Notice to Readers: Risk for Meningococcal Disease Associated With the
Hajj 2001
Please note:
An
erratum has been published for this article. To view the erratum, please click here.
Every year approximately two million pilgrims from more than 140
countries gather in Saudi Arabia for a pilgrimage to the holy places of Islam known as the
Hajj. Coinciding with the Hajj pilgrimage during March 2000, Saudi Arabian health
officials identified an outbreak of meningococcal disease; a substantial proportion of
the isolates were the bacterial strain Neisseria
meningitidis serogroup W-135. Four cases of meningococcal disease subsequently were identified among the estimated
15,000 pilgrims returning to the United States, their close contacts, and community.
In addition, approximately 400 cases of meningococcal disease caused by
N. meningitidis serogroup W-135 were identified worldwide during 2000
(1). Whether an outbreak of meningococcal disease will recur in 2001 is unknown.
Following an outbreak of serogroup A meningococcal disease associated with
the Hajj during 1987, the Saudi Arabian government required all pilgrims to receive
the meningococcal polysaccharide vaccine (2). In the United States, the available
vaccine,
quadrivalent meningococcal polysaccharide vaccine, contains serogroup
W-135 polysaccharide. However, vaccination does not protect against
asymptomatic nasopharyngeal carriage of the bacteria. Persons may transmit
N. meningitidis infection to close contacts upon their return from Saudi Arabia, and taking an
antibiotic can reduce the risk for transmission and disease. It is not known whether
returning pilgrims will have increased rates of acquisition of nasopharyngeal carriage of
N. meningitidis.
To assess the risk for meningococcal disease in returning pilgrims and their
close contacts, CDC is planning to evaluate nasopharyngeal carriage among a set of
pilgrims returning from the Hajj. The results of this evaluation and any recommendations
will be posted on the World-Wide Web, http://www.cdc.gov/travel, when they
become available. Information also will be available by telephone, (888) 232-3228.
References
Popovic T, Sacchi CT, Reeves MW, et al.
N. meningitidis serogroup W135 isolates
associated with the ET-37 complex [Letter]. Emerg Infect Dis 2000;6:428--9.
Moore PS, Harrison LH, Telzak EE, et al. Group A meningococcal carriage in
travelers returning from Saudi Arabia. JAMA 1988;260:2686--9.
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