Geographical Distribution of Tick-borne Encephalitis and Its Vectors in Mongolia, 2005-2016

Objectives: In the last several years, the incidence and fatality rates of tick-borne encephalitis (TBE) in Mongolia have been increasing with new cases being registered in areas without the main tick vector. Therefore, we sought to determine the geographical distribution of TBE in Mongolia. Methods: Data were analyzed on TBE virus prevalence of collected ticks and seroprevalence rate of TBE and TBE incidence rate among the human population from 2005 to 2016. Results: During this time, TBE incidence was 0.75 per 10,000 populations in Mongolia. Among 2,182 people investigated, seroprevalence rate was 14.6±10.9% (n=312) in 10 provinces and Ulaanbaatar city. The seroprevalence rate among the populations of Selenge, Bulgan and Khuvsgul provinces, which are home to the main tick vector I.Persulcatusis, were 1.8 times (CI 95% 1.5-2.3, p< 0.001) higher than other provinces where the tick species D.nuttalli and D.silvarumare found. The TBE virus prevalence of I.Persulcatus was 3.18%, D.nuttalli was 0.61% and D.silvarum was 2.9% among the 10,464 ticks sampled. Conclusion: Endemic areas of TBE are expanding from northern parts of the country where the main vector I. persulcatus is more common to steppe areas where the vector D. nuttalli is abundant

Yersinia pestis Lineages in Mongolia

BACKGROUND: Whole genome sequencing allowed the development of a number of high resolution sequence based typing tools for Yersinia (Y.) pestis. The application of these methods on isolates from most known foci worldwide and in particular from China and the Former Soviet Union has dramatically improved our understanding of the population structure of this species. In the current view, Y. pestis including the non or moderate human pathogen Y. pestis subspecies microtus emerged from Yersinia pseudotuberculosis about 2,600 to 28,600 years ago in central Asia. The majority of central Asia natural foci have been investigated. However these investigations included only few strains from Mongolia. METHODOLOGY/PRINCIPAL FINDINGS: Clustered Regularly Interspaced Short Prokaryotic Repeats (CRISPR) analysis and Multiple-locus variable number of tandem repeats (VNTR) analysis (MLVA) with 25 loci was performed on 100 Y. pestis strains, isolated from 37 sampling areas in Mongolia. The resulting data were compared with previously published data from more than 500 plague strains, 130 of which had also been previously genotyped by single nucleotide polymorphism (SNP) analysis. The comparison revealed six main clusters including the three microtus biovars Ulegeica, Altaica, and Xilingolensis. The largest cluster comprises 78 isolates, with unique and new genotypes seen so far in Mongolia only. Typing of selected isolates by key SNPs was used to robustly assign the corresponding clusters to previously defined SNP branches. CONCLUSIONS/SIGNIFICANCE: We show that Mongolia hosts the most recent microtus clade (Ulegeica). Interestingly no representatives of the ancestral Y. pestis subspecies pestis nodes previously identified in North-western China were identified in this study. This observation suggests that the subsequent evolution steps within Y. pestis pestis did not occur in Mongolia. Rather, Mongolia was most likely re-colonized by more recent clades coming back from China contemporary of the black death pandemic, or more recently in the past 600 years

Molecular Epidemiological Study of Bacillus anthracis Isolated in Mongolia by Multiple-Locus Variable-Number Tandem-Repeat Analysis for 8 Loci (MLVA-8)

SUMMARY: The incidence of anthrax, which is caused by Bacillus anthracis, in the human and animal population of Mongolia has increased recently, and control of this infection is a nationwide concern. In this study, 29 isolates obtained from animals and various regions in Mongolia from 2001 to 2007 were analyzed by performing multiple-locus variable-number tandem-repeat analysis for 8 loci (MLVA-8) to understand the genetic relationship between the Mongolian B. anthracis isolates. We found that all the Mongolian isolates can be classified into A3 cluster along with the Japanese and the Chinese B. anthracis isolates. Our data revealed that MLVA-8 is useful for studying the molecular epidemiology of the Mongolian B. anthracis isolates and would help characterize B. anthracis infections in Mongolia

Little evidence of avian or equine influenza virus infection among a cohort of Mongolian adults with animal exposures, 2010-2011.

Avian (AIV) and equine influenza virus (EIV) have been repeatedly shown to circulate among Mongolia's migrating birds or domestic horses. In 2009, 439 Mongolian adults, many with occupational exposure to animals, were enrolled in a prospective cohort study of zoonotic influenza transmission. Sera were drawn upon enrollment and again at 12 and 24 months. Participants were contacted monthly for 24 months and queried regarding episodes of acute influenza-like illnesses (ILI). Cohort members confirmed to have acute influenza A infections, permitted respiratory swab collections which were studied with rRT-PCR for influenza A. Serologic assays were performed against equine, avian, and human influenza viruses. Over the 2 yrs of follow-up, 100 ILI investigations in the cohort were conducted. Thirty-six ILI cases (36%) were identified as influenza A infections by rRT-PCR; none yielded evidence for AIV or EIV. Serological examination of 12 mo and 24 mo annual sera revealed 37 participants had detectable antibody titers (≥1∶10) against studied viruses during the course of study follow-up: 21 against A/Equine/Mongolia/01/2008(H3N8); 4 against an avian A/Teal/Hong Kong/w3129(H6N1), 11 against an avian-like A/Hong Kong/1073/1999(H9N2), and 1 against an avian A/Migrating duck/Hong Kong/MPD268/2007(H10N4) virus. However, all such titers were <1∶80 and none were statistically associated with avian or horse exposures. A number of subjects had evidence of seroconversion to zoonotic viruses, but the 4-fold titer changes were again not associated with avian or horse exposures. As elevated antibodies against seasonal influenza viruses were high during the study period, it seems likely that cross-reacting antibodies against seasonal human influenza viruses were a cause of the low-level seroreactivity against AIV or EIV. Despite the presence of AIV and EIV circulating among wild birds and horses in Mongolia, there was little evidence of AIV or EIV infection in this prospective study of Mongolians with animal exposures

Study participants with detectable microneutralization assays titers against A/Equine/Mongolia/01/2008(H3N8) or A/Hong Kong/1073/1999(H9N2), with seroconversions.

<p>enroll = enrollment; 12 mo = 12 month annual follow-up; 24 mo = 24 month annual follow-up;</p><p> = 4-fold rise in titer between 2 timer periods;</p

A path to cooperation between China and Mongolia towards the control of echinococcosis under the Belt and Road Initiative

Health is the core of development. Health cooperation between countries plays a pivotal role under the Belt and Road Initiative (B&amp;R). In 2013, China launched its B&amp;R to improve the international cooperation of which health was an important component. As one of the neglected zoonotic diseases, echinococcosis has become a public health concern and is on top of the government agenda among neglected zoonosis in Mongolia. The transmission of the disease involves animal husbandry, and its characteristics determine the prevention and control of such diseases which requires cross-sector collaboration and comprehensive prevention and control strategies. Taking echinococcosis as an entry point and adopting a 'Mongolia-led, China-supported, and results-sharing' approach to public health cooperation will not only contribute to the advancement of Mongolia's national health coverage, but also promoting China's capacity to engage in global health. In this way, it contributes to meeting the sustainable development goals, especially goal 3, target 3.3: by 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases. This paper provides an overview on how the cooperation between China and Mongolia under the context of B&amp;R was initiated, planned and moved forward to implementation. The experience may provide a good model and inform policy and practice for other bilateral cooperations

Distribution of antibody titers against equine and avian influenza viruses among Mongolian participants, 2008–2011.

<p>0 mo = enrollment; 12 mo = 12 month annual follow-up; 24 mo = 24 month annual follow-up.</p

Viruses used in serological studies.

<p>Unless otherwise indicated, serologic study was performed using the microneutralization assay.</p><p>Virus studied with hemagglutination inhibition assay</p><p>Highly pathogen virus</p><p>Similar to 2009 pandemic H1N1 virus.</p><p>Virus of avian origin but cultured from a man.</p

Protospacers for newly identified spacers a6′, a85–88, and b48–49.

<p>Protospacers for newly identified spacers a6′, a85–88, and b48–49.</p