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Reuters/Amr Dalsh
Muslim pilgrims circle the Kaaba at the annual Hajj.

One of the world’s largest gatherings is a hotspot for deadly outbreaks

The annual Hajj—the Islamic pilgrimage to Mecca, Saudi Arabia—is known to be one of the world’s largest gatherings, drawing approximately three million Muslims globally into the journey to the Grand Mosque and Masjid al-Haram, which houses the Kaaba, the holiest site in Islam. The pilgrimage occurs from the 8th to the 12th day of the last month in the Islamic calendar; this year it’s likely to fall between October 2nd and 7th.

As one of the five pillars of Islam, Hajj is a duty for every able-bodied Muslim. But this year’s Ebola and Middle East respiratory syndrome coronavirus outbreaks could hold back the dutiful, especially when Saudi Arabian and world authorities are cracking down on infected regions.

The Saudi Arabian health ministry banned Hajj visas from Liberia, New Guinea, and Sierra Leone last month. The three countries are the hardest hit with Ebola, with roughly 5,800 cases and at least 2,909 people dead. Nigeria, home to around 20 reported cases, was not included in the ban, but the density of its capital is a worry for health officials.

Nigeria has one of the highest concentrations of Hajj pilgrims in the world. As such, World Health Organization officials are conducting health screenings of pilgrims at Murtala Muhammed International Airport in Lagos and the King Abdulaziz International Airport airport near Mecca. The screenings involve taking travelers’ body temperatures, and taking note of their travel history and contact information.

In addition to the Ebola threat, pilgrims face the threat of MERS, a viral respiratory illness hitting Saudi Arabia with a death toll of about 317 in the region. Other infected countries include Jordan, the United Arab Emirates, Qatar, France, Germany, the United Kingdom, Italy, and Tunisia.

Health organizations including the WHO and the Centers for Disease Control and Prevention have suggested those from infected regions reconsider their travel plans, especially those with weakened immune systems or respiratory problems. They also have some guidelines for basic hygiene and avoiding contact with camels, believed to be hosting MERS. Morocco’s health minister has urged residents to abstain from the trip this year, for fear of introducing MERS to the country.

The concern is justified. The density of bodies at Hajj creates a breeding ground for illness. A meningitis outbreak followed the Hajj in 1987, and as a result, is now a required vaccination for the visa (along with vaccines for tuberculosis, polio, influenza and yellow fever). One study calculated the meningitis carriage rate at Hajj to be as high as 80%. A cholera strain was discovered in pilgrims upon their return Egypt from Hajj in 1905, leading to the deaths of thousands of pilgrims and residents.

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