Pilgrimage and the H1N1 (Swine Flu) Virus

Saint Roch, among other things patron saint of epidemics. Note that he is dressed in the garb of a pilgrim to Santiago de Compostela!

Yesterday I received a note from a news group on the Camino de Santiago about the dangers of the H1N1 virus (my wife is a physician with a specialty in public health, and she forbids my use of the term "swine flu" in favor of the more technically correct H1N1!) for pilgrims this autumn and winter. Fear of the virus is not an idle one, for Spain has one of the highest rates of infection and death among Northern Hemisphere countries. In the Southern Hemisphere where the winter flu season is just ending, Brasil, a major source of pilgrims to Santiago de Compostela, has the largest number of deaths attributable to H1N1 of any country where reliable records are kept. Fortunately pilgrimage to Santiago is mostly a summer phenomenon with the largest numbers during the warmer months, peaking on July 25 St. James Day. In consequence even if over the winter flu season the pilgrimage suffers from the potential pandemic, only a fairly small number of people will likely be struck with the illness. A daily general report on the situation and forecasts for Europe with data for much of the world is provided by the European Centre for Disease Prevention and Control.

The Hajj is perhaps the largest gathering of pilgrims from many parts of the world into a single place over a short time period. The 2009 pilgrimage is expected to be from 25-30 November, well into the Northern Hemisphere flu season. While most government officials in Saudi Arabia are dismissing the dangers of a pandemic, health authorities in the various other countries sending pilgrims to Mecca have expressed great concern about the dangers of the H1N1 virus. Egypt has even considered a ban on its nationals making the trip to Medina and Mecca. In Saudi Arabia religious officials have warned about the disease, and at least one cleric has issued a fatwa against people carrying the disease making the Hajj.

Elsewhere I have not found many reports of linkages between pilgrimages other than the Hajj and the virus. India, a country with numerous pilgrimages involving large numbers of people, is greatly concerned with the spread of the disease, but I was unable to locate any materials in a western European language on its linkage to pilgrimages other than the Hajj. China is taking particularly aggressive measures to control the spread of the virus, limiting pilgrimages of its Muslim citizens to Mecca and imposing quarantine on visitors to China suspected of carrying the virus. Meanwhile Iran claims that half of all its cases of H1N1 are pilgrims returning from Saudi Arabia.

The concern about the spread of H1N1 is important, for the virus could create a demographic disaster given its tendency to strike young adults, especially pregnant women. Pilgrimages have been important in the spread of disease for at least as long as epidemiologists are able to trace records. The ease of travel and the dispersed origins of pilgrims to major sites like Mecca or Santiago mean an epidemic can quickly spread from a local site to much of the world. I will write more about this later if conditions suggest updates.