Approximately 20,000 people from the U.K. will travel to the Kingdom of Saudi Arabia for
Hajj in October 2013. Many more go for Umrah throughout the year. While most will travel
and return safely, Hajj may increase the risk of certain health problems; the Hajj cough, for
example, is well-known.

Each year the Ministry of Health in the Kingdom of Saudi Arabia issues health instructions for
the coming Hajj. This year the Ministry of Health in the Kingdom of Saudi Arabia has issued
additional advice aimed at reducing the risk of a recently discovered virus called Middle Eastern
Respiratory Syndrome Coronavirus or MERS-CoV.

What is MERS-CoV?

MERS-CoV is a virus which was first seen in Jordan in 2012. Most cases have been diagnosed
in the Middle East, principally the Kingdom of Saudi Arabia. The disease mainly affects the
respiratory system and can cause serious illness and death, particularly in those with health
problems before becoming infected. Some people have had MERS-CoV without any symptoms.

How do I know if I have MERS-CoV?

Most respiratory symptoms you may get during or after Hajj will not be serious – colds and
‘Hajj cough’ are common.
MERS-CoV usually causes an illness similar to flu or pneumonia but some people with the
infection have had been very unwell with fever and diarrhoea but have had no cough or
shortness of breath. Therefore if you have fever with respiratory symptoms (for example,
cough, shortness of breath, chest pain) or any other severe symptoms, either during or on
return from Hajj, you should contact a doctor as soon as possible.

Preparing to go for Hajj:

Certain people may be more vulnerable to respiratory illness or more likely to become
seriously ill if they become infected with MERS-CoV. These individuals should seriously
consider postponing Hajj this year.

The Saudi Arabia Ministry of Health strongly recommends that the following people postpone their Hajj and Umrah in 2013 for their own safety:

• the elderly (above 65 years of age)
• those with chronic diseases (e.g. heart disease, kidney disease, respiratory disease, diabetes)
• immune deficiency (congenital and acquired)
• malignancy
• terminal illnesses
• pregnant women
• children (under 12 years)

If you are planning to go to Hajj this year and you have any medical problems, see your GP
before you go to make sure you have had all the correct vaccinations and know how to
manage your health problems while you are travelling.
Pack tissues, hand cleansing gel and a supply of facemasks in your luggage.

At Hajj

The Ministry of Health in the Kingdom of Saudi Arabia has provided pilgrims with the following
health advice to reduce the spread of respiratory infections:

• Wash hands with soap and water or disinfectant, especially after coughing and sneezing.
• Use disposable tissues when coughing or sneezing and dispose of them appropriately.
• Avoid hand contact with the eyes, nose and mouth.
• Avoid direct contact with those showing symptoms of respiratory or other infections.
• Wear facemasks, especially when in crowded places.
• Replace the facemask with a new one according to the manufacturer’s instructions.
• Maintain good personal hygiene

If you become ill while performing Hajj, seek medical help early.

On your return

If you are unwell, especially if you have a fever and respiratory symptoms on your return from
Hajj, you should contact your GP as soon as possible. MERS-CoV is a rare disease and it is
likely that any symptoms you have will be caused by other bacteria or viruses, but to minimise
the risk of serious illness and to protect your family, you should discuss this with your GP.

The following websites provide further advice on health issues and the Hajj:

•  Kingdom of Saudi Arabia Ministry of Health: http://www.moh.gov.sa
• The Council of British Hajjis: https://cbhuk.org
• FitforTravel: http://www.fitfortravel.nhs.uk

© TRAVAX/Health Protection Scotland 2013

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