Mecca and MERS – Pandemic in The Making?

This week approximately two million Muslims from around the world are making the Hajj pilgrimage to Mecca, which is the greatest religious observances in Islam. The annual Hajj is the largest gathering of Muslim people in the world, and according to the Saudi Embassy, “Muslim pilgrims have made their way to Mecca every year for 14 centuries.”

Undertaking the Hajj at least once is a duty for Muslims who are physically and financially able to make the journey. The emphasis on “financial ability” is meant to ensure that a Muslim takes care of his “family first.” The requirement that a Muslim be “healthy and physically capable” of undertaking the pilgrimage is intended to exempt those who cannot endure the rigors of extended travel.

More than 2 million Muslims from more than 183 countries make Hajj each year (2.5 million in 2009). At least 11,000 of of the Hajj travelers will be from the United States. This year, more than any other year, Saudi Arabia is telling people who are ill to say home. Also, they have asked that the elderly over 65, women who are pregnant and children under 12 years old to take a pass on the pilgrimage this year. This is because Saudi Arabia is taking pre-emptive measures to prevent spreading of the MERS-CoV during the Holy week.

What is MERS-CoV?

MERS-CoV or MERS (Middle East Respiratory Syndrome Coronavirus) a new coronavirus strain (in the SARS family) that appeared last year. MERS was first identified in Saudi Arabia in 2012 when a man came down with “SARS-like” symptoms. He died in June 2012. In Saudi Arabia alone, 51 people have died and 119 have fallen ill so far this year.

The World Health Organization has warned that although MERS is now considered a regional virus in places like Saudi Arabia, it definitely has the potential to cause a pandemic. “To date, it’s been seen mostly in Saudi Arabia, centered around Riyadh, but has spread to France, Germany, Britain, Italy, UAE, Tunisia, Jordan, Qatar, and other countries.”

How is Mers-CoV Transmitted to Humans?

It appears to be unclear how MERS infects humans which makes it a silent and deadly killer. If the people who fall ill don’t get treatment in time, if they assume they only have a bad case of the flu – it will be too late.

Virus experts say they’ve linked MERS to bats, but say it’s unlikely bats are directly infecting people. Another animal may be involved. In Saudi Arabia, some researchers are starting to point their finger at camels as the intermediary transmitter between the bats to the humans.

MERS researchers have some evidence that also links this virus to camels; however, they have not discovered live virus in a camel yet. What they have found is anti-bodies in camels from Sudan, Egypt, Oman and the Canary Island that indicate the camels have recovered from MERS or a close relative. This does not make the camel an instigator in the transmission of MERS.

There have been a few camel stories being spread around about the camels involvement that do need to be considered:

  • According to Asharq Al-Awsat, a 38-year-old man from Batin, Saudi Arabia, who died of what was diagnosed as bacterial pneumonia was a camel dealer with at least one sick camel. Later other members of his family fell ill and two died, all diagnosed with MERS. The World Health Organization identified them as members of a MERS cluster. No specific evidence that the camel was at fault.
  • In April, Science Magazine reported a wealthy 73-year-old man from Abu Dhabi fell ill after contact with a sick racing camel in his stable. He went to Germany for treatment, but still died. After his death, doctors there said they had been told that his brother had also fallen ill after contact with the camel.
  • The first confirmed MERS victim was an owner of a paint warehouse in Bisha, Saudi Arabia, according to the New York Times. He was the owner of four pet camels, according Dr. Lipkin, a virologist at Columbia University who took blood samples from the camels.
  • The World Health Organization has said “emergence of the MERS-CoV has created a difficult situation for affected countries as well as the global community at large. On the one hand, the number of affected countries, especially those with community-acquired cases, is limited. On the other hand, this infection is associated with a high case fatality rate, has demonstrated its ability to persist over time, has caused community acquired diseases in multiple locations, and can be transmitted from person to person in certain circumstances.”

    The Kaaba, in Mecca, 1910
    The Kaaba, in Mecca, 1910

    Saudi Preparations

    mecca kaaba view
    A view across Mecca, towards the Kaaba, with the massive Abraj AlBait Towers, known as the The Mecca Royal Clock Hotel Tower on the right.

    The Saudi Government prepared well for this year’s Hajj. King Abdullah appointed Crown Prince Salman to oversee Hajj and care for the pilgrims. The Saudi Interior Minister announced, “Saudi Arabia has deployed 95,000 security forces to maintain order during this year’s Hajj, adding that these troops will be augmented by additional forces from the Ministry of Defense, Ministry of the National Guard, and the Presidency of the General Intelligence. We have confidence in the citizens and expatriates in the Kingdom to take the exceptional circumstances during this Hajj season into consideration, committing to Hajj regulations, and gaining the required permits needed for those who want to perform Hajj rituals.”

    In addition to these security measures, authorities in the kingdom have mobilized health services in Mecca and the holy sites which together have 25 public hospitals with 5,250 beds and hundreds of scattered medical centres.

    With all the efforts that the Saudi Government has taken, we can only hope that MERS will not take this opportunity to turn pandemic.

    Kimberly Jones is a global nomad with a special interest in the Middle East and North Africa. She grew up in Saudi Arabia and traveled throughout the MENA growing deeply attached to the people and the culture.