Then, as now, there was little local effort to limit the number of pilgrims to safe levels or to provide adequate infrastructure and security to handle the masses of visitors. Annual influxes of hundreds of thousands of pilgrims closely packed into steamships were blamed for spreading cholera through port cities from Bombay to Hamburg, making the hajj a major cause of death around the world.
现代麦加朝圣最初起源于19世纪麦加宗教旅游的兴起，那时的蒸汽轮船开始将大量朝圣者运抵阿拉伯半岛。当时和现在一样对朝圣者安全游览的数量没有任何限制，当地也没有为大量旅游者提供充足的基础设施和安全服务。每年蒸汽轮船中塞得满满当当的数十万朝圣者被指在孟买和汉堡等港口城市传播霍乱，导致麦加朝圣成为世界主要的死亡原因之一。