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Alshamrani M, Farahat F, Alzunitan M, Hasan MA, Alsherbini N, Albarrak A, Johani SMA, Shibl A, Al-Tawfiq JA, Zumla A, Memish ZA. Hajj vaccination strategies: Preparedness for risk mitigation. J Infect Public Health 2024; 17:102547. [PMID: 39353398 DOI: 10.1016/j.jiph.2024.102547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 08/28/2024] [Accepted: 09/15/2024] [Indexed: 10/04/2024] Open
Abstract
Millions of pilgrims travel annually to Makkah and Madinah, Saudi Arabia, for the Hajj, posing unique challenges for public health management and disease control. The large influx of pilgrims from diverse backgrounds traveling to a confined geographic area, coupled with the close proximity and interactions among them, create significant pressure on the healthcare system and heighten the potential for the spread of communicable diseases. This review examines current trends in communicable diseases and their impact, drawing insights from expert perspectives on the required (i.e., meningococcal meningitis, polio, and yellow fever) and recommended vaccinations (influenza, COVID-19) for Hajj participants. The updated COVID-19 vaccine is mandatory for local pilgrims and is strongly recommended for international visitors, with ongoing discussions on adapting protocols to address emerging variants. The timing and strain coverage of influenza vaccination, along with quadrivalent meningococcal vaccination, are also emphasized as critical preventive measures. Diseases such as cholera and yellow fever are addressed underscoring the need for rigorous surveillance and targeted vaccination strategies to mitigate the risk of transmission during the Hajj. By providing up-to-date information on mandated and recommended vaccinations, this review aims to empower pilgrims and healthcare professionals to make informed decisions regarding public health and disease prevention during this significant event.
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Affiliation(s)
- Majid Alshamrani
- Infection Prevention and Control Program, King Abdulaziz Medical City, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Fayssal Farahat
- Infection Prevention and Control Program, King Abdulaziz Medical City, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
| | - Mohammed Alzunitan
- Infection Prevention and Control Program, King Abdulaziz Medical City, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | | | - Nisreen Alsherbini
- Infectious Disease Division, Internal Medicine Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Ali Albarrak
- Infectious Disease Division, Internal Medicine Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Sameera M Al Johani
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia; King AbdulAziz Medical City, Department of Pathology & Laboratory Medicine, Riyadh, Saudi Arabia
| | - Atef Shibl
- Al Faisal University, Riyadh, Saudi Arabia
| | - Jaffar A Al-Tawfiq
- Infectious Disease Unit, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, IN, USA; Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD, USA
| | - Alimuddin Zumla
- Department of Infection, Division of Infection and Immunity, Centre for Clinical Microbiology, University College London, London, UK; NIHR Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK
| | - Ziad A Memish
- King Salman Humanitarian Aid and Relief Center and College of Medicine, Al faisal University, Riyadh, Saudi Arabia; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Divisionof Infectious Diseases, Kyung Hee University, Seoul, South Korea
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Manyanga D, Masvikeni B, Daniel F. The experiences of using polio outbreak simulation exercises to strengthen national outbreaks preparedness and response plans in sub-Saharan Africa. Pan Afr Med J 2020; 36:340. [PMID: 33193993 PMCID: PMC7603828 DOI: 10.11604/pamj.2020.36.340.23824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/15/2020] [Indexed: 11/11/2022] Open
Abstract
Introduction globally, by 2020 the paralytic poliomyelitis disease burden decreased to over 99% of the reported cases in 1988 when resolution 41.8 was endorsed by the World Health Assembly (WHA) for global polio eradication. It is clearly understood that, if there is Wild Poliovirus (WPV) and circulating Vaccines Derived Poliovirus (cVDPV) in the world, no country is safe from polio outbreaks. All countries remain at high risk of re-importation depending on the level of the containment of the types vaccine withdrawn, the laboratory poliovirus isolates, and the population immunity induced by the vaccination program. In this regard, countries to have polio outbreak preparedness and response plans, and conducting the polio outbreak simulation exercises for these plans remain important. Methods we conducted a cross-section qualitative study to review to 8 countries conducted polio outbreak simulation exercises in the East and Southern Africa from 2016 to 2018. The findings were categorized into 5 outbreak response thematic areas analyzed qualitatively and summarized them on their strengths and weaknesses. Results we found out that, most countries have the overall technical capacities and expertise to deal with outbreaks to a certain extent. Nevertheless, we noted that the national polio outbreak preparedness and response plans were not comprehensive enough to provide proper guidance in responding to outbreaks. The guidelines were inadequately aligned with the WHO POSOPs, and IHR 2005. Additionally, most participants who participated in the simulation exercises were less familiar with their preparedness and response plans, the WHO POSOPs, and therefore reported to be sensitized. Conclusion we also realized that, in all countries where the polio simulation exercise conducted, their national polio outbreak preparedness and response plan was revised to be improved in line with the WHO POSOPs and IHR 2005. we, therefore, recommend the polio outbreak simulation exercises to be done in every country with an interval of 3-5 years.
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Affiliation(s)
- Daudi Manyanga
- WHO Inter-Country Support Team office for East and Southern Africa, P.O. Box 5160, Harare, Zimbabwe
| | - Brine Masvikeni
- WHO Inter-Country Support Team office for East and Southern Africa, P.O. Box 5160, Harare, Zimbabwe
| | - Fussum Daniel
- WHO Inter-Country Support Team office for East and Southern Africa, P.O. Box 5160, Harare, Zimbabwe
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Al-Tawfiq JA, Memish ZA. The Hajj 2019 Vaccine Requirements and Possible New Challenges. J Epidemiol Glob Health 2019; 9:147-152. [PMID: 31529930 PMCID: PMC7310822 DOI: 10.2991/jegh.k.190705.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 07/05/2019] [Indexed: 01/02/2023] Open
Abstract
Each year millions of pilgrims perform the annual Hajj from more than 180 countries around the world. This is one of the largest mass gathering events and may result in the occurrence and spread of infectious diseases. As such, there are mandatory vaccinations for the pilgrims such as meningococcal vaccines. The 2019 annual Hajj will take place during August 8-13, 2019. Thus, we review the recommended and mandated vaccinations for the 2019 Hajj and Umrah. The mandatory vaccines required to secure the visa include the quadrivalent meningococcal vaccine for all pilgrims, while yellow fever, and poliomyelitis vaccines are required for pilgrims coming from countries endemic or with disease activity. The recommended vaccines are influenza, pneumococcal, in addition to full compliance with basic vaccines for all pilgrims against diphtheria, tetanus, pertussis, polio, measles, and mumps. It is imperative to continue surveillance for the spread of antimicrobial resistance and occurrence of all infectious diseases causing outbreaks across the globe in the last year, like Zika virus, MDR-Typhoid, Nipah, Ebola, cholera, chikungunya and Middle East Respiratory Syndrome Coronavirus.
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Affiliation(s)
- Jaffar A. Al-Tawfiq
- Infectious Disease Section, Specialty Medicine Department, Johns Hopkins Aramco Healthcare, Dhahran, Kingdom of Saudi Arabia
- Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ziad A. Memish
- Department of Medicine, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Infectious Diseases Division, Department of Medicine, Prince Mohammed Bin Abdulaziz Hospital (PMAH), Ministry of Health, Riyadh, Saudi Arabia
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Memish ZA, Steffen R, White P, Dar O, Azhar EI, Sharma A, Zumla A. Mass gatherings medicine: public health issues arising from mass gathering religious and sporting events. Lancet 2019; 393:2073-2084. [PMID: 31106753 PMCID: PMC7159069 DOI: 10.1016/s0140-6736(19)30501-x] [Citation(s) in RCA: 137] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 02/19/2019] [Accepted: 02/27/2019] [Indexed: 12/14/2022]
Abstract
Mass gathering events are associated with major public health challenges. The 2014 Lancet Series on the new discipline of mass gatherings medicine was launched at the World Health Assembly of Ministers of Health in Geneva in May, 2014. The Series covered the planning and surveillance systems used to monitor public health risks, public health threats, and experiences of health-care providers from mass gathering events in 2012 and 2013. This follow-up Review focuses on the main public health issues arising from planned mass gathering events held between 2013 and 2018. We highlight public health and research data on transmission of infectious diseases and antibiotic-resistant bacteria, mass casualty incidents, and non-communicable diseases, including thermal disorders. In the events discussed in this Review, the combination of a large influx of people, many from countries with outbreak-prone infectious diseases, with a high degree of crowd interactions imposed substantial burdens on host countries' health systems. The detection and transmission of antibiotic-resistant bacteria in pilgrims attending the Kumbh Mela and the Hajj raise concern of possible globalisation from mass-gathering religious events. Priorities for further investments and opportunities for research into prevention, surveillance, and management of these public health issues are discussed.
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Affiliation(s)
- Ziad A Memish
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; Infectious Diseases Division, Department of Medicine and Research, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Robert Steffen
- Epidemiology, Biostatistics and Prevention Institute, WHO Collaborating Centre for Travellers' Health, University of Zurich, Zurich, Switzerland; Division of Epidemiology, Human Genetics & Environmental Sciences, The University of Texas School of Public Health, Houston, TX, USA
| | - Paul White
- Commonwealth of the Northern Mariana Islands, Epidemiology and Laboratory Capacity Program, Public Health & Hospital Emergency Preparedness Program, Commonwealth Health Care Corporation, Saipan, Northern Mariana Islands, USA
| | - Osman Dar
- Public Health England and Chatham House Centre on Global Health Security, Royal Institute of International Affairs, London, UK
| | - Esam I Azhar
- Special Infectious Agents Unit, King Fahd Medical Research Center, Jeddah, Saudi Arabia; Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Avinash Sharma
- National Centre for Microbial Resource, Pune, Maharashtra, India; National Centre for Cell Science, Pune, Maharashtra, India
| | - Alimuddin Zumla
- Division of Infection, University College London, London, UK; NIHR Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK.
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