Hajj – the pilgrimage of muslims Prof. Dr. Günt

Muslims have to respect five pillars of Islam:Shahadah (profession of faith)

The Noble Qur’ân, surat 2, alto the ways of Prophet MuhammadAllah”. Every year about 2The extremely diverse population from about 185 countriesstate of purity and holiness (getting old challenge for Saudi

AssessmentEstimated health risks Holy sites along the Hajjroute

Stay in MinaPlain of ArafatJamarat-BridgeGreat MosqueSafa - MarwahPublic routes

Measures of healthprevention to minimize health hazards(Saudi Arabia invests billionsof dollars p.a. since decades

Results: Hajj, rites, holy siteFigure: Route of

the pilgrimage of muslims Prof. Dr. Günter Schmolz, MD, MSc, member of

Muslims have to respect five pillars of Islam:Shahadah (profession of faith)

The Noble Qur’ân, surat 2, alto the ways of Prophet Muhammad

Every year about 2extremely diverse population from about 185 countries

state of purity and holiness (getting old and are restrictedchallenge for Saudi Arabian authorities.

ssessment of persistent

the Hajj Malaria, other VBD

Mina 0 - + Plain of Arafat 0 - +

Bridge 0 - + Great Mosque 0 - +

Marwah 0 Public routes 0 -+

res of health care,prevention and precautionto minimize health hazards(Saudi Arabia invests billions

ollars p.a. since decades

Results: Hajj, obligatory pilgrimage of the Islamic world, reveals a lot of different risks to health. The knowledge of the holy sites and the health state of the traveler will

oute of hajj (CDC);Pctures: M

the pilgrimage of muslims er Schmolz, MD, MSc, member of

Muslims have to respect five pillars of Islam:Shahadah (profession of faith) – sala’at(prayer)

The Noble Qur’ân, surat 2, al-baqarah (to the ways of Prophet Muhammad

Every year about 2- 3 Mio Muslims follow thextremely diverse population from about 185 countries

state of purity and holiness (Ihram). Manyrestricted in theirArabian authorities.

health risks of the holy sites and the routeCommunicable diseases

Tuberculosis

+ - ++ (+) + + - ++ - -

care, and precaution

to minimize health hazards (Saudi Arabia invests billions

ollars p.a. since decades)

Obligatory vaccination- meningococcal meningitis - poliomyelitis- YF of people from endemic regionsRecommended vaccinations- Influenza,

bligatory pilgrimage of the Islamic world, reveals a lot of different risks to health. The knowledge of the and the health state of the traveler will

Ministry of Haj (SA);References:

the pilgrimage of muslims - archetypeer Schmolz, MD, MSc, member of the board, German Society for Travel Medicine

Muslims have to respect five pillars of Islam: sala’at(prayer) - zakat (purification

baqarah (‘the cow’)to the ways of Prophet Muhammad ), the Hajj and ‘Umrah (i.e.

Muslims follow thextremely diverse population from about 185 countries

. Many of these people their health. The s

Arabian authorities. During the hajj

of the holy sites and the routeommunicable diseases

Tuberculosis Invasive Meningo- coccal disease

++ 0 - ++ 0 - + 0 - +

++ 0 - + 0 0

The main

Mina:Thousands of to accommodate million people

Jamarat:Stoning the devil

Safain Reminiscence of Hagar

Obligatory vaccinations: meningococcal meningitis poliomyelitis

people from endemic regionsRecommended vaccinations

Influenza, dPT, HepA, measles, PNC

bligatory pilgrimage of the Islamic world, reveals a lot of different risks to health. The knowledge of the and the health state of the traveler will

eferences: The Noble Qu

archetype the board, German Society for Travel Medicine

purification, tax for the poors)

) 196:” And perform properly (i.e. all the ceremonies according Hajj and ‘Umrah (i.e.

Muslims follow this demand of Muhammadextremely diverse population from about 185 countries perform

these people wereThe security of the pilgrims and their health care

During the hajj, pilgrims often neglect

of the holy sites and the routes to get there

Gastro- enteritis diarrhea

Exacerbation of diseases

++ + -(+) ++ - + ++ + -

0 – (+) 0 -+ +

The main holy sites

Mina: Thousands of tents to accommodate a million people

Plain of Arafat:Pilgrimsnoon to climb the mountain

Jamarat: Stoning the devil

Meccseven walks around the holy shrine Kissing of the stone

a – Marwah runs in Reminiscence of Hagar and Ismael

- - - - - -

meningococcal meningitis ACYW

people from endemic regions Recommended vaccinations

dPT, HepA, measles, PNC

bligatory pilgrimage of the Islamic world, reveals a lot of different risks to health. The knowledge of the and the health state of the traveler will allow

The Noble Qur’ân(Darussalam), Schmolz

of a mass gatheringthe board, German Society for Travel Medicine

, tax for the poors) – saum (fasting)

And perform properly (i.e. all the ceremonies according Hajj and ‘Umrah (i.e. the perennial

demand of Muhammadperforms the same activitiesere not able to afford their attendance before

ecurity of the pilgrims and their health care pilgrims often neglect

to get there; legend: 0 = no risk, + = Non-Communicable diseases

Exacerbation of diseases

Panic attacks, psychiatr. disorders

++ + +++ + - ++ + ++ - +++ ++ ++ - +++ - + 0 - + + +

ly sites of the hajj

Plain of Arafat: Pilgrims pray from noon to sunset and climb the mountain

ecca Great Mosque: seven walks around the holy shrine Kaaba Kissing of the stone

Air-conditioned rooms Everywhere offering drinking water Mobile hospitals Ambulances > 20.000 members of Intensive care and dialysis units

bligatory pilgrimage of the Islamic world, reveals a lot of different risks to health. The knowledge of the allow adequate advice to travel medicine staff

Schmolz G, Hadsch(FTR 2009:117

mass gatheringthe board, German Society for Travel Medicine

saum (fasting) – hajj (annual pilgrimage)

And perform properly (i.e. all the ceremonies according the perennial pilgrimage to Makkah) for

demand of Muhammad. the same activities

not able to afford their attendance before ecurity of the pilgrims and their health care

pilgrims often neglect obvious and hidden

0 = no risk, + = littleCommunicable diseases

Heart attacks, collapse

Heat exhaustion,sunstroke

+ ++ - +++ ++ ++ - +++ ++ - +++

0 - + + - ++

Possible and probable health risks

Communicable diseases

Non-communicable diseases

Other risks

rooms, sun protectionverywhere offering drinking water

members of medical staff care and dialysis units

bligatory pilgrimage of the Islamic world, reveals a lot of different risks to health. The knowledge of the adequate advice to travel medicine staff

2009:117-124), ECDC:Rapid

mass gathering (Poster NECTM 7)

the board, German Society for Travel Medicine

hajj (annual pilgrimage)

And perform properly (i.e. all the ceremonies according pilgrimage to Makkah) for

the same activities within 6 days in a not able to afford their attendance before

ecurity of the pilgrims and their health care is a huge obvious and hidden health risks.

little risk, ++ = moderate risk,+++ = high riskviolenceInjuries

Heat ex- haustion, sunstroke

+ + ++ - +++ +

++ ++ ++ + - ++0 (+)

+ - ++ + - ++

Possible and probable health risks

Communicable diseases Malaria, and other VBD Hepatitis A, E Cutaneous leishmaniosis Invasive meningococcal Tuberculosis Influenza Gastroenteritis, diarrhea Poliomyelitis

communicable diseases Sunstroke/heat exhaustion/cramps Circulatory collapse

syndrome Renal failure Panic attack and other psychiatric

disorders Exacerbation of

like diabetes or coronary heart disease

Other risks Road accidents Stampede Injuries, for example by falling down Acts of terrorism

, sun protection - Gate control (Jeddah, Great Mosque- Extended presence of police, fire Brigade, security staff- Fireproof tents in Mina- Developed public transport system - Compulsory vis

bligatory pilgrimage of the Islamic world, reveals a lot of different risks to health. The knowledge of the adequate advice to travel medicine staff

Rapid risk assessment for

NECTM 7)

hajj (annual pilgrimage)

And perform properly (i.e. all the ceremonies according pilgrimage to Makkah) for

within 6 days in a not able to afford their attendance before

a huge health risks.

= moderate risk,+++ = high riskviolence njuries

Stampede

(+) +

++ - +++ ++ ++ (+)

++ (+)

Possible and probable health risks

Communicable diseases , and other VBD

Hepatitis A, E Cutaneous leishmaniosis

meningococcal meningitisTuberculosis

enteritis, diarrhea liomyelitis

communicable diseases Sunstroke/heat exhaustion/crampsCirculatory collapse, coronary

enal failure Panic attack and other psychiatric

Exacerbation of preexisting diseases like diabetes or coronary heart disease

Road accidents

, for example by falling downActs of terrorism

Gate control (Jeddah, Great MosqueExtended presence of police, fire Brigade, security staff ireproof tents in Mina eveloped public transport system ompulsory visa contingents

bligatory pilgrimage of the Islamic world, reveals a lot of different risks to health. The knowledge of the adequate advice to travel medicine staff

risk assessment for the hajj (10.08.2017)

= moderate risk,+++ = high risk Acts of terrorism

(+)? (+)?

+ - ++? ++? (+)? (+)

meningitis

Sunstroke/heat exhaustion/cramps coronary

Panic attack and other psychiatric

preexisting diseases like diabetes or coronary heart disease

, for example by falling down

Gate control (Jeddah, Great Mosque Extended presence of police, fire

eveloped public transport system a contingents

bligatory pilgrimage of the Islamic world, reveals a lot of different risks to health. The knowledge of the

2017), WHO-WER