Travellers arriving in Saudi Arabia must carry vaccination certificates with them for inspection by the Saudi Authority at port of entry. Hajj and Umrah pilgrims and seasonal workers at the pilgrimages are at increased risk due to the crowded conditions and possible close contact with people from countries with higher rates of meningococcal disease.
Meningococcal disease in Saudi Arabia
The UKHSA and Foreign and Commonwealth Office (FCO) are both actively reminding possible travellers of this following five confirmed UK cases of serogroup W (MenW) associated with people travelling to Saudi Arabia in February and March 2025. Outbreaks of meningococcal meningitis were reported in 1987, 2000 and 2001 during the Hajj. Practices should expect more patients to be seeking meningococcal ACWY vaccinations due to this advice and suggest patients check they have had one within the appropriate window if a patient mentions they plan to travel to Saudi Arabia.
Meningococcal disease vaccination
For pilgrims and seasonal workers proof of vaccination with a meningococcal ACWY vaccine is a visa requirement for entry.
- Age 14-24 – MenACWY can be administered in general practice on request (catch-up, where not administered under schools programme. Core and IoS).
- Age 25+ – MenACWY can be administered in general practice on request (core contract).
When the meningococcal ACWY conjugate vaccine is used, this should be given at least 10 days before, and within the last 5 years of planned travel. Details of the vaccine name and type (ie conjugate vaccine) should be recorded in a patient held vaccine record showing the traveller’s full name. It is advisable that this vaccination record is issued by the traveller’s doctor, nurse or pharmacist and should reflect accurately details of the vaccine administered and be authenticated with the healthcare providers official stamp.
The meningococcal ACWY conjugate vaccine is recommended. If a polysaccharide ACWY vaccine has been administered previously (no longer available in UK) it should have been administered within the last 3 years of planned travel.
Prevention advice for patients
Meningococcal disease is a bacterial infection transmitted by inhaling respiratory droplets or direct contact with respiratory secretions from an infected person. This is usually following prolonged or frequent close contact. The most common forms of meningococcal disease are meningococcal meningitis (infection of the protective lining around the brain) and septicaemia (blood poisoning) – these are severe conditions that can kill or leave people with life-changing disabilities.
Travellers may reduce their risk by avoiding overcrowded situations where possible. While risk to UK travellers remains low, pilgrims should:
- Avoid consuming raw or undercooked animal products.
- Avoid contact with camels and animal waste.
- Practise good hygiene, particularly washing hands after visiting farms, barns or markets.
Symptoms patients should be looking for
While abroad and in the 2 weeks after returning to the UK, pilgrims and travellers returning from Saudi Arabia should monitor for symptoms such as:
- fever,
- severe headache,
- vomiting,
- stiff neck,
- rash,
- extreme sleepiness, and/or
- seizures.
Symptoms may resemble flu initially and can appear in any order, but can lead to serious illness within hours. Anyone who has symptoms and becomes concerned about their own or someone else’s health should seek immediate medical advice or dial 999 in a medical emergency.
If you or anyone at home becomes unwell with fever, coughing or breathing difficulties or other symptoms of meningitis within two weeks of returning from Saudi Arabia, contact your GP or NHS 111, mentioning your recent travel history and any contact with respiratory cases, healthcare facilities or camels during travel, or dial 999 in case of emergency.
This information is contained in the UKHSA and FCO advice which practices may wish to point patients to.
The UKHSA has this page describing meningitis symptoms to patients, at the bottom of it are download links to translated versions.