KABUL (Pajhwok Afghan News) — Seven women were among 18 Afghan pilgrims who died during the performance of this year’s Hajj in Saudi Arabia, the Ministry of Hajj and Religious Affairs (MoHR) said on Tuesday.

MoHR’s spokesman Naseruddin Darez told Pajhwok Afghan News the Afghan pilgrims died of natural causes and as a result of traffic accidents. Of the millions of pilgrims each year, many are elderly, and some die of their illnesses, exacerbated in some cases by the heat and exertion.

Mingling of visitors from many countries, some of which have poor health care systems still plagued by preventable infectious diseases, can lead to the spread of epidemics. If an outbreak were to occur on the road to Mecca, pilgrims could exacerbate the problem when they returned home and passed their infection on to others. This was more of a problem in the past.

One such disease is meningitis as it became a primary concern after an international outbreak following the Hajj in 1987. Due to post-Hajj outbreaks globally of certain types of meningitis in previous years, it is now a visa requirement to be immunised with the ACW135Y vaccine before arrival.

Nearly three million people from 160 countries participated in this year’s Hajj pilgrimage with 10% of them Saudi pilgrims. From Afghanistan, 29,699 people performed the annual ritual and their journey back home from Saudi Arabia began on August 4, process still ongoing.