CDC has recently reported on 12 cases of invasive meningococcal disease, associated with travel to the UMRAH in Saudi Arabia.
Millions of pilgrims attend the Umrah and Hajj in Saudi Arabia each year. These are “mass gatherings” which have particular health concerns. Saudi Arabia requires all attendees to receive the meningococcal (ACYW) vaccination prior to travel.
According to the report more than 30 million people performed Umrah during Ramadan this year (2024). This is a huge increase on 2 years previously. More than 13 million attended from overseas. Two cases were initially identified in the United States and public health authorities were alerted in overseas jurisdictions. As of May 29, a total of 12 cases have been identified in the United States (5), France (4), and the UK (3). Nine of the cases were unvaccinated with the status of the other 3 unknown.
Large meningococcal outbreaks were associated with the Hajj and Umrah prior to 2000.
Since 2001, Saudi Arabia has required all pilgrims to show documentation on meningitis vaccination. Unfortunately, vaccination compliance has been shown to be less than 50%.
The meningitis ACYW conjugate vaccine provides excellent protection against invasive disease and should be given at least 10 days before arrival in country.
This vaccine is provided under the National Immunisation Program (NIP) and routinely given at 12 months of age. A dose is also being provided between years 10 and 12 at high school.
Did you know?
More than 90 cases of invasive meningococcal disease were reported after the 2000 Hajj pilgrimage. The cases were identified in nine countries and there were 14 deaths. The peak of the outbreak occurred 2 weeks after the return of the first pilgrims. Many of the subsequent cases were contacts of people who attended the Hajj.
The importance of vaccination cannot be understated. It is likely the immunization requirements instituted after the outbreak has made a large impact on the number of reported cases since.
