Crackdown on vaccination improves Hajj health
After two successive outbreaks of IMD in 2000 and 2001, Saudi Arabia tightened its health regulations, requiring all residents of, and visitors to, Mecca and Medina to be vaccinated.
A study of IMD cases before and after the change shows the mean annual incidence of IMD ranged from 0.25 cases per 100,000 people in 1995, to 1.42/100,000 in the outbreak year of 2000, to a low of 0.01/100,000 in 2010. Case fatality rates dropped from 19.3% in pre-epidemic years to 11.4% in post-epidemic years.
Eurosurveillance 2013; online 12 Sept