Intended for healthcare professionals

Letters MERS-CoV and the Hajj

Middle East respiratory syndrome coronavirus (MERS-CoV) in pilgrims returning from the Hajj

BMJ 2015; 351 doi: (Published 30 September 2015) Cite this as: BMJ 2015;351:h5185
  1. Alexander Kumar, NIHR academic clinical fellow infectious diseases1,
  2. Gail Beckett, senior health protection nurse2,
  3. Martin Wiselka, infectious diseases consultant1
  1. 1Department of Infection and Tropical Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
  2. 2Public Health England, East Midlands Centre, Nottingham City Hospital, Nottingham, UK
  1. ak583{at}

Last month around two million international pilgrims travelled to Mecca in Saudi Arabia to join in the annual Islamic Hajj pilgrimage before returning home to their countries of origin. Crowded close human and animal contact has caused previous communicable disease outbreaks.1 Coronaviruses2 such as Middle East respiratory syndrome coronavirus (MERS-CoV), which causes Middle East respiratory syndrome (MERS), have resulted in nosocomial outbreaks characterised by early nosocomial super-spreading events and transmission patterns involving healthcare workers. This poses great clinical concern as a potential cause of epidemics and threat to global health.

In Saudi Arabia, 1231 MERS-CoV infections have resulted in 521 deaths and onward transmission to 21 …

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