Saudi Arabia
Meningococcal Meningitis

Saudi Arabia: Required Vaccination

Meningococcal Meningitis

Entry requirements

Proof of vaccination is required for travellers 2 years of age and older who are Hajj or Umrah pilgrims and seasonal or pilgrim workers in Hajj and Umrah areas. Vaccination with quadrivalent ACYW135 (either polysaccharide or conjugate) must be issued not less than 10 days before arrival and not more than 3 years (polysaccharide vaccine) or 5 years (conjugate vaccine) before arrival. The immunization certificate should clearly state if the traveller was vaccinated with the conjugate vaccine for the 5-year validity to apply.

Vaccination is also required for domestic pilgrims, residents of Mecca and Medina, and any persons participating in Hajj or Umrah or seasonal or pilgrimage work in Hajj and Umrah zones. At the discretion of the Ministry of Health, travellers may be administered prophylactic antibiotics upon arrival.


Recommendations for all travellers

Vaccination is recommended for all persons 9 months of age and older travelling extensively or on work assignments and persons participating in Hajj or Umrah or seasonal or pilgrimage work in Hajj and Umrah zones.



Description

Meningococcal Meningitis is primarily caused by Neisseria meningitidis bacteria transmitted from person to person through infected air droplets, saliva, or respiratory secretions. The infection spreads easily when an infected person comes into close proximity or has long term contact with others. Staying in overcrowded housing, dormitories, cruise ships, attending a sports or cultural event, as well as sharing utensils, coughing, sneezing, or kissing can contribute to outbreaks. The bacteria target the meninges – the thin lining that surrounds the brain and the spinal cord. Of the 12 Meningococcal Meningitis serogroups identified, the following five cause illness: A, B, C, Y, and W135. Note that other meningitis infections can also be caused by viruses, fungi, and parasites.

Risk

Long-term travellers, persons on work assignments, students, military recruits, persons with a weakened immune system, children under five years of age, men having sex with men, and persons attending large cultural or sporting events are at risk.

The bacteria are present worldwide with variable geographic occurrence. Regional outbreaks can occur anytime. The highest risk areas are in the Meningitis Belt – the semi-arid area of sub-Saharan Africa that extends from the Atlantic Ocean to the Red Sea. Large outbreaks have also occurred in other sub-Saharan African countries.

Symptoms

Usually symptoms appear 4 to 10 days after exposure to the bacteria and typically include sudden onset of headache, fever, stiff neck, sensitivity to light, confusion, and vomiting. The infection can lead to brain damage, hearing loss, or cognitive disabilities in some. Meningococcal Meningitis can cause death in 5% to 10% of patients even if they received prompt treatment. The infection can progress to Meningococcal Sepsis, also known as Meningococcemia, causing a rash, hemorrhaging, and multi-organ failure. A lumbar puncture may be performed to diagnose the illness. Treatment includes antibiotics and supportive care of symptoms.

Prevention
  • Avoid sharing utensils or coming into close contact with people with upper respiratory infections. 
  • Wash your hands thoroughly and frequently with soap and water. If not available, use an alcohol-based hand sanitizer.
  • Stay away from people coughing or sneezing. Use a tissue or your sleeve to cover your sneezes and coughs. 
  • Seek immediate medical attention if Meningococcal Meningitis is suspected.
Vaccination

Quadrivalent vaccination against serotypes ACYW135 is recommended for travellers going to the Meningitis Belt of Africa or to areas with current outbreaks.

There are several inactivated and Meningococcal-containing combined vaccines available. There is also a vaccine against serotype B, but it isn’t available in all countries. Discuss your options with a healthcare provider regarding boosters and / or re-vaccination.


Information last updated: February 23, 2021.

  • Guhadasan R, Carrol ED. Acute Bacterial Meningitis. In: McGill, A; Ryan, E; Hill, D; Solomon, T, eds. Hunter's Tropical Medicine and Emerging Infectious Diseases. 9th ed. New York: Saunders Elsevier; 2013: 501-507.
  • Centres for Disease Control and Prevention: Yellow Book, Meningococcal Meningitis
  • Committee to Advice on Tropical Medicine and Travel, PHAC: Statement on Meningococcal Disease and the International Traveller
  • Public Health Agency of Canada: Canadian Immunization Guide, Meningococcal Vaccine
  • World Health Organization: International Travel and Health, Vaccine Preventable Diseases and Vaccines