Each year around 40 000 Britons make the pilgrimage to Mecca in Saudi Arabia, most travelling during the Hajj season, which this year will fall later this month. The extreme overcrowding (numbers for the Hajj are estimated at around three million) and oppressive climate pose considerable health risks to pilgrims. The most significant is the risk of meningitis.

Although the risk of infection with meningitis A and C is well recognised, the Hajj of 2000 heralded the introduction of W135 meningococcal disease. During the past two years 79 cases of W135 meningococcal disease have occurred in returning pilgrims, of whom 18 died. The government of Saudi Arabia has now made quadrivalent meningococcal vaccination (ACWY Vac) a visa requirement for pilgrims.1

The Department of Health, working in conjunction with the Muslim Council of Britain, has distributed appropriate advice to general practitioners and travel clinics. Public information leaflets, available in six languages, have also been distributed to those preparing to perform the pilgrimage through mosques and Muslim community organisations throughout Britain.2

In addition, the Department of Health has provided important support to the work of the newly formed British Hajj Delegation in providing much needed health and consular expertise to British pilgrims during their stay in Saudi Arabia.3

Abdul Rashid Gatrad, consultant paediatrician.
Manor Hospital, Walsall WS2 9PS

Aziz Sheikh, NHS research and development national primary care training fellow.
Imperial College of Science, Technology and Medicine, London W6 8RP

Abdul Raheem Khan, chairman.
London Task Group, Muslim Council of Britain, PO Box 52, Wembley, Middlesex HA9 0XW
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