Table 202-5.

Hajj Mitigation Actions

Type	Incident	Examples of Mitigation Actions	Results
Communicable diseases	Meningitis outbreak (1987)	•Bivalent A and C meningococcal vaccines required for attending the Hajj	No further outbreaks to serogroup A
	Hepatitis B and C outbreaks due to head shaving by unlicensed barbers (shaving is part of Hajj completion rituals)	•Full hepatitis B vaccine encouraged for all pilgrims •Only licensed barbers with strict hygiene measures are allowed to shave pilgrims	No published results
	Cholera outbreak (1989), 109 pilgrims affected	•Improvement in water supply and sewage treatment •Strict regulation of food importation by pilgrims	No further outbreaks reported
	H1N1 pandemic (2009)	•Discouraged pilgrims with high risk from participating in Hajj •Thermography screening for febrile pilgrims at the airport •Encouraged H1N1 vaccines •Public health campaign (masks and hand hygiene)	Limited documentation of H1N1 cases in 2009 Hajj season
Non-communicable hazards	Stampede: 1990 (1426 deaths) 1994 (270 deaths) 2006 (350 deaths)	•Construction of Jamarat Bridge reduced crowding from 10 people per m2 to fewer than 4 •Unidirectional flow of pilgrims •Antipanic systems and automated human stream networking	No major events after 2006
	Fire in Mina: 1995 (150 deaths) 1997 (350 deaths)	•Fiberglass tents •Use of electrical stoves instead of cooking gas	Only limited cases