The appearance of poliomyelitis (polio) in Mecca, Saudi Arabia, immediately prior to last month's annual hajj pilgrimage by two-million Muslims to Islam's holy city has given rise to concern among World Health Organization (WHO) officials that the disease could now be spreading around the world, carried by pilgrims as they return home.

Developing countries, where massive population overcrowding has led to sporadic vaccination reach - such as Bangladesh and Indonesia - are at greatest risk.

Despite the country having been declared polio-free in 1995, two cases of the disease were diagnosed in Saudi Arabia towards the end of last year.

Medical geographers attribute the rapid spread of polio in Africa largely to the 2003 ban on immunization imposed by activists in the northern Nigeria's Muslim Sahel region.

Muslims in Niger have also resisted vaccination. These developments are said to have led to 12 previously polio-free west and central African countries becoming reinfected with the virus, and the derailment of the WHO-led initiative to eradicate polio by the end of 2004.

“The prospect of a polio pandemic is alarming, but is clearly also a potential reality,” said Dr Andrew Jamieson, medical director: SAA-Netcare Travel Clinics.

“Anyone who completed their hajj in January this year, or who has been in contact with such a pilgrim since their return to South Africa, is at risk of contracting the disease and should seek medical help should any symptoms appear. The healthcare community is on high alert to ensure early detection of any cases introduced to the country in this way and is equipped to treat patients appropriately.”