Characteristics of Heat Illness during Hajj: A Cross-Sectional Study

Abstract

Introduction Data regarding the characteristics and outcomes of heat illness are lacking in the literature. The present study aimed to identify the clinical characteristics, morbidity, management, and mortality associated with heat illness among Hajj participants. Methods A cross-sectional study was conducted during the Hajj in 2016 on patients who presented to emergency departments and were diagnosed with heat exhaustion or heatstroke. Data were collected using a structured collection sheet developed based on the literature. Results A total of 267 patients were recruited. Of these, 80 (29%) and 187 (67.75%) were diagnosed with heatstroke and heat exhaustion, with 6.3% and 0.0% mortality, respectively. The mean age of the patients was 54.0 ± 16 years. Diabetes mellitus was the most common comorbidity among both heatstroke and heat exhaustion patients. The majority of patients had hyperthermia and electrolyte imbalance. Most of the heat illness cases were treated per heat illness guidelines. Conclusions Although authorities are working on research and forming interdisciplinary teams to prevent health problems during the Hajj, the mortality rate from heatstroke is high and the majority of the patients had hyperthermia, varied signs and symptoms, elevated creatinine levels, and electrolyte imbalances.

Implementing the Health Early Warning System based on syndromic and event-based surveillance at the 2019 Hajj

“…During the deployment period, 121 automated alarms were generated for the following syndromes: acute febrile syndrome without rash (60), severe acute respiratory infections (18), acute febrile syndrome with neurological manifestation (14), acute febrile syndrome with rash (10), heat-related illnesses (HRI) (10), acute jaundice syndrome (7), and chemical injuries (2). Of these, 49 field investigations were conducted and an additional alert was issued for trauma/injuries based on analysis of a hotline-generated event, in the aftermath of an unexpected heavy rainfall in the Hajj areas.…”

“…In contrast to sporting mass gatherings where injuries often arise from athletic activities, the risk of injuries in the Hajj is predominantly heightened by crowd-related incidents (3,12). Heat-related illnesses are among the leading causes of morbidity and mortality at the Hajj, when the pilgrimage is held during the summer months (13)(14)(15). The HEWS surveillance finding is consistent with historical data regarding the geographical distribution of HRI cases during Hajj (13,14).…”

“…Heat-related illnesses are among the leading causes of morbidity and mortality at the Hajj, when the pilgrimage is held during the summer months (13)(14)(15). The HEWS surveillance finding is consistent with historical data regarding the geographical distribution of HRI cases during Hajj (13,14). A plausible reason for the high HRI disease burden in Mina and Arafat is the intensified physical exertion and increased exposure of pilgrims to hot weather as they perform the required Hajj rites in mostly open and unsheltered areas.…”

Health knowledge and attitude practices in Pakistani Hajj Pilgrims.

“…5 Extreme heat of the country causes problems with food storage and dehydration. 6 One major over looked aspect is people travelling with comorbid illnesses and poor education on how to handle the situation. For this reason, the Saudi Government issues guidelines every now and then, to facilitate the pilgrims.…”

“…There is documentation of heat related issues faced by patients during hajj. 6 Management of chronic illness is also another important aspect in which patient knowledge is deficient. 9 these studies are deficient from our perspective, because we live in a different environment.…”