Please wear masks as a precaution against the MERS coronavirus which is circulating in the country, Saudi authorities has asked pilgrims. About two million pilgrims are expected this month at the holy sites.

Seniors, people with chronic diseases, as well as patients with weakened immune systems have been told to postpone their pilgrimage.

Pilgrims have also been asked to be extra careful regarding hand hygiene, to sneeze or cough into a paper tissue or the inside of their elbow, and to make sure they are up-to-date with all their vaccinations.

These are the strictest regulations for the pilgrimage in the country’s history, as authorities try to stem the spread of MERS-CoV (Middle East Respiratory Syndrome Coronavirus), a new coronavirus that kills approximately 50% of humans who become infected.

MERS-CoV, which causes SARS-like symptoms plus kidney failure, has infected 85 people so far, of whom 41 died. Most of the infections and deaths have occurred in Saudi Arabia.

There are two peak periods for pilgrimage visits to the holy sites of Saudi Arabia, one is towards the end of Ramadan, and the other is the October Hajj. Pilgrims journey to Mecca, and pray in the Al-Masjid Al-Haram (Grand Mosque) before the Kaaba. Some also travel to the Masjid Al-Nabawi (Mosque of the Prophet), in Medina.

  • Ramadan, the month of fasting during daylight hours started on July 8th and ends on August 7th. Towards the end of Ramadan, millions of pilgrims from every corner of the globe come to Saudi Arabia. This pilgrimage is known as “Umrah” (the lesser pilgrimage which can be done at any time of the year. The major pilgrimage “Hajj”, is explained below)
  • Hajj – which in Arabic means “pilgrimage”, is one of the largest annual pilgrimages in the world. It occurs during a five-day period from the 9th through the 13th of Dhu Al-Hijjah, the twelfth month of the Muslim lunar calendar, or October 13th-18th this year (2013) in the Gregorian calendar (Western calendar). More pilgrims travel to Mecca and Medina during Hajj than at the end of Ramadan.


Al-Masjid Al-Haram (Grand Mosque) and Kaaba

This latest Saudi health announcement came after the World Health Organization (WHO) had talks with an Emergency Committee of international experts on MERS-CoV. The announcement did not specify whether elderly individuals or those with weakened immune systems would be denied visas to come into the country.

WHO has not recommended any travel restrictions, but advises countries to carefully monitor unusual respiratory infections or patterns.

MERS-CoV (Middle East Respiratory Syndrome) is a member of the coronavirus family. Coronaviruses are responsible for one third of all cases of the common cold. MERS-CoV is similar to the SARS coronavirus (SARS-CoV), but much more deadly. SARS-CoV had a 10% death rate, compared to 50% with MERS-Cov.

MERS-CoV appeared last year. People started becoming ill in the Middle East. It was first identified in an adult male in Saudi Arabia who had “SARS-like” symptoms. He died in June last year.

A few months later another patient, an adult male from Qatar, became ill with the same symptoms after visiting Saudi Arabia. He was sent to the United Kingdom for further treatment. UK laboratories confirmed MERS-CoV infection.

So far, MERS-CoV infections have been reported in Saudi Arabia, the United Arab Emirates, Qatar, Tunisia, Jordan, the United Kingdom, Germany, France, and Italy.

Signs and symptoms of MERS-CoV infection include:

  • Kidney failure – not the case with SARS-CoV infection
  • Diarrhea (less common)
  • Fever
  • Chest pain
  • Fatigue and malaise
  • Shortness of breath
  • Mucous
  • Coughing
  • Sneezing

Most patients have pneumonia when they arrive in hospital.

One patient in Jordan had MERS-CoV infection but no symptoms, (he was not ill). This means there may be many more infected people out there than official figures suggest. They could potentially infect others.

The World Health Organization says that although MERS-CoV is more deadly than SARS-CoV, it is much less human transmissible. However, experts from Johns Hopkins University who visited Saudi Arabia wrote in NEJM (New England Journal of Medicine) that in healthcare settings, MERS-CoV infection spreads more easily.

Another problem with MERS-CoV is that we know so little about it. We have no idea where it comes from, how many asymptomatic infected people there are, or exactly how human transmission occurs outside hospital settings.

Written by Christian Nordqvist