Date: Fri, 27 Sep 2019 03:42:05 +0200 (METDST)
By Anuj Chopra

Riyadh, Sept 27, 2019 (AFP) - Saudi Arabia said Friday it will offer tourist visas for the first time, opening up the ultra-conservative kingdom to holidaymakers as part of a push to diversify its economy away from oil.   Kickstarting tourism is one of the centrepieces of Crown Prince Mohammed bin Salman's Vision 2030 reform programme to prepare the biggest Arab economy for a post-oil era.

The announcement comes just two weeks after devastating attacks on Saudi Arabia's oil infrastructure -- blamed by Washington on Iran -- which roiled global energy markets and raised fears of a wider regional conflict.   "Opening Saudi Arabia to international tourists is a historic moment for our country," tourism chief Ahmed al-Khateeb said in a statement.   "Visitors will be surprised... by the treasures we have to share -- five UNESCO World Heritage Sites, a vibrant local culture and breathtaking natural beauty."

Saudi Arabia will open applications for online tourist visas to citizens of 49 countries on Saturday, Bloomberg News quoted Khateeb as saying.   Khateeb said the kingdom will also ease its strict dress code for foreign women, allowing them to go without the body-shrouding abaya robe that is still mandatory public wear for Saudi women.   Foreign women, however, will be required to wear "modest clothing", he added, without elaborating.   Visas in the desert kingdom, endowed with rich bedouin heritage and archaeological sites, are currently restricted to expat workers, their dependents and Muslim pilgrims travelling to holy sites in Mecca and Medina.

- Hard sell -
In a rare move, Saudi Arabia last year began issuing temporary visas to visitors to attend sporting and cultural events in a bid to kickstart tourism.   But the austere kingdom, which forbids alcohol and has a strict social code, is seen by many as a hard sell for tourists.   Prince Mohammed is seeking to change that through a sweeping liberalisation drive that has brought new cinemas, mixed-gender concerts and sporting extravaganzas to Saudi Arabia.

International criticism of the kingdom's human rights record, including the gruesome murder last year of critic Jamal Khashoggi and a crackdown on female activists, could further put off foreign visitors, observers say.   Fears of a regional conflict after the September 14 attacks on state oil giant Aramco may also dampen the kingdom's appeal to holidaymakers.   The government, reeling from low oil prices, says it hopes tourism will contribute up to 10 percent of the gross domestic product by 2030, compared to three percent currently.   It says by 2030 it aims to attract up to 100 million annual visits by both domestic and foreign tourists.

But the kingdom currently lacks the infrastructure to accomodate visitors in such high numbers, with officials estimating 500,000 new hotel rooms will be required nationwide over the coming decade.   The sector is expected to create up to one million tourism jobs, the government says, as it battles high youth unemployment.   Saudi Arabia has splurged billions in an attempt to build a tourism industry from scratch.

In 2017, the kingdom announced a multi-billion dollar project to turn 50 islands and other pristine sites on the Red Sea into luxury resorts.   Last year, construction of Qiddiya "entertainment city" was launched near Riyadh, which would include high-end theme parks, motor sport facilities and a safari area.   The country is also developing historic sites such as the centuries-old Mada'in Saleh, home to sandstone tombs of the same civilisation which built the Jordanian city of Petra.
Date: Wed 19 Jun 2019 [date accessed]
Source: WHO/EMRO Epidemic and pandemic-prone diseases [edited]
<http://www.emro.who.int/pandemic-epidemic-diseases/mers-cov/mers-situation-update-may-2019.html>

MERS situation update, May 2019
--------------------------
- At the end of May 2019, a total of 2442 laboratory-confirmed cases of Middle East respiratory syndrome (MERS), including 842 associated deaths (case fatality rate: 34.5%), were reported globally; the majority of these cases were reported from Saudi Arabia (2051 cases, including 765 related deaths with a case fatality rate of 37.3%). During the month of May [2019], a total of 14 laboratory-confirmed cases of MERS were reported globally. All 14 cases were reported from Saudi Arabia with 4 associated deaths.

- This month [May 2019], Saudi Arabia has not reported any new cases related to the Al-Khafji city outbreak. The outbreak has presumed to have stopped due to the effective response measures taken by Saudi Arabia. This month [May 2019], one household cluster was reported from Al-Kharj city, including 2 symptomatic national females aged 22 and 44. One 23-year-old national female healthcare worker was also infected this month [May 2019] in Riyadh. All 4 cases that died this month [May 2019] were symptomatic males with one or more co-morbidities.

- The demographic and epidemiological characteristics of reported cases, when compared during the same corresponding period of 2013 to 2019, do not show any significant difference or change.

Summaries:
- Laboratory-confirmed cases reported since April 2012: 2442
- Deaths reported since April 2012 globally: 843
- Number of countries that have reported cases since April 2012: 27
- Number of countries in the Eastern Mediterranean Region that have reported cases since April 2012: 12
- 13 laboratory-confirmed cases reported linked to an outbreak in Saudi Arabia in April [2019]
- The age group 50-59 years continues to be at highest risk for acquiring infection of primary cases. The age group 30-39 years is most at risk for secondary cases. The number of deaths is higher in the age group 50-59 years for primary cases and 70-79 years for secondary cases.

Date: Fri 31 May 2019 Source: Vaxbeforetravel [edited] <https://www.vaxbeforetravel.com/level-1-travel-vaccine-requirements-updated-pilgrims-attending-hajj>

The Hajj, or annual pilgrimage to Mecca, Saudi Arabia, is scheduled for 9-14 Aug 2019, which enables those planning on attending this worldwide event have ample time to appropriately prepare for the trip. The Hajj is one of the world's largest mass gatherings each year and is associated with unique health risks.

More than 2 million Muslims from over 183 countries make Hajj each year, with approximately 11,000 Hajj pilgrims traveling from the United States.

Before attending the Hajj, both the US Centers for Disease Control and Prevention (CDC) and the Ministry of Health in the Kingdom of Saudi Arabia published vaccine requirements and travel recommendations. The CDC updated its Level 1 Travel Alert on 31 May 2019, saying those participating in the Hajj should be up-to-date on all routine vaccines, especially the measles-mumps-rubella (MMR).

The CDC says the measles virus is extremely contagious, and the crowded conditions during Hajj provide an ideal opportunity for measles transmission. As of 7 May 2019, the European Region reported 34 300 measles cases in 42 countries during 2019. For travellers who do not have evidence of measles immunity or who lack written documentation of measles vaccination, the CDC recommends 2 doses of MMR vaccine separated by at least 28 days, to be completed before travel.

Additionally, the Saudi Ministry of Health recommends that Hajj pilgrims confirm they have been vaccinated against these diseases:

- Yellow fever: all travellers arriving from countries or areas at risk of yellow fever transmission must present a valid yellow fever vaccination certificate, stating vaccinated against the disease before the arrival of the Kingdom no later than 10 days and not more than 10 years. The Stamaril vaccine is available in the USA.

- Meningococcal meningitis: visitors are required to submit a valid vaccination certificate with a tetravalent (ACYW135) meningococcal vaccine administered no less than 10 days prior to arrival to Saudi Arabia.

- Poliomyelitis: travellers arriving from countries with circulating wild or vaccine-derived poliovirus (cVDPV2) and from countries at risk of polio reintroduction, are required to submit a valid polio vaccination certificate. - Seasonal influenza: the Ministry of Health in the kingdom of Saudi Arabia recommends that all pilgrims get vaccinated against the 2018/19 seasonal influenza.

Previously, on [15 Apr 2019], a joint declaration regarding vaccinations was issued at the Afghanistan-Pakistan Eminent Ulama Conference. In his opening address, His Excellency the Deputy of Al Azhar Al Sharif, Dr Saleh Abbas Goma Saleh, called upon parents to vaccinate their children to protect them from harm. "The family bears the responsibility of the proper upbringing of, and caring for children and maintaining their health," he said.

The CDC suggests scheduling a visit with a travel vaccine specialist at least 4 to 6 weeks before departure. Travel vaccine counselling sessions can be scheduled at Vax-Before-Travel [<https://www.vaxbeforetravel.com/vax-before-travel/appointment>].

The CDC Vaccine Price List provides the private sector vaccine prices for general information, and vaccine financial support programs can be found at Vaccine Discounts. And, pack enough prescription and over-the-counter medicines to last your entire trip.

The CDC says if you develop a fever and symptoms of respiratory illness within 14 days after traveling from countries in or near the Arabian Peninsula, you should call a healthcare provider and mention your recent international travel.

Americans traveling abroad can enrol with the nearest US embassy or consulate through the Smart Traveler Enrollment Program [<https://travel.state.gov/content/travel/en/international-travel/before-you-go/step.html>] to receive the latest safety updates and assistance in an emergency.  [Byline: Don Ward Hackett]
===========================
[Saudi Arabia issues its requirements for entry into Saudi Arabia for the Hajj, which are updated annually.

The Hajj requirements for 2019 can be found at
<https://www.saudiembassy.net/hajj-requirements>. - ProMED Mod.ML]

[HealthMap/ProMED-mail map of Saudi Arabia: <http://healthmap.org/promed/p/131>]

Date: 26 May 2019
Source: Saudi MOH 23-26 May 2019 [edited]
<https://www.moh.gov.sa/en/CCC/events/national/Pages/2019.aspx>

In the past 4 days since the last update, there have been a total of 3 newly confirmed cases of MERS-CoV infection including 2 deaths reported from Saudi Arabia.
Date: Sun 21 Apr 2019 14:40 IST
Source Business-Standard [edited]
<https://www.business-standard.com/article/pti-stories/health-ministry-left-with-no-vaccines-for-haj-pilgrims-119042100274_1.html>

Following the ban on the Ghaziabad-based pharmaceutical company Biomed Pvt Ltd, the ministry is now looking for options to arrange the vaccines in time for vaccinating the pilgrims, the sources said. Around 1.27 lakh people are expected to go for the annual Hajj pilgrimage in July this year [2019] for which the ministry will have to arrange for at least 1.47 lakh doses. [A lakh is a unit in the Indian numbering system equal to one hundred thousand (100,000).] Extra vaccines are kept as some are rendered ineffective in the process of delivery to the states.

The Health Ministry is already in talks with 2 firms which import the vaccines, the sources said. Those going to Saudi Arabia for the purpose of Umrah or pilgrimage are required to submit a certificate of vaccination with the quadrivalent (ACYW135) vaccine against meningitis, proving the vaccine was administered no more than 3 years ago and no less than 10 days before arrival in the country.

Biomed Pvt Ltd was a licensed indigenous manufacturer for meningococcal polysaccharide vaccine while 2 firms M/s Sanofi Pasteur India Pvt Lt, Mumbai and M/s GlaxoSmithKline Pharmaceuticals Ltd, Mumbai are importers for quadrivalent meningococcal meningitis conjugate vaccine in the country. "Earlier with Biomed Pvt Ltd providing the vaccines, government spent Rs 250 [about USD 3.60] for each vaccine but now if they have to buy from companies which import the vaccines, they may have to shell out around Rs 1500 [about USD 21.50] per dose. The Health Ministry is already in talks with the 2 firms which import the vaccines," the sources said.

Biomed Pvt Ltd was directed to stop the manufacture, sale, and distribution of all human vaccines including the quadrivalent meningococcal meningitis vaccine after type-2 polio virus was found in the sewage and stool samples in Maharashtra, Telangana, and Uttar Pradesh in September [2018]. The polio drops were sent for testing, which confirmed that some of them were contaminated with type-2 virus, a strain believed to have been eradicated in 2016.

The managing director of Biomed Pvt Ltd., which was supplying polio vaccines for only government-run immunisation programmes, was arrested after the central drug regulator filed a complaint and an FIR [first information report] was registered.

The destruction of traces of type-2 polio virus was ordered by the central drug regulator to all manufacturers in 2016.
======================
[The problem with oral polio vaccine manufactured by Biomed Pvt Ltd. being contaminated by poliovirus type 2 was discussed by ProMED-mail moderator MPP in Poliomyelitis update (46): (India, Papua New Guinea) trivalent vaccine, fatal http://promedmail.org/post/20181002.6065964.

Umrah and Hajj are pilgrimages to Mecca, Saudi Arabia, performed by Muslims. Umrah can be undertaken at any time of the year, in contrast to the Hajj. The days of Hajj in 2019 begin in the evening of Fri 9 Aug and end in the evening of Wed 14 Aug. The Hajj is a mandatory religious pilgrimage to Mecca, Saudi Arabia that must be carried out at least once in their lifetime by all adult Muslims who are physically and financially capable of undertaking the journey (<https://en.m.wikipedia.org/wiki/Hajj>); the Umrah is not compulsory (<https://en.wikipedia.org/wiki/Umrah>).

Saudi Arabia issues its requirements for entry into Saudi Arabia for the Hajj, which are updated annually. The Hajj requirements for 2019 can be found at <https://www.saudiembassy.net/hajj-requirements>. With regard to vaccinations, "The applicant must submit proof of vaccination for meningitis and ACYW135. For infants and children up to 15 years of age, a vaccination report is required for polio as well as meningitis and polio.

Children over 15 years of age should present the same vaccinations requested for adults:
============================
a. meningitis and ACYW135;
b. seasonal (or common) flu, which should be taken 2 weeks before applying for the visa;
c. H1N1 flu, if a vaccine is made available before Hajj season, and should be taken 2 weeks before applying for the visa;
d. infants and children up to 15 years of age should provide a vaccination report for meningococcal and polio;
e. children above 15 years of age should present the same vaccinations requested for adults;
f. health experts advise the following groups to postpone their plans for Hajj and Umrah this year for their own safety: The elderly, the terminally ill, pregnant women, and children." "Travelers must carry vaccination certificates with them for inspection by the Saudi Authority at port of entry." - ProMED Mod.ML]

[HealthMap/ProMED map of India: <http://healthmap.org/promed/p/142>]
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