Who is eligible for this vaccination: Everybody who is over 6 months old and wish to be vaccinated against A(H1N1) 2009 pandemic virus, including foreigners permanently living in Mongolia could be vaccinated.

Which vaccine is to be used? The brand name of vaccine is “Arepanrix”. This is an inactivated vaccine prepared from A/California/7/2009(H1N1) pandemic influenza virus produced by Glaxo-Smith-Klein, Canada. It is used as an intra-muscular injection of 0.25 ml for children up to 9 years old and of 0.5 ml for children and adults over 9 years old. The vaccine is capable induce life-long immunity against the A/California/7/2009(H1N1) virus and will offer 30%-70% cross-protection against other A(H1N1) virus variants.

Are there some contra-indications against the vaccine? Yes. The contra-indications are:

• Elevated sensitivity to eggs, chicken proteins, allergic background to formaldehyde, mercury containing preparations and some antibiotics;
• Early stage of pregnancy (till 20th week of gravidity);
• Patients with fever and other signs of acute infections;
• Chronic patients using immunosuppressive and cytostatic medicines have to be vaccinated only on the permission of their doctors.

World Bank (WB) Project “Avian influenza control and human influenza pandemic preparedness and response” has initiated in April 2009 the establishment of virological laboratories in Darkhan-Uul and Orkhon aimaks. The sites were selected due to their rapidly increasing population and becoming major center for cross-country transportation routes which in turn increasing risks of influenza spread and its health and economic consequences. After the purchase of the advanced technology equipment (real-time PCR and other associated devices) and needed reagents it has been started since October 2009 the constructions of BSL 2 laboratory rooms in the General Hospital (GH), Darkhan-Uul aimak and in the Regional Diagnostic and Treatment Center (RDTC), Orkhon aimak by local Governments under supervision of specialists from NCCD and the on-site specialized trainings of the selected manpower in NIC, NCCD. Since beginning of 2010 the equipment has been installed in the prepared laboratory rooms in Darkhan and Erdenet Cities and since March 2010 the laboratories test running has started. In the mean time the new pilot laboratories have tested around 100 clinical samples each and the concordance rate of specific influenza viral nucleic acids detection was 97-100% when it re-tested in the Virology Laboratory, NIC, NCCD. So, the Direction of WB Project has decided it is now the time to hand over the laboratory to the local Governments. The PCR machine provided is able to detect not only the influenza viruses, also the specific nucleic acids from different viral and bacterial agents provided with diagnostic kits which opens a good perspective of rapid diagnostic supports to clinicians and epidemiologists dealing with different infectious disease outbreak control and management measures.

On April 8-9, 2010 the official opening ceremonies of the new laboratories took place in Darkhan and Erdenet Cities. During the ceremonies Dr D.Nyamkhuu, MD, PhD, Director-Geberal, NCCD and Director, NIC, Mongolia has handed over the Diplomas of Virologists to Drs (Mrs) B.Byamba-erdene,MD (Darkhan-Uul) and E.Erdenejargal,MD (Orkhon) and laboratory assistants Mr P.Erdene-ochir (Darlhan-Uul) and Ms T.Munkhzul (Orkhon) graduated from the 6-months on-site training course at NCCD.

The spread of HFMD (Hand-Foot-Mouth Disease) or Enteroviral Vesicular Stomatitis with Exanthem (CCDM-18 terminology) which has started in February 2010 in the southern China has increased dramatically in March 2010 covering now more than 30 regions of the mainland China with more than 78,000 registered cases and 40 deaths (0.05%). According to the official channels of China the most cases have been registered in the rural areas with poorer sanitary conditions.

Information sources:
- http://www.chinacdc.net.cn/n272562/n276003/30035.html accessed on 2010.04.13;
- http://chinadaily.com.cn/china/2010-04/08/content_9699355.htm accessed on 2010.04.13;
- http://news.hinhuanet.com/english2010/health/2010.-04-09/c_13244172.htm accessed on 2010.04.13;

Mongolia was the first country received the pandemic influenza vaccine in the first week of January 2010 from WHO. 100,000 doses of the vaccine have been fully used to the professionally risk group contingents, like health workers, throughout the country.

In this week MoH, Mongolia has received the 2nd batch of 170,000 doses of pandemic influenza vaccine and NCCD is working on the refinement of the distribution plan of it.

We appreciate the great efforts of WHO and WHO Country Representative’s Office granting the supply of pandemic influenza vaccines to Mongolia helping us to organize an effective control measures against pandemic influenza.

NIC, NCCD, MoH

The inauguration of the Mongolian translation of the 18th Edition of the “Control of Communicable Diseases Manual” (CCDM-18) executed by the Mongolian Academy of Medical Sciences (MAMS) took place on March 2, 2010 in the Hall B of the Health Education Center of the Ministry of Health, Mongolia (MoH). As it has been expressed by Dr Wiwat Rojanapithayakorn, WHO Resident Representative in Mongolia “It is a significant event in the Mongolian public health the translation of this “Bible” of the infectious disease hunters valued worldwide for 93 years since its first publication in 1917”. The book will be distributed for the epidemiologists throughout the country by WHO Country Office with the guidance of MoH, Mongolia.

The book is also placed free on-line on the MoH website:
http://moh.mn/moh%20db/HealthReports.nsf/32fe9f3e7452a6f3c8256d1b0013e24e/c676561e5c276497482576d900399ceb/$FILE/Control%20of%20Communicable%20Diseases_final.pdf and

NIC, Mongolia website:
http://www.flu.mn/mgl/images/stories/Sudalgaa_shinjilgee/Control%20of%20Communicable%20Diseases_final.pdf