Travel vaccinations for Mongolia

Hepatitis A is a viral infection transmitted through contaminated food and water or by direct contact with an infectious person. Symptoms are often mild or absent in young children, but the disease can be more serious with advancing age. Recovery can vary from weeks to months. Following hepatitis A infection immunity is lifelong. All travellers should take care with personal, food and water hygiene. As hepatitis A vaccine is well tolerated and affords long-lasting protection, it is recommended for all previously unvaccinated travellers.

Tetanus is caused by a toxin released from Clostridium tetani bacteria and occurs worldwide. Tetanus bacteria are present in soil and manure and may be introduced through open wounds such as a puncture wound, burn or scratch. Travellers should thoroughly clean all wounds and seek medical attention for injuries such as animal bites/scratches, burns or wounds contaminated with soil. Travellers should have completed a tetanus vaccination course according to the UK schedule. If travelling to a country or area where medical facilities may be limited, a booster dose of a tetanus-containing vaccine is recommended if the last dose was more than ten years ago even if five doses of vaccine have been given previously. Country-specific information on medical facilities may be found in the 'health' section of the FCDO foreign travel advice pages.

Typhoid is a bacterial infection transmitted through contaminated food and water. Previous typhoid illness may only partially protect against re-infection. Vaccination is recommended for most travellers, particularly travellers visiting friends and relatives, those in contact with an infected person, young children, frequent or long-stay travellers visiting areas where sanitation and food hygiene are likely to be poor, and laboratory personnel who may handle the bacteria for their work. All travellers should take care with personal, food and water hygiene. Oral and injectable typhoid vaccinations are available.

Hepatitis B is a viral infection spread through blood, semen and vaginal fluids. This mostly occurs during sexual contact or as a result of blood-to-blood contact (for example from contaminated equipment during medical and dental procedures, tattooing or body piercing procedures, and sharing of intravenous needles). Mothers with the virus can also pass on the infection to their baby during childbirth. This country is considered to have an intermediate or high prevalence of hepatitis B. Travellers should avoid contact with blood or body fluids. This includes: Avoiding unprotected sexual intercourse. Avoiding tattooing, piercing, public shaving, and acupuncture (unless sterile equipment is used). Not sharing needles or other injection equipment. Following universal precautions if working in a healthcare or other higher risk setting. A sterile medical equipment kit may be helpful when travelling to resource poor areas. Vaccination could be considered for all travellers and is recommended for those whose activities or medical history put them at increased risk. This includes: Those who may have unprotected sex. Those who may be exposed to contaminated needles through injecting drug use. Those who may be exposed to blood or body fluids through their work (e.g. health and aid workers). Those at high risk of requiring medical or dental procedures or hospitalisation e.g. those with pre-existing medical conditions, those who may require travelling for medical care abroad, or those travelling to visit families or relatives. Long-stay travellers. Those who are participating in contact sports. Families adopting children from this country.

Measles is a highly infectious viral illness, spread by airborne or droplet (coughing, sneezing, drops from mouth/nose) transmission. Measles usually starts with cold-like symptoms e.g. fever, cough, runny nose and conjunctivitis (sore, red eyes). This is followed by a blotchy rash starting on the face/head and spreading to the rest of the body. Complications of measles infection can include ear infections, diarrhoea, pneumonia and convulsions (fits). Life-threatening complications such as encephalitis (brain inflammation) can occur on rare occasions. Measles can have serious consequences especially in children under 1 year of age, immunosuppressed individuals (those with a weakened immune system) and during pregnancy. Measles is either 'endemic' (continuous transmission in a 12-month period) and/or the measles risk is assessed to be greater than in the UK due to current outbreaks, conflict, damaged infrastructure, travel-related cases or poor vaccine coverage. All travellers should follow good respiratory hygiene rules and avoid contact with individuals with measles infection. All travellers should make sure they are up to date with the measles, mumps and rubella (MMR) or measles, mumps, rubella and chickenpox (MMRV) vaccines, according to current UK recommendations. Guidance on vaccinating adults can be found in Measles: the green book chapter – GOV.UK.Consider early Measles Mumps Rubella (MMR)/Measles Mumps Rubella Varicella (MMRV) vaccination for infants and children. Infants from six months of age who are likely to be mixing with local people, should receive a MMR vaccine. The MMRV vaccine can be given from nine months of age if MMR is not available at the time of the appointment. Not all children will respond to MMR/MMRV given in the first year of life. When the vaccine has been given before one year of age this dose should be discounted and two further doses of MMR/MMRV should be given at the recommended ages. Children who are travelling and have already received one dose of MMR/MMRV at the routine age should have the second dose brought forward to at least one month after the first. If a child is given the second dose less than three months after the first dose and is less than 18 months of age, then the routine 18-month dose (which would constitute a third dose) should be given in order to provide optimum protection.

Rabies is a viral infection which is usually transmitted following contact with the saliva of an infected animal most often via a bite, scratch or lick to an open wound or mucous membrane (such as on the eye, nose or mouth). Although many different animals can transmit the virus, most cases follow a bite or scratch from an infected dog. In some parts of the world, bats are an important source of infection. Rabies symptoms can take some time to develop, but when they do, the condition is almost always fatal. The risk of exposure is increased by certain activities and length of stay (see below). Children are at increased risk as they are less likely to avoid contact with animals and to report a bite, scratch or lick. Rabies is considered a risk and has been reported in domestic animals in this country. Bats may also carry rabies-like viruses. Travellers should avoid contact with all animals. Rabies is preventable with prompt post-exposure treatment. Following a possible exposure, wounds should be thoroughly cleansed and an urgent local medical assessment sought, even if the wound appears trivial. Post-exposure treatment and advice should be in accordance with national guidelines. A full course of pre-exposure vaccines simplifies and shortens the course of post-exposure treatment and removes the need for rabies immunoglobulin which is in short supply world-wide. Pre-exposure vaccinations are recommended for travellers whose activities put them at increased risk including: those at risk due to their work (e.g. laboratory staff working with the virus, those working with animals or health workers who may be caring for infected patients). those travelling to areas where access to post-exposure treatment and medical care is limited. those planning higher risk activities such as running or cycling. long-stay travellers (more than one month).

Tick-borne encephalitis (TBE) is a viral infection spread by the bite of infected ticks. Occasionally cases of TBE occur after consumption of raw (unpasteurised) milk or dairy products from infected animals (e.g. cows, goats and sheep). Travellers are at increased risk of exposure during outdoor activities in areas of vegetation such as gardens, parks, meadows, woods, forest fringes and glades. This includes urban parks and woodland areas in cities. Ticks are usually most active between early spring and late autumn. There is a risk of TBE in some areas of this country. The transmission season varies, however, ticks are most active during early spring to late autumn.Cases have been reported in the provinces of Bulgan, Darkhan-Uul and Orkhon and Selenge. There is a possible risk in the province of Töv. All travellers should avoid tick bites during outdoor activities, apply insect repellent frequently and follow tick bite avoidance advice. Travellers should check their skin and clothes regularly for ticks and remove them as soon as possible with a recommended technique. Wearing light coloured clothes makes it easier to spot ticks. Travellers should not eat or drink any unpasteurised milk products. Vaccination is recommended for those visiting affected areas whose activities put them at increased risk including: Living in TBE risk areas. Working in forestry, woodcutting, farming and the military. Visiting forested areas and urban parks, e.g. camping, fieldwork, hiking and hunting. Laboratory workers who may be exposed to TBE.

TB is a bacterial infection most commonly affecting the lungs but can affect any part of the body. When a person with TB in their lungs or throat coughs or sneezes they could pass TB on to other people. TB is curable but can be serious if not treated. The BCG vaccination helps to protect some people, particularly babies and young children who are at increased risk from TB. This country has reported an annual TB incidence of greater than or equal to 40 cases per 100,000 population at least once in the last five years (further details). Travellers should avoid close contact with individuals known to have infectious pulmonary (lung) or laryngeal (throat) TB. Those at risk during their work (such as healthcare workers) should take appropriate infection control and prevention precautions. BCG vaccine is recommended for those at increased risk of developing severe disease and/or of exposure to TB infection. See UK Health Security Agency Immunisation against infectious disease, the 'Green Book'. For travellers, BCG vaccine is recommended for: Unvaccinated, children under 16 years of age, who are going to live for more than 3 months in this country. A tuberculin skin test is required prior to vaccination for all children from 6 years of age and may be recommended for some younger children. Unvaccinated, tuberculin skin test-negative individuals at risk due to their work such as healthcare or laboratory workers who have direct contact with TB patients or potentially infectious clinical material and vets and abattoir workers who handle animal material, which could be infected with TB. There are specific contraindications to BCG vaccine. Health professionals must be trained and assessed as competent to administer this vaccine intradermally. Following administration, no further vaccines should be administered in the same limb for 3 months. The BCG vaccine is given once only, booster doses are not recommended.