The Ministry of Health today attested to the fact that, thanks to strict preventive measures, the incidence of meningitis in the Kingdom is low, with only 11 cases reported in the first ten months of 1420 H [May 1999 to February 2000]. The measures taken include comprehensive campaigns every three years, the most recent in 1998 when over 3 million people were vaccinated; regulations stipulating presentation of certificates of vaccination against meningitis for all citizens and residents planning to perform Hajj, and for all those arriving in the Kingdom from anywhere in the world to perform pilgrimage, both Hajj and Umrah; inspection of these vaccination certificates at the air, land and sea arrival points for all pilgrims, in conjunction with mandatory on-the-spot vaccinations for any pilgrim not carrying a valid certificate; and campaigns conducted around the Holy Sites to locate any person who has neglected to be vaccinated.

In spite of these efforts two cases of meningitis were detected on February 24, 2000. It is a matter of record that some pilgrims who carry vaccination certificates have not actually been vaccinated in their country of origin, and that about 10 to 15 percent of those vaccinated do not acquire immunity. Therefore, the number of cases rose with the increasing number of pilgrims. In the week ending March 30, a peak was reached with 56 cases registered. The following week there were 51 cases, and thereafter the number dropped. As of April 11, the total number for this year's Hajj season was around 200, which, given the vastness of the gathering, cannot be considered to constitute an epidemic. Moreover, the source of all the cases is from overseas. When the French health ministry reports five cases of meningitis among returning pilgrims, two of which resulted in death, it has to be remembered that the source of the infection is not Saudi Arabia.

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The text of Hajj requirements (dated January 14, 2000) as provided to all pilgrims applying for Hajj visas in the United States contains the following item:

9. Meningitis Vaccination Certificate. All pilgrims must submit their vaccination certificates to the Comsular Section of the Royal Embassy of Saudi Arabia. All pilgrims must carry these certificates to Saudi Arabia for inspection by the Saudi Arabian Passport Authority. Children from the age of two (2) and above must take a dose of the meningitis A + C vaccine and those between the ages of three (3) months and two (2) years must take two doses of the vaccine A, which requires an interval of three months between each dose.

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