CDC issues travel notice for Hajj pilgrimage due to meningococcal disease
Earlier this week, the Centers for Disease Control and Prevention (CDC) issued a travel notice for pilgrims for the Hajj, or pilgrimage to Mecca, Saudi Arabia due to recent cases of meningococcal disease linked to Umrah travel to the Kingdom of Saudi Arabia (KSA).
Since April 2024, 12 cases of meningococcal disease linked to KSA travel for Umrah have been reported to national public health agencies in the United States (5 cases), France (4 cases), and the United Kingdom (3 cases).
Ten cases were in patients who traveled to KSA, and two were in patients who had close contact with travelers to KSA. Ten cases were caused by Neisseria meningitidis serogroup W (NmW), one U.S. case was caused by serogroup C (NmC), and the serogroup is unknown for one U.S. case.
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Of nine patients with known vaccination status, all were unvaccinated.
In 2024, Hajj will take place during June 14–19th.
CDC says mass gatherings, such as Hajj or Umrah, can increase the risk for infections such as meningococcal disease.
Before traveling to Saudi Arabia, you should be up to date on all routine vaccines and travel related vaccines, including meningococcal vaccine.
Saudi Arabia requires that all travelers aged one year and older arriving for Hajj or Umrah pilgrimage show proof they have received a quadrivalent (ACWY) meningococcal vaccine in the last 3–5 years (depending on vaccine type) and at least 10 days prior to the planned travel. This vaccine is recommended for protection against meningococcal disease caused by serogroups A, C, W, and Y.
Visit a travel medicine specialist or healthcare professional 4–6 weeks before travel for specific advice related to your destination and this event.Â
CDC Yellow Book 2024: Health Information for International Travel
In the United States, quadrivalent meningococcal (MenACWY) conjugate vaccination is routinely recommended for adolescents, and also recommended for travelers to countries where meningococcal disease is hyperendemic or epidemic, including a booster dose of MenACWY if the last dose was administered 3–5 or more years previously (depending on the age at most recent dose received). In addition, all Hajj and Umrah pilgrims aged one year and older are required by KSA to receive quadrivalent meningococcal vaccine.
Meningococcal disease refers to illness caused by bacteria called Neisseria meningitidis. These illnesses are often severe, can be deadly, and include infections of the lining of the brain and spinal cord (meningitis) and bloodstream.
Meningococcal disease often presents as meningitis with symptoms that may include fever, headache, stiff neck, nausea, vomiting, photophobia, or altered mental status. Meningococcal disease may also present as a meningococcal bloodstream infection with symptoms that may include fever, chills, fatigue, vomiting, cold hands and feet, severe aches and pains, rapid breathing, diarrhea, or, in later stages, a petechial or dark purple rash (purpura fulminans).
People spread meningococcal bacteria to other people by sharing respiratory and throat secretions (saliva or spit). Generally, it takes close contact (for example, coughing or kissing) or lengthy contact (for example, sharing a room) to spread these bacteria. Crowding and mass gatherings have been associated with meningococcal disease outbreaks in the past.
Close contacts of people with meningococcal disease should receive antibiotic chemoprophylaxis as soon as possible after exposure, regardless of immunization status, ideally less than 24 hours after the index patient is identified.