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Update April 12, 2024

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Saudi Arabia

Travel Advisory January 24, 2024

Saudi arabia - level 3: reconsider travel.

Updated after periodic review to provide information on the risk of arrest due to social media use and the importation of prohibited items.

Reconsider travel to Saudi Arabia due to  the threat of missile and drone attacks.   Exercise increased caution in Saudi Arabia due to  terrorism, the risk of arrest based on social media activity, and importation of prohibited items.  Some areas have increased risk.  Read the entire Travel Advisory.

Do not travel to the following locations due to the threat of  missile and drone attacks  and  terrorism :

• Within 50 miles of the Saudi-Yemen border, as well as the cities of Abha, Jizan, Najran, and Khamis Mushayt;
• Abha airport;
• Qatif in the Eastern Province and its suburbs, including Awamiyah.

Country Summary : U.S. government personnel under Chief of Mission responsibility must adhere to the above travel restrictions.  As such, the U.S. government has limited ability to provide emergency services to U.S. citizens in these locations.

Missile and drone attacks perpetrated by Iran and Iran-supported militant groups have occurred as recently as September 2023.  The Islamic Republic of Iran has in the past supplied Yemen-based Houthis and regional proxy groups with weapons to conduct destructive and sometimes lethal attacks using drones, missiles, and rockets against a variety of Saudi sites, including critical infrastructure, civilian airports, military bases, and energy facilities throughout the country, as well as vessels in Red Sea shipping lanes.  Past attacks were aimed at targets throughout Saudi Arabia including Riyadh, Jeddah, Dhahran, Jizan, Khamis Mushayt, the civilian airport in Abha, Al Kharj, military installations in the south, as well as oil and gas facilities.

Debris from intercepted drones and missiles has also represented a significant risk to civilian areas and populations in the recent past.  Militant groups have threatened to conduct attacks against locations in Saudi Arabia.  U.S. citizens living and working near military bases and critical civilian infrastructure, particularly near the border with Yemen, are at heightened risk if missile, drone, or rocket attacks reoccur.

Terrorism continues to be a concern in Saudi Arabia.  Attacks can occur with little or no warning.  Past attacks have targeted tourist locations, large gatherings, transportation hubs, markets/shopping malls, and local government facilities.  Terrorists are also known to time attacks around major holidays and/or in response to military operations.  Terrorists have targeted both Saudi and international interests, mosques and other religious sites (both Sunni and Shia), and places frequented by U.S. citizens.

Be advised that social media commentary – including past comments – which Saudi authorities may deem critical, offensive, or disruptive to public order, could lead to arrest .  This may include posting, re-posting, or liking comments about Saudi institutions, policies, and public life.  U.S. citizens have been convicted for social media activity under Saudi laws concerning cybercrime, terrorism, and disrupting public order.  Punishment for social media activity has included prison sentences of up to 45 years in some cases.  Saudi courts do not necessarily consider the timeframe of the posts or the location from which they were made to be material to these cases.

The importation of drugs (including marijuana), drug paraphernalia, alcohol, weapons, pork, or any materials that could be considered pornographic or suggestive, is prohibited.   Penalties for drug possession, consumption, and trafficking are severe by U.S. standards.  An extensive list of banned items is available on our Saudi Arabia country information page .

Due to risks to civil aviation operating within the Persian Gulf and the Gulf of Oman region, including Saudi Arabia, the Federal Aviation Administration (FAA) has issued an advisory Notice to Air Missions (NOTAM).  For more information U.S. citizens should consult the  Federal Aviation Administration’s Prohibitions, Restrictions and Notices .

Read the  country information page  for additional information on travel to Saudi Arabia.

If you decide to travel to Saudi Arabia:

• Visit our website for information on  travel to high-risk areas .
• Stay alert in large crowds and/or locations frequented by foreign nationals.
• Obtain comprehensive medical insurance that includes medical evacuation.
• Review local laws and conditions before traveling, including our Saudi Arabia country information on arrest notification and the Department of State’s general information on arrests of U.S. citizens abroad .
• Enroll in the  Smart Traveler Enrollment Program  ( STEP ) to receive Alerts and make it easier to locate you in an emergency.
• Follow the Department of State on  Facebook  and  Twitter .
• Follow the U.S. Embassy in Saudi Arabia on  Facebook  and  Twitter .
• Review the  Country Security Report   for Saudi Arabia.
• Visit the CDC page for the latest  Travel Health Information  related to your travel.
• Prepare a contingency plan for emergency situations. Review the  Traveler’s Checklist .

Yemen Border, Abha airport, and Qatif in the Eastern Province and its suburbs, including Awamiyah – Level 4: Do Not Travel

Militants in Yemen have attacked Saudi border towns and other sites in Saudi Arabia with armed drones, missiles, and rockets .  Civilians that are near the border with Yemen are especially at risk.   Terrorist groups continue plotting possible attacks in Saudi Arabia, including in Qatif.

The U.S. government has limited ability to provide emergency services to U.S. citizens within 50 miles of the Saudi-Yemen border as U.S. government personnel and their families are restricted from travel to this area.

Visit our website for information on  travel to high-risk areas

Embassy Messages

View Alerts and Messages Archive

Quick Facts

A valid passport is required for U.S. citizens to enter or exit the Kingdom of Saudi Arabia. A minimum of six months’ validity beyond the date of travel is recommended.

One page required for entry stamp.

Required for certain visa classes

More than 16,000 USD must be declared. Customs details are here .

Embassies and Consulates

The normal work week in Saudi Arabia is Sunday through Thursday.

U.S. Embassy Riyadh Abdullah Ibn Hudhafah As Sahmi Street Roundbaout no. 9, Diplomatic Quarter Riyadh, Saudi Arabia Telephone: (966) (11) 488-3800 Emergency Telephone: (966) (11) 488-3800 Fax: (966) (11) 488-7670 [email protected]

U.S. Consulate General Jeddah Al Safa Street, Al Muhammadiyah District, near the new American School building. Jeddah, Saudi Arabia Telephone: (966) (12) 220-5000 Fax: (966) (12) 220-5093 [email protected]

U.S. Consulate General Dhahran Off King Saud bin Abdulaziz Road, at the corner of Salaheddin al Ayoubi Street and Prince Fahd bin Sultan bin Abdulaziz Street, Dhahran, Saudi Arabia Telephone:   (966) (13) 839-5700 Emergency Telephone:   (966) (13) 839-5700 Fax:   (966) (13) 330-6816 [email protected]

Destination Description

Learn about the U.S. relationship to countries around the world.

Entry, Exit and Visa Requirements

See the  Embassy of Saudi Arabia’s website  for visa information.

COVID-19 Requirements: There are no COVID-related entry requirements for U.S. citizens.

For residency permit-holders (iqama), an exit/reentry permit is required to leave Saudi Arabia as well as six month’s validity on your passport to request an exit/reentry permit.

• Saudi law requires that residency permit-holders carry their residency card (iqama) at all times while in the Kingdom. Failure to do so could result in a fine of 3,000 Saudi riyals and a jail sentence of six weeks.
• Females and minors may require a male guardian’s permission to leave the country, including U.S. citizens or dual-nationals.
• You must exit Saudi Arabia using the passport for the nationality corresponding to the one on which you entered Saudi Arabia.

Saudi law requires all Saudi citizens to enter and depart the country with a Saudi travel document. If you enter the country on a Saudi laissez-passer (temporary travel document), you may encounter difficulty leaving the Kingdom.

Saudi embassies do not have the authority to adjudicate citizenship claims or issue passports, but they may issue a laissez-passer for presumed Saudi citizens for whom citizenship has not been adjudicated, such as children of a Saudi parent or parents who were married outside of Saudi Arabia. Once admitted to Saudi Arabia on a laissez-passer, the traveler must obtain a Saudi passport before leaving the country. Saudi nationality is not conferred quickly or easily, and the processing time for a Saudi passport in these cases has often been six months or years in some cases. Obtaining a U.S. passport will not help, as you will not be able to leave Saudi Arabia without an exit visa which will not be granted if you entered as a Saudi citizen.

The Department strongly recommends that U.S. citizens enter Saudi Arabia on a U.S. passport and Saudi visa, and not a laissez-passer.

Length of Stay:  Bearers of tourist visas are generally admitted for a 90-day stay and may not remain in the Kingdom more than 180 days in a twelve month period. Carefully check your visa validity and length of stay granted, and clarify any questions on permitted length of stay with Saudi immigration officials on arrival. Dates are calculated in accordance with the Hijri calendar, which differs from the Gregorian calendar.

If you overstay your visa, you could face significant fines, detention, and/or deportation, and a ban from returning to Saudi Arabia.

The U.S. Embassy is unable to intercede, reduce fines, or prevent incarceration if you violate Saudi law.

Travel Bans:  When placed under a travel ban, you cannot exit the country, even if you are a U.S. citizen or a dual U.S.-Saudi citizen. Travel bans are rigidly enforced and can take months or even years to resolve. Only Saudi Arabian authorities and sponsors can remove travel bans.

The government may issue travel bans on people who are/have:

• charged with criminal offenses;
• under investigation;
• involved in financial or labor disputes;
• failed to report to work according to the terms of the contract (absconded);
• unpaid debts or who have passed bad checks.

The list above is not exhaustive. Private Saudi citizens may also initiate travel bans against foreign citizens for various reasons.

Residency Permits:  If you are seeking residency in Saudi Arabia, make sure you have all required legal documents authenticated before arriving. Neither the U.S. Embassy in Riyadh nor the U.S. Consulates General in Jeddah or Dhahran can provide this service.

You should have all U.S. issued documents authenticated by the  Department of State Office of Authentications  (202-485-8000) and attested by the  Embassy of Saudi Arabia  in Washington D.C.

Work Visas: If you plan on working in Saudi Arabia, you must obtain a work visa before you arrive. Foreigners working in Saudi Arabia are subject to the country’s sponsorship system, which concedes substantial legal authority over the worker to the employer. This can include the ability to prevent the employee from leaving the country. American citizens considering working in Saudi Arabia should carefully review the information about employment in the “Local Laws and Special Circumstances” section below.

If the visitor or business visa has been annotated “not permitted to work,” you are not allowed to legally work in Saudi Arabia. You risk substantial financial penalties, detention, deportation, and a ban from returning to Saudi Arabia if you work without legal permission. Additionally, without a work visa, there would be no legal grounds to pursue a case against an employer should a dispute arise.

HIV/AIDS:  To obtain work and residence permits, you are required to obtain a medical report or physical examination confirming that you are free from contagious diseases, including HIV/AIDS and hepatitis. If you test positive for HIV/AIDS or hepatitis, you will not be allowed to work in the Kingdom. Saudi Arabia has not imposed HIV/AIDS or hepatitis travel restrictions on other categories of travelers. Please inquire directly with the  Embassy of Saudi Arabia  before you travel.

Vaccinations:  Visitors to Saudi Arabia should check vaccination requirements on the  Saudi Ministry of Health website.

Yemen Travel:  The Department strongly advises U.S. citizens against travel to Yemen due to the ongoing conflict in that country. See our  Yemen Travel Advisory  for further information. A visa is required to enter Saudi Arabia, and Saudi authorities generally do not permit foreign citizens to enter Saudi Arabia using land border crossings from Yemen. The Embassy and Consulates General cannot provide assistance to U.S. citizens seeking to cross the Yemeni-Saudi border.

Safety and Security

The Department of State advises you to exercise increased caution when traveling to Saudi Arabia due to terrorism and the threat of missile and drone attacks on civilian targets. See the Travel Advisory for Saudi Arabia here .

Do not travel:

• Within 50 miles of the border with Yemen due to terrorism and armed conflict.

Terrorist groups continue plotting possible attacks in Saudi Arabia. Terrorists may attack with little or no warning, targeting tourist locations, transportation hubs, markets/shopping malls, and local government facilities. Terrorists have targeted both Saudi and Western government interests, mosques and other religious sites (both Sunni and Shia), and places frequented by U.S. citizens and other Westerners.

Houthis operating in Yemen have fired long-range missiles into Saudi Arabia, specifically targeting populated areas and civilian infrastructure; they have publicly stated their intent to continue doing so. Missile attacks have targeted major cities such as Riyadh and Jeddah, Riyadh’s international airport, Saudi Aramco facilities, and vessels in Red Sea shipping lanes. Rebel groups are also in possession of unmanned aerial systems (UASs or drones) which they have used to target civilian infrastructure and military facilities in Saudi Arabia. U.S. citizens living and working on or near such installations, particularly in areas near the border with Yemen, are at heightened risk of missile and drone attack.

On October 11, 2018 the Saudi General Authority for Civil Aviation issued a Notice to Airmen about threats to civil aviation and airports in Saudi Arabia posed by missiles and UASs launched from Yemen. For more information, U.S. citizens should consult the U.S. Government’s Defense Internet NOTAM Service (Type “OEJD” in the search field, then click “View NOTAMs,” then scroll down to W0438/18 and click to view).

The U.S. government has limited ability to provide emergency services to U.S. citizens in the following locations as U.S. government personnel and their families are restricted from travel to:

• Within 50 miles of the Saudi-Yemen border, including the cities of Jizan and Najran;
• Qatif in the Eastern province and its suburbs, including Awamiyah.

You can find additional details relating to safety and security in our Travel Advisory and Alerts and the website of the U.S. Mission in Saudi Arabia .

Crime: Crime in Saudi Arabia has increased over recent years but remains at levels far below most major metropolitan areas in the United States.

• You should be aware of your surroundings, keep valuables out of sight and secure, and travel with a companion, if possible.
• Some Saudi citizens who perceive that a foreigner is not observing conservative standards of conduct or dress have been known to harass, pursue, or assault that person.
• Even when released from detention, witnesses to criminal incidents may be prohibited from leaving the country until investigation of the incident is complete.

See the websites of the Department of State  and the  FBI for information on scams.

Victims of Crime: If you or someone you know becomes the victim of a crime, you should contact the local police at “999” and contact the Embassy in Riyadh or one of the Consulates in Jeddah or Dhahran.Remember that local authorities are responsible for investigating and prosecuting the crime.

See the Department of State’s webpage on help for U.S. victims of crime overseas .

The Department can:

• help you identify appropriate medical care;
• assist you in reporting a crime to the police;
• contact relatives or friends with your written consent;
• explain the local criminal justice process in general terms;
• provide a list of local attorneys;
• provide information on victim’s compensation programs in the U.S. ;
• provide an emergency loan for repatriation to the United States and/or limited medical support in cases of destitution;
• help you find accommodation and arrange flights home;
• replace a stolen or lost passport.

Domestic Violence: If you are the victim of any form of physical violence, including domestic violence, you should contact the Saudi police by calling “999”.  In addition, victims of domestic violence can contact the Saudi National Domestic Violence Hotline by dialing “1919.” The Saudi Ministry of Labor and Social Development runs a network of shelters for women and children. Contacting the domestic violence hotline (“1919”) is the only way to access these shelters. The Saudi National Family Safety Program also runs a Child Help Line “116111” and can assist children in accessing Saudi social services.

When reporting domestic violence, it is imperative to get a case reference number as all Saudi social and legal assistance is tied to this case number. It is also a good idea to document any injuries and obtain a copy of any medical reports. U.S. citizens should be advised that filing a police report or utilizing any Saudi victims’ assistance services may result in the Saudi authorities informing your sponsor or guardian.

U.S. citizen victims of domestic violence may contact the Embassy or Consulates for assistance.

Tourism:  The tourism industry is unevenly regulated, and safety inspections for equipment and facilities do not commonly occur. Hazardous areas/activities are not always identified with appropriate signage, and staff may not be trained or certified either by the host government or by recognized authorities in the field. In the event of an injury, appropriate medical treatment is typically available only in/near major cities. First responders are generally unable to access areas outside of major cities and to provide urgent medical treatment. U.S. citizens are encouraged to purchase medical evacuation insurance. See our webpage for more information on insurance providers for overseas coverage .

Local Laws & Special Circumstances

Dual Citizenship: Saudi Arabia generally does not recognize dual nationality. Saudi law requires Saudi citizens to obtain official permission from the government before obtaining a second nationality. At times, Saudi authorities have confiscated the passports of U.S. citizens applying for Saudi citizenship. This does not constitute loss of U.S. citizenship. If this happens to you or someone you know, report the incident to the U.S. Embassy.

Arrest Notification: If you are arrested or detained, ask police or prison officials to notify the U.S. Embassy or consulate immediately. Be aware that Saudi Arabia generally restricts consular notification of the arrest of foreigners to the Embassy of the country that issued the travel document used to enter the Kingdom. If you enter Saudi Arabia with a Saudi travel document, or with the passport of a country other than the United States, it will be extremely difficult for the U.S. Embassy to provide consular services if you are subsequently detained. Persons detained in Saudi Arabia may be held without charges for lengthy periods and denied access to counsel; dual citizens may not have consular assistance. See the Embassy’s webpage for further information.

Drones: The importation of drones for commercial or personal use is prohibited without prior approval from the General Authority for Civil Aviation (GACA). A customs clearance certificate authorizing importation can be obtained as part of the GACA approval process. Visit GACA’s website for further information.

Criminal Penalties: While in Saudi Arabia, you are subject to local laws. If you violate Saudi laws, even unknowingly, you may be expelled; arrested; imprisoned; held without trial for lengthy periods of time; interrogated without counsel; subject to corporal punishments, including lashings; or executed.

Penalties for the import, manufacture, possession, and consumption of alcohol or illegal drugs in Saudi Arabia are severe. Convicted offenders can expect long jail sentences, heavy fines, public floggings, and deportation. The penalty for drug trafficking is death. Furthermore, some laws are prosecutable in the United States regardless of local law. For examples, see our webpage on crimes against minors abroad and the Department of Justice website .

There are substantial limitations on freedom of speech and political expression in Saudi Arabia. For additional information see the Department of State’s Human Rights Report for Saudi Arabia .

Faith-Related Travel Issues: Islam is the official religion of the country and is present in all aspects of life in Saudi Arabia. See our Hajj and Umrah Fact Sheet .

• Saudi authorities do not permit criticism of Islam or Muslim religious figures, including on social media.
• The government prohibits the public practice of religions other than Islam. Non-Muslims suspected of violating these restrictions have been jailed and/or deported. Church services in private homes have been raided, and participants have been jailed and/or deported.
• Muslims who do not adhere to the strict interpretation of Islam prevalent in much of Saudi Arabia may encounter societal discrimination and constraints on public worship.
• Public display of non-Islamic religious articles, such as crosses and Bibles, is not permitted.
• Non-Muslims are forbidden to travel to Mecca and parts of Medina, the cities where two of Islam’s holiest mosques are located.
• See the Department of State’s International Religious Freedom Report .

LGBTI Travelers: Same-sex sexual relations, even when consensual, are criminalized in Saudi Arabia. Violations of Saudi laws governing perceived expressions of, or support for, same-sex sexual relations, including on social media, may be subject to severe punishment. Potential penalties include fines, jail time, or death. See our LGBTI Travel Information page and section 6 of the Department of State's Human Rights report for further details.

Travelers Who Require Accessibility Assistance: Individuals with disabilities may find accessibility and accommodation very different from what is generally found in the United States. Saudi law does not prohibit discrimination against people with disabilities, and there is no legislation requiring public accessibility. Newer commercial and government buildings, however, often include such access. According to the Ministry of Labor and Social Development, there are numerous government-sponsored centers for people with disabilities. Note that Saudi Arabia has limited infrastructure to care for those with mental disabilities.

Students: See the Department’s Students Abroad page and FBI travel tips .

Women Residents and Travelers: Married women, including non-Saudis, require their husband's permission to depart the country, while unmarried women and children require the permission of their father or male guardian.

Minor children must have their father’s permission in order to leave the Kingdom. Children visiting their fathers in Saudi Arabia, even when there is a custody agreement, can be prevented from leaving unless the father consents. This is true even if the child is an American citizen. The U.S. Embassy and Consulates cannot obtain exit visas for the departure of minor children without their father/guardian's permission.

If a foreigner and a Saudi living in Saudi Arabia divorce, Saudi courts rarely grant permission for the foreign parent to leave the country with the children born during the marriage, even if he or she has been granted physical custody.

Foreign mothers of Saudi children, who are divorced or widowed, may apply for a permanent residency permit(iqama) without the need for a sponsor. To do so, they must prove maternity and that they were legally married to the Saudi father.

Also see the Department’s travel tips for Women Travelers .

Employment: The Arabic text of a contract governs employment and business arrangements under Saudi law. Verbal assurances or side letters are not binding under Saudi law. In the event of any contract dispute, Saudi authorities refer to the written contract.

• Sponsors have wide latitude and responsibilities for employees and family members under their sponsorship, including obtaining residence permits for the employee and for any family members.
• All residents should be issued a Saudi residence permit (iqama) and are legally required to carry it at all times.
• The U.S. Embassy and Consulates General in Saudi Arabia cannot sponsor private U.S. citizens for Saudi visas.
• Sponsors have been known to demand that residents working in Saudi Arabia surrender their passports while in the Kingdom. Such practices are illegal and should be reported to the Ministry of Labor and Social Development .
• Since the Saudi sponsor controls the issuance of exit permits, U.S. citizens may be prevented by the sponsor from leaving Saudi Arabia in the event of a labor or business dispute, which could take months or years to resolve.
• To change employers within the Kingdom, Saudi Arabia requires the written permission of the original sponsoring employer.
• The U.S. Embassy and U.S. Consulates General cannot assist in labor or business disputes, nor can they provide translation or legal services.
• U.S. consular officers can provide lists of local attorneys to help U.S. citizens settle business disputes, but ultimate responsibility for the resolution of disputes through the Saudi legal system, and payment for those services, lies with the parties involved. For additional information on Saudi labor law, please refer to the Ministry of Labor and Social Development’s webpage .
• Saudi customs authorities enforce strict regulations concerning the importation of such banned items as alcohol, weapons, and any item that is held to be contrary to the tenets of Islam (such as pork, anything considered pornographic under strict Islamic principles, and religious materials).
• Imported and domestic audiovisual media and reading matter are censored.
• Christmas and other holiday decorations, fashion magazines, and "suggestive" videos may be confiscated and the owner subject to penalties and fines.
• Electronic devices may be subject to inspection upon entry or exit. Please see the Department’s Customs Information page as well as the Saudi Customs webpage.

Importing Animals: The Saudi Ministry of Agriculture must approve all pets imported into Saudi Arabia.

• Cats and dogs entering Saudi Arabia require a Veterinary Health Certificate and a dated letter from the veterinary practitioner addressed to his/her sponsor to obtain the necessary approval from the Ministry of Agriculture.
• Both documents must be authenticated by the Department of Agriculture Veterinary Service Office and the State Department's Authentications Office and attested by the Embassy of Saudi Arabia .
• The certificate must indicate that the animal was examined and is free from disease and confirm that rabies and other vaccines are current. Information on the name, breed, sex, color, and age of the animal must also be stated.
• Please see additional information on taking a pet overseas .

Teaching English in Saudi Arabia: In recent years, increasing numbers of American language teachers have experienced contractual and other problems. Some teachers have complained about arbitrary dismissals, difficult living conditions, salary arrears, unwanted reassignments, restrictions on their movement, and inability to leave the country. Prospective teachers in Saudi Arabia should vet their potential employer and carefully review their employment offer as well as the detailed information found in the Embassy’s Guide to Teaching English in Saudi Arabia . Additionally, prospective teachers should also take care to make sure that they obtain the appropriate work visa prior to coming to Saudi Arabia. The Embassy cannot help you if you violate Saudi labor law.

Standards of Conduct and Religious Police: Norms for public behavior in Saudi Arabia are extremely conservative. Both the uniformed police and the religious police, referred to colloquially as the mutawwa or al-hay’a, are charged with enforcing these standards.

• Mutawwa are required to carry special identification and usually are accompanied by uniformed police.
• While a 2016 government decree withdrew the authority of the mutawwa to make arrests independently of regular police forces, visitors should be prudent in their interactions with mutawwa.
• An individual must, if requested, present his/her residence permit (iqama) or other identification to the mutawwa or the police.
• U.S. citizens who are involved in an incident with the mutawwa should report the incident to the U.S. Embassy in Riyadh or the U.S. Consulates General in Jeddah or Dhahran.

In most areas of Saudi Arabia, and particularly in Riyadh and the central part of the Kingdom, women wear a full-length covering known as an abaya. Most women in conservative areas also cover their hair with a hijab for modesty, and many also cover their faces with a niqab.

Tourists are expected to dress modestly in public, avoiding tight fitting clothing or clothes with profane language or images; women are not required to wear abayas or cover their hair but are expected to cover their shoulders and knees, and men should not go without a shirt. Women who choose not to conform to Saudi Arabia’s dress code face a risk of confrontation by mutawwa, negative or hostile comments by Saudi citizens, and possible detention Guidelines on public decorum for tourists are available at the Saudi government’s official tourism website, www.visitsaudi.com. Many areas of life in Saudi Arabia are segregated by sex to ensure that unrelated men and women have no possibility of mingling (a punishable crime) by unmarried men and women. Less frequently, members of the mutawwa try to enforce this by asking for proof that a couple is married or related. Men and women detained for socializing with individuals who are not relatives may be charged with moral crimes such as khulwa (mixing with unrelated members of the opposite sex). Less frequently, some restaurants may refuse to serve women who are not accompanied by a close male relative In addition, a few restaurants or cafes do not have a "family section" in which women are permitted to eat. Men not accompanied by a close female family member are not allowed to enter family sections and cannot use services (such as registers at supermarkets) designated as “family.” These restrictions are not always clearly posted.

While there are now movie theaters, musical concerts, and artistic performances in Saudi Arabia, the country remains socially conservative. Social media postings which contravene cultural standards can have legal and/or criminal consequences.

Photography: The Saudi government does not permit photography of governmental facilities, such as military bases and government buildings, nor military, security, or police personnel. The Saudi government is also sensitive to photographs that may be perceived as portraying the country in an unfavorable light. This policy can include photos of mosques, impoverished areas, the local population, and traditional souks (markets). You should not take anyone’s picture without clear consent, and never take a picture of a woman or a place where women congregate. Be aware of local sensitivities whenever you are taking pictures in public. U.S. citizens have been routinely detained for violating these policies. The U.S. Embassy and Consulates General are unable to intervene if you violate Saudi law.

The Hajj and Umrah: Please review the Department of State’s Hajj and Umrah Fact Sheet for useful information on traveling to perform the Hajj or Umrah.

COVID-19 Testing:  COVID-19 testing is available to U.S. citizens throughout Saudi Arabia at public and private facilities. Private hospitals and clinics charge a fee for COVID-19 testing.  Cost, delivery method, and timing of results varies. Some facilities can electronically deliver results within 24 hours or less.  

COVID-19 Vaccines:  The COVID-19 vaccine is available for U.S. citizens to receive in Saudi Arabia. For more information, please see the Ministry of Health’s website.

Visit the FDA's website to learn more about FDA-approved vaccines in the United States.

Medical care varies greatly in quality, and high-profile cases of medical malpractice and errors have occurred. Consult your regular physician if you are considering serious medical treatment in Saudi Arabia.

The U.S. Embassy and U.S. Consulates General do not pay medical bills.  Be aware that U.S. Medicare does not apply overseas.

Medical Insurance: Make sure your health insurance plan provides coverage overseas. Most care providers in Saudi Arabia accept cash or credit card payments.  See the Department’s webpage for more  information on insurance providers for overseas coverage . Supplemental insurance to cover medical evacuation is strongly recommended. If you are covered by Saudi insurance, be sure to read the fine print: local insurance can have exclusions that are unusual in the United States. For example, some local policies may not supply coverage for accidents that occur while engaging in adventure sports, such as riding quad vehicles in the desert, that are a common past-time for expatriates.

If traveling with prescription medication, check with the  government of Saudi Arabia  to ensure the medication is legal in Saudi Arabia. Always carry your prescription medication in original packaging, along with your doctor’s prescription. 

Please note:

• Saudi Arabia has a dry climate with extreme heat several months of the year – travelers should stay hydrated.
• Air pollution is a significant concern in many parts of Saudi Arabia including Riyadh, Al Jubail, Jeddah, and Dammam.
• Many infectious diseases, such as measles, typhoid, dengue, and Middle East Respiratory Syndrome (MERS), are present in Saudi Arabia.

Be up-to-date on all  vaccinations  recommended by the U.S. Centers for Disease Control and Prevention.

For further health information, go to:

• World Health Organization (WHO)
• U.S. Centers for Disease Control and Prevention   (CDC)
• Saudi Ministry of Health

Medical care varies greatly in quality, and high profile cases of medical malpractice and errors have occurred. Consult your regular physician if you are considering serious medical treatment in Saudi Arabia.

We do not pay medical bills.  Be aware that U.S. Medicare does not apply overseas.

Medical Insurance: Make sure your health insurance plan provides coverage overseas. Most care providers overseas only accept cash payments.  See our webpage for more  information on insurance providers for overseas coverage . We strongly recommend supplemental insurance to cover medical evacuation. If you are covered by Saudi insurance, be sure to read the fine print: local insurance can have exclusions that are unusual in the United States. For example, some local policies may not supply coverage for accidents that occur while engaging in adventure sports, such as riding quad vehicles in the desert, that are a common past-time for expats.

Always carry your prescription medication in original packaging, along with your doctor’s prescription.

If traveling with prescription medication, check with the  government of Saudi Arabia  to ensure the medication is legal in Saudi Arabia. Always carry your prescription medication in original packaging, along with your doctor’s prescription.

For health-related information on the Middle East respiratory syndrome coronavirus (MERS-CoV), formerly called “novel coronavirus,” visit the  CDC’s MERS-CoV webpage .

Be up-to-date on all  vaccinations   recommended by the U.S. Centers for Disease Control and Prevention.

• World Health Organization
• U.S. Centers for Disease Control and Prevention  (CDC)

Travel and Transportation

Road Conditions and Safety: Driving in Saudi Arabia can be hazardous due to speeding and aggressive driving, lax enforcement of traffic regulations, and a high volume of traffic.

Beginning on June 24, 2018, women have been able to obtain a driver’s license and can legally drive in Saudi Arabia. With a valid visitor visa and U.S. or international driver’s license, visitors may drive a rental car. However, outside the major cities of Riyadh, Dhahran and Jeddah, visitors—especially women—may experience difficulty renting a car. Female residents with independent sponsorships and U.S. or international driver’s licenses also may obtain a Saudi driver’s license, necessary to drive vehicles other than rental cars. Foreign women residing in Saudi Arabia who are listed as dependents on their Saudi residency permit (“iqama”) may experience difficulties in obtaining Saudi driver’s licenses. To drive vehicles other than rental cars, a Saudi driver’s license, appropriate car registration, and auto insurance are required. Police may detain you if you cannot produce these documents.

See the Saudi Arabian Ministry of Interior website for further information.

Traffic Laws :

• Temporary visitors may drive using their valid U.S. or international driver's license for up to 90 days.
• Foreigners resident in Saudi Arabia who wish to drive must obtain a local driver's license from the Department of Traffic Police.
• In the event of a traffic accident, U.S. citizens should dial “993” to report the accident. You must remain on the scene until the traffic police arrive. Failure to do so can result in a criminal offense.
• Additionally, U.S. citizens should contact Najm, a private company contracted by the traffic police to complete the accident report (+966 9200 00560).
• In the event of a traffic accident resulting in personal injury, everyone involved (if not seriously injured) is likely be taken to the local police station.
• All drivers, regardless of fault, can be held in custody for several days until responsibility is determined and any reparations paid.
• Use of front seat belts (driver and passenger) is required by law.
• U.S. citizens involved in a serious accident resulting in injury or death should immediately contact their sponsors and the U.S. Embassy or nearest U.S. Consulate.
• Residents should update their personal details through one of the methods available here to receive SMS notifications once a traffic ticket is issued.
• Delay in payment of any ticket might result in doubling of the ticket amount.
• Travelers will need to pay any fines issued through this system before leaving the country.

Public Transportation:

• U.S. Government employees are prohibited from using taxis in Saudi Arabia with the exception of Uber Black in Riyadh, Kareem First in Jeddah, and Majestic taxi service in Dhahran. If you must use a taxi, only use established companies, such as those offering cabs with meters. Taxis and lift services are available throughout major cities, and you should arrange a pickup by telephone or via smartphone app when possible.
• Avoid sitting in the front seat of a taxi, do not travel to unfamiliar areas, and do not enter taxis with unknown passengers.

Please refer to the Department’s Road Safety page for more information. Also, it is recommended that you visit the website of the Saudi Arabian Ministry of Interior .

Aviation Safety Oversight: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Saudi Arabia's Civil Aviation Authority as being in compliance with International Civil Aviation Organization aviation safety standards for oversight of Saudi Arabia's air carrier operations. Further information may be found on the FAA safety assessment page .

Information for Mariners:

Mariners should also review U.S. maritime alerts and advisories on the Maritime Security Communications with Industry Web Portal .

For additional travel information

• Enroll in the  Smart Traveler Enrollment Program (STEP)  to receive security messages and make it easier to locate you in an emergency.
• Call us in Washington, D.C. at 1-888-407-4747 (toll-free in the United States and Canada) or 1-202-501-4444 (from all other countries) from 8:00 a.m. to 8:00 p.m., Eastern Standard Time, Monday through Friday (except U.S. federal holidays).
• See the  State Department’s travel website  for the  Worldwide Caution  and  Travel Advisories .
• Follow us on  Twitter  and  Facebook .
• See  traveling safely abroad  for useful travel tips.

Review information about International Parental Child Abduction in Saudi Arabia . For additional IPCA-related information, please see the International Child Abduction Prevention and Return Act ( ICAPRA ) report.

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CDC eases COVID travel assessment for Saudi Arabia, Myanmar, Haiti

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Taiwan says it will discuss with US how to use new funding

Taiwan's defence ministry said on Sunday it will discuss with the United States how to use funding for the island included in a $95 billion legislative package mostly providing security assistance to Ukraine and Israel.

Saudi Arabia reopens to vaccinated Americans as it tries to rebrand itself to tourists

Saudi Arabia will reopen its borders to tourists on Sunday for the first time in 18 months after imposing restrictions at the start of the pandemic to curb the spread of the coronavirus.

The historically closed-off kingdom introduced electronic visas for tourists in late 2019, just before the pandemic struck.

Saudi Arabia is looking to rebrand itself as a unique tourist destination for nature lovers and curious travelers as a way to boost non-oil revenue and create more jobs.

Citizens of 49 countries, including the U.S. and China, will be allowed to enter the kingdom under the new rules without quarantine if they provide a negative PCR test before travel and have vaccine certificates proving a single dose of the Johnson & Johnson vaccine or two doses of the Pfizer/BioNTech, Moderna or Oxford/Astra Zeneca vaccines.

►Saudi Arabia tourism: As kingdom opens up to tourists, will people visit?

Learn more: Best travel insurance

►Have COVID vaccine, will travel: These are the countries open to fully vaccinated Americans

Travelers vaccinated with the Chinese Sinopharm or Sinovac vaccine must have received a third dose of one of the other vaccines.

Earlier this week, the kingdom warned that any citizen who travels to red-listed countries, such as neighboring Dubai where the delta variant is present, could face a three-year travel ban.

►Delta variant: How mutations led to the most transmissible COVID-19 virus yet

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Saudi Arabia is rebranding itself as a moderate country, but what’s the truth? Just ask our female activists

My sister Loujain has been placed under a travel ban and lives in constant fear of arrest. She is one of many

• Lina al-Hathloul is head of monitoring and advocacy at ALQST for Human Rights

S audi Arabia is rebranding. Since 2016, when it first announced plans to diversify its economy, it has poured billions into making the kingdom appear more progressive to outsiders. Women can now drive and work in jobs they were previously banned from. Vast sums are being invested in futuristic, architectural “gigaprojects”, such as the Line – a sprawling, desert supercity – to attract global tourism.

And yet, inside the kingdom, its citizens tell a very different story. Against a backdrop of image-building projects, thousands of Saudi citizens, according to some reports , could be being blocked by the state from leaving the country with arbitrary and illegal travel bans. Their crime? Advocating for basic human rights.

Among them is my sister, Loujain al-Hathloul. Loujain is a prominent Saudi women’s rights defender who led the campaign against the ban on women driving and tirelessly campaigned for the abolition of the male guardianship system.

Loujain’s brave and outspoken activism was met with repression by the Saudi authorities. In March 2018, she was abducted from the streets of the United Arab Emirates and forcibly brought back to Saudi Arabia . Once on Saudi soil, she was placed under an illegal travel ban and forbidden from leaving the country – only to be arrested arbitrarily a few months later. Her charges explicitly mentioned her human rights work, and my sister was tried under counter-terrorism legislation in the specialised criminal court (SCC), routinely used as a tool to muzzle civil society. Loujain was released from prison in February 2021 under strict conditions, including being barred from leaving the kingdom. Her travel ban was supposed to end, after nearly three years, on 13 November 2023. Yet, in February of this year, well after the expiry of the ban, Loujain was told that she remains under a permanent travel ban with no expiry date. The authorities have never provided any justification, and continue to ignore our inquiries.

This is the case not just for Loujain, but for our entire remaining family in Saudi Arabia, who found out in 2018 that they too were prohibited from travelling, without reference to any judicial ruling – and have been unable to resolve the issue since. These blatant violations of the right to freedom of movement are in direct contradiction of international law as well as Saudi Arabia’s own legal framework.

Living in Saudi Arabia under a travel ban is to live in a constant state of fear, as we know the modus operandi of the authorities. Usually, as was the case with Loujain, the kingdom bans someone from leaving and then, later, they arrest them.

I live in Brussels, and I haven’t seen my family in more than six years. Every day, when I wake up in the morning, I have to check whether my family is still safe. I miss them and wish I could have the opportunity, like everyone else, to go back to Saudi Arabia to see them. But I know I would be trapped there too if I were to go back.

My family’s story is one of many. Maryam al-Otaibi, another courageous women’s rights activist, has also experienced imprisonment and repression . She was placed under an illegal travel ban in 2019. When she denounced her treatment on social media, she was summoned by police and charged for speaking out about her ordeal. She was sentenced to four months in prison and fined 100,000 riyals (£21,300).

This is a systemic issue that will not go away by itself. Despite outward shows that the kingdom is becoming more progressive, the Saudi authorities routinely employ arbitrary travel bans as a tool of repression. As a result, individuals are deterred from engaging in human rights work for their own safety and that of their relatives.

Since such travel bans lack legal basis, there is no way to formally appeal them. Those affected are not notified and only find out about the restrictions when attempting to travel outside the kingdom. They are unable to pursue their personal goals or visit family members abroad.

As Saudi Arabia seeks to rebrand itself on the world stage as an increasingly moderate power, we must not ignore the glaring hypocrisy of the government promoting tourism while denying its own citizens the fundamental right to freedom of movement. The international community must hold Saudi Arabia to account for its egregious human rights violations – and not let sportswashing and celebrity partnerships distract from what life is truly like for the kingdom’s citizens.

It is high time for Saudi Arabia to open itself up not only to tourists but also to the voices of its own people. Until then, the facade of glittering progress will remain just that, masking a harsh reality of repression and injustice.

Lina al-Hathloul is head of monitoring and advocacy at ALQST for Human Rights. She is co-author of the book Loujain Dreams of Sunflowers. Foz al-Otaibi, who also contributed to this article, is a social media influencer and a women’s rights activist who was indicted by the Saudi government for her social media activity and is now living in exile

Do you have an opinion on the issues raised in this article? If you would like to submit a response of up to 300 words by email to be considered for publication in our letters section, please click here .

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Most viewed

Middle East Respiratory Syndrome (MERS) is an illness caused by a virus (more specifically, a coronavirus ) called Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Most MERS patients developed severe respiratory illness with symptoms of fever, cough and shortness of breath. About 3 or 4 out of every 10 patients reported with MERS have died.

All cases are linked to the Arabian Peninsula

Health officials first reported the disease in Saudi Arabia in September 2012. Through retrospective (backward-looking) investigations, they later identified that the first known cases of MERS occurred in Jordan in April 2012. So far, all cases of MERS have been linked through travel to, or residence in, countries in and near the Arabian Peninsula. The largest known outbreak of MERS outside the Arabian Peninsula occurred in the Republic of Korea in 2015. The outbreak was associated with a traveler returning from the Arabian Peninsula.

People with MERS can spread it to others

MERS-CoV has spread from ill people to others through close contact, such as caring for or living with an infected person.

MERS can affect anyone. MERS patients have ranged in age from younger than 1 to 99 years old.

CDC continues to closely monitor the MERS situation globally. We are working with partners to better understand the risks of this virus, including the source, how it spreads, and how to prevent infections. CDC recognizes the potential for MERS-CoV to spread further and cause more cases globally and in the U.S. We have provided information for travelers and are working with health departments, hospitals, and other partners to prepare for this.

Listen to a 4-minute podcast about Middle East Respiratory Syndrome or download a fact sheet [2 pages] .

Describes signs and symptoms of MERS infection and some of the serious complications that can occur with illness.

Information about how MERS-CoV has spread from ill people to others.

Tips on protecting yourself from respiratory illnesses.

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• Section 5 - Melioidosis
• Section 5 - Pertussis / Whooping Cough

Meningococcal Disease

Cdc yellow book 2024.

Author(s): Lucy McNamara, Amy Blain

Infectious Agent

Transmission, epidemiology, clinical presentation.

INFECTIOUS AGENT: Neisseria meningitidis

Worldwide, but greatest incidence occurs in the meningitis belt of Africa (see Map 5-01 )

TRAVELER CATEGORIES AT GREATEST RISK FOR EXPOSURE & INFECTION

PREVENTION METHODS

Meningococcal disease is vaccine-preventable

DIAGNOSTIC SUPPORT

Neisseria meningitidis is a gram-negative diplococcus bacterium. Meningococci are classified into serogroups based on the composition of their capsular polysaccharide. The 6 major meningococcal serogroups associated with disease are A, B, C, W, X, and Y.

Meningococci spread through respiratory secretions and require close contact for transmission. Both asymptomatic carriers and people with overt meningococcal disease can be sources of infection. Asymptomatic carriage is transient and typically affects ≈5%–10% of the population at any given time.

N. meningitidis is found worldwide, but incidence is greatest in the “meningitis belt” of sub-Saharan Africa ( Map 5-01 ). Meningococcal disease is hyperendemic in this region, and periodic epidemics during the dry season (December–June) reach an incidence of up to 1,000 cases per 100,000 population. By contrast, rates of disease in Australia, Europe, South America, and the United States range from 0.10–2.4 cases per 100,000 population per year.

Although meningococcal disease outbreaks can occur anywhere in the world, they are most common in the African meningitis belt, where large-scale epidemics occur every 5–12 years. Historically, outbreaks in the meningitis belt were primarily due to serogroup A. With the introduction of a monovalent serogroup A meningococcal conjugate vaccine (MenAfriVac) in the region starting in 2010, however, recent meningococcal outbreaks in the meningitis belt have primarily been caused by serogroups C and W; serogroup X outbreaks also have been reported.

Outside the meningitis belt, infants, adolescents, and adults >80 years of age have the highest rates of disease. In meningitis belt countries, high rates of disease are seen in people ≤30 years old; the highest rates are in children and adolescents aged 5–14 years.

Unvaccinated travelers visiting meningitis belt countries and having prolonged contact with local populations during an epidemic are at greatest risk for meningococcal disease. The Hajj pilgrimage to Saudi Arabia also has been associated with outbreaks of meningococcal disease among returning pilgrims and their contacts, including 4 cases in travelers from the United States during a large Hajj-associated outbreak in 2000.

Map 5-01 The meningitis belt & other areas at risk for meningococcal meningitis epidemics

View Larger Figure

Disease data source: World Health Organization. International Travel and Health. Geneva, Switzerland: 2015.

Meningococcal disease generally occurs 1–10 days after exposure and presents as meningitis in ≈50% of cases in the United States. Meningococcal meningitis is characterized by sudden onset of headache, fever, and neck stiffness, sometimes accompanied by nausea, vomiting, photophobia, or altered mental status. Meningococcal disease progresses rapidly and has a case-fatality rate of 10%–15%, even with antimicrobial drug treatment. Without rapid treatment, fatality rates can be much higher.

Approximately 30% of people with meningococcal disease present with meningococcal sepsis, known as meningococcemia. Symptoms of meningococcemia can include abrupt onset of fever, chills, vomiting, diarrhea, and a petechial or purpuric rash, which can progress to purpura fulminans. Meningococcemia often involves hypotension, acute adrenal hemorrhage, and multiorgan failure. An additional 15% of meningococcal disease cases in the United States, primarily among adults >65 years of age, present as bacteremic pneumonia.

Other presentations (e.g., septic arthritis) also occur. Among infants and children aged <2 years, meningococcal disease can have nonspecific symptoms. Neck stiffness, usually seen in people with meningitis, might be absent in this age group.

Early diagnosis and treatment are critical. If bacterial meningitis is suspected, collect blood for culture right away and perform a lumbar puncture (LP) to collect cerebrospinal fluid (CSF) for microscopic examination and Gram stain. In general, diagnosis is made by isolating N. meningitidis from a normally sterile body site (e.g., blood, CSF) either by culture or by PCR detection of N. meningitidis –specific nucleic acid. State health departments can provide diagnostic and testing support if needed.

Signs and symptoms of meningococcal meningitis are like those of other causes of bacterial meningitis (e.g., Haemophilus influenzae , Streptococcus pneumoniae ). Proper treatment and prophylaxis depend on correctly identifying the causative organism. Meningococcal disease is nationally notifiable in the United States; report cases to the state or local health department without delay.

Meningococcal disease can be rapidly fatal and should always be viewed as a medical emergency. As soon as disease is suspected and blood cultures and CSF have been collected, deliver appropriate treatment; if the LP is to be delayed for any reason (e.g., imaging studies of the head prior to LP), administer antimicrobial drugs immediately after collecting blood cultures. Begin empiric antimicrobial drug treatment early and prior to receiving diagnostic test results.

Third-generation cephalosporins are recommended for empiric treatment. Although ampicillin or penicillin also can be used for treatment, determine meningococcal isolate susceptibility before switching to one of these antibiotics; recent reports indicate emerging penicillin resistance among meningococcal isolates in the United States. If a patient presents with suspected bacterial meningitis of uncertain etiology, some treatment algorithms recommend empiric use of dexamethasone in addition to an antimicrobial drug until a bacterial etiology is established; if meningococcal meningitis is confirmed or suspected, steroids can be discontinued.

Five meningococcal vaccines (3 quadrivalent, 2 monovalent) are licensed and available in the United States. Travelers should receive vaccines 7–10 days before travel to enable time for protective antibody levels to develop. See Table 5-03 for more information about available meningococcal vaccines.

Table 5-03 Meningococcal vaccines licensed & available in the United States: recommendations for travelers to or residents of countries where meningococcal disease is hyperendemic or epidemic 1

Abbreviations: IM, intramuscular

1 Source: TABLE 9. Recommended vaccination schedule and intervals for people who travel to or are residents of countries where meningococcal disease is hyperendemic or epidemic—Advisory Committee on Immunization Practices, United States, 2020 ( www.cdc.gov/mmwr/volumes/69/rr/rr6909a1.htm#T9_down ).

2 For people at continued risk, revaccination (booster) with meningococcal conjugate vaccine (MenACWY-CRM, -D, or -TT) is recommended for the following age groups: <7 years old, a single dose 3 years after primary vaccination and every 5 years thereafter; ≥7 years old, a single dose 5 years after primary vaccination and every 5 years thereafter.

3 A 2-dose primary series (DOSE 2 given 8–12 weeks after DOSE 1) is recommended for the following groups: people with HIV; people with anatomic or functional asplenia; people with persistent complement component deficiency (C3, C5-9, properdin, factor D, factor H); and people taking a complement component inhibitor (e.g., eculizumab [Soliris] or ravulizumab [Ultomiris]).

4 Can be administered ≥8 weeks apart in travelers.

5 MenB-FHbp and MenB-4C are not interchangeable; the same vaccine should be used for all doses, including booster doses.

6 A 3-dose primary series (DOSE 2 given 1–2 months after DOSE 1; DOSE 3 given 6 months after DOSE 2) is recommended for the following groups: people with anatomic or functional asplenia; people with persistent complement component deficiency (C3, C5-9, properdin, factor D, factor H); people taking a complement component inhibitor (e.g., eculizumab [Soliris] or ravulizumab [Ultomiris]); microbiologists routinely exposed to Neisseria meningitidis isolates; and people at risk during a serogroup B meningococcal disease outbreak.

7 A single booster dose of MenB vaccine is recommended for people at increased risk due to a serogroup B meningococcus outbreak if they completed the MenB primary series ≥1 year prior (≥6 months might also be considered by public health professionals). See: www.cdc.gov/meningococcal/downloads/meningococcal-outbreak-guidance.pdf  [PDF}].

8 A booster dose of MenB vaccine is recommended 1 year after completion of the primary vaccination series and every 2–3 years thereafter for people who remain at increased risk of serogroup B meningococcal disease for any other reason.

Routine Immunization

The Advisory Committee on Immunization Practices (ACIP) recommends routine administration of a quadrivalent meningococcal conjugate vaccine (MenACWY) for all people aged 11–18 years. Administer a single dose of vaccine to patients at age 11 or 12 years and a booster dose at age 16 years. Routine immunization with MenACWY is not recommended for other age groups in the United States, except for people at increased risk for meningococcal disease, including those with a persistent complement component deficiency (C3, C5-9, properdin, factor D, factor H); people taking a complement component inhibitor (e.g., eculizumab [Soliris] or ravulizumab [Ultomiris]); people who have functional or anatomic asplenia; or people with HIV. ACIP describes vaccine, product, number of doses, and booster dose recommendations, based on age and risk factors for each risk group, in Meningococcal Vaccination: Recommendations of the Advisory Committee on Immunization Practices, United States, 2020 .

ACIP also recommends adolescents and young adults aged 16–23 years be vaccinated with a serogroup B meningococcal (MenB) vaccine series, based on shared clinical decision-making. A MenB vaccine series provides short-term protection against most strains of serogroup B meningococcus; 16–18 years is the optimal age for MenB vaccination. ACIP also recommends routine use of MenB vaccine for people aged ≥10 years who are at increased risk for meningococcal disease, including people who have persistent complement component deficiency and those with functional or anatomic asplenia. ACIP recommendations for use of MenB vaccines can be found in Meningococcal Vaccination: Recommendations of the Advisory Committee on Immunization Practices , United States, 2020.

Immunization For Travelers

Quadrivalent meningococcal conjugate (menacwy) vaccines.

ACIP recommends that travelers aged ≥2 months who visit or reside in parts of the meningitis belt of sub-Saharan Africa (see Map 5-01 ) during the dry season (December–June) receive vaccination with a MenACWY vaccine before travel. The Centers for Disease Control and Prevention (CDC) issues advisories for travelers to other countries when outbreaks of meningococcal disease are recognized; travelers should check the CDC Travelers’ Health website before travel. There are 3 meningococcal vaccines licensed and available in the United States for children; the age at vaccine initiation and schedule differs for each. See Table 5-03 for more information about meningococcal vaccines for young children.

The Kingdom of Saudi Arabia (KSA) requires travelers >2 years of age making the Umrah or Hajj pilgrimage to provide documentation of quadrivalent vaccine ≥10 days and ≤3 years before arrival for polysaccharide vaccine (MPSV4, no longer available in the United States) and ≤5 years before arrival for conjugate vaccine. Travelers should confirm visa requirements with the KSA embassy. Although the KSA Ministry of Health advises against travel to Hajj for pregnant people or children, these groups should receive meningococcal vaccination according to licensed indications for their age if they travel.

International travelers at risk for meningococcal disease who were previously vaccinated with a quadrivalent vaccine should receive a booster dose. For children who completed the primary dose or series at <7 years of age, administer a booster dose of MenACWY after 3 years and repeat every 5 years thereafter for those who live in or travel to hyperendemic areas. For people who received the primary dose or series at ≥7 years of age, administer a booster dose after 5 years and every 5 years thereafter for people who live in or travel to a hyperendemic area.

Monovalent Vaccines (Serogroups A, B & C)

In 2010, the Meningitis Vaccine Project introduced MenAfriVac, a monovalent serogroup A meningococcal conjugate vaccine, into meningitis belt countries through mass vaccination campaigns and the routine childhood immunization schedule. This vaccine is not licensed for use in the United States. US travelers going to live or work in the meningitis belt should receive a quadrivalent meningococcal conjugate vaccine (MenACWY) before leaving, to protect against 4 serogroups.

MenB vaccine is not recommended for people who live in or travel to meningitis belt countries, because serogroup B disease is extremely rare in this region. MenB vaccine is not routinely recommended for travelers to other regions of the world unless an outbreak of serogroup B disease has been reported.

In some countries outside the meningitis belt, meningococcal vaccination (e.g., monovalent conjugate C vaccine or MenB vaccine) might be recommended as part of the routine immunization program for infants. Clinicians can consider meningococcal vaccination for infants residing in these countries, according to the routine immunization recommendations of that country.

Safety & Adverse Reactions

Side effects after MenACWY vaccination include low-grade fevers and local reactions (e.g., injection-site pain, arm swelling, pain that limits movement of the injected arm). Symptoms are generally mild to moderate and resolve within 48–72 hours. Severe adverse events (e.g., high fever, chills, joint pain, rash, seizures) are rare (<5% of vaccinees).

Although no clinical trials of meningococcal vaccines have been conducted in people who are pregnant or lactating, post-licensure safety data have not identified any serious safety concerns to the mother or fetus. Pregnancy or lactation should not preclude vaccination with MenACWY if indicated.

Precautions & Contraindications

People with moderate or severe acute illness should defer vaccination until their condition improves. Vaccination is contraindicated for people who have had a severe allergic reaction to any component of the vaccines or to a prior dose of the vaccine. A severe allergic reaction to any diphtheria toxoid- or CRM197-containing vaccine also is a contraindication for MenACWY-D and MenACWY-CRM; severe allergic reaction to any tetanus toxoid–containing vaccine is a contraindication for MenACWY-TT.

To avoid interference with the immune response to meningococcal vaccine, MenACWY-D should be given either before or at the same time as DTaP in children. MenACWY-D may be given at any time in relation to Tdap or Td.

All meningococcal vaccines are inactivated and can be given to people who are immunosuppressed.

Postexposure Prophylaxis

In the United States and most industrialized countries, antibiotic chemoprophylaxis is recommended for close contacts of a patient with invasive meningococcal disease to prevent secondary cases. Chemoprophylaxis ideally should be initiated within 24 hours after the index patient is identified; prophylaxis given >2 weeks after exposure has little value.

Antibiotics used for prophylaxis include ceftriaxone, ciprofloxacin, and rifampin. Ceftriaxone is recommended for pregnant people. CDC provides detailed information on meningococcal prophylaxis in the Manual for the Surveillance of Vaccine-Preventable Diseases .

CDC website: Meningococcal disease

The following authors contributed to the previous version of this chapter: Sarah A. Mbaeyi, Lucy A. McNamara

Bibliography

American Academy of Pediatrics. Meningococcal infections. In: Kimberlin DW, Brady MT, Jackson M, Long SS, editors. Red Book: 2015 report of the Committee on Infectious Diseases, 30th edition. Elk Grove Village (IL): American Academy of Pediatrics; 2015. pp. 547–58.

Centers for Disease Control and Prevention. Public health dispatch: Update: assessment of risk for meningococcal disease associated with the Hajj 2001. MMWR Morb Mortal Wkly Rep. 2001;50(12):221–2.

Folaranmi T, Rubin L, Martin SW, Patel M, MacNeil JR. Use of serogroup B meningococcal vaccines in persons aged >/=10 years at increased risk for serogroup B meningococcal disease: recommendations of the Advisory Committee on Immunization Practices, 2015. MMWR Morb Mortal Wkly Rep. 2015;64(22):608–12.

Halperin SA, Bettinger JA, Greenwood B, Harrison LH, Jelfs J, Ladhani SN, et al. The changing and dynamic epidemiology of meningococcal disease. Vaccine. 2012;30(Suppl 2):B26–36.

MacNeil JR, Rubin L, Folaranmi T, Ortega-Sanchez IR, Patel M, Martin SW. Use of serogroup B meningococcal vaccines in adolescents and young adults: recommendations of the Advisory Committee on Immunization Practices, 2015. MMWR Morb Mortal Wkly Rep. 2015;64(41):1171–6.

Mbaeyi SA, Bozio CH, Duffy J, Rubin LG, Hariri S, Stephens DS, et al. Meningococcal vaccination: recommendations of the Advisory Committee on Immunization Practices, United States, 2020. MMWR Recomm Rep. 2020;69(9):1–41.

McNamara LA, Potts C, Blain AE, Retchless AC, Reese N, Swint S, et al. Detection of ciprofloxacin-resistant, β-lactamase-producing Neisseria meningitidis serogroup Y isolates—United States, 2019–2020. MMWR Morb Mortal Wkly Rep. 2020;69(24):735–9.

Patton ME, Stephens D, Moore K, MacNeil JR. Updated recommendations for use of MenB-FHbp serogroup B meningococcal vaccine—Advisory Committee on Immunization Practices, 2016. MMWR Morb Mortal Wkly Rep. 2016;66(19);509–13.

Trotter CL, Lingani C, Fernandez K, Cooper LV, Bita A, Tevi-Benissan C, et al. Impact of MenAfriVac in nine countries of the African meningitis belt, 2010–2015: an analysis of surveillance data. Lancet Infect Dis. 2017;17(8):867–72.

World Health Organization. Epidemic meningitis control in countries of the African meningitis belt, 2016. Wkly Epidemiol Rec. 2017;92(13):145–54.

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Saudi Arabia says it helped defend Israel against Iran — report

Many of the drones and missiles had to travel over jordanian and saudi airspace to reach israel. .

Israel-Saudi normalization seemed on the horizon before Oct 7

Take a closer look at the plans for the main regions of Neom, Saudi's epic megacity project

• Saudi Arabia is plowing on with its ambitious Neom project, despite reported setbacks.
• The Kingdom has said "millions of cubic meters of earth and water" are being moved each week.
• Here's a closer look at the main regions that officials plan to build as part of the project.

Saudi Arabia 's futuristic and highly ambitious Neom megacity has been billed by officials as a place where people can "dream big."

First announced in 2017, Neom is being constructed in Tabuk, located on the northern tip of the Red Sea.

In February, the Kingdom released a promotional video sharing updates on Neom's progress. The video claimed the project was "progressing rapidly," adding that "millions of cubic meters of earth and water" were being moved each week.

Denis Hickey, the chief development officer for The Line, said: "We've done a lot of the foundation work literally and figuratively. We are ready to go. I think the construction of The Line is unique in terms of its industrialization and its modularized approach."

"We think there's an opportunity to create a better model for a city to interact with the landscape and nature and the environment and we think The Line is going to be an example to the rest of the world," Hickey said.

The kingdom has been funneling money into the 26,500 km² megacity, with costs projected to reach around $1.5 trillion for the development . The Line — a key part of the project — was planned to be finished by 2030, but recent reports suggest developers may be facing financial difficulties.

In February, The Wall Street Journal reported that Saudi Arabia was borrowing to help fund an array of ambitious projects, including Neom. A month later, Bloomberg reported that the Gulf kingdom has significantly reduced estimates for the number of people expected to settle in The Line .

Neom is the flagship project of the Vision 2030 plan announced by Saudi Arabia's Crown Prince Mohammed bin Salman.

Saudi wants its Vision 2030 projects to boost residency, provide better opportunities, and help the nation diversify beyond fossil fuels — but it remains to be seen whether expectations will match up with reality.

Neom is designed to comprise several regions. Here's how officials say the city will be laid out.

The Line is the most well-known section of Neom.

Officials say the city is set to be contained within two 1640-foot-high mirrored skyscrapers positioned 656 feet apart. According to Neom's website, the city will have no roads, cars, or emissions and run on 100% renewable energy.

The city was originally planned to accommodate nine million people by 2030. However, Bloomberg reported that this estimate was recently downgraded to less than 300,000 people by the same deadline.

US studio Morphosis is reportedly working on the glossy city, with several more architects on board to design smaller sections .

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Several e xperts have raised ethical issues about the city, claiming it could be fitted with Chinese technology to gather data on residents as part of a sweeping surveillance program.

Located on the coast of the Red Sea, Neom officials have announced plans for an octagonal city, which they claim will house a "next-generation" sustainable port.

If completed, the plan is for Oxagon, as it's being called, to spill partly into the sea, with a section set to float above on the shore. Neom officials have made the bold claim the floating part of the city will be the "world's largest floating structure."

Planners have also claimed the city will cover 48km² and house 90,000 people by 2030, as set out in the Vision 2030 plans .

Saudi officials claim Sindalah, a luxury island resort, will be the first region of Neom to be completed.

Developers have said they want the island to act as an "exclusive gateway to the stunning Red Sea," adding that they planned to welcome the global yachting community and luxury visitors.

The resort is set to feature several luxury spots, including a beach club, a spa and wellness center, and a yacht club.

Located in the mountains of the Tabuk region, Trojena has been designed to be Neom's ski and adventure resort.

Neom's website says the region will host 36 km of ski slopes. The site is also aiming to generate 10,000 jobs, per Neom's promotional site.

Saudi plans for Trojena to play host to 700,000 tourists annually by 2030.

The Gulf Of Aqaba

Saudi plans for the Gulf of Aqaba coast include several of Neom's main tourist destinations, including Epicon.

Plans for Epicon include an "ultra-luxury" hotel and resort and include a residential offering. Official statements say it will feature two towers, one 738 feet tall and another 902 feet tall.

If completed, the Gulf of Aqaba will include Leyka, a natural valley with three boutique hotels; Xaynor, an exclusive beach club; Siranna, a "luxury hospitality experience," and Aquellum, a community built inside a 1,476-feet high mountain range.

There are plans for the region to also host several other luxury escapes and wellness retreats.

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