This year's Haj was epidemic-free with very minimal spread of infectious diseases, said a visiting team of the United States Centers for Disease Control and Prevention (CDC), Saturday in Makkah. The Ministry of Health has succeeded in fighting the swine flu virus (H1N1), remarkably reducing the risk of flu exposure for pilgrims at increased risk of flu complications. Only 20 percent of this year's pilgrims were vaccinated against swine flu, the team said. The World Health Organization (WHO) and CDC would credit the Ministry of Health for this achievement, the CDC team said. As of Thursday, there were only 57 proven infections and less than 20 more suspected cases, according to health ministry spokesman Khaled Merghalani. The infections were not concentrated in any specific group of pilgrims, though the largest number was from those coming from south and southeast Asia, the source of the largest number of pilgrims to the Haj overall. Health officials expressed relief at the low number. But since the flu's incubation period can be as long as a week, the number of cases from the Haj will not be known until after pilgrims return home, starting Sunday. Then it will be up to their home countries to monitor new cases. “We don't expect there to be a big number of cases in the next two days; it will be the week after Haj when you will see the escalation,” said a WHO official. The CDC team, involved in the Haj for the first time after fears of a breakout of swine flu among pilgrims, arrived in the Kingdom two months ahead of the Haj to inspect entry points of pilgrims and the health situation at the holy sites within a collaborative program with the Ministry of Health. The team has worked with highly sophisticated devices that can detect infections in crowded and grouping areas. All data registered are property of the Saudi government. The CDC team will not be able to take the information to their headquarters in Atlanta, Georgia, US. A CDC survey revealed that at least 60 percent of this year's pilgrims are aware of swine flu, said Shahul Ebrahim, who is part of the CDC team. American and Saudi health officials circulated among the sprawling tent camp at Mina where the pilgrims live and gave the faithful cheek swabs for testing later. Health authorities hung posters of correct hand washing, and hand sanitizer dispensers were placed on walls in the camps, near public bathrooms and at ritual sites. So far, five pilgrims have died from swine flu since arriving in Saudi Arabia. Many pilgrims already infected may have such mild symptoms they do not even know they are infected. Others simply do not seek treatment. “A guesstimate is that 30 percent of sick people will not come in for treatment because they are afraid of missing some of the rituals,” said Ebrahim. Saudi Arabia this year recommended that those highly susceptible to H1N1 - the very young and the very old - stay away this year, and that may have had some impact in limiting cases. Still, some pilgrims were seen carrying newborn babies and dragging infants behind them as they circled the Ka'ba. Many elderly pilgrims were feebly slumped in wheelchairs as relatives pushed them through the motions of the rites. For the old in particular, it is hard to pass on the Haj, since many want to do it at least once in their lifetimes. World health authorities are concerned about the H1N1 virus because it is a new strain to which the vast majority of the world's people have no immunity. While it is mostly mild right now, the flu could mutate into a more dangerous form the more it circulates. The same Haj petri dish that could help the disease spread gives epidemiologists a unique chance to study the virus. Saudi and CDC experts are working to get cheek swabs from a representative sample of the population for later study. Some pilgrims were swabbed upon entry at the airport and at exit, said Ebrahim. Authorities have also begun taking samples from illegal pilgrims who sneak in by land or sea without Haj visas and have set up sprawling makeshift camps on the rugged mountains of Mina. The samples will be tested for H1N1 and any new strains of the swine flu that may have developed. “This data will help with what to do in future mass gatherings, like the World Cup,” Ebrahim said.
