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Influenza Warning for Hajj Pilgrims

Recombinomics Commentary
January 14, 2005

>>But doctors in the medical journal warn that the five-day pilgrimage and its rituals, due this year to take place in late January, can prove as physically demanding as it is spiritually challenging.
"In view of the very large numbers of people from disparate regions and the hostile climate of the Arabian desert, the chances of disease, particularly in elderly and infirm people, are high," the journal says.
The biggest dangers, the journal says, are heat stroke and heat exhaustion as the ritual requires the pilgrims to travel long distances in desert conditions.
"It is the most complex of Islamic rituals and involves... walking long distances and camping in desert tents, often with only the most basic sanitation." <<

Bird flu concerns will be particularly high in late January.  Right now H5N1 is spreading rapidly in Vietnam.  This spread is being facilitated by asymptomatic ducks that excrete feces with highly concentrated stable virus.  The avian influenza has spread from the Mekong Delta region and now has been detected in both northern and southern Vietnam.  There have been 6 confirmed cases and none have recovered.  Four have died and two are in critical condition. There are also 9 reported suspect cases.

Although there have been no reported human cases in Thailand or Indonesia, the potential for human cases is high.  Both countries have had H5N1 outbreaks in poultry this season and both have been impacted by the tsunami, which also created cramped living conditions at relief camps, providing an environment for the spread of infectious disease.

Sri Lanka is another country impacted by the tsunami. There was an outbreak of fatal flu in the south before the tsunami, and additional cases in the northeast after the tsunami.  These were human flu cases and the virus was readily transmissible.

Another country with transmissible disease is the Philippines.  The meningococcal linked disease has been spreading.  The case fatality rate of the meningococcemia-like disease is 68%, virtually the same as bird flu.  This illness can be passed more easily from human to human.

The conditions described for the Hajj would be favorable for the spread of each of these infectious diseases, so close monitoring would be advisable.
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