Knowledge and practices surrounding zoonotic disease among Mongolian herding households

Abstract The strong bond between herder and livestock was forged centuries ago in rural Mongolia and remains an element of national pride and a cornerstone to the economy. However, semi-nomadic herders frequently live at the edge of human health care, veterinary services, and municipal infrastructure like water and sanitation. This study examined zoonotic risk factors and disease perceptions among 150 rural herding households. Less than half of the participating households used an improved drinking water source (43.3%), and the majority of herding families did not use an improved sanitation service (68.5%). Almost half of the study population practise open defaecation (49.7%). Hand washing occurs after animal contact (78%) but not after defaecation/urination (76.6%). Domestic animal ownership and/or presence was reported at every household, and exposure risks varied by the gender of the household member. Most households had knowledge about zoonotic disease transmission (74%) but far less recognized the risk of reverse zoonoses, or human-to-animal disease transmission (53.3%). Few survey respondents believed that animal contact is a risk factor for diarrhoeal disease (8.7%). This study highlights zoonotic disease exposure risks from animal husbandry practices and inadequate water, sanitation, and hygiene access and behaviours among rural herding households. Zoonotic disease prevention among Mongolian herders should be implemented using a One Health framework to simultaneously address human, animal, and environmental health concerns of rural herding households

A case series of fatal meningoencephalitis in Mongolia: epidemiological and molecular characteristics of tick-borne encephalitis virus

In Mongolia, the incidence and fatality rates of tick-borne encephalitis (TBE) have been increasing. We aimed to identify the epidemiological and molecular characteristics of tick-borne encephalitis virus (TBEV) associated with fatal meningoencephalitis in Mongolia. We conducted a descriptive study of 14 fatal cases of TBE that occurred between 2008 and 2017 in Mongolia. Reverse transcription polymerase chain reaction (RT–PCR) was used to detect viral RNA in brain tissue. RT–PCR products from six patients who died from TBE between 2013 and 2017 were directly sequenced and analysed phylogenetically. Ticks collected from Selenge and Bulgan provinces were also tested for TBEV by RT–PCR. Between 2008 and 2017, there were 14 fatal TBE cases in hospitals in Mongolia. The 14 patients who died reported receiving tick bites in Bulgan or Selenge province; 71.4% of deaths resulted from tick bites in Bulgan province. The TBE case fatality rate was 28.6% for patients in Bulgan province and 2.7% for those in Selenge province. All of the fatalities were men; the median age was 45 ± 12.6 years. Tick bites occurred between April and June in forested areas. In 2013, a 388 base pair fragment of the envelope (E) gene was obtained from a hospitalized patient. The closest relatives of this virus are Far-Eastern TBEV isolates. The case fatality rate differed between two provinces where tick bites occurred. A higher number of TBE cases and the virulent Far-Eastern subtype occurred in patients in Bulgan province. This province should increase vaccination coverage, training, education and investigations