Hajj and Umrah, 2013

The annual Hajj pilgrimage to Mecca, Saudi Arabia, is among the largest mass gatherings in the world. This year, it will take place from approximately October 13 to 18. Hajj draws about 3 million Muslims from around the world, and more than 11,000 Americans make the pilgrimage each year. Umrah is a similar pilgrimage that can be undertaken at any time of the year, but it is likely to be more crowded during the month of Ramadan (approximately July 9 to August 7, 2013) than at other times of the year. Because of the crowds, mass gatherings such as Hajj and Umrah are associated with unique health risks.
This year the Embassy of Saudi Arabia

recommends that the following groups should postpone their plans for Hajj and Umrah: the elderly, the terminally ill, pregnant women, and children.

Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

MERS-CoV (formerly called "novel coronavirus") has caused respiratory illness in a number of people in the Middle East, including Saudi Arabia. Most people infected with MERS-CoV had severe illness and pneumonia, and about half of them have died. The virus can spread from person to person through close contact, so pilgrims living and traveling in close quarters may be at risk.
Minarets

Pilgrims can help protect themselves from respiratory illnesses by washing their hands often; not touching their mouth, nose, or eyes; and avoiding contact with sick people. They should pay attention to their health when traveling in the Arabian Peninsula and seek medical care if they develop a fever and cough or shortness of breath within 14 days after returning from their trip.
At this time, CDC does not recommend changing travel plans for Hajj or Umrah because of MERS. To learn more about CDC's travel recommendations for MERS, please see the travel health notice, A Novel Coronavirus Called "MERS-CoV" in the Arabian Peninsula.

Other Diseases

Because they bring together large numbers of people from all around the world, mass gatherings such as Hajj and Umrah can increase the risk for infectious diseases. Outbreaks of meningococcal disease used to be a problem, so the Saudi Ministry of Health requires all pilgrims to receive the meningococcal vaccine, and neither Hajj nor Umrah visas can be issued without proof of vaccination. Polio vaccine is not required for pilgrims from the United States, but it's best to receive an adult booster before travel. CDC also recommends vaccination against hepatitis A and B and typhoid for travel to Saudi Arabia, and all travelers, regardless of destination, should be up-to-date on routine vaccines (such as measles and pertussis) and should receive an annual flu shot.
Since not all infectious diseases can be prevented by vaccines, pilgrims should practice good hygiene and avoid contact with animals. Diarrhea is common during Hajj and Umrah, so eat only food that is cooked and served hot and drink only beverages from sealed containers. Men are required to shave their heads after Hajj (many men shave their heads after Umrah as well), and unclean blades can transmit disease. Male pilgrims should go to officially designated centers to be shaved, where barbers are licensed and use disposable, single-use blades.

Injuries

Being caught in a human stampede is a major fear of many people attending a mass gathering. Stampedes at previous Hajj events have injured or killed hundreds, most recently in 2006. However, the Saudi government has spent more than $25 billion to help thin crowds and minimize this risk. To further protect yourself, try to avoid the most densely congested areas and always be aware of the location of emergency exits. Saudi religious authorities have also expanded the times when certain rituals can be performed, and pilgrims can expect fewer crowds if they perform these rituals during nonpeak hours.

Heat-Related Illnesses

Temperatures in Mecca can easily exceed 100°F in the summer and early fall. Heat exhaustion and heatstroke are leading causes of illness in people undertaking Hajj or Umrah during these months. Pilgrims should drink plenty of water (bottled), wear sunscreen, rest, and seek shade as much as possible. Pilgrims who are fasting for Ramadan and cannot drink water during daylight hours should be sure to rehydrate after dusk. Some rituals can be performed at night to avoid daytime heat. Symptoms of heat-related illness can include profuse sweating, chills, headache, dizziness or confusion, and nausea. Travelers who develop these symptoms should move to a cool area and seek medical care.