title: Hajj: infectious disease surveillance and control.
abstract: Religious festivals attract a large number of pilgrims from worldwide and are a potential risk for the transmission of infectious diseases between pilgrims, and to the indigenous population. The gathering of a large number of pilgrims could compromise the health system of the host country. The threat to global health security posed by infectious diseases with epidemic potential shows the importance of advanced planning of public health surveillance and response at these religious events. Saudi Arabia has extensive experience of providing health care at mass gatherings acquired through decades of managing millions of pilgrims at the Hajj. In this report, we describe the extensive public health planning, surveillance systems used to monitor public health risks, and health services provided and accessed during Hajj 2012 and Hajj 2013 that together attracted more than 5 million pilgrims from 184 countries. We also describe the recent establishment of the Global Center for Mass Gathering Medicine, a Saudi Government partnership with the WHO Collaborating Centre for Mass Gatherings Medicine, Gulf Co-operation Council states, UK universities, and public health institutions globally.
authors.affiliation: Global Center for Mass Gathering Medicine, Ministry of Health, Riyadh, Saudi Arabia; WHO Collaborating Centre for Mass Gatherings Medicine, Riyadh, Saudi Arabia; Al-Faisal University, Riyadh, Saudi Arabia; Ministry of Health, Riyadh, Saudi Arabia. Electronic address: zmemish@yahoo.com.
authors.forename: Ziad A
authors.initials: ZA
authors.lastname: Memish
authors.affiliation: Global Center for Mass Gathering Medicine, Ministry of Health, Riyadh, Saudi Arabia; Division of Infection and Immunity, University College London, London, UK; University College London Hospitals NHS Foundation Trust, London, UK.
authors.forename: Alimuddin
authors.initials: A
authors.lastname: Zumla
authors.affiliation: Global Center for Mass Gathering Medicine, Ministry of Health, Riyadh, Saudi Arabia; Ministry of Health, Riyadh, Saudi Arabia.
authors.forename: Rafat F
authors.initials: RF
authors.lastname: Alhakeem
authors.affiliation: Ministry of Health, Riyadh, Saudi Arabia.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Assiri
authors.affiliation: Ministry of Health, Riyadh, Saudi Arabia.
authors.forename: Abdulhafeez
authors.initials: A
authors.lastname: Turkestani
authors.affiliation: Ministry of Health, Riyadh, Saudi Arabia.
authors.forename: Khalid D
authors.initials: KD
authors.lastname: Al Harby
authors.affiliation: Ministry of Health, Riyadh, Saudi Arabia.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Alyemni
authors.affiliation: Ministry of Health, Riyadh, Saudi Arabia.
authors.forename: Khalid
authors.initials: K
authors.lastname: Dhafar
authors.affiliation: Aix Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Inserm, and Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Gautret
authors.affiliation: Global Center for Mass Gathering Medicine, Ministry of Health, Riyadh, Saudi Arabia; Preparedness, Surveillance and Response, Global Capacity Alert and Response, World Health Organization, Geneva, Switzerland.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Barbeschi
authors.affiliation: Global Center for Mass Gathering Medicine, Ministry of Health, Riyadh, Saudi Arabia; WHO Collaborating Centre on Mass Gatherings and High Visibility/High Consequence Events, London, UK.
authors.forename: Brian
authors.initials: B
authors.lastname: McCloskey
authors.affiliation: Global Center for Mass Gathering Medicine, Ministry of Health, Riyadh, Saudi Arabia; Chatham House, London, UK; London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: David
authors.initials: D
authors.lastname: Heymann
authors.affiliation: Global Center for Mass Gathering Medicine, Ministry of Health, Riyadh, Saudi Arabia; Ministry of Health, Riyadh, Saudi Arabia.
authors.forename: Abdullah A
authors.initials: AA
authors.lastname: Al Rabeeah
authors.affiliation: Saudi Aramco Medical Services Organization, Dhahran, Saudi Arabia; Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Jaffar A
authors.initials: JA
authors.lastname: Al-Tawfiq
mesh_terms: D003140:Communicable Disease Control / Q000458:organization & administration*; D003141:Communicable Diseases / Q000453:epidemiology* / Q000635:transmission; D003441:Crowding; D004196:Disease Outbreaks / Q000517:prevention & control; D006285:Health Planning / Q000458:organization & administration; D006801:Humans; D007514:Islam; D011635:Public Health Administration / Q000379:methods; D062486:Public Health Surveillance / Q000379:methods*; D012068:Religion and Medicine; D012529:Saudi Arabia / Q000453:epidemiology; D014195:Travel