Hajj and Umrah Pilgrimage
The Hajj is the largest annual pilgrimage in the world.
The pilgrimage occurs from the 8th-13th day of the 12th month in the Islamic calendar (Dhu al-Hijjah). The Islamic calendar is eleven days shorter than the Gregorian calendar used in the western world. The Gregorian date of the Hajj is eleven days earlier from year to year. In 2017, it is expected that Hajj will fall approximately between 30th August and 4th September.
The Umrah is a pilgrimage to Mecca that can be undertaken at any time of the year. Umrah is not considered as compulsory but it is highly recommended in Islam. There are two different types of Umrah.
Umrah can be combined with the Hajj (Umrat al-tammatu) or taken independently of the Hajj (al-Umrat al mufradah).
General Travel Advice
All pilgrims should aim to be fit for Hajj, the pilgrimage can be an arduous undertaking for even the fittest individual. Keeping active, improving mobility and exercising appropriately is recommended. Some travellers may benefit from a general health check-up with their GP prior to departure to optimise their health, particularly the elderly, those with underlying health problems or during pregnancy. Female pilgrims may wish to delay menstruation during Hajj and this should be discussed well in advance with the GP who may prescribe hormonal therapy.
Pilgrims taking regular medication should review their prescription with their GP and ensure that they have sufficient medicines to cover the trip. A letter from the GP with details of current medication may be useful for immigration purposes and all medicines should be kept in their original packaging and carried in the hand luggage with a printed copy of the prescription.
A personal medical/first aid kit is essential for pilgrims. It should include dressings, plasters, small bandages, antiseptic lotion/cream, adhesive tape, sun burn lotion, scissors, safety pins, antihistamine cream, blister dressings, rehydration salts, analgesics for pain and an antidiarrhoeal agent such as loperamide.
Saudi Arabia Hajj Regulations
The health requirements for pilgrimage to Mecca (Hajj and Umrah) are published by the Saudi Arabia Ministry of Health annually.
Saudi Arabia Ministry of Health Updated Advice (2017)
For Hajj 1438 (2017) the Saudi Arabia Ministry of Health recommends that the elderly (above 65 years of age), those with chronic diseases (e.g. heart disease, kidney disease, respiratory disease, diabetes), immune deficiency (congenital and acquired), malignancy, terminal illness, pregnant women and children (under 12 years) postpone the performance of the Hajj and Umrah for their own safety.
Hajj and Umrah Vaccination Requirements
Visitors from any country arriving for Hajj pilgrimage and Umrah, or for seasonal work, are required to produce a certificate of vaccination against meningococcal meningitis infection ACWY.
- Conjugate vaccine (Menveo/Nimenrix)- single dose to be given not more than 5 years and not less than 10 days prior to arrival in Saudi Arabia
- Polysaccharide vaccine (ACWY Vax) - single dose to be given not more than 3 years and no less than 10 days prior to arrival in Saudi Arabia
- All arrivals from countries within the African Meningitis Belt (Benin; Burkina Faso; Cameroon; Chad; Central African Republic; Cote d'Ivoire; Eritrea; Ethiopia; Gambia; Guinea; Guinea-Bissau; Mali; Niger; Nigeria; Senegal, Sudan and South Sudan) will also be administered antibiotic treatment at the point of entry as an added precaution.
In the UK, visas will not be issued unless proof of vaccination, at least 10 days prior to the expected date of entry, is submitted with the visa application.
Requirements from Countries other than the UK
The Saudi Arabia Ministry of Health has other vaccination requirements for Hajj pilgrims entering from countries other than the UK:
Yellow Fever - All travellers arriving from countries known to be infected with Yellow Fever (as per World Health Organisation) must present a valid yellow fever vaccination certificate.
Poliomyelitis – the Saudi Arabia Ministry of Health has announced that regardless of age and vaccination status, proof of receipt of a dose of oral or inactivated polio vaccine within the previous 12 months, and at least 4 weeks prior to departure, is required for visa purposes from travellers arriving from the following countries. These travellers will also receive 1 dose of oral polio vaccine at border points on arrival.
- countries within endemic polio (currently Afghanistan, Nigeria and Pakistan)
- countries with imported or circulating vaccine-derived cases of polio in the past 12 months
- countries which remain vulnerable to polio
Refer to individual fitfortravel country records for the most up-to-date polio affected countries.
Recommended Vaccines for Hajj and Umrah
All travellers should ensure that they are up-to-date with the recommended immunisations for life in the UK e.g. 5 doses of tetanus vaccine and five doses of polio vaccine. If it has been more than 10 years since the traveller's last dose of polio vaccine a booster dose should be given.
The Saudi Ministry of Health recommends seasonal influenza vaccine for Hajj attendees before arrival.
Measles and Rubella
With the recent resurgence of measles and rubella cases, special attention is needed for both of these diseases to avoid widespread outbreaks during this year's Hajj and Umrah. Check that you are immune, either from previous immunisation (2 doses of MMR) or natural measles infection.
- Other vaccine recommendations for Saudi Arabia are available on the country record.
Other Health Risks
There is no risk of malaria in the cities of Mecca or Medina and antimalarial prophylaxis is not advised while in either city.
The journey between the two cities passes through an area of high risk for malaria. The journey takes 6 hours by road. If it is undertaken during the daytime, in an air conditioned vehicle, the risk of malaria is very low and it is reasonable to practice bite avoidance only.
Note: Bite avoidance measures are important for the prevention of other mosquito-borne infections present in Saudi Arabia e.g. dengue fever.
Respiratory Infections and MERS CoV
Respiratory tract infections can spread easily in crowded areas. Middle East Respiratory Syndrome Coronavirus (MERS CoV) can cause fever, cough and breathing difficulties. The precise way it is spread in not fully known, but very close contact with cases and contact with dromedary camels are linked to infection.
The Saudi Arabia Ministry of Health advises pilgrims to comply with health guidelines to curb the spread of respiratory infections including MERS CoV, which can be summarized as follows:
- Wash hands with soap and water or disinfectant, especially after coughing and sneezing.
- Use disposable tissues when coughing or sneezing and dispose of them appropriately.
- Avoid hand contact with the eyes, nose and mouth.
- Avoid direct contact with infected persons or use of their personal gadgets.
- Avoid direct contact with animals, particularly camels and stay away from their gathering places.
- Avoid drinking camel milk unless it is pasteurized or boiled, camel urine or eating undercooked camel meat.
- If symptoms of fever, cold, flu-like illness or cough develop
- seek medical help early
- avoid crowded areas or wear facemasks if this is not possible.
- Maintain good personal hygiene.
Diarrhoeal disease is common during Hajj and all travellers are at risk. Diarrhoeal disease may be more severe in young children, the elderly and those with underlying health problem who may become rapidly and dangerously dehydrated.
Climate Related Health Risks
Even during the winter months temperatures during the day in Saudi Arabia can reach 30°C, sunburn, sunstroke, heat exhaustion, heat stroke and dehydration are a risk. Good quality footwear is essential as sand in the desert can get very hot. To ensure that shoes do not get lost when removed for prayer they should be kept in a small bag.
Ideally pilgrims should arrive in time to allow acclimatisation to the hot conditions before undertaking Hajj. Pilgrims should be advised to rest, maintain good hydration with safe liquids, seek shade where possible and use a sunscreen factor 15 or higher. Pilgrims can create shade by using an umbrella. Some rituals can be performed in the evening to avoid high daytime temperatures; Saudi authorities have decreed that pilgrims can perform the Stoning of the Devil anytime between sunrise and sunset.
Blood-borne Virus Transmission Associated with Shaving
At the end of Hajj, Muslim men shave their heads, and non-sterile blades can transmit blood-borne infections, such as hepatitis B, hepatitis C, and HIV. Only licensed barbers at officially designated centres should be visited. A disposable single-use blade or your personal razor should be used.
Accidents and Injuries
In the unique setting of Hajj pilgrimage it is unsurprising that accidents and injuries occur. The Saudi Arabia government has made improvements to ensure the safety of pilgrims.
Traffic vehicle accidents are a potential hazard as pilgrims may walk long distances through or close to dense traffic and busy roads. Minor injuries to the feet are common. Pilgrims with diabetes or poor circulation to the lower limbs must take particular care and wear appropriate footwear.
It is strongly recommended that all pilgrims obtain comprehensive travel and medical insurance (including repatriation) before travel.
Resources and Information
The posters and leaflet in this section have been produced by Health Protection Scotland (HPS) have been designed to help protect Hajj pilgrims, their family and the wider community from travel associated infections.
The infographic poster below recommends that Hajj pilgrims prepare themselves for travel by visiting their GP 6-8 weeks before departure. It is available in English, Urdu and Punjabi.
The leaflet below has been designed to to raise awareness of MERS–CoV. It is available in English, Urdu and Punjabi.
The poster below may be displayed in GP surgeries, mosques, social clubs and other venues where they may be seen by those planning to go to Hajj or Umrah. It is designed to be used in conjunction with the MERS CoV Hajj Leaflet (above). It is available in English, Urdu and Punjabi.
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