Pandemic H1N1 and the 2009 Hajj
Shahul H. Ebrahim, Ziad A. Memish, Timothy M. Uyeki, Tawfik A. M. Khoja, Nina Marano, Scott J. N. McNabb

Advice to Pilgrims for the Prevention of Influenza during Hajj

The Ministry of Health of the Kingdom of Saudi Arabia (KSA) urges pilgrims to take the following actions to protect themselves and other pilgrims from influenza. General:

• For current information, visit the Web sites of the Saudi Arabian Ministry of Health (www.moh.gov.sa), the Ministry of Hajj (www.hajinformation.com), the Centers for Disease Control (www.cdc.gov/flu), and the World Health Organization (www.who.int/topics/influenza).
• If you are at risk for influenza transmission or severe complications from influenza (including pregnant women, those with chronic diseases, and people under 12 or over 65 years of age), refrain from performing Hajj this year. When to suspect influenza:
• Influenza-like symptoms include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, and fatigue. Some people may also have vomiting and diarrhea. People may be infected with influenza, including 2009 H1N1, and have respiratory symptoms without a fever.

Before departure from home country:

• Check for advisories from your authorities for current information on influenza.
• Take time to get the seasonal influenza vaccine and, if available, the H1N1 vaccine.
• Procure a personal protection kit containing face masks, hand sanitizers, and disposable tissue paper.
• Keep your personal protection kit with you all the time and use it.

Everyday preventive actions while on travel and at Hajj:

• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
• Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
• Try to avoid close contact with sick people.

If you get ill:

• The KSA will provide full treatment for all persons who become ill during Hajj.
• Seek medical care from your country medical mission or the Hajj health facility near you.
• If you are sick with influenza-like illness, stay in your hotel or tent for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.)
• While sick, limit contact with others as much as possible to keep from infecting them.

Take influenza antiviral drugs if your doctor recommends them:

• If you get seasonal or 2009 H1N1 influenza, antiviral drugs can make illness milder and shorten the time you are sick. They may also prevent serious flu complications.
• Antiviral drugs are not sold over the counter and should be prescribed by a physician.