Giuseppe
Emeritus
[Source: World Health Organization, Weekly Epidemiological Record, full PDF document: (LINK). Edited.]
Weekly epidemiological record / Relev? ?pid?miologique hebdomadaire
23 september 2011, 86th year / 23 septembre 2011, 86e ann?e - No. 39, 2011, 86, 425?436 - 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 2011.
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 (list of countries 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 20112):
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, Sudan (north and south), Togo and Uganda.
Americas:
Argentina, Bolivarian Republic of Venezuela, Brazil, Colombia, Ecuador, French Guiana, 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. M eningococcal meningitis
(A) For all arrivals
Visitors from all over the world 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 over the age of 2 years are given 1 dose of the quadrivalent polysaccharide (ACYW135) vaccine.
(B) For arrivals 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 all arrivals from these countries to lower the carriers rate among them. Adults will receive ciprofloxacin tablets (500 mg), children will receive rifampicin, 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 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, Angola, Chad, the Democratic Republic of Congo, India, Nigeria, Pakistan and Sudan (north and south), regardless of age and vaccination status, should receive 1 dose of oral poliovirus vaccine (OPV). Proof of OPV vaccination at least 6 weeks prior departure is required to apply for entry visa for Saudi Arabia. These travellers will also receive 1 dose of OPV at borders points on arrival in Saudi Arabia.
(B) All visitors age under 15 years travelling to Saudi Arabia from countries with imported cases of poliomyelitis in the past 12 months (see list below) should be vaccinated against poliomyelitis with the OPV. Proof of OPV 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.
Imported cases have been registered during the past 12 months in the following countries: Burkina Faso, C?te d?Ivoire, Congo, Gabon, Guinea, Kazakhstan, Liberia, Mali, Mauritania, Nepal, Niger, Russian Federation, Senegal, Sierra Leone, Somalia, Tajikistan, Turkmenistan and Uganda.
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 with WHO approved strains specific to the northern or southern hemispheres, particularly those with pre-existing conditions (e.g. the elderly over 65 years of age, people with neurological or metabolic diseases, chronic respiratory or heart diseases, hepatic or renal failure, diabetes, obesity, immunodeficiency caused by HIV or cancer treatment and pregnant women.
In Saudi Arabia, seasonal influenza vaccine is recommended for internal pilgrims, particularly those with pre-existing health conditions, and all health staff working 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. International outbreaks response
Updating immunization against vaccine-preventable diseases in all travellers is strongly recommended. With the recent resurgence of measles and rubella cases, special attention is needed for both of these vaccines to avoid widespread outbreaks with this virus during this year Hajj and Umra. Preparation for international travel provides opportunity to review the immunization status of travellers. 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 International Travel and Health 2011,2 WHO recommends that travellers ensure immunity against measles by having at least 2 doses of vaccine and against rubella by one dose of vaccine.
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, following consultation with WHO, will undertake additional preventive precautions (not included in the measures mentioned above) necessary to avoid the spread of infection during the pilgrimage or on return to their country of origin.
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 2005. Geneva, WHO, 2005 (available at (LINK) accessed September 2011).
(2) International travel and health. Geneva, WHO, 2011 (available at (LINK), accessed September 2011).
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Weekly epidemiological record / Relev? ?pid?miologique hebdomadaire
23 september 2011, 86th year / 23 septembre 2011, 86e ann?e - No. 39, 2011, 86, 425?436 - 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 2011.
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 (list of countries 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 20112):
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, Sudan (north and south), Togo and Uganda.
Americas:
Argentina, Bolivarian Republic of Venezuela, Brazil, Colombia, Ecuador, French Guiana, 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. M eningococcal meningitis
(A) For all arrivals
Visitors from all over the world 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 over the age of 2 years are given 1 dose of the quadrivalent polysaccharide (ACYW135) vaccine.
(B) For arrivals 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 all arrivals from these countries to lower the carriers rate among them. Adults will receive ciprofloxacin tablets (500 mg), children will receive rifampicin, 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 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, Angola, Chad, the Democratic Republic of Congo, India, Nigeria, Pakistan and Sudan (north and south), regardless of age and vaccination status, should receive 1 dose of oral poliovirus vaccine (OPV). Proof of OPV vaccination at least 6 weeks prior departure is required to apply for entry visa for Saudi Arabia. These travellers will also receive 1 dose of OPV at borders points on arrival in Saudi Arabia.
(B) All visitors age under 15 years travelling to Saudi Arabia from countries with imported cases of poliomyelitis in the past 12 months (see list below) should be vaccinated against poliomyelitis with the OPV. Proof of OPV 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.
Imported cases have been registered during the past 12 months in the following countries: Burkina Faso, C?te d?Ivoire, Congo, Gabon, Guinea, Kazakhstan, Liberia, Mali, Mauritania, Nepal, Niger, Russian Federation, Senegal, Sierra Leone, Somalia, Tajikistan, Turkmenistan and Uganda.
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 with WHO approved strains specific to the northern or southern hemispheres, particularly those with pre-existing conditions (e.g. the elderly over 65 years of age, people with neurological or metabolic diseases, chronic respiratory or heart diseases, hepatic or renal failure, diabetes, obesity, immunodeficiency caused by HIV or cancer treatment and pregnant women.
In Saudi Arabia, seasonal influenza vaccine is recommended for internal pilgrims, particularly those with pre-existing health conditions, and all health staff working 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. International outbreaks response
Updating immunization against vaccine-preventable diseases in all travellers is strongly recommended. With the recent resurgence of measles and rubella cases, special attention is needed for both of these vaccines to avoid widespread outbreaks with this virus during this year Hajj and Umra. Preparation for international travel provides opportunity to review the immunization status of travellers. 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 International Travel and Health 2011,2 WHO recommends that travellers ensure immunity against measles by having at least 2 doses of vaccine and against rubella by one dose of vaccine.
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, following consultation with WHO, will undertake additional preventive precautions (not included in the measures mentioned above) necessary to avoid the spread of infection during the pilgrimage or on return to their country of origin.
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 2005. Geneva, WHO, 2005 (available at (LINK) accessed September 2011).
(2) International travel and health. Geneva, WHO, 2011 (available at (LINK), accessed September 2011).
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