After a deadly coronavirus outbreak killed 17 out of 33 people who contracted it in Saudi Arabia in the past year, Reuters reports that the World Health Organization (WHO) has pledged to further investigate the disease spread before millions of Muslims descend on holy sites in Mecca and Medina during the Hajj pilgrimage season in October.

The virus strain, which the WHO has dubbed the Middle East Respiratory Syndrome Coronavirus (MERS-CoV), causes respiratory symptoms from mild coughing and fever to severe pneumonia. Including the Saudi Arabian cases, it has affected 44 people worldwide and caused 22 deaths since the first known cases, in spring 2012.

Aside from Saudi Arabia, the coronavirus has been confirmed in Jordan, Qatar, and the United Arab Emirates in the Middle East. Infected travelers also brought the virus back to Germany, France, Tunisia, and the United Kingdom, though transmission seems to have been limited in those countries.

Assessing Coronavirus Disease Risk

The WHO sent a team to provide a risk assessment of the MERS-CoV outbreak in Saudi Arabia earlier this month, reports Reuters, and is now planning to send a second team in the next few weeks, allowing enough time to prepare for the Hajj.

"Without that proper risk assessment, we cannot have clarity on the incubation period, on the signs and symptoms of the disease, on the proper clinical management and then, last but not least, on travel advice," said Margaret Chan, Director-General of the WHO, according to Reuters.

The coronavirus situation is not serious enough yet to merit travel or trade restrictions to Saudi Arabia, said the WHO in the most recent news release, and no special screening procedures have been recommended for travelers at airports.

Still, the WHO suggests that travelers recently returning from the Middle East who develop severe acute respiratory infections should be tested for the MERS-CoV strain.

"We need to get the facts clear and get the appropriate advice to all your countries where your pilgrims want to go to Mecca. It is something quite urgent," said Chan.

Controlling MERS-CoV Spread in Saudi Arabia

The Saudi Arabian Ministry of Health notified the WHO of a new fatal case of MERS-CoV this week, a 63-year-old man in the central Al-Qaseem region of the country who died on May 20 only five days after being admitted to a hospital for respiratory distress.

The case was unrelated to a recent cluster of coronavirus cases in the eastern Al-Ahsa region of Saudia Arabia, said officials in the news release. That cluster infected 22 patients and caused 10 deaths to date.

Deputy Health Minister Ziad Memish told the WHO's annual meeting in Geneva on May 24 that infection control measures, like separating patients in high-risk hospital wings like the intensive care unit and the hemodialysis unit, helped stanch the Al-Ahsa coronavirus outbreak, according to Reuters.

It's unclear how the coronavirus spreads to people. Saudi health officials are sending samples from possible animal vectors like bats, camels, sheep, and cats to be tested in the United States, said Memish.

There has been limited contagion infection from prolonged person-to-person contact, according to the WHO's update, mostly within families and health care facility patients and workers exposed to the infected.

Almost 80 percent of those infected with the coronavirus are male, and the patients range in age from 24 to 94.

Avoiding Infectious Diseases During the Hajj Pilgrimage

The Hajj pilgrimage is one of the largest mass gatherings in the world, bringing about 3 million ethnically diverse Muslims to Mecca each year, according to estimates from the Centers for Disease Control and Prevention (CDC).

That creates a perfect opportunity for infectious diseases, especially respiratory tract infections like coronavirus, to spread. Millions of people from all over the world are gathered in tight spaces over the span of several weeks, and they take back any diseases they might have caught when they return home.

Saudi health initiatives, like requiring proof of vaccination for diseases like yellow fever, meningitis, and polio, have helped stop previous outbreaks that occurred during the Hajj. The CDC also recommends that Americans get vaccinated against hepatitis A and B, typhoid, and the seasonal flu before traveling to Saudi Arabia.

Aside from vaccinations, standard hygiene practices like washing one's hands, sneezing into a tissue or sleeve, and avoiding sick people are important to remember.


Safe and Healthy Hajj. Centers for Disease Control and Prevention (CDC) Features. 2012.

Weekly epidemiological record. World Health Organization. 2012.

Memish Z A. The Hajj: communicable and non-communicable health hazards and current guidance for pilgrims. Eurosurveillance. 2010.