Zahedan University of Medical Sciences

Implementation of International Health Regulations (IHR) and screening of the 2018 Hajj pilgrims for communicable disease upon arrival at the Zahedan International Airport, southeast of Iran

Report from: ZAUMS Communicable Diseases Control Department

Published on: 9 September 2018

One of the largest regular mass gatherings in the world is the Hajj, that involves over two million Muslims from all over the world. Mass gatherings may pose major public health challenges, particularly the transmission of infectious diseases. Respiratory and gastrointestinal tract bacterial and viral infections can spread rapidly and affect attendees of mass gatherings.

Following the approval and putting into effect of International Health Regulations, all members of the World Health Organizations are required to pave the way for its full implementation. In compliance with guidelines prepared by the Iranian Ministry of Health, Zahedan University of Medical Sciences implemented the International Health Regulations (IHR) upon arrival of the Hajj pilgrims through public health prevention and the syndromic surveillance programs.

During the operation, a total of 23 health workers including medical doctors, communicable diseases control officers, environmental health officers along with emergency paramedics were deployed.  The hospitals affiliated with Zahedan University of Medical Sciences , including the Boo-Ali Infectious Diseases Specialty Hospital, with medical and surgical wards and intensive care units were on alert during pilgrims flights back, so that in case of emergency, they could render optimal health services to the pilgrims. All public health and medical teams offer high quality of care to ensure the risks of ill health to all pilgrims and the wider society are minimal. Furthermore, two rapid response back up teams were predicted for emergency situations.

A total of 2068 Hajj Pilgrims from 15 caravans arrived at the Zahedan International Airport were screened for communicable diseases at the Border Health Surveillance Unit stationed at the airport. Border Health Surveillance Units are the first spot for control and prevention of potential health hazards from people traveling abroad. Considering the large number of pilgrims, the possibility of transmission and spread of communicable diseases from the host country and other countries which dispatch pilgrims is so high. Therefore,  the main objective of the implementation of the IHR is the control and prevention of communicable diseases. The pilgrims with acute respiratory diseases, who had high temperature and respiratory symptoms were directed to the physicians and were instructed with regard to preventive measures and if needed samples were taken for influenza viruses, and if necessary, they were  dispatched to the hospitals. All the suspected cases were recorded in a web-based Syndromic  Surveillance System database designed by the Iranian Ministry of Health.

A total of 22 Hajj pilgrims with respiratory symptoms were referred to hospital and one person was admitted for severe acute respiratory infection. The hospitalized patient was a known case of asthma who contracted infection during the Hajj. No confirmed cases of MERS-Cov or influenza was detected among the suspected cases.

The patients with reparatory symptoms were recommended using face masks and avoiding hugging and kissing those who come to visit them, have full rest in a separate room, and avoiding presence in gatherings after manifestation of symptoms based on physicians’ instructions.

The pilgrims arriving at the airport were requested to immediately report any  symptoms such as fever, cough, sore throat, short breathing in themselves or those in their company within 14 days of their arrival. Pilgrims’ awareness raising was also carried out by public health teams and  pamphlets containing relevant health messages were distributed.

The public health teams of Zahedan University of Medical Sciences prior to the departure of the pilgrims to the Hajj  organized various training sessions and  provided the pilgrims with important health related instructions and necessary preventive measures.

Copyright © 2018 Zahedan University of Medical Sciences. All rights reserved.Date updated: 09/09/2018

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