Saudi Arabia has banned foreign pilgrims from entering the kingdom to visit Islam’s holiest sites amid concerns over the coronavirus.

The ban potentially disrupts the plans of millions of people ahead of the holy fasting month of Ramadan and as the annual hajj pilgrimage looms.

The decision showed the growing worry across the Middle East about the strain of coronavirus – also known as Covid-19 – as Iran confirmed that infected cases in the country spiked by over 100, to 254 now. A total of 26 people have died so far in Iran, the world’s highest death toll outside of China, where the outbreak began.

Those with the virus in the Islamic Republic now include Iranian vice president Masoumeh Ebtekar, better known as the English-language spokeswoman “Mary” for the 1979 hostage-takers who seized the US Embassy in Tehran and sparked the 444-day diplomatic crisis, state media reported.

Virus Outbreak Mideast
The decision stops foreigners from reaching the Kaaba, the cubic building at the Grand Mosque (Amr Nabil/AP)

Saudi Arabia’s barring of pilgrims from Mecca, home to the cube-shaped Kaaba that the world’s 1.8 billion Muslims pray toward five times a day, and Medina appeared unprecedented in modern history. The kingdom’s Al Saud ruling family stake their legitimacy in overseeing and protecting the sites. Authorities also suspended entry to travellers from nations affected by the virus who hold tourist visas for the kingdom.

It appeared Saudi officials are worried about the risk of pilgrims spreading the virus as they had to Iran. The virus’ epicentre in the Islamic Republic is the holy Shiite city of Qom, where the faithful in reverence reach out to kiss and touch a famous shrine. That shrine and others have remained open, despite Iran’s civilian government calling for them to be closed.

The tiny, oil-rich nation of Kuwait announced a sudden jump to 43 cases from 26 on Thursday as well, all linked to travellers who recently came from Iran. There have been no confirmed cases of the new coronavirus in Saudi Arabia amid the outbreak.

“Saudi Arabia renews its support for all international measures to limit the spread of this virus, and urges its citizens to exercise caution before travelling to countries experiencing coronavirus outbreaks,” the Saudi Foreign Ministry said in a statement announcing the decision. “We ask God Almighty to spare all humanity from all harm.”

A Saudi tour guide wears a face mask
The hajj is required of all able-bodied Muslims once in their life (AP/Amr Nabil)

News of the cancellation has shocked the Muslim world, as many save up for their entire lives for a chance to see the Kaaba and walk along the path of the Prophet Muhammad and visit his tomb in Medina.

Hundreds landed in Pakistan as the ban came into effect, while Indonesia and Turkey had to turn away thousands of pilgrims set to fly. Authorities at Cairo’s international airport said the Saudi decision created “intense confusion” and “extreme anger” among thousands of passengers waiting for flights. Security officials needed to call in reinforcements to control the crowd as news of the ban broke.

Disease outbreaks have always been a concern surrounding the hajj, required of all able-bodied Muslims once in their life, especially as pilgrims come from all over the world. The earliest recorded outbreak came in 632 as pilgrims fought off malaria. A cholera outbreak in 1821 killed an estimated 20,000 pilgrims. Another cholera outbreak in 1865 killed 15,000 pilgrims and then spread worldwide.

More recently, Saudi Arabia faced the danger from another coronavirus, one that caused the Middle East respiratory syndrome, or MERS, which jumped from ill camels to humans. The kingdom increased its public health measures during the hajj in 2012 and 2013 and urged the ill and elderly not to take part in the pilgrimage.

Since September 2012, there have been nearly 2,500 cases of MERS reported, with 858 deaths attributed to the virus, according to the World Health Organisation (WHO). However, the hajj itself saw no MERS outbreak. Saudi officials also instituted bans on pilgrims coming from countries affected by the Ebola virus in recent years.

Since the new coronavirus emerged in December in central China, there have been at least 82,000 cases globally, with more than 2,700 deaths.