November 16, 2009. CDC Updates Healthy Travel Recommendations to Saudi Arabia
| SOURCE: | Centers for Disease Control and Prevention |
Each year, millions of people travel to the Kingdom of Saudi Arabia to perform the Hajj, a pilgrimage to the holy places of Islam. This year, the week of the Hajj begins on November 25.
If you are traveling to Saudi Arabia for the Hajj, you can expect large crowds at mass gatherings and places of worship and lodging. This overcrowding may lead to an increased risk of accidental injury and infectious diseases, such as meningococcal disease (meningitis), influenza (including 2009 H1N1 flu), and other diseases spread easily from person to person.
Note: To limit the spread of 2009 H1N1 flu and to reduce the risk of flu exposure for people at increased risk of flu complications, Saudi Arabia recommends that pilgrims should be at least 12 years old and not over 65 years of age. Saudi Arabia also recommends that pilgrims refrain from performing the Hajj if they have chronic diseases such as heart, liver, or kidney diseases, complications of diabetes, obesity, or any other diseases or conditions that affect a person's overall health and immunity.
Vaccinations for pilgrims traveling from the United States to Saudi Arabia to perform Hajj:
Required for entry:
Meningococcal vaccine (quadrivalent) and seasonal influenza vaccine may also be required for a Hajj visa.
Recommended for travel:
Routine vaccinations (such as MMR, tetanus, diphtheria, pertussis) Influenza vaccine (seasonal flu vaccine), Influenza A (H1N1) 2009 monovalent vaccine (when available and traveler is at high risk for flu complications), Polio, Hepatitis A, Hepatitis B, and Typhoid
Vaccinations Required by Saudi Arabia
To protect the health and safety of pilgrims, the Saudi Ministry of Health has established the following health requirements for all visitors:
All pilgrims over 2 years old must get a vaccine to protect against meningococcal disease. This requirement means that you
Need to have had your vaccine no more than 3 years and no less than 10 days before you arrive in Saudi Arabia.
Must show proof of meningococcal vaccination on a valid certificate of vaccination (International Certificate of Vaccination or Prophylaxis) before you can enter the cities of Mecca and Medina to perform the Hajj. If you do not have this proof of vaccination, you may be denied entry.
All pilgrims will be screened for diseases that must be reported under the International Health Regulations, including dengue fever, meningococcal meningitis, and yellow fever. This year screening may include 2009 H1N1 flu.
CDC-Recommended Vaccinations
Quadrivalent (A/C/Y/W-135) Meningococcal Vaccine
In addition to the Saudi government requirement, CDC recommends quadrivalent meningococcal vaccine because of outbreaks of meningitis associated with the Hajj in 1987 and 2000. There are two types of quadrivalent meningococcal vaccine: meningococcal conjugate vaccine, which is recommended for people aged 2–55, and meningococcal polysaccharide vaccine, which is recommended for people over 55 but can be given to people aged 2–55.
Routine Vaccines
Before you leave for Saudi Arabia, make sure you are up to date on all routine vaccinations, which include polio, measles/mumps/rubella (MMR), tetanus, diphtheria, and pertussis. These vaccines are necessary to protect you from diseases that are still common in many parts of the world, even though they may rarely occur in the United States.
If you are traveling with a child, his or her routine schedule for immunizations may need to change to meet pre-travel recommendations.
Seasonal and 2009 H1N1 Influenza Vaccines
All travelers are urged to get a yearly flu vaccine to protect against seasonal influenza. Before you travel to Saudi Arabia to perform the Hajj, make sure you have been vaccinated against seasonal influenza at least 2 weeks before traveling.
In addition, the Saudi Ministry of Health recommends that pilgrims should be vaccinated with the 2009 H1N1 flu vaccine when it becomes available.
Other Recommended Vaccines for Saudi Arabia
Travelers to Saudi Arabia should consider some additional vaccinations. Hepatitis A and typhoid fever are diseases you can get through contaminated food and water. In addition to practicing safe food and water habits, you can also get vaccinated against these two diseases.
The prevalence of Hepatitis B is high in the Middle East, including Saudi Arabia. Travelers to this region are recommended to receive this vaccine, if they have not already completed the series.
Other Recommendations for Travelers
Tips to reduce the chances of illness and injury—
Prepare for your health before you leave.
Heat-related illness is a risk due to large crowds, high temperatures, and extensive walking. Children, the elderly, and those with certain health problems (such as cardiac disease) are at even higher risk.
Drink plenty of water to prevent dehydration.
Drink only beverages that have been bottled and sealed.
Avoid tap water, fountain drinks, and ice cubes. If this is not possible, learn how to make water safer to drink.
Wash your hands often with soap and water, especially after coughing or sneezing. If soap and water are not available, use an alcohol-based hand rub,* when your hands are not visibly dirty.
* If soap and water are not available and you do not have an alcohol-based product while you are traveling, other hand sanitizers that do not contain alcohol may be useful.
Avoid sharing sharp objects, such as razors, with others.
Wear sunscreen (at least SPF15) to prevent sunburn, and wear sunglasses with UV protection to protect your eyes.
Cover your head, when possible, to reduce heat exposure.
If you are not feeling well during your trip, you should get medical attention.
If you do not feel well after you return from your trip, you should get medical attention and mention that you have recently traveled.
What to do if you have symptoms of flu—
Symptoms of flu (including 2009 H1N1 flu) include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, and fatigue. Some people may also have vomiting and diarrhea. People may be infected with the flu and have respiratory symptoms without a fever.
If you become sick with symptoms of flu before or during travel:
Most people are expected to recover without needing medical care. If you have severe illness or you are at high risk for flu complications, seek medical care.
Avoid further travel for at least 24 hours after fever or fever-like symptoms are gone. Your fever should be gone without using a medicine that reduces fever.
Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
Wash your hands often with soap and water, especially after coughing or sneezing. If soap and water are not available, use an alcohol-based hand rub,* when your hands are not visibly dirty.
*If soap and water are not available and you do not have an alcohol-based product while you are traveling, other hand sanitizers that do not contain alcohol may be useful.
Avoid touching your eyes, nose, or mouth.
Follow all local health recommendations. For example, if you are sick, you may be asked to put on a surgical mask to protect others or to stay in your home or hotel to prevent the spread of 2009 H1N1 flu.
Safety Tips
Make a photocopy of your passport to carry with you at all times. Develop plans for where to meet if you become separated from your traveling companions.
A Note to Travelers
The information in this document is intended for U.S. travelers. If you are not traveling directly from the United States to Saudi Arabia, the requirements may be different. For example:
People entering Saudi Arabia for the Hajj who are coming from countries/areas where there is a risk of yellow fever transmission must show proof of yellow fever vaccination. This requirement does not apply for travelers coming from the United States, since there is no risk of yellow fever transmission in the United States.
Pilgrims under 15 years of age who enter Saudi Arabia from polio-affected countries are required to receive the oral polio vaccine before applying for an entry visa. The Saudi government will also give these travelers, regardless of their vaccination history, a dose of oral polio vaccine (OPV) when they arrive. While this requirement does not apply to pilgrims traveling from the United States, it is still a good idea to talk to your doctor and make sure that you have been fully vaccinated against polio. To learn more, see polio vaccination.
Copyright © 2009, Centers for Disease Control and Prevention