Middle East respiratory syndrome and Hajj (4 to 9 June 2025)

The annual Islamic pilgrimage, Hajj, will take place from 4 to 9 June 2025. It is anticipated that approximately 2,000 Australians will travel to the Kingdom of Saudi Arabia to participate.

Middle East respiratory syndrome (MERS) is a viral respiratory illness with a high fatality rate (approximately 39%), caused by MERS coronavirus. Saudi Arabia is experiencing ongoing clusters of MERS, with 84% of cases worldwide reported from this region.

Dromedary camels are thought to be the primary source of infection in humans, through direct or indirect contact with the camels and raw camel products (e.g., uncooked meat and milk). The virus does not easily spread in the community, and person to person spread of the virus has predominantly occurred in healthcare settings and within households.

People with existing health conditions that make them more vulnerable to respiratory disease are at a higher risk of becoming very unwell or dying due to MERS. This includes the elderly, the immunocompromised and those with comorbidities.

There is no vaccination against MERS, however, travellers should ensure they are up to date with all recommended vaccinations, including for COVID-19, measles, and influenza. The Ministry of Health in the Kingdom of Saudi Arabia has specific health requirements and guidelines for Hajj pilgrims travelling from other countries, these can be found can be found on their website.

All travellers should know how to avoid infection. Travellers can protect themselves from MERS by:

• avoiding close contact with sick people and sick animals
• washing hands regularly and taking particular care when visiting places where animals are present
• avoiding consuming raw or undercooked camel products, such as meat, urine, and milk, and
• particularly for people with existing health problems, avoiding all contact with camels.

The Department of Health and Aged Care maintains MERS information for health professionals on its website, including:

• A MERS information card for travellers – available in English, Arabic, Bengali, Chinese (simplified), Chinese (traditional), Dari, Indonesian, Turkish and Urdu. The card explains what to do during and after travelling to an area affected by MERS.
• Factsheet – information about MERS for health professionals.
• Management guidelines for MERS coronavirus in general practice.
• Posters (scroll to bottom of page)

Health professionals should remain vigilant for signs of MERS in returned travellers and ensure suspected cases are managed appropriately. MERS is a nationally notifiable disease, so all suspected, probable, and confirmed cases should be reported to the appropriate state or territory public health unit.

Measles vaccination

Measles is a highly infectious but vaccine-preventable viral illness transmitted by respiratory aerosols. Measles-containing vaccine is recommended for children at 12 and 18 months of age, and all patients born during or since 1966 should have either documented evidence of two doses of measles-containing vaccine, or serological evidence of immunity.

NSW Health funds the measles, mumps and rubella (MMR) vaccine for any individual born during or after 1966 who has not had two doses of a measles-containing vaccine, or with an uncertain measles vaccination history. If there is no documentation available, then it is safe and recommended to give a dose of MMR.

Please check the vaccination status of your patients who plan on travelling for Hajj and recommend the MMR vaccine to patients who are not fully vaccinated. Be alert for travellers returning who may have measles; prodromal symptoms include fever, cough, conjunctivitis and coryza, followed by a rash which develops after 3-4 days of prodrome.