data as of September 2009): Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, C?te d?Ivoire, Democratic Republic of the Congo, Ethiopia, Ghana, Guinea, Kenya, Liberia, Mali, Nepal, Niger, Sierra Leone, Somalia, Sudan, Togo, Uganda.
(B) All travellers arriving from Afghanistan, India, Nigeria and Pakistan, regardless of age and vaccination status, should receive 1 OPV dose 6 weeks prior to departure for Saudi Arabia; they should also receive 1 OPV dose at border points on arrival in Saudi Arabia.
VI. Disease surveillance and health regulations at entry points (airports, ports)
(A) All pilgrims arriving at entry points in Saudi Arabia for the Hajj or Umra will be screened for diseases of international concern, for example pandemic infl uenza A (H1N1) 2009 virus, dengue fever, meningococcal meningitis and yellow fever, to isolate cases and observe direct contacts.
(B) Chemoprophylaxis (ciprofloxacin for adults, rifampicin for children) will be administered at points of entry to all travellers who have not received quadrivalent (ACYW135) vaccine against meningitis or who have been vaccinated more than 3 years ago or less than 10 days before arrival in Saudi Arabia.
(C) All travellers arriving from countries at risk of yellow fever transmission must present a valid yellow fever vaccination certificate in accordance with the International Health Regulations (2005).1 In the absence of such a certificate, the individual will be placed under strict surveillance for 6 days from the date of vaccination or the last date of potential exposure to infection, whichever is earlier. Health offi ces at entry points will be responsible for notifying the appropriate Director General of Health Affairs in the region or governorate about the temporary place of residence of the visitor.
(D) Travellers aged under 15 years who are visiting Saudi Arabia from polio-affected countries will be vaccinated with 1 dose of OPV regardless of previous vaccination history. All travellers (adults and children) arriving from Afghanistan, India, Nigeria and Pakistan will also receive 1 dose of OPV at border points. In the event of a public health emergency of international health concern, or in the case of any disease outbreak subject to notification under the International Health Regulations (2005),1 the health authorities in Saudi Arabia are authorized to undertake for pilgrims arriving from any country where the Umra has been performed any additional preventive precautions (not included in the measures mentioned above) following consultation with WHO to avoid the spread of infection.
VII. Food
Food carried by visitors and pilgrims is banned and disallowed from Saudi Arabia. Only properly canned foods available in quantities sufficient for 1 person for the duration of travel are permitted. Please address any queries to the Assistant Deputy Minister of Health for Preventive Medicine in Saudi Arabia
(email: zmemish@yahoo.com).
1 International Health Regulations. Geneva, WHO, 2005 (available at http://www.who.int/csr/ihr/en/; accessed October 2009)
2 International travel and health. Geneva, WHO, 2009 (available at http://www.who.int/ith/en/; accessed October 2009).
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[Source PDF Document: LINK. EDITED.]
Weekly epidemiological record - 13 NOVEMBER 2009, 84th YEAR - No. 46, 2009, 84, 477?484 - http://www.who.int/wer
Health conditions for travellers to Saudi Arabia for the pilgrimage to Mecca (Hajj)
Editorial note
This publication in the Weekly Epidemiological Record is to inform visitors of the full requirements for entry into Saudi Arabia; it does not imply an endorsement by WHO of all measures stipulated.
The Ministry of Health of Saudi Arabia has issued the following requirements and recommendations for entry visas for the Hajj and Umra seasons in 2009.
I. Pandemic influenza A (H1N1) 2009 virus
(A) Individuals with certain chronic diseases (such as cardiac, renal, respiratory or neurological diseases and diabetes mellitus) and acquired or congenital immunodeficiency, pregnant women and extremely overweight individuals are more likely to experience complicated forms of pandemic influenza A (H1N1) 2009 virus infection. It is therefore recommended that people with the above-mentioned conditions defer from performing the Hajj this year (2009).
(B) It is further recommended that individuals aged less than 12 years or more than 65 years defer from performing the Hajj this year (2009). The health authorities in the pilgrim?s country of origin are responsible for adherence to this recommendation. Pilgrims who arrive in Saudi Arabia for the purpose of performing the Hajj will be allowed to do so regardless of their age.
(C) For seasonal influenza vaccine and pandemic (H1N1) 2009 vaccine, Saudi Arabian embassies will address health authorities in all countries about the availability of vaccines for this year?s pilgrimage to Hajj. Where the vaccines are available in countries, proof of both vaccinations will be required by competent authorities before issuing visas. Where vaccines are not available, visas will be issued to pilgrims by the responsible health authority of each country.
(D) Health authorities in pilgrims? countries of origin are responsible for educating and advising pilgrims about simple public health measures to prevent the spread of respiratory infections, especially pandemic (H1N1) 2009. Emphasis should be placed on adherence to good personal hygiene measures, including cough etiquette, use of antiseptic hand gels, wearing of masks when in crowded areas or public places while experiencing symptoms of upper respiratory tract infection, avoiding close contact with sick people, and frequent hand-washing with soap and water.
II. Yellow fever
(A) In accordance with the revised International Health Regulations (2005),1 all travellers arriving from countries or areas at risk of yellow fever transmission must present a valid certificate of yellow fever vaccination showing that the individual was vaccinated at least 10 days previously and not more than 10 years before arrival at the border. The following countries or areas are at risk of yellow fever transmission (as defined by International travel and health2):
Africa: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo, C?te d?Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Mali, Mauritania, Niger, Nigeria, Rwanda, Sao Tome and Principe, Senegal, Sierra Leone, Somalia, Sudan, Togo, Uganda, United Republic of Tanzania.
Americas: Argentina, Bolivarian Republic of Venezuela, Brazil, Colombia, Ecuador, French Guyana, Guyana, Panama, Paraguay, Peru, Plurinational State of Bolivia, Suriname, Trinidad and Tobago.
(B) Aircraft arriving from areas at risk for yellow fever transmission must be disinsected in accordance with methods recommended by WHO and a completed Health Part of the Aircraft General Declaration including the details of the disinsection submitted to the competent authority on arrival in accordance with the International Health Regulations (2005).1
In accordance with the International Health Regulations (2005), all arriving ships will be requested to provide to the competent authority a valid Ship Sanitation Certificate. Ships arriving from areas at risk for yellow fever transmission may also be required to submit to inspection to ensure they are free of yellow fever vectors, or disinsected, as a condition of granting free pratique (including permission to enter a port, to embark or disembark and to discharge or load cargo or stores).
III. Bubonic plague
In addition to providing a valid Ship Sanitation Certificate, arriving ships may also be required to submit to inspection to ensure they are free of plague vectors and reservoirs or be subjected to health control measures, as a condition of granting free pratique (including permission to enter a port, to embark or disembark and to discharge or load cargo or stores).
IV. Meningococcal meningitis
(A) For all arrivals Visitors arriving from around the world to participate in the ?Umra?, the pilgrimage or for seasonal work are required to produce a certifi cate of vaccination with the quadrivalent (ACYW135) vaccine against meningitis issued not more than 3 years previously and at least 10 days before arrival in Saudi Arabia. The responsible authorities in the visitor?s country of origin should ensure that vaccination has been carried out as follows:
- Adults and children aged over 2 years have received 1 dose of the quadrivalent (ACYW135) vaccine;
(B) For arrivals from countries of the African meningitis belt (namely Benin, Burkina Faso, Cameroon, Chad, Central African Republic, Chad, C?te d?Ivoire, Eritrea, Ethiopia, Gambia, Guinea, Guinea-Bissau, Mali, Niger, Nigeria, Senegal, Sudan).
- In addition to the above stated requirements, chemoprophylaxis will be administered at the port of entry to all arrivals from these countries to lower the carrier rates among them. Adults will receive ciprofl oxacin tablets (500 mg); children will receive rifampicin tablets; and pregnant women will receive ceftriaxone injections.
(C) Interior pilgrims and the Hajj workers Vaccination with quadrivalent (ACYW135) vaccine is required for:
− all citizens and residents of Mecca and Medina who have not been vaccinated during the past 3 years;
− all citizens and residents undertaking the Hajj;
− all Hajj workers who have not been vaccinated in the past 3 years;
− any individual working at entry points in Saudi Arabia.
V. Poliomyelitis
(A) All visitors aged under 15 years travelling to Saudi Arabia from countries reinfected with poliomyelitis (see list below) should be vaccinated against poliomyelitis with oral poliovirus vaccine (OPV). Proof of OPV vaccination is required 6 weeks prior to application for an entry visa. Irrespective of previous vaccination history, all visitors aged under 15 years arriving in Saudi Arabia will also receive 1 dose of OPV at border points. The following countries are considered to be reinfected with poliomyelitis (data as of September 2009): Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, C?te d?Ivoire, Democratic Republic of the Congo, Ethiopia, Ghana, Guinea, Kenya, Liberia, Mali, Nepal, Niger, Sierra Leone, Somalia, Sudan, Togo, Uganda.
(B) All travellers arriving from Afghanistan, India, Nigeria and Pakistan, regardless of age and vaccination status, should receive 1 OPV dose 6 weeks prior to departure for Saudi Arabia; they should also receive 1 OPV dose at border points on arrival in Saudi Arabia.
VI. Disease surveillance and health regulations at entry points (airports, ports)
(A) All pilgrims arriving at entry points in Saudi Arabia for the Hajj or Umra will be screened for diseases of international concern, for example pandemic infl uenza A (H1N1) 2009 virus, dengue fever, meningococcal meningitis and yellow fever, to isolate cases and observe direct contacts.
(B) Chemoprophylaxis (ciprofloxacin for adults, rifampicin for children) will be administered at points of entry to all travellers who have not received quadrivalent (ACYW135) vaccine against meningitis or who have been vaccinated more than 3 years ago or less than 10 days before arrival in Saudi Arabia.
(C) All travellers arriving from countries at risk of yellow fever transmission must present a valid yellow fever vaccination certificate in accordance with the International Health Regulations (2005).1 In the absence of such a certificate, the individual will be placed under strict surveillance for 6 days from the date of vaccination or the last date of potential exposure to infection, whichever is earlier. Health offi ces at entry points will be responsible for notifying the appropriate Director General of Health Affairs in the region or governorate about the temporary place of residence of the visitor.
(D) Travellers aged under 15 years who are visiting Saudi Arabia from polio-affected countries will be vaccinated with 1 dose of OPV regardless of previous vaccination history. All travellers (adults and children) arriving from Afghanistan, India, Nigeria and Pakistan will also receive 1 dose of OPV at border points. In the event of a public health emergency of international health concern, or in the case of any disease outbreak subject to notification under the International Health Regulations (2005),1 the health authorities in Saudi Arabia are authorized to undertake for pilgrims arriving from any country where the Umra has been performed any additional preventive precautions (not included in the measures mentioned above) following consultation with WHO to avoid the spread of infection.
VII. Food
Food carried by visitors and pilgrims is banned and disallowed from Saudi Arabia. Only properly canned foods available in quantities sufficient for 1 person for the duration of travel are permitted. Please address any queries to the Assistant Deputy Minister of Health for Preventive Medicine in Saudi Arabia
(email: zmemish@yahoo.com).
1 International Health Regulations. Geneva, WHO, 2005 (available at http://www.who.int/csr/ihr/en/; accessed October 2009)
2 International travel and health. Geneva, WHO, 2009 (available at http://www.who.int/ith/en/; accessed October 2009).
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