The Ministry of Health of Saudi Arabia has issued the following requirements and recommendations for entry visas for the year 1431H (2010) Hajj and Umra seasons.

I. Yellow fever
(A) In accordance with the revised International Health Regulations (1) 2005, all travellers arriving from countries or areas at risk of yellow fever transmission (list of countries below) must present a valid yellow fever vaccination certificate showing that the person was vaccinated at least 10 days previously and not more than 10 years before arrival at the border.

In the absence of such a certificate, the individual will be placed under strict surveillance for 6 days from the date of vaccination or the last date of potential exposure to infection, whichever is
earlier. Health offices at entry points will be responsible for notifying the appropriate Director General of Health Affairs in the region or governorate about the temporary place of residence of the visitor.

The following countries/areas are at risk of yellow fever transmission (as defined by the International

Travel and Health:
Africa: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo, Côte d’Ivoire, Democratic Republic of Congo, Equatorial Guinea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Mali, Mauritania, Niger, Nigeria, Rwanda, Sao Tome and Principe, Senegal, Sierra Leone, Somalia, Sudan, Togo, Uganda and United Republic of Tanzania.
This report will appear in WHO publication WER issue no. 43, Volume 85, scheduled for release October 22nd Year 2010. Americas: Argentina, Bolivia, Brazil, Colombia, Ecuador, French Guyana, Guyana, Panama, Paraguay, Peru, Suriname, Trinidad and Tobago and Venezuela.

II. Meningococcal meningitis

(A) For all arrivals: Visitors from all over the world arriving for the purpose of ‘‘Umra’’ or pilgrimage or for seasonal work are required to produce a certificate of vaccination with the quadrivalent (ACYW135) vaccine against meningitis issued not more than 3 years previously and not less than 10 days before arrival in Saudi Arabia. The responsible authorities in the visitor’s country of origin should ensure that adults and children over the age of 2 years are given 1 dose of the quadrivalent polysaccharide (ACYW135) vaccine.

(B) Arrivals from countries of the African meningitis belt, Benin, Burkina Faso, Cameroon, Chad, Central African Republic, Côte d’Ivoire, Eritrea, Ethiopia, Gambia, Guinea, Guinea-Bissau, Mali, Niger, Nigeria, Senegal and Sudan.

In addition to the above stated requirements, chemoprophylaxis will be administered at port of entry to all arrivals from these countries to lower the carriers rate among them. Adults will receive ciprofloxacin tablets (500 mg); children will receive rifampicin, and pregnant women will receive ceftriaxone injections.

III. Poliomyelitis

(A) All visitors age under 15 years travelling to Saudi Arabia from countries reinfected with poliomyelitis (list below) should be vaccinated against poliomyelitis with the oral polio vaccine (OPV). Proof of OPV vaccination is required 6 weeks prior the application for entry visa. Irrespective of previous immunization history, all visitors under 15 years arriving in Saudi Arabia will also receive a dose of OPV at border points.

The following countries are considered to be reinfected with poliomyelitis (as of 10th of September 2010).

Angola, Cameroon, Benin, Burkina Faso, Burundi, Chad, Côte d’Ivoire, Democratic Republic of the Congo, Central African Republic, Guinea, Kenya, Liberia, Mali, Mauritania, Nepal, Niger, Russian Federation, Senegal, Sierra Leone, Sudan, Tajikistan, Togo, Turkmenistan, Uganda, Uzbekistan.

(B) All travellers from Afghanistan, India, Nigeria and Pakistan: Regardless of age and vaccination status, should receive 1 dose of OPV. Proof of OPV vaccination at least 6 weeks prior departure is required to apply for entry visa for Saudi Arabia.

These travellers will also receive a dose of OPV at borders points when arriving in Saudi Arabia. IV. Influenza vaccination After the declaration by WHO that the world is no longer in phase 6 influenza H1N1 pandemic alert, the Ministry of Health of Saudi Arabia recommends that international pilgrims be vaccinated against seasonal influenza before arrival into the kingdom of Saudi Arabia with WHO approved strains specific to the Northern or Southern hemispheres, particularly those with pre-existing conditions (e.g. the elderly, people with chronic chest or heart diseases or cardiac, hepatic or renal failure). In KSA seasonal influenza vaccine is recommended for internal pilgrims particularly those with pre-existing conditions and all HCW’s working in the hajj premises.

V. Food
Visitors and pilgrims are not allowed to bring fresh food into the country. Only properly canned food is allowed in a small amount enough for one person for the duration of his or her trip.

VI. International outbreaks response
(C) In case of health emergency causing international health concern or in case of outbreaks subjective to international health regulations in any country from where the pilgrims and Umra performance come the Saudi Arabia Health Authorities may take any additional preventive precautions (not included in the measures mentioned above) after consultation with the WHO to avoid the spread of infection among pilgrims and Umra performance or the diffusion to their countries.