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Blood Borne Hepatitis at Hajj

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Abstract:

An pilgrims estimated 2.5 million Muslims from all over the world are expected to converge in Mecca, Saudi Arabia by the end of this December for Hajj pilgrimage. Overcrowding during the largest annual mass gathering of such enormous proportions inevitably increases exposure to and risk of a variety of infections, some with pandemic potential (1). Adopting simple measures and offering appropriate immunisations to the pilgrims can prevent many of these infections. Knowledge of the nature and extent of infections however is important to implement the effective protective measures.As part of the rites of Hajj, men shave their heads although trimming the hair is also acceptable; women cut a lock of their hair. Communal use of razors or blades carries the risk of blood borne infections such as Hepatitis B, hepatitis C or HIV(2). To minimise this risk the Saudi authorities require all barbers looking after the pilgrims to be licensed but many pilgrims use the services of opportunistic makeshift barbers or help by shaving each other, often reusing their razors at the risk of transmitting blood borne virus infections. Unlike the respiratory infections that have a short incubation, infection with blood borne viruses takes much longer to manifest or indeed may remain undetected for many years while it may progress to chronic liver disease.Studies on barbers have shown a high prevalence of carriage and disease among barbers. Extrapolating from various studies Memish et al. (2003) estimated that about 10% of the barbers are carriers of hepatitis C and 4% carry hepatitis B, over a tenth of whom are in active carrier stage (3). Many pilgrims will come from areas of the world with a high endemicity of blood borne infections such as hepatitis B and/or C. To our knowledge there have not been any studies to establish the exact incidence of viral hepatitis among the pilgrims. There is an urgent need to understand the true epidemiology and to measure the burden of hepatitis among Hajj pilgrims.An effective vaccine against Hepatitis B is available and pilgrims should be advised to obtain it before departure if they are known to be susceptible or uncertain of their immune status against* Correspondence:Harunor Rashid Ph.D, Academic Unit of Paediatrics, QueenMary University of London, 38 New Road, London, E1 2AX,UK.Telefax: +44 (0)207 377 71 67E-mail: h.rashid@qmul.ac.ukHep Mon 2006; 6 (2): 87-88 Pilgrims are getting their heads shaved by their fellows. Hepatitis B. An accelerated 3-dose regimen on 0-, 7- and 21-day schedule particularly designed for travellers is shown to co

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