Even before MERS emerged in 2012, and the Ebola outbreak began to sweep across Guinea, Liberia and Sierra Leone this summer, preparing for the public health needs during the annual Hajj in Saudi Arabia was a big job.
More than two million pilgrims – many of an advanced age and coming from regions of the world with relatively poor health care – make the journey each year and Saudi Arabia spends millions preparing to deal with their health issues.
The logistics of providing free medical care for several million pilgrims during the Hajj is a daunting one, and in MERS, Mass Gatherings & Public Health, we looked at some of the immense challenges that Saudi Arabia faces every year with the Hajj.
Prof Ziad A Memish MD , Gwen M Stephens MD, Prof Robert Steffen MD , Qanta A Ahmed MD
Within the immediate vicinity of the Hajj, there are 141 primary health-care centres and 24 hospitals with a total capacity of 4964 beds including 547 beds for critical care. The latest emergency management medical systems were installed in 136 health-care centres and staffed with 17 609 specialised personnel. More than 15 000 doctors and nurses provide services, all at no charge.
This confluence of millions of people into a confined space, coming from all over the world, provides a perfect `mixing bowl’ for viruses and bacteria, and has the real potential to seed them to new regions of the globe when the pilgrims leave.
Last month, in EID Journal: Respiratory Viruses & Bacteria Among Pilgrims During The 2013 Hajj, we looked at the extraordinarily high percentage of Hajjis (approx. 80%) who either acquire or leave with some type of respiratory infection while doing this pilgrimage.
The vast majority of these respiratory infections were due to either rhinoviruses or influenza, with a smaller number of cases of pneumonia.
One of the concerns has been that it is pretty much impossible to differentiate between an early or mild MERS-CoV infection – and a more common viral illness like influenza - without doing one (or more) lab tests.
With the Hajj set for early October – a time of year when respiratory viruses are often on the rise, anyway – this will present some major public health challenges both in Saudi Arabia, and in those countries to where these travelers will return when the Hajj is over.
This year, added to the usual concerns, and the emerging threat of MERS, the Gulf States must also decide how best to protect against the Ebola virus.
While it was announced late last week that Saudi Arabia Bans Sierra Leone, Guinea, Liberia Muslims From performing Hajj, Nigeria - which has reported 12 cases thus far - remains a question mark.
And there are concerns that other nations – particularly those bordering the affected countries – could potentially provide a conduit for the virus to make it to Saudi Arabia.
While we don’t have much in the way of details, today AFP is reporting:
Published: 13/08/2014 06:49 PM
RIYADH - Representatives of the Gulf monarchies met in Riyadh on Wednesday to discuss precautions against the Ebola epidemic ahead of the annual hajj pilgrimage to Mecca in early October.
The executive bureau of the Gulf Cooperation Council's committee of health ministers met in the light of "preventive measures taken by some countries to protect against the Ebola virus... and the approach of the hajj," bureau director Taufik Khoja said.
Each year the challenges surrounding these mass gatherings seem to grow, as do the number of emerging infectious diseases they must deal with. While the odds of Ebola showing up in Mecca during the Hajj this fall is probably small , it is a classic Low Risk – High Impact scenario, and must be planned for.
The good news is that despite concerns to the contrary – due to abundant good public health planning and perhaps a bit of luck – we’ve seen venues like last year’s Hajj, the FIFA World Cup in Brazil, the 2012 London Olympics, and the UEFA EURO 2012 football championship come off without any serious public health incidents (see How The ECDC Will Spend Your Summer Vacation).
The goal is making sure that that lucky streak remains intact.