Abstract
The Hajj and Umrah mass gatherings represent many of the risk factors for meningococcal disease and have historically been associated with both local and international outbreaks of the disease. The implementation of strict preventative measures including mandatory meningococcal vaccination with the quadrivalent (A,C,Y,W) vaccine has prevented pilgrimage-associated meningococcal outbreaks and significantly reduced the incidence of the disease at these events. However, meningococcal disease remains an important public health threat at the Hajj and Umrah due in part to the evolving nature of the disease, characterized with diverse and varying geographic trends, fluctuations in incidence and shifts in serogroups and genotypes. In addition, the current Hajj and Umrah meningococcal disease preventative measure do not protect against all invasive serogroups and do not necessarily affect carriage and transmission as the polysaccharide vaccine is still widely used. As a consequence, these events are still susceptible to outbreaks of the disease including those due to serogroups not included in the required vaccines such as serogroups B and X. In this context, despite the global decline in incidence of meningococcal disease, including th...Continue Reading
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