Health Requirements for Travellers to Saudi Arabia for Pilgrimage to Makkah (2016/1437H Hajj)
The Ministry of Health (MOH) of Saudi Arabia has issued the following requirements and recommendations to obtain entry visas for 2016/1437H-Hajj and Umrah seasons:
I- Yellow fever
A) In accordance with the International Health Regulations 2005, all travellers arriving from countries or areas at risk of yellow fever transmission (see list below) must present a valid yellow fever vaccination certificate. The life-long certificate of yellow fever vaccination is valid for the life of the vaccinated person, starting from 10 days after the vaccination date .
In the absence of such a certificate, the individual will be placed under strict surveillance until the certificate become valid or until a period of not more than 6 days from the last date of potential exposure to infection have lapsed, whichever is earlier. Health offices at entry points will be responsible for notifying the appropriate Director General of Health Affairs in the region or governorate about the temporary place of residence of the visitor.
The following countries/areas are at risk of yellow fever transmission (as defined by the International travel and health 2016).
Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo, Côte d’Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, Sudan, The Republic of South Soudan, Togo and Uganda.
Argentina, Bolivarian Republic of Venezuela, Brazil, Colombia, Ecuador, French Guyana, Guyana, Panama, Paraguay, Peru, Plurinational State of Bolivia, Suriname and Trinidad and Tobago.
In accordance with the International Health Regulations 2005, all arriving ships will be requested to provide to the competent authority a valid Ship Sanitation Certificate. Ships arriving from areas at risk for yellow fever transmission may also be required to submit to inspection to ensure they are free of yellow fever vectors, or disinfected, as a condition of granting free pratique (including permission to enter a port, to embark or disembark and to discharge or load cargo or stores).
II- Meningococcal meningitis
Visitors arriving for the purpose of Umrah or pilgrimage (Hajj) or for seasonal work are required to submit a certificate of vaccination with the tetravalent (ACYW135) vaccine against meningitis, proving the vaccine was administered no less than 10 days before arrival in Saudi Arabia. Both polysaccharide and conjugate vaccines are valid options*; the first one confers a protection of at least three years and the latter at least eight years. The vaccine should have been administered not more than 3 and 8 years respectively, prior to entry into the country. The responsible authorities in the visitor’s country of origin should ensure that adults and children aged over 2 years are given 1 dose of the tetravalent ACYW135 vaccine and state clearly the name of the vaccine used on the vaccination card.
Please note that the conjugate meningococcal vaccine certificate is valid for 8 years. However, the certificate must state clearly that the Hajji actually received the conjugate meningococcal vaccine. If the vaccine type it not indicated in the certificate, then it will be assumed that it is not the conjugate vaccine and it the validity of the certificate will to be for 3 years
For visitors arriving from countries in the African meningitis belt: Benin, Burkina Faso, Cameroon, Chad, Central African Republic, Côte d’Ivoire, Eritrea, Ethiopia, Gambia, Guinea, Guinea-Bissau, Mali, Niger, Nigeria, Senegal, Sudan and South Sudan. The above stated requirements apply. In addition one tablet (500mg) of ciprofloxacin chemoprophylaxis will be administered to adults (excluding pregnant women) and children over 12 years of age at port of entry to lower the rate of carriers.
Vaccination with tetravalent (ACYW135) vaccine is required for:
All citizens and residents of Medina and Mecca who have not been vaccinated during the past 3 years with a polysaccharide vaccine or 8 years with a conjugate vaccine;
All citizens and residents undertaking the Hajj who have not been vaccinated during the past 3 years with a polysaccharide vaccine or 8 years with a conjugate vaccine;
All Hajj workers , including individuals working at entry points or in direct contact with pilgrims, who have not been vaccinated in the past 3 years with a polysaccharide vaccine or 8 years with a conjugate vaccine.
Regardless of age and vaccination status, proof of receipt of a dose of oral polio vaccine (OPV), or inactivated poliovirus vaccine (IPV), within the previous 12 months and at least 4 weeks prior to departure, is required to apply for an entry visa for Saudi Arabia for travellers arriving from the following countries, territories or areas (as of 1 July 2016):
- A) those who have uninterrupted indigenous virus transmission: Afghanistan and Pakistan (as of 1 July 2016);
- B) those which have had transmission of a circulating vaccine-derived poliovirus within the past 12 months: Guinea, Laos People’s Democratic Republic, Madagascar, Myanmar, Nigeria, and Ukraine;
- C) those which remain vulnerable to polio: Iraq, Somalia, Syrian Arab Republic and Yemen.
All travellers from these countries will also receive 1 dose of OPV at border points on arrival in Saudi Arabia.
Saudi Arabia encourages vaccination of travelers from polio-free countries which remain at particular risk of importations (e.g. India, Indonesia).
IV- Seasonal influenza
The Ministry of Health of Saudi Arabia recommends that international pilgrims be vaccinated against seasonal influenza with most recently available vaccines (i.e. those for Southern Hemisphere 2016) prior to arrival, particularly those at increased risk of severe influenza diseases including pregnant women, children aged over 5 years, the elderly, and individuals with pre-existing health conditions such as asthma, chronic heart or lung diseases and HIV/AIDS infection.
In Saudi Arabia, seasonal influenza vaccination is recommended for internal pilgrims, particularly those with pre-existing health conditions as described above, as well as for all health-care workers in the Hajj premises.
V- Zika virus disease and Dengue
The Aedes aegypti mosquito has not been detected in the Hajj and Umrah areas for many years, however this mosquito is present in surrounding cities. The Ministry of Heath recommends travellers for Hajj and Umrah to take insect bite avoidance measures during daytime and night time hours to reduce the risk of infection.
For travellers arriving from areas with Zika virus transmission, it is recommended to follow WHO advice.
Aircrafts, ships and other means of transportation coming from countries affected by Zika virus are requested to submit a certificate indicating that it applied disinsection in accordance with methods recommended by WHO.
Countries and Territories with Active Zika Virus Transmission:
Barbados, Guadeloupe, Paraguay, Bolivia, Guatemala, Puerto Rico, Brazil, Guyana, Saint Martin, Colombia, Haiti, Suriname, Dominican Republic, Honduras, U.S. Virgin Islands, Ecuador, Martinique, Venezuela, El Salvador, Mexico, Jamaica, French Guiana, Panama, Costa Rica, Nicaragua, Curacao , Aruba, Bonaire, Trinidad and Tobago, Saint Vincent and the Grenadines, Cuba, Dominica, Sint Maarten, Saint Lucia, Belize, Peru, Grinada, Saint Vincent and the Grenadines, Argentina, Anguilla.
Samoa, American Samoa, Tonga, Solomon Island, Vanuatu, Marshall Islands, Lao People’s Democratic Republic (Laos), Malaysia, Philippines, Papua, New Guinea, Fiji.
Cape Verde, Gabon
Maldives, Thailand, Bangladesh, Indonesia
VI- Health education
Health authorities in countries of origin are required to provide information to pilgrims on infectious diseases symptoms, methods of transmission, complications, and means of prevention as well as on changes in temperature that may have adverse effects on health. Hajj and Umrah performers need to be reminded to drink enough fluid to be able to maintain usual urine production and that older travellers should take particular care to consume extra fluids in hot conditions. Also, consumption of salt-containing food and drink (unless this is contraindicated for the individual) that helps to replenish the electrolytes should be recommended in case of heat exhaustion and after excessive sweating.
Countries and individuals are encouraged to consider the physical ability and health conditions of individuals applying for Hajj and Umrah. Those with sever medical conditions like terminal cancers, advanced cardiac or respiratory, liver or kidney diseases and senility should be exempted from these religious duties.
VII- Food Items
Hajj and Umrah performers are not allowed to bring fresh food in Saudi Arabia. Only properly canned or sealed food or food stored in containers with easy access for inspection is allowed in small quantities, sufficient for one person for the duration of his or her trip.
VIII- International outbreaks response
The Saudi Ministry of Health recommends that people aged over 65 years and those with chronic diseases (e.g. heart disease, kidney disease, respiratory disease, diabetes) and pilgrims with immune deficiency (congenital and acquired), malignancy and terminal illnesses, pregnant women and children aged under 12 years planning to come for Hajj and Umrah this year, to postpone the performance of the Hajj and Umrah for their own safety.
The Saudi Ministry of Health also advises all pilgrims to comply with common public health recommendations to prevent the spread of respiratory infectious disease, such as the following:
- Washing hands with soap and water or disinfectant, especially after coughing and sneezing, after using toilets, before handling and consuming food, after touching animals;
- Using disposable tissues when coughing or sneezing and dispose of it in the waste basket;
- Trying as much as possible to avoid hand contact with the eyes, nose and mouth;
- Wearing masks, especially when in crowded places;
- Avoiding direct contact with the persons who appear ill with cough, sneeze, expectoration, vomiting, diarrhea and not sharing their personal belongings; and maintaining good personal hygiene;
- Avoiding close contact with animals, particularly camels, when visiting farms, markets, or barn areas
- Avoiding contact with sick animals;
- Avoiding drinking raw camel milk or camel urine or eating meat that has not been properly cooked.
Updating immunization against vaccine-preventable diseases in all travellers is strongly recommended. Preparation for international travel provides opportunity to review the immunization status of travellers. Incompletely immunized travellers can be offered routine vaccinations recommended in national immunization schedules (these usually include diphtheria, tetanus, pertussis, polio, measles and mumps), in addition to those needed for the specific travel (e.g. meningococcal vaccination for Hajj).
In the event of a public health emergency of international health concern, or in the case of any disease outbreak subject to notification under the International Health Regulations 2005, the health authorities in Saudi Arabia will undertake additional preventive precautions (not included in the measures mentioned above) following consultation with WHO and necessary to avoid the spread of infection during the pilgrimage or on return to their country of origin.