tetano
Editor, Senior Moderator
- CORRESPONDENCE
- 03 June 2024
- By
- Shahul H. Ebrahim,
- Alimuddin Zumla,
- Justin Wong,
- Mujeeb Ur Rahman,
- Seif S. Al-Abri,
- Abdullah A. Al Rabeeah &
- Ziad A. Memish
The Festival of Sacrifice marks the conclusion of the annual Hajj pilgrimage to Mecca, Saudi Arabia, attended in person by approximately 4 million Muslims. Animal sacrifice is performed as part of the Hajj pilgrimage, as well as for Muslims in their respective home countries, with an estimated 143 million animals sacrificed during this period.
Animal sacrifice may be performed by individuals or families, although outsourcing to community organizations is increasing, with the meat both consumed by family members and distributed among the community. In the non-Hajj community settings worldwide, adults and children can be exposed to the animals, as well as to uncooked meat, which is typically cooked and consumed the same day, without refrigeration.
In Saudi Arabia, over three million animals are sacrificed during the Hajj, of which about one million are imported from Sudan, Somalia and Djibouti; the remaining two million are procured domestically[SUP]1[/SUP]. In the past, pilgrims either personally slaughtered the animals at the Hajj or oversaw the slaughtering, exposing themselves and others to potential health risks. In 1983, the Saudi Arabian government established The Saudi Project for Utilization of Hajj Meat to streamline ritual slaughter and limit related adverse outcomes, including zoonotic spread[SUP]1[/SUP][SUP],[/SUP][SUP]3[/SUP][SUP],[/SUP][SUP]4[/SUP][SUP],[/SUP][SUP]5[/SUP][SUP],[/SUP][SUP]6[/SUP][SUP],[/SUP][SUP]7[/SUP]. This project, overseen by the Islamic Development Bank, allows pilgrims to pay for animal slaughter online, eliminating direct contact with animals or visits to the abattoir in Makkah or Mina[SUP]1[/SUP]. The Mina abattoir, the world’s largest, can handle 300,000 herds daily — equivalent to New Zealand’s entire meat-processing industry[SUP]6[/SUP][SUP],[/SUP][SUP]7[/SUP]. The process involves approximately 40,000 people, including 800 veterinary physicians responsible for health checks, ensuring compliance with best practices, elimination of ill animals and maintenance of safe abattoir practices. The Islamic Development Bank distributes frozen meat to low-income communities in 25 countries across north Africa, the Eastern Mediterranean and the central Asia region.
Circulation of the highly pathogenic avian influenza virus strain H5N1 in dairy cattle during the 2024 sacrifice season poses challenges for the Hajj, for Muslim communities worldwide and for global efforts to combat viral transmission. First, although the current H5N1 outbreak among cattle has been reported only among US dairy cattle, the virus has been associated with large and deadly outbreaks in wild and farmed bird populations across multiple continents since 2020 (refs[SUP]2[/SUP][SUP],[/SUP][SUP]8[/SUP]). During 2003–2023, of the cumulative 868 human highly pathogenic avian influenza virus H5N1 cases and 457 deaths reported from 23 countries, 66% of cases and 64% of deaths occurred in nine countries with Muslim-majority populations[SUP]8[/SUP]. If the virus is prevalent among animals in exporting countries, importation and mass herding of animals in Saudi Arabia before Hajj offers opportunities for adaptation and establishment of H5N1 strains among various animal species used for sacrifice, including goat, sheep, camel and cattle[SUP]2[/SUP][SUP],[/SUP][SUP]9[/SUP].
Second, the mode of animal-to-human transmission is not fully understood, and exposure of the virus from cattle to several million humans in the same period could allow further viral adaptation for transmission to humans. Third, there is limited animal-surveillance infrastructure in the countries that export animals for the Hajj; the lack of clarity on the incubation period among animals could mask subclinical or asymptomatic infections. Fourth, it is unlikely that animal sacrifice in community settings would adhere to sufficient hygiene practices to prevent viral transmission or use appropriate personal protective equipment[SUP]3[/SUP][SUP],[/SUP][SUP]5[/SUP]. Finally, the lack of detection of H5N1 in cattle outside of the United States may cause a lack of vigilance elsewhere, which could increase the risk of undetected animal-to-animal or animal-to-human transmission.
Avian influenza virus H5N1 has been detected in humans in several countries in the Eastern Mediterranean region, including Iraq and Egypt, but the prevalence of the virus in animals is largely unknown. Vigilance and preparedness (Table 1) are critical, with the risks to public health increasing if the virus adapts and becomes established among domesticated or other animals. An organized response is needed for human and animal pathogen surveillance in order to advance knowledge on the transmission potential of H5N1, and to potentially collect and store tissue samples for future analysis[SUP]2[/SUP][SUP],[/SUP][SUP]10[/SUP]. Given that transportation stress, known as ‘shipping fever’, can predispose cattle to infections, it is important to assure adherence to safe animal transportation practices, including provision of food, water and rest.
The Hajj provides a unique opportunity to fully implement a ‘One Health’ approach to mass-gathering preparedness that can improve H5N1 surveillance and assist with other zoonosis. This One Health approach should include global stakeholders for human and animal health, such as the Quadripartite collaboration on One Health, as well as the Organisation of Islamic Cooperation, the Gulf Cooperation Council, the Arab League and the Islamic Development Bank. The Islamic Development Bank has a unique role in aiding countries to conduct surveillance and preparedness, as well as risk communication, given its role in the global distribution of sacrificed meat from the Hajj mass gathering. Proactive steps to avert large-scale intra-animal and animal–human transmissions is a global health security priority.
https://www.nature.com/articles/d41591-024-00042-0