MECCA, Saudi Arabia — The recent outbreak of the deadly and untreatable Middle East Respiratory Syndrome (MERS) has diminished, but the upcoming Hajj pilgrimage to Saudi Arabia poses a major risk of revitalizing the disease.
The World Health Organization (WHO) has thus far reported over 800 MERS-infected patients, mostly in Saudi Arabia and neighboring countries, and at least 315 deaths worldwide. And although there is no longer evidence of human-to-human transmission in communities, the WHO has expressed concern about the conditions and health risks of the Hajj.
In October, more than 3 million Muslims will travel to Mecca for the annual religious pilgrimage, which all able Muslims are encouraged to perform at least once during their lifetime. The mass migration during such a religious event exposes pilgrims to numerous health hazards.
Extreme overcrowding of people and vehicles increases the risk of transmission of infectious diseases. And with ever-rising global travel, it is becoming increasingly difficult to prevent the spread of diseases across borders, continents and oceans.
There have been significant efforts taken by health officials in Saudi Arabia, as well as other countries with reported MERS cases, to improve disease prevention and control during the Hajj. The U.N. facilitated a teleconference of health officials from Algeria, Iran, Jordan, the Netherlands, Saudi Arabia, the United Arab Emirates and the United States. Bangladesh has even made wearing masks mandatory for its Muslim citizens.
The WHO also provided a list of recommended precautions for all pilgrims. Safety measures include getting vaccinated against common diseases, washing hands, focusing on personal hygiene and possibly postponing or avoiding the Hajj if one has pre-existing major medical conditions. Pilgrims are also encouraged to cover their mouth and nose when coughing or sneezing, and to keep a distance of at least one meter from anyone with fever or breathing issues. A last recommendation is to avoid crowds other than mandatory Hajj gatherings or rituals.
According to a preliminary investigation by the WHO, MERS in humans has likely been caused by close contact with camels. Infected camels may be asymptomatic and have the potential to spread MERS through “nasal and eye discharge, feces, [organs and meat]and . . . their milk and urine.”
This poses a problem for Muslims on the Hajj, who must slaughter a sheep or camel for ritual purposes.
For those in close contact with camels, the WHO suggests avoiding visibly sick animals, washing hands and only consuming cooked meat and pasteurized milk.
Although the current concern about MERS is justified, the guidelines provided for pilgrims by the WHO has the capability to drastically reduce the spread of the virus. Awareness about MERS can also provide a gateway for a broader discussion about other health implications of the Hajj — or of any mass gathering of people with inadequate organization, infrastructure or provision of health care. Common risks include mass stampedes, fires and outbreaks of diseases such as malaria and tuberculosis. The conversations about health generated by MERS has the potential to diminish these other risks alongside of it.
– Mari LeGagnoux