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Health Tips – NATHNAC

Advice for pilgrims for the Hajj and Umrah
Updated October 2010

Vaccine Advice

Hajj, the yearly Muslim pilgrimage to Makkah (Mecca) in the Kingdom of Saudi Arabia, represents the largest gathering in the world; every year over two million Muslims from around the world come together. The Hajj pilgrimage is estimated to fall between 14 and 18 November 2010.

Umrah is a shorter pilgrimage that can be performed at any time.

Vaccine advice

  • General vaccine advice for Saudi Arabia is available on the NaTHNaC Country Information Page.
  • Be up-to-date with all routine vaccines, including measles, mumps and rubella (MMR).
  • Seasonal influenza: The Ministry of Health of Saudi Arabia recommends that all pilgrims are vaccinated against seasonal flu. Flu spreads easily in crowded conditions through coughs and sneezes. Some people are at higher risk of complications and should receive a free flu vaccine each year from their GP:
  • anyone with a medical condition, including diabetes, chest problems like asthma, heart, liver or kidney disease
  • people aged 65 years and older
  • people without an effectively working spleen
  • pregnant womenAll others can request a flu vaccine from a private travel clinic or some high street chemists. More advice about preventing flu can be found on NaTHNaC’s information sheet on seasonal flu.
  • Many pilgrims catch a respiratory infection (known as Hajj cough). This can cause anything from mild illness to severe infection. Follow these precautions:
  • do not travel if you are ill
  • wash your hands frequently
  • use tissues for coughs and sneezes – dispose of dirty tissues promptly and carefully
  • try to avoid close contact with anyone who is ill
  • Meningitis: All pilgrims to Hajj and Umrah have to show proof of vaccination against the meningitis strains A, C, W135 and Y. This is also a visa requirement.
  • You should have a vaccine against A, C, W135 and Y meningitis not more than three years and not less than ten days before you arrive in Saudi Arabia. This needs to be recorded in a vaccination book showing your full name. This is your proof of vaccination. A new meningitis vaccine, called Menveo® is now the recommended vaccine. Children aged from two months to one year need two doses of Menveo® a month apart. Your nurse or doctor can discuss this fully with you.
  • The Saudi Arabian government will give antibiotics to any pilgrims arriving from countries in the African meningitis belt: Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Côte d’Ivoire, Eritrea, Ethiopia, Gambia, Guinea, Guinea-Bissau, Mali, Niger, Nigeria, Senegal, and Sudan.
  •  Polio: All pilgrims should ensure their polio vaccination is up-to-date.  If your last polio vaccine was more than ten years ago, you should get a booster, using the combined tetanus, diphtheria and polio vaccine. If you are not travelling to Saudi Arabia directly from the UK, discuss your travel plans carefully with your GP or nurse.  The Saudi government has strict polio vaccine entry requirements for travellers from countries with cases of polio.
  • Hepatitis B: Pilgrims should consider hepatitis B vaccine. Hepatitis B virus is found in body fluids and is spread through contaminated medical or dental equipment, such as needles and syringes, or by sexual contact. Male head shaving is a rite of the Hajj. The Saudi Arabian government provides licensed barbers with a new razor blade for each pilgrim. However, unlicensed barbers may not do this. Do not share razor blades, as this carries a risk of hepatitis B and other blood borne viruses, such as HIV and hepatitis C. The safest option is to bring your own personal disposable razor.
  • Yellow fever:  The Saudi Arabian government requires any pilgrim arriving from yellow fever risk countries to present a valid yellow fever vaccination certificate in accordance with International Health Regulations (2005). You can look at NaTHNaC’s country information pages to check which countries are a risk for yellow fever.

Food and water advice

  • All pilgrims should follow food and water hygiene precautions. Sickness and diarrhoea spreads via contaminated food or water. Dehydration following diarrhoea is a particular risk in hot weather. Babies, infants, older people and those with medical conditions are more vulnerable to dehydration. Immediate medical attention should be sought for anyone with suspected dehydration.
  • You should take supplies of oral rehydration salts such as Dioralyte® and a medicine to relieve symptoms, such as loperamide (Imodium®). These are available at UK pharmacies.
  • You can also ask your GP about antibiotics to take if you have diarrhoea.

Insect-transmitted diseases

  • Malaria is not a problem in Medina or Makkah, but is a risk in south-western and some rural areas of Saudi Arabia. If you are travelling before or after the Hajj and going to risk areas in Saudi Arabia, or any countries in Asia, Africa and Latin America, you need malaria advice and may need to take malaria prevention tablets. Check the NaTHNaC Country Information Pages to see if you are going to a malaria risk country.

Heat and sun-related hazards

  • Daytime temperatures in Saudi Arabia can reach over 30°C. This increases your risk of sunburn, dehydration, heat exhaustion and heat stroke. If possible, try to travel before the start of Hajj, so that you have time to acclimatise to the heat.  Drink plenty of clean (preferably bottled or boiled) water to avoid dehydration.
  • High protection sun screen (factor 15 to 30) should be regularly applied to exposed skin. Male pilgrims are not permitted to cover their heads. However umbrellas are allowed and can provide shade. Desert sand is very hot. You need sturdy, comfortable shoes or sandals to avoid burning your feet. Footwear must be removed during prayer.

Accidents and injuries

  • Minor injuries are common, particularly to feet. Serious injuries and deaths have occurred in the past, as a result of stampedes. Try to avoid peak times. Take care with road safety and during the stoning rite. Elderly and infirm pilgrims are allowed to ask someone else to perform the stoning right on their behalf.

Other health advice

  • Physical fitness: Performing the Hajj is demanding and involves walking long distances, usually in very hot weather. You must make sure you are physically fit before you go.
  • Periods (menstruation): Women expecting their period during the Hajj may wish to delay menstruation. This is possible using hormonal medication – you should discuss this with your GP or family planning clinic well before departure.
  • Medical kits: take a basic medical kit, including pain relief tablets, plasters and diarrhoea treatment.
  • If you take regular medicines, you must carry a good supply, along with a copy of your prescription and a letter from your doctor explaining your medical history. It is useful to carry your GP’s contact details in case any emergency medical care is needed.
  • Insurance: Make sure you have comprehensive travel health insurance and declare all medical problems to your insurance company.
  • The Saudi Arabian government checks all pilgrims for symptoms of specific diseases. These include: dengue fever, meningococcal meningitis, measles and yellow fever. Suspect cases are isolated and direct contacts will be placed under observation.

Further information on health risks for travellers to Saudi Arabia and for any other countries you are visiting can be found on the NaTHNaC Country Information Page.

Source: NaTHNaC

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