Hajj and Umrah: Vaccinations, Medications, and More
Hajj and Umrah Travel Advice for Pilgrims
Embarking on Hajj or Umrah is a momentous occasion for Muslims worldwide. Hajj and Umrah pilgrimages see a massive influx of pilgrims to Saudi Arabia, each year.
Hajj and Umrah, while incredibly rewarding experiences, can pose some health risks due to large crowds, hot weather, and physical exertion.
To ensure a healthy and fulfilling pilgrimage, proper health preparation is crucial. This includes being up-to-date on essential vaccinations and knowing what treatments might be necessary.
About Hajj
Thousands upon thousands of people make the yearly Hajj pilgrimage to Mecca during the eighth and thirteenth days of Dhu al-Hijjah, the 12th month of the Islamic calendar.
With around 3.7 million participants each year, the Hajj is one of the largest yearly pilgrimages in the world, culminating in the stunning and revered regions of Saudi Arabia's Makkah Province.
In a British diary, the date of Hajj is 11 days earlier every year due to the 11-day difference between the Islamic and Gregorian calendars, which is the calendar most widely used in western nations.
The Hajj fell in 2019 in the approximate period of August 9–14. The Hajj will take place in 2020 between July 28 and August 2.
Umrah
Umrah is a year-round pilgrimage to Mecca that is not restricted by the dates of Hajj. For Muslims, this is a highly recommended pilgrimage, though it is not required like Hajj.
There are two types of Umrah:
- Umrat al-tammatu: This is the Umrah taken alongside Hajj
- al-Umrat al mufradah: This is Umrah that is taken on its own, without Hajj
The Saudi Arabian government has specific requirements for individuals coming to the Kingdom for Hajj and Umrah.
Pre-pilgrimage Preparation
At least four to six weeks before their trip, pilgrims should consult their healthcare professional or travel clinic for pre-travel medical advice.
Hajj ceremonies are difficult to do and require walking long distances, frequently in hot weather. Before contemplating performing the Hajj or the Umrah, pilgrims are advised by MoH KSA to take into account their physical condition and capabilities.
Before departing, pilgrims should make sure they are in good physical shape. Those who have pre-existing medical conditions should consult their physician about whether or not to travel.
When there is a high risk assessment for the pilgrim, it may be appropriate in some circumstances to postpone the Hajj.
Travellers should make sure they have received any necessary or suitable vaccinations for their trip, in addition to all usual immunizations.
Large crowds have the potential to spread respiratory diseases more widely. Everyone should abide by the most recent UK guidelines in order to lower their risk of contracting respiratory diseases, such as COVID-19, and spreading it to other people.
Travelers who are more likely to contract the severe COVID-19 illness should evaluate their unique situation and decide whether to postpone their trip .
Women should talk to their healthcare professional well in advance of the Hajj if they would like to postpone menstruation in order to avoid having their periods during the pilgrimage.
Before departing on their journey, pilgrims should research the available medical facilities in their destination and make sure they have enough health insurance in case they become unwell. There is health insurance that complies with Sharia law.
In order to assist them in treating common ailments like cuts and scrapes, headaches, and traveller's diarrhoea, pilgrims should also bring a first aid kit.
Vaccinations
Pilgrims ought to be up to date on all vaccinations, such as the diphtheria-tetanus-polio vaccine and the measles, mumps, and rubella (MMR) shots that are regularly given in the United Kingdom (UK).
Required Vaccinations:
- Meningococcal Meningitis A, C, W, and Y (MenACWY): This vaccine guards against a serious bacterial infection affecting the membranes surrounding the brain and spinal cord.
- Saudi Arabia requires a Meningococcal Meningitis A, C, W and Y (MenACWY) vaccination certificate for all Hajj pilgrims over 2 years old.
- The certificate needs to be valid for at least 10 days before arrival and for 3 years after vaccination
Meningococcal disease is a serious illness caused by the bacteria Neisseria meningitidis, also known as meningococcus. It can infect the lining of the brain and spinal cord (meningitis) and the bloodstream (septicemia).
Key information about Meningococcal disease:
Transmission:
- Spread through respiratory and throat secretions (saliva or spit) during close contact, such as coughing, kissing, or sharing utensils.
- Not as contagious as the common cold or flu.
Symptoms:
Can develop rapidly, sometimes within hours.
Symptoms of meningitis may include:
- Severe headache
- Nausea and vomiting
- Sudden high fever
- Stiff neck
- Sensitivity to light
Septicemia
A serious condition that happens when the body’s immune system has an extreme response to an infection is called sepsis. Septicaemia is a condition where bacteria enter the bloodstream, causing blood poisoning, which then triggers sepsis.
Septicemia can cause:
- Fever
- Rash that doesn't fade when pressed (a hallmark sign)
- Cold hands and feet
- Rapid breathing
- Shock
Complications:
Meningococcal disease can be life-threatening if not treated promptly.
Serious complications include:
- Brain damage
- Hearing loss
- Learning disabilities
- Amputation (in severe cases of septicemia)
- Death
Prevention:
Vaccination is the most effective way to prevent meningococcal disease. Several vaccines targeting different strains of the bacteria are available.
Practising good hygiene, like frequent handwashing and avoiding close contact with sick individuals, can also help reduce the risk of infection. Consult your doctor to determine which vaccine is right for you based on your age, health, and travel plans.
Treatment:
- Early diagnosis and treatment with antibiotics are crucial.
Recommended Vaccinations:
Seasonal Influenza: Large gatherings like Hajj and Umrah can increase the risk of contracting influenza. Vaccination, especially for high-risk individuals like the elderly, those with chronic illnesses,
and pregnant women, is highly recommended. Ideally, get the influenza vaccine at least 2 weeks before your trip.
Seasonal influenza, often simply called the flu, is a respiratory illness caused by influenza viruses. It's a common infection that spreads rapidly, especially during the winter months in temperate climates.
However, outbreaks can occur year-round in tropical regions. Here's a closer look at seasonal influenza:
Transmission:
- The flu virus spreads through respiratory droplets expelled by coughing, sneezing, or talking.
- Indirect contact with contaminated surfaces can also transmit the virus if you then touch your eyes, nose, or mouth.
Symptoms:
Symptoms usually appear within 1-4 days of infection and can last for several days, even up to a week in some cases.
Common flu symptoms include:
- Fever or chills
- Cough (usually dry)
- Sore throat
- Runny or stuffy nose
- Muscle aches and body pains
- Headache
- Fatigue (feeling tired)
- Some people may also experience vomiting and diarrhea
Prevention:
Vaccination is the most effective way to prevent the flu and its complications. The influenza vaccine is reformulated each year to target the most prevalent strains. Ideally, get vaccinated at least 2 weeks before the start of flu season in your area.
Other preventive measures include:
- Frequent handwashing
- Avoiding close contact with sick people
- Covering your cough or sneeze with a tissue
- Disinfecting frequently touched surfaces
Treatment:
There is no specific cure for the flu, but antiviral medications can help shorten the duration and severity of symptoms if taken within 48 hours of illness onset.
Treatment generally focuses on relieving symptoms with:
- Over-the-counter pain relievers (like acetaminophen or ibuprofen)
- Enough rest
- Fluids to prevent dehydration
Seasonal Influenza and Hajj/Umrah
Due to large gatherings, pilgrims are at an increased risk of contracting influenza during Hajj and Umrah. Vaccination is highly recommended, especially for high-risk individuals.
Measles, Mumps, and Rubella (MMR): Staying current on MMR vaccination is vital, especially for adults who may not have received two doses in childhood.
Measles, Mumps, and Rubella (MMR) are three highly contagious viral infections that can cause significant health problems. Fortunately, these diseases are preventable with a safe and effective combination vaccine.
Measles:
Symptoms: Fever, cough, runny nose, red, watery eyes, a red, blotchy rash that starts on the face and spreads to the rest of the body.
Complications: Ear infection, pneumonia, diarrhea, encephalitis (brain swelling), death (in rare cases)
Mumps:
Symptoms:
Fever, headache, muscle aches, swelling of the salivary glands under the ears (parotid glands).
Complications: Deafness, meningitis (inflammation of the lining of the brain and spinal cord), orchitis (inflammation of the testicles in males), oophoritis (inflammation of the ovaries in females).
Rubella (German Measles):
Symptoms:
Mild fever, headache, swollen lymph nodes, a light pink or red rash that starts on the face and spreads to the rest of the body.
Complications:
In pregnant women, rubella infection can cause miscarriage, birth defects (known as Congenital Rubella Syndrome) in the baby, such as heart problems, blindness, and deafness.
Hajj and Umrah:
While not mandatory, getting the MMR vaccine is highly recommended for individuals travelling for Hajj or Umrah, especially if:
- You haven't received two doses of the MMR vaccine in childhood
- You are unsure of your vaccination history
- You are travelling with young children.
Diphtheria, Tetanus, and Polio (DTP):
Ensure you and your family are up-to-date on this routine vaccination for lifelong protection. Diphtheria, tetanus, and polio (DTP) are three serious infectious diseases preventable through a combined vaccination. Here's a breakdown of each disease and the importance of DTP vaccination:
Diphtheria:
- Caused by the bacterium Corynebacterium diphtheriae.
- Symptoms: Sore throat, fever, difficulty breathing, thick gray coating on the back of the throat (pseudomembrane), muscle weakness, paralysis (in severe cases).
- Complications: Heart failure, kidney failure, paralysis, death (especially in young children).
Tetanus (Lockjaw):
- Caused by the bacterium Clostridium tetani
- Tetanus spores live in soil and dust and enter the body through wounds.
- Symptoms: Painful muscle stiffness, especially in the jaw and neck (hence the nickname "lockjaw"), difficulty swallowing, seizures.
- Complications: Can be fatal if not treated promptly.
Polio:
- Caused by poliovirus
Symptoms: Fever, fatigue, headache, vomiting, muscle weakness or paralysis (in severe cases).
Complications: Paralysis (can be permanent), difficulty breathing, death (in rare cases).
COVID-19
Those who are invited to participate in the UK program and receive a COVID-19 vaccination should accept the invitation and make sure their immunisation is current. The NHS website has details about the COVID-19 vaccination program in the United Kingdom.
For anyone planning to perform or attend the Hajj or Umrah, the KSA Ministry of Health recommends the COVID-19 immunisation for those who are 12 years of age and older. However, only individuals who qualify for vaccination under the national program can currently get the COVID-19 vaccine in the UK.
Additionally, guests visiting Saudi Arabia must be ready to abide by any COVID-19 preventive measures that the Public Health Authority may impose locally. These measures may be implemented suddenly.
Treatments for Common Ailments
Diarrhoea:
Diarrhoea is a frequent travel complaint. Pack over-the-counter medications like loperamide (consult your doctor for appropriate dosage) and rehydration salts to combat mild cases.
Musculoskeletal Pain:
The physical demands of Hajj and Umrah can lead to muscle aches and pains. Over-the-counter pain relievers like acetaminophen or ibuprofen can help manage discomfort.
Minor Cuts and Scrapes:
A basic first-aid kit with bandages, antiseptic wipes, and pain relievers is advisable for minor injuries.
Periods during Hajj/Umrah:
By tracking your menstrual cycle properly, you can avoid it altogether during Hajj/Umrah or delay them. Period delay medications contain norethisterone, a synthetic form of progesterone.
These work by artificially keeping the body's progesterone levels higher for an extended length of time, delaying the onset of menstruation.
The thicker uterine lining can only last for a limited time, though. You can therefore only delay your period by about two weeks with these medications. Period delay tablets are available online at Ashcroft Pharmacy.
Malaria: Since the pilgrimage centres around Mecca and Medina, the malaria risk is generally low for most pilgrims. However, be mindful of your travel route to and from Saudi Arabia. If it includes areas with malaria risk, consult a travel clinic for antimalarial medication.
By prioritising vaccinations and taking preventative measures, you can significantly enhance your well-being and focus on the spiritual significance of your Hajj or Umrah experience. Remember, a healthy pilgrim is a happy pilgrim!
