Last month around two million international pilgrims travelled to Mecca in Saudi Arabia to join in the annual Islamic Hajj pilgrimage before returning home to their countries of origin. Crowded close human and animal contact has caused previous communicable disease outbreaks.1 Coronaviruses2 such as Middle East respiratory syndrome coronavirus (MERS-CoV), which causes Middle East respiratory syndrome (MERS), have resulted in nosocomial outbreaks characterised by early nosocomial super-spreading events and transmission patterns involving healthcare workers. This poses great clinical concern as a potential cause of epidemics and threat to global health.

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