CAIRO – Arab health ministers banned children, the elderly and those with chronic illnesses from attending the annual Muslim pilgrimage to Saudi Arabia this year over fears the mass gathering could speed the spread of swine flu.

In a meeting in Cairo that ended late Wednesday, the ministers, however, stopped short of calling for the cancellation of this year's hajj — a duty for all able-bodied Muslims in their lifetime. The ritual attracts about 3 million people every year to the holy cities of Mecca and Medina.

The ban, which applies to adults over the age of 65 and children under 12, could affect a large number of people because many Muslims save up their whole lives to make the trip and others go to cleanse their souls before dying.

The ministers hope that excluding those most vulnerable to swine flu will reduce the possibility of contagion during the hajj, which takes place in late November following peak flu season.

The Saudi health minister endorsed Wednesday's decision, but some influential clerics in the country have said the warning about swine flu exposure at the hajj is exaggerated and opposed any travel bans over the illness.

But the risks from the disease are real. A 28-year-old Egyptian woman died from swine flu last week after returning from a pilgrimage to Mecca — the first such death from the H1N1 virus in the Middle East.

Worldwide, deaths from the disease have doubled in the past three weeks to over 700 from about 330, according to the World Health Organization.

The race is now on to develop a vaccine that is effective against the pandemic strain before the flu season begins this fall in the northern hemisphere. Estimates for when a vaccine will be available range from September to December.

The ministers demanded the WHO set aside a quota of any future vaccine for developing countries. They said that if a vaccine is ready before the hajj, pilgrims will have to provide an immunization report to obtain their visa for the pilgrimage.

A limited number of pilgrims from each country is allowed to attend the hajj every year. Government officials enforce the quota, enabling them to enforce the travel ban and other restrictions mandated by the ministers.

Egypt's highest religious authority, Grand Mufti Ali Gomaa, said Thursday that anyone who disregards the ministers' decisions will be considered a "sinner," according to the country's official Middle East News Agency.

One of Sunni Islam's highest authorities, Grand Sheik Mohammed Sayyed Tantawi of Al-Azhar, also backed the ministers, saying "they are the specialists and have the final say over this issue," according to MENA.

Others were less supportive. Sheik Abdul-Mohsen al-Obaikan, an adviser to the Saudi royal family, was quoted by Okaz newspaper Thursday as saying it is unIslamic to ban people from the hajj.

Saudi Arabia's Grand Mufti, Sheik Abdul-Aziz Al Sheikh, has said the fear about swine flu exposure at the hajj is "exaggerated."

There are 952 reported cases in the WHO's eastern Mediterranean region, which includes the Middle East and parts of North Africa and South Asia. The grouping excludes Israel, which has 727 cases, according to the WHO.

The latest figures, however, may seriously underestimate the true toll because not all swine flu cases are being detected due to testing limitations.

There has been a great deal of debate in the Middle East about skipping the hajj altogether this year to avoid exacerbating the spread of the disease. The decision to enforce a travel ban seems to be an attempt to mitigate the risks without taking such a radical step.

In Lebanon, the widely respected Shiite Grand Ayatollah Mohammed Hussein Fadlallah decreed that Muslims who have serious concerns about contracting swine flu while performing pilgrimage may stay away this year. But described hajj as a "divine duty" and dismissed the idea of canceling it altogether.

An editorial in the London-based Al-Quds Al-Arabi daily Thursday, however, still called on Saudi authorities to take the initiative and cancel it.

"Mecca receives millions of pilgrims and worshippers 24 hours a day, shoulder to shoulder ... and if one person carries the virus, he can spread it to a ten thousand others," the paper said.