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Expected immunizations and health protection for Hajj and Umrah 2018 —An overview

TLDR
The expected obligations for immunizations for the 2018 Hajj and Umrah are reviewed and it is recommended that all pilgrims have an updated immunization against vaccine-preventable diseases (diphtheria, tetanus, pertussis, polio, measles and mumps).
Abstract
Background The annual Hajj and Umrah are one of the largest recurring religious mass gatherings across the globe drawing pilgrims from more than 185 countries. The living circumstances and activities of the pilgrims may create an environment for the occurrence and spread of communicable diseases. Each year, the Health authority of the Kingdom of Saudi Arabia, in coordination with international health authorities, updates health requirements for pilgrims. The Hajj for 2017 took place from August 24 to September 5, 2017. Here, we review the expected obligations for immunizations for the 2018 Hajj and Umrah. Results The Hajj and Umrah vaccine requirements include mandatory vaccinations against yellow fever, quadrivalent meningococcal polysaccharide (every 3 years) or conjugated (every 5 years) vaccines and poliomyelitis vaccine. Influenza vaccine utilizing the 2016 (Southern Hemisphere vaccine to all pilgrims) was recommended but was not obligatory for pilgrims. Ciprofloxacin is required for individuals >12 years excluding pregnant women as chemoprophylaxis to be given at the port of entry for Pilgrims coming from the meningitis belt. With the ongoing outbreaks of measles in Europe, it is recommended that all pilgrims have an updated immunization against vaccine-preventable diseases (diphtheria, tetanus, pertussis, polio, measles and mumps). Conclusion The mandatory vaccines remain the same with continued vigilance for the development of any new or emerging infectious diseases. Continuing surveillance for Zika virus, cholera and MERS-CoV are ongoing.

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Citations
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Infectious Diseases and Mass Gatherings

TL;DR: Findings in the field of infectious diseases with a variety of pathogens associated with international MGs in the last 5 years are summarized.
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A systematic review of emerging respiratory viruses at the Hajj and possible coinfection with Streptococcus pneumoniae

TL;DR: In this article, the authors searched MEDLINE/PubMed and Scopus databases for relevant papers describing the prevalence of respiratory viruses among Hajj pilgrims, and retrieved articles were summarized based on the methodology of testing for these viruses.
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Review of seasonal influenza vaccination in the Eastern Mediterranean Region: Policies, use and barriers.

TL;DR: An extensive review of literature published between 2006 and 2016 in the Eastern Mediterranean Region on influenza vaccine policies, use, recommendations and coverage revealed knowledge gaps and misconceptions about influenza and its vaccines even among healthcare workers.

Clinical respiratory infections and pneumonia during the Hajj pilgrimage: A systematic review

TL;DR: Evaluated papers evaluated the prevalence of clinical symptoms of respiratory infections, including pneumonia, among Hajj pilgrims, as well as their influenza and pneumococcal vaccination status, finding the definition of ILI was inconsistent across studies.
References
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Global epidemiology of meningococcal disease.

TL;DR: Although this review summarizes the current status of meningococcal disease epidemiology, the dynamic nature of this disease requires ongoing surveillance both to provide data for vaccine formulation and vaccine policy and to monitor the impact of vaccines following introduction.
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Health risks at the Hajj

TL;DR: The response of clinicians, the Saudi Ministry of Health, and Hajj authorities to these unique problems are examined, and health recommendations for prospective pilgrims are listed.