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Biological Attack

Author: Laurie Garrett, Senior Fellow for Global Health
October 22, 2013


As the annual hajj came to its end in early October, and hundreds of thousands of pilgrims departed Saudi Arabia having honored the highest traditions of Islam, the kingdom cautiously breathed a sigh of relief: No epidemic erupted among the roughly 1.4 million visitors. But though it may have seemed that attentions were focused on concern over the possible spread of the Middle East respiratory syndrome MERS -- a disease that has affected more than 135 people in eight countries, killing 45 percent of those infected -- for months Saudi health authorities have been keeping a nervous eye on another disease, polio, which is spreading rapidly across the Middle East, most recently inside war-torn Syria.

Though Saudi Arabia has been polio-free for decades, its Ministry of the Hajj has always borne special responsibility for the health and safety of all religious pilgrims to the holy city of Mecca. In Muslim tradition Crown Prince Abdullah, himself, is the custodian of the Two Holy Mosques, accountable for any tragedies that befall sacred visitors.

Given the intense religious significance of Saudi Arabia's responsibilities, all possible disease outbreaks among pilgrims are a concern for the government. But it has been a long time since the Ministry of the Hajj had to take a position that stands diametrically opposite to the stance held by some followers of the faith: when it came to polio, the Kingdom stood firmly against Muslim extremism. This year, the ministry insisted that all pilgrims be fully immunized against polio, and bring proof of vaccination as part of their visa application process. Given that Muslim extremists -- the Taliban and some al-Qaeda adherents -- oppose polio vaccination, and have executed immunizers, the Saudi position was gutsy.

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