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Health conditions for travellers to Saudi Arabia for the pilgrimage to Mecca (Hajj) (WHO/WER, August 9 2013, edited)
[Source: World Health Organization, Weekly Epidemiological Record, full PDF document: (LINK). Extract.]
Weekly epidemiological record / Relev? ?pid?miologique hebdomadaire, 9 AUGUST 2013, 88th year / 9 AO?T 2013, 88e ann?e, No. 32, 2013, 88, 337?348, 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 2013.
I. Yellow fever
(A) In accordance with the International Health Regulations 2005,1 all travellers arriving from countries or areas at risk of yellow fever (see list below) must present a valid yellow fever vaccination certificate showing that the person was vaccinated at least 10 days previously and not more than 10 years before arrival at the border.
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 offices 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.
The following countries/areas are at risk of yellow fever transmission (as defined by the International travel and health 20122).
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, Senegal, Sierra Leone, South Soudan, Sudan, Togo and Uganda.
Americas
Argentina, Bolivarian Republic of Venezuela, Brazil, Colombia, Ecuador, French Guyana, Guyana, Panama, Paraguay, Peru, Plurinational State of Bolivia, Suriname and Trinidad and Tobago.
(B) Aircrafts, ships and other means of transportation coming from countries affected by yellow fever are requested to submit a certificate indicating that it applied disinsection in accordance with methods recommended by WHO.
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).
II. Meningococcal meningitis
(A) Visitors from all countries
Visitors arriving for the purpose of Umra or pilgrimage or for seasonal work are required to produce a certificate of vaccination with the quadrivalent (ACYW135) vaccine against meningitis issued not more than 3 years previously and not less than 10 days before arrival in Saudi Arabia. The responsible authorities in the visitor?s country of origin should ensure that adults and children aged over 2 years are given 1 dose of the quadrivalent polysaccharide (ACYW135) vaccine.
(B) For visitors arriving from countries in the African meningitis belt, namely Benin, Burkina Faso, Cameroon, Chad, Central African Republic, C?te d?Ivoire, Eritrea, Ethiopia, Gambia, Guinea, Guinea-Bissau, Mali, Niger, Nigeria, Senegal and Sudan.
In addition to the above stated requirements, chemoprophylaxis will be administered at port of entry to lower the rate of carriers among them.
Adults will receive ciprofloxacin tablets (500 mg) and children will receive rifampicin.
(C) Interior pilgrims and the Hajj workers
Vaccination with quadrivalent (ACYW135) vaccine is required for:
III. Poliomyelitis
(A) All travellers arriving from polio-endemic countries and re-established transmission countries, namely, Afghanistan, Chad, Kenya, Nigeria, Pakistan and Somalia regardless of age and vaccination status, should receive 1 dose of oral polio vaccine (OPV). Proof of OPV at least 6 weeks prior departure is required for visitors from polio-endemic and re-established transmission countries to apply for entry visa for Saudi Arabia and travellers will also receive 1 dose of OPV at borders points on arrival in Saudi Arabia. The same requirements are valid for travellers from recently endemic countries at high risk of re-importation of poliovirus, i.e. India.
(B) All visitors age under 15 years travelling to Saudi Arabia from countries reporting polio following importation or due to circulating vaccine-derived poliovirus (see list below) in the past 12 months (as of mid-February 2013), should be vaccinated against poliomyelitis with the OPV. Proof of OPV or inactivated poliovirus vaccine (IPV) vaccination is required 6 weeks prior the application for entry visa. Irrespective of previous immunization history, all visitors under 15 years arriving in Saudi Arabia will also receive 1 dose of OPV at border points.
Polio cases related to wild poliovirus importation or to circulating vaccine-derived poliovirus have been registered during the past 12 months in the following countries:
Niger and Yemen.
IV. Seasonal influenza
The Ministry of Health of Saudi Arabia recommends that international pilgrims be vaccinated against seasonal influenza before arrival into the kingdom of Saudi Arabia, particularly those at increased risk of severe influenza diseases including pregnant women, children aged over 5 years, the elderly, and individuals with preexisting health conditions such as asthma, chronic heart or lung diseases and HIV/AIDS infection.
In Saudi Arabia, seasonal influenza vaccination is recommended for internal pilgrims, particularly those with pre-existing health conditions described above, as well as for all health-care workers in the Hajj premises.
V. Health education
Health authorities in countries of origin are required to provide information to pilgrims on infectious diseases symptoms, methods of transmission, complications, and means of prevention.
VI. Food
Hajj and Umrah performers are not allowed to bring fresh food in Saudi Arabia. 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 his or her trip.
VII. I nternational outbreaks response
The Saudi Ministry of Health recommends that people aged over 65years and those with chronic diseases (e.g. heart disease, kidney disease, respiratory disease, diabetes) and pilgrims with immune deficiency (congenital and acquired), malignant and terminal illnesses, pregnant women and children aged under 12 years planning to come for Hajj and Umra this year, to postpone the performance of the Hajj and Umra for their own safety.
The Saudi Ministry of Health also advises all pilgrims to comply with common public health recommendations to prevent the spread of respiratory infectious disease, such as:
Incompletely immunized travellers can be offered routine vaccinations recommended in national immunization schedules (these usually include diphtheria, tetanus, pertussis, polio, measles and mumps), in addition to those needed for the specific travel (e.g. meningococcal vaccination for Hajj).
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, the health authorities in Saudi Arabia will undertake additional preventive precautions (not included in the measures mentioned above) following consultation with WHO and necessary to avoid the spread of infection during the pilgrimage or on return to their country of origin. Please address any queries to the Deputy Minister for Public Health at the Ministry of Health of Saudi Arabia (email: zmemish@yahoo.com )
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1) International Health Regulations 2005. Geneva, World Health Organization, 2005 (available at http://www.who.int/ihr/en, accessed July 2013).
2) International travel and health. Geneva, WHO, 2012 (available at http://www.who.int/ith, accessed July 2013).
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Weekly epidemiological record / Relev? ?pid?miologique hebdomadaire, 9 AUGUST 2013, 88th year / 9 AO?T 2013, 88e ann?e, No. 32, 2013, 88, 337?348, 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 2013.
I. Yellow fever
(A) In accordance with the International Health Regulations 2005,1 all travellers arriving from countries or areas at risk of yellow fever (see list below) must present a valid yellow fever vaccination certificate showing that the person was vaccinated at least 10 days previously and not more than 10 years before arrival at the border.
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 offices 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.
The following countries/areas are at risk of yellow fever transmission (as defined by the International travel and health 20122).
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, Senegal, Sierra Leone, South Soudan, Sudan, Togo and Uganda.
Americas
Argentina, Bolivarian Republic of Venezuela, Brazil, Colombia, Ecuador, French Guyana, Guyana, Panama, Paraguay, Peru, Plurinational State of Bolivia, Suriname and Trinidad and Tobago.
(B) Aircrafts, ships and other means of transportation coming from countries affected by yellow fever are requested to submit a certificate indicating that it applied disinsection in accordance with methods recommended by WHO.
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).
II. Meningococcal meningitis
(A) Visitors from all countries
Visitors arriving for the purpose of Umra or pilgrimage or for seasonal work are required to produce a certificate of vaccination with the quadrivalent (ACYW135) vaccine against meningitis issued not more than 3 years previously and not less than 10 days before arrival in Saudi Arabia. The responsible authorities in the visitor?s country of origin should ensure that adults and children aged over 2 years are given 1 dose of the quadrivalent polysaccharide (ACYW135) vaccine.
(B) For visitors arriving from countries in the African meningitis belt, namely Benin, Burkina Faso, Cameroon, Chad, Central African Republic, C?te d?Ivoire, Eritrea, Ethiopia, Gambia, Guinea, Guinea-Bissau, Mali, Niger, Nigeria, Senegal and Sudan.
In addition to the above stated requirements, chemoprophylaxis will be administered at port of entry to lower the rate of carriers among them.
Adults will receive ciprofloxacin tablets (500 mg) and children will receive rifampicin.
(C) Interior pilgrims and the Hajj workers
Vaccination with quadrivalent (ACYW135) vaccine is required for:
- all citizens and residents of Medina and Mecca 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 or in direct contact with pilgrims in Saudi Arabia.
III. Poliomyelitis
(A) All travellers arriving from polio-endemic countries and re-established transmission countries, namely, Afghanistan, Chad, Kenya, Nigeria, Pakistan and Somalia regardless of age and vaccination status, should receive 1 dose of oral polio vaccine (OPV). Proof of OPV at least 6 weeks prior departure is required for visitors from polio-endemic and re-established transmission countries to apply for entry visa for Saudi Arabia and travellers will also receive 1 dose of OPV at borders points on arrival in Saudi Arabia. The same requirements are valid for travellers from recently endemic countries at high risk of re-importation of poliovirus, i.e. India.
(B) All visitors age under 15 years travelling to Saudi Arabia from countries reporting polio following importation or due to circulating vaccine-derived poliovirus (see list below) in the past 12 months (as of mid-February 2013), should be vaccinated against poliomyelitis with the OPV. Proof of OPV or inactivated poliovirus vaccine (IPV) vaccination is required 6 weeks prior the application for entry visa. Irrespective of previous immunization history, all visitors under 15 years arriving in Saudi Arabia will also receive 1 dose of OPV at border points.
Polio cases related to wild poliovirus importation or to circulating vaccine-derived poliovirus have been registered during the past 12 months in the following countries:
Niger and Yemen.
IV. Seasonal influenza
The Ministry of Health of Saudi Arabia recommends that international pilgrims be vaccinated against seasonal influenza before arrival into the kingdom of Saudi Arabia, particularly those at increased risk of severe influenza diseases including pregnant women, children aged over 5 years, the elderly, and individuals with preexisting health conditions such as asthma, chronic heart or lung diseases and HIV/AIDS infection.
In Saudi Arabia, seasonal influenza vaccination is recommended for internal pilgrims, particularly those with pre-existing health conditions described above, as well as for all health-care workers in the Hajj premises.
V. Health education
Health authorities in countries of origin are required to provide information to pilgrims on infectious diseases symptoms, methods of transmission, complications, and means of prevention.
VI. Food
Hajj and Umrah performers are not allowed to bring fresh food in Saudi Arabia. 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 his or her trip.
VII. I nternational outbreaks response
The Saudi Ministry of Health recommends that people aged over 65years and those with chronic diseases (e.g. heart disease, kidney disease, respiratory disease, diabetes) and pilgrims with immune deficiency (congenital and acquired), malignant and terminal illnesses, pregnant women and children aged under 12 years planning to come for Hajj and Umra this year, to postpone the performance of the Hajj and Umra for their own safety.
The Saudi Ministry of Health also advises all pilgrims to comply with common public health recommendations to prevent the spread of respiratory infectious disease, such as:
- wash hands with soap and water or disinfectant, especially after coughing and sneezing;
- use disposable tissues when coughing or sneezing and dispose of it in the waste basket;
- try as much as possible to avoid hand contact with the eyes, nose and mouth;
- avoid direct contact with the persons who appear ill with cough, sneeze, expectoration, vomiting, diarrhoea and do not share their personal belongings;
- wear masks, especially when in crowded places;
- maintain good personal hygiene.
Incompletely immunized travellers can be offered routine vaccinations recommended in national immunization schedules (these usually include diphtheria, tetanus, pertussis, polio, measles and mumps), in addition to those needed for the specific travel (e.g. meningococcal vaccination for Hajj).
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, the health authorities in Saudi Arabia will undertake additional preventive precautions (not included in the measures mentioned above) following consultation with WHO and necessary to avoid the spread of infection during the pilgrimage or on return to their country of origin. Please address any queries to the Deputy Minister for Public Health at the Ministry of Health of Saudi Arabia (email: zmemish@yahoo.com )
_________
1) International Health Regulations 2005. Geneva, World Health Organization, 2005 (available at http://www.who.int/ihr/en, accessed July 2013).
2) International travel and health. Geneva, WHO, 2012 (available at http://www.who.int/ith, accessed July 2013).
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