title: Yellow fever and Hajj: with all eyes on Zika, a familiar flavivirus remains a threat.
abstract: Hajj is among the world's largest mass gatherings, drawing between 2 and 3.5 million Muslims from 183 nations annually to perform pilgrimage in Mecca, Saudi Arabia. Infectious disease outbreaks can be imported both into the Hajj population and exported internationally by returning pilgrims. The domestic Saudi population can also be at risk of outbreaks traveling amid this mass migration. With yellow fever reported for the first time in China following the infection of expatriate Chinese workers in Angola and a full blown outbreak underway in wider West Africa, the prospect of yellow fever outbreaks in Asia threatens to impact Saudi Arabia, both during and beyond the Hajj season. With global focus trained on Zika, the rising threat of yellow fever cannot be overlooked. Strategies to mitigate risk to Saudi Arabia and the global population are thereby suggested.
authors.affiliation: Division of Pulmonary Disease and Critical Care Medicine, Department of Medicine, Winthrop University Hospital; State University of New York (SUNY) at Stony Brook, Stony Brook, NY, 11790, USA.
authors.forename: Qanta A
authors.initials: QA
authors.lastname: Ahmed
authors.affiliation: Ministry of Health, Riyadh, 11514, Kingdom of Saudi Arabia. Zmemish@yahoo.com.|College of Medicine, Alfaisal University, Riyadh, 11533, Kingdom of Saudi Arabia. Zmemish@yahoo.com.
authors.forename: Ziad A
authors.initials: ZA
authors.lastname: Memish
mesh_terms: D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D005416:Flavivirus; D006801:Humans; D038622:Internationality; D007514:Islam; D012529:Saudi Arabia; D014195:Travel; D015004:Yellow Fever / Q000453:epidemiology / Q000517:prevention & control*; D000071244:Zika Virus; D000071243:Zika Virus Infection / Q000453:epidemiology / Q000517:prevention & control*
keywords: Hajj; Saudi Arabia; Zika virus; mass gathering; yellow fever