With millions of people expected to participate in the annual Hajj and Umrah pilgrimages to Mecca and Medina between July and October, the heightened risk of the global spread of MERS-CoV infection in the period is causing concern among health officials.
The Umrah or "lesser Hajj" is expected to peak during the holy month of Ramadan between July 9 and August 7 this year in Saudi Arabia, while the "greater Hajj" will take place from October 13 to 18.
Experts fear that due to the fact that the virus can spread through close contact, the peak periods of Umrah and Hajj, in which millions of pilgrims crowd in holy sites in Mecca and Medina, heighten risks of transmission of the virus and could trigger mass global outbreak of the illness as infected pilgrims returning home after the Hajj spread the infection. The annual Hajj alone draws about 3.7 million Muslims from around the world. Foreign Policy reports that last year, about 6 million pilgrims visited Saudi Arabia as part of the annual Umrah-Hajj pilgrimage.
According to the Centers for Disease Control and Prevention (CDC), WHO and Saudi health officials are working ahead of the annual Hajj and the peak period of the Umrah to track and control spread of the new deadly virus and prevent a mass outbreak during the pilgrimage.
MERS-CoV has proven deadlier than the 2003 SARS outbreak which killed about 800 people, with similar symptoms including fever and cough that develops into pneumonia.
Death rates are higher among MERS-CoV patients. While only about 8 percent of SARS patients died more than 50 percent of MERS-CoV patients have died. Since September 2012, WHO has reported a total of 64 laboratory-confirmed cases of infection with MERS-CoV and 38 deaths, more than half the number of cases.
Voice of Russia reports that the Ministry of Health in Saudi Arabia recently announced an additional three laboratory-confirmed cases.
WHO officials say that because MERS-CoV infections have not been previously identified in humans experts have very little knowledge about its transmission, clinical features and treatment. The number of cases that have been reported are not enough to build a complete picture of the infection.
So far, the Middle East has been the focal point of transmission, with Saudi Arabia, the United Arab Emirates (UAE) and Qatar the major countries in the Middle East where cases have been reported. The highest incidence has been in Saudi Arabia and it is possible that the infection was introduced and spread during previous pilgrimages. Cases have been reported in Europe: France, Germany, the UK, and Italy. All the European cases have been linked to the Middle East.
According to the CDC, the Embassy of Saudi Arabia has recommended that the elderly, the terminally ill, pregnant women and children refrain from conducting the Hajj.
CDC advises pilgrims to protect themselves from infection by washing their hands very often and not touching their mouth, nose, or eyes. Pilgrims should also avoid contact with sick people and seek medical care if they develop symptoms of fever, cough and shortness of breath within 14 days of returning from the pilgrimage.
Authorities have issued no directives or recommendations that people should change their Hajj travel plans over fears of MERS-CoV infection. However, WHO has expressed concerns that the virus could spark a pandemic.
Digital Journal reported that while addressing the closing of the 66th session of the World Health Assembly, the D-G of the WHO, Dr. Chan, raised an alarm, saying that the Middle East respiratory symptom coronavirus was a "threat to the entire world."
According to Digital Journal, Chan said: "We understand too little about this virus when viewed against the magnitude of its potential threat. We do not know where the virus hides in nature. We do not know how people are getting infected. Until we answer these question, we are empty-handed when it comes to prevention. These are alarm bells. And we must respond... The novel coronavirus is not a problem that any single affected country can keep to itself or manage all by itself. It is a threat to the entire world."