Manama: For Saudi Arabia officials, the challenge of dealing with a crowd as large as the two million people expected from around the globe to perform Umrah during the current month of Ramadan, the Muslim month of fasting, has this year gained an unexpected dimension: The threat of the latest viral respiratory illness, the Middle East Respiratory Syndrome Coronavirus (Mers-CoV).

According to officials, 38 people have so far died from the Mers coronavirus circulating in the country. The health ministry has leapt into the forefront of the battle waged by the authorities with Mers as Ramadan started and three months ahead of the larger gathering of the Haj, the annual pilgrimage when more than three million people gather in Makkah and its outskirts over five days.

“In order to enable people to perform the rituals easily, healthily and conveniently, and within the framework of the precautionary measures against Novel Coronavirus (Mers-COV), the Ministry of Health has issued health regulations and requirements,” the health ministry said in a statement. “They must be met by those coming to the Kingdom for performing Umrah and Haj for the year 1434 Hijri.”

The ministry recommended “postponing Umrah and Haj this year by the elderly, patients suffering from chronic diseases such as heart, kidney, and respiratory diseases and diabetes, patients with congenital and acquired immune deficiency, patients suffering from tumours, as well as pregnant women and children.” Those who make it to the holy city of Makkah should be extra careful with hand hygiene, make sure they sneeze or cough into a paper tissue or the inside of their elbow, and must be up-to-date with all their vaccinations, the ministry said. The no-risk policy has been dictated by the threat posed by Mers-CoV.

Although similar to the Severe Acute Respiratory Syndrome (Sars) coronavirus (Sars-CoV), the new disease is reportedly much more deadly. Sars-CoV, which sparked a global health scare in 2003 and killed 800 people, had a 10 per cent death rate, while the fatality rate is as high 50 per cent with Mers-Cov, causing grave concerns among health officials.

According to health authorities, 45 deaths have been recorded worldwide until July 12 out of 81 cases. Saudi Arabia leads with 38 deaths from 66 cases, while the other deaths occurred in Jordan (two from two cases), UK (two from three cases), Tunisia (one from two cases), France (one from two cases) and the UAE (one from one case). The family of the Tunisian man said that he had just returned home from a trip to Saudi Arabia.

The first case of Mers-CoV was detected last year and the first victim was identified as an adult male in Saudi Arabia who reportedly had “SARS-like” symptoms. Another adult man from Qatar died a few months later, reportedly after visiting Saudi Arabia. Laboratories confirmed that he had a Mers-CoV infection. Most patients who were infected with Mers-CoV developed severe acute respiratory illness with symptoms of fever, cough, and shortness of breath, and kidney failure.