Only Saudi Arabia requires that travelers to that country for the annual Hajj and Umrah pilgrimage have a certificate of vaccination against meningococcal disease, issued not more than 3 years and not less than 10 days before arrival in Saudi Arabia.Travelers to or residents of areas where N. meningitidis is highly endemic or epidemic are at risk of exposure should receive primary immunization against meningococcal disease. HIV-infected individuals
HIV-infected individuals are likely to be at increased risk for meningococcal disease; HIV-infected individuals who wish to reduce their risk of meningococcal disease may receive primary immunization against meningococcal disease. Although efficacy of meningitis A, C, Y and W-135 vaccines have not been evaluated in HIV-infected individuals to date, HIV-infected individuals 11–55 years of age may receive primary immunization with the conjugated vaccine. Vaccination against meningitis does not decrease CD4+ T-cell counts or increase viral load in HIV-infected individuals, and there has been no evidence that the vaccines adversely affect survival. Close contacts
Protective levels of anticapsular antibodies are not achieved until 7–14 days following administration of a meningococcal vaccine, vaccination cannot prevent early onset disease in these contacts and usually is not recommended following sporadic cases of invasive meningococcal disease. Unlike developed countries, in sub-Saharan Africa and other under developed countries, entire families live in a single room of a house.Meningococcal infection is usually introduced into a household by an asymptomatic person. Carriage then spreads through the household, reaching infants usually after one or more other household members have been infected.
Buschke–Ollendorff syndrome (BOS) is a rare genetic disorder associated with LEMD3. It is believed to be inherited in an autosomal dominant manner. It is named for Abraham Buschke and Helene Ollendorff Curth, who described it in a 45-year-old woman. Its frequency is almost 1 case per every 20,000 people, and it is equally found in both males and females. Signs and symptoms
The signs and symptoms of this condition are consistent with the following (possible complications include aortic stenosis and hearing loss):

Osteopoikilosis
Bone pain
Connective tissue nevi
Metaphysis abnormality

Pathogenesis
Buschke–Ollendorff syndrome is caused by one important factor: mutations in the LEMD3 gene (12q14), located on chromosome 12.Among the important aspects of Buschke–Ollendorff syndrome condition, genetically speaking are:

LEMD3 (protein) referred also as MAN1, is an important protein in inner nuclear membrane. LEMD3 gene gives instructions for producing protein that controls signaling for transforming growth factor-beta. LEMD3 gene helps in the bone morphogenic protein pathway
Both of the above pathways help grow new bone cells
BMP and TGF-β pathways controls SMADs proteins, which then bind to DNA
LEMD3 once mutated, causes a reduction of the protein, which in turn causes excess of the above two pathways. Diagnosis
The diagnosis of this condition can be ascertained via several techniques one such method is genetic testing, as well as:
X-ray
Ultrasound
Histological test

Differential diagnosis
The differential diagnosis for an individual believed to have Buschke–Ollendorff syndrome is the following:
Melorheostosis
Sclerotic bone metastases. Treatment
In terms of the treatment of Buschke–Ollendorff syndrome, should the complication of aortic stenosis occur then surgery may be required.Treatment for hearing loss may also require surgical intervention.