Ministry of Health sets requirements for pilgrims and other visitors

August 24, 2013

The Ministry of Health has established a number of requirements that must be met by visitors to obtain an Entry Visa for Hajj and Umrah in the Kingdom of Saudi Arabia for Hajj season 1434 H. These health regulations include:

1- Yellow Fever

a) In accordance with the International Health Regulations 2005, all travelers arriving from countries or areas at risk of yellow fever must present a valid yellow fever vaccination certificate showing that the person was vaccinated at least 10 days and at most 10 years before arrival at the border. In case of the absence of such a certificate, the individual will be placed under strict surveillance for 6 days from the date of vaccination or the last date of potential exposure to infection, whichever is earlier. Health offices at entry points will be responsible for notifying the appropriate Director General of Health Affairs in the region or governorate about the temporary place of residence of the visitor.

The following countries/areas are at risk of yellow fever transmission: Angola, Argentina, Benin, Bolivia, Brazil, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Colombia, Congo, Cote d’Ivoire, Democratic Republic of the Congo, Ecuador, Equatorial Guinea, Ethiopia, French Guyana, Gabon, Gambia, Ghana, Guinea, Guinea Bissau, Guyana, Kenya, Liberia, Mali, Mauritania, Niger, Nigeria, Panama, Paraguay, Peru, Rwanda, Senegal, Sierra Leone, South Sudan, Sudan, Suriname, Togo, Trinidad and Tobago, Uganda, and Venezuela

b) Aircrafts, ships and other means of transportation coming from countries affected by yellow fever are requested to submit a certificate indicating that it applied disinfection in accordance with methods recommended by the World Health Organization (WHO). In accordance with the International Health Regulations 2005, all arriving ships will be requested to provide to the competent authority a valid Ship Sanitation Certificate. Ships arriving from areas at risk for yellow fever transmission may also be required to undergo inspection to ensure they are free of yellow fever vectors, or disinfected, as a condition for granting free pratique (including permission to enter a port, to embark or disembark and to discharge or load cargo or stores).

2-Meningococcal Meningitis

a) Visitors from all countries: Visitors arriving for the purpose of Umrah or pilgrimage (Hajj) or for seasonal work are required to submit a certificate of vaccination with the quadrivalent (ACYW135) vaccine against meningitis issued no more than 3 years and no less than 10 days before arrival in Saudi Arabia. The responsible authorities in the visitor’s country of origin should ensure that adults and children over the age of 2 years are given 1 dose of the quadrivalent polysaccharide (ACYW135) vaccine.

b) Visitors from African Countries: For visitors arriving from countries in the African meningitis belt, namely Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Cote d’Ivoire, Eritrea, Ethiopia, Gambia, Guinea, Guinea-Bissau, Mali, Niger, Nigeria, Senegal and the Sudan, in addition to the above stated requirements, ciprofloxacin tablets (500 mg) chemoprophylaxis will be administered at port of entry to lower the rate of carriers.

c) Interior pilgrims and the Hajj workers vaccination with quadrivalent (ACYW135) vaccine is required for:
All citizens and residents of Madinah and Makkah who have not been vaccinated during the past 3 years;
All citizens and residents undertaking the Hajj;
All Hajj workers who have not been vaccinated in the past 3 years;
Any individual working at entry points or in direct contact with pilgrims in Saudi Arabia.

3- Poliomyelitis

All travelers arriving from polio-endemic countries and re-established transmission countries, namely, Afghanistan, Chad, Nigeria and Pakistan, regardless of age and vaccination status, should receive 1 dose of oral polio vaccine (OPV). Proof of polio vaccination at least 6 weeks prior to departure is required for visitors from polio-endemic and re-established transmission countries to apply for an entry visa for Saudi Arabia and travelers will also receive 1 dose of OPV at border points on arrival in Saudi Arabia. The same requirements are valid for travelers from recently endemic countries at high risk of re-importation of poliovirus, i.e. India.

All visitors under the age of 15 travelling to Saudi Arabia from countries reporting polio following importation or due to circulating vaccine-derived poliovirus in the past 12 months (as of mid-February 2013, see list below) should be vaccinated against poliomyelitis with the OPV. Proof of OPV or IPV vaccination is required 6 weeks prior to the application for entry visa. Irrespective of previous immunization history, all visitors under 15 years arriving in Saudi Arabia will also receive 1 dose of OPV at border points.

Polio cases related to wild poliovirus importation or to circulating vaccine-derived poliovirus have been registered during the past 12 months in the following countries: Chad, Kenya, Niger, Somalia and Yemen.

4- Seasonal Influenza:

The Saudi Ministry of Health recommends that international pilgrims be vaccinated against seasonal influenza before arrival into the Kingdom of Saudi Arabia, particularly those at increased risk of severe influenza diseases, including pregnant women, children under 5 years, the elderly, and individuals with underlying health conditions such as HIV/AIDS, asthma, and chronic heart or lung diseases. In Saudi Arabia, seasonal influenza vaccination is recommended for internal pilgrims, particularly those at risk described above, and all health-care workers in the Hajj premises.

Health Education:

Health authorities in countries of origin are required to provide information to pilgrims on infectious diseases symptoms, methods of transmission, complications, and means of prevention.

Food Material:

Hajj and Umrah performers are not allowed to bring fresh food into Saudi Arabia. Only properly canned or sealed food or food stored in containers with easy access for inspection is allowed in small quantities, sufficient for one person for the duration of his or her trip.

Responses to International Outbreaks:

1- MERS-COV Precautions: The Saudi Ministry of Health recommends that the elderly (above 65 years of age) and those with chronic diseases (e.g. heart disease, kidney disease, respiratory disease, diabetes) and pilgrims with immune deficiency (congenital and acquired), malignancy and terminal illnesses, pregnant women and children (under 12) coming for Hajj and Umrah this year, postpone the performance of the Hajj and Umrah for their own safety.

The Saudi Ministry of Health also advises all pilgrims to comply with common public health guidelines to curb the spread of respiratory infectious disease, which can be summarized as follows:

A - Wash hands with soap and water or disinfectant, especially after coughing and sneezing
B - Use disposable tissues when coughing or sneezing and dispose of them in a waste basket.
C - Try as much as possible to avoid hand contact with the eyes, nose and mouth.
D - Avoid direct contact with infected persons (people with symptoms such as cough, sneezing, expectoration, vomiting, and diarrhea) and do not share their personal gadgets.
E- Wear masks, especially when in crowded places.
F- Maintain good personal hygiene.

2- General Precautions: Updating immunization against vaccine-preventable diseases in all travelers is strongly recommended. Preparation for international travel provides opportunity to review the immunization status of travelers. Incompletely immunized travelers can be offered routine vaccinations recommended in national immunization schedules (these usually include diphtheria, tetanus, pertussis, polio, measles, and mumps), in addition to those needed for the specific travel (e.g. meningococcal vaccination for Hajj).

3- Emergency Precautions: In the event of a public health emergency of international health concern, or in the case of any disease outbreak subject to notification under the International Health Regulations 2005, the health authorities in Saudi Arabia will undertake additional preventive precautions (not included in the measures mentioned above), following consultation with the WHO, that are necessary to avoid the spread of infection during the pilgrimage or on return to their country of origin.