Abstract
The Hajj is the largest annual mass gathering on Earth. Respiratory infections are one of the leading causes of disease and hospitalisation during the pilgrimage, with pneumonia and influenza most common among these infections despite the availability of prophylactic vaccines. In fact, immunisation against influenza and pneumococcal disease is currently not a requirement for South African pilgrims entering Saudi Arabia. This review examines the burden of respiratory infections during the Hajj, particularly pneumonia and influenza, with a focus on pilgrims from South Africa. Although the number of South African pilgrims attending the Hajj has been capped at 2 000 since 2013, 30 000 South Africans perform the minor Umrah pilgrimage annually. Understanding the aetiology of disease in this group could have implications for medical resourcing during the Hajj.
Highlights
The Hajj is a compulsory five-day pilgrimage to Makkah, Saudi Arabia, that is undertaken by all able-bodied Muslims with financial means.[1,2] Whereas pilgrims typically visit both Makkah and Madinah, by strict definition only travel to Makkah is classified as the Hajj
In 2006, the South African Hajj quota was fixed at 5 000 pilgrims[3]; by 2013 this number had been reduced to 2 000.10 Quotas were expected to increase after renovation of the Holy Mosque.[11]
Among the 2 000 South African pilgrims attending the 2014 Hajj, there were 3 780 medical consultations logged by the South African Hajj and Umrah Council (SAHUC) clinics located in Makkah, Azizia, Madinah and Meena/Arafat (Table 1)
Summary
The Hajj is the largest annual mass gathering on Earth. Respiratory infections are one of the leading causes of disease and hospitalisation during the pilgrimage, with pneumonia and influenza most common among these infections despite the availability of prophylactic vaccines. Immunisation against influenza and pneumococcal disease is currently not a requirement for South African pilgrims entering Saudi Arabia. This review examines the burden of respiratory infections during the Hajj, pneumonia and influenza, with a focus on pilgrims from South Africa. The number of South African pilgrims attending the Hajj has been capped at 2 000 since 2013, > 30 000 South Africans perform the minor Umrah pilgrimage annually.
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