Pandemic Viruses at Hajj: Influenza and COVID-19

Abstract

Hajj is the largest annual mass gathering event on the planet and usually attracts two to three million people from all over the world and is one of the most significant events in the life of a practicing Muslim. Viruses that may cause pandemic outbursts, such as influenza and COVID-19, are important public health threats at Hajj. Influenza, both seasonal and pandemic, has been reported at Hajj at variable frequencies. Preventive measures including vaccination and hand hygiene are known to be beneficial. The vaccination uptake is still suboptimal but improving, and time is ripe to consider using quadrivalent influenza vaccine that provides protection against both lineages of influenza B. In response to COVID-19, Hajj pilgrimage was essentially cancelled in 2020, downscaling to just a few thousand local pilgrims who were required to comply with strict preventive measures including maintaining optimum physical distance from fellow pilgrims, and no case of Hajj-associated COVID-19 has been reported. To combat COVID-19 in the coming years, all evidence-based preventive measures, including hand hygiene and use of personal protective equipment, should be considered for Hajj pilgrims in addition to limiting the number of attendees. The recently approved and rolled out COVID-19 vaccines would be important preventive measures for prospective Hajj pilgrims.