Mongolia has joined the list of must-visit places for an increasing number of Australian travellers, going on the number of enquiries to our free travel health advisory service (1300 360 164).
Still relatively undeveloped and unexplored, Mongolia offers unspoiled landscapes ranging from the mighty Gobi Desert to sparkling lakes, and the verdant Holy Peaks surrounding the capital, Ulaanbaatar. Combine that natural beauty with a centuries-old culture that still revolves around its nomadic herders.
Sound like you? Here’s our pre-travel advice to protect your health before striking out for the wilds of Mongolia in the footsteps of Genghis Khan.
HEALTHCARE IN MONGOLIA
Health care services are limited outside the capital, Ulaanbaatar. An exception is the SOS Medica clinic in Ulaanbaatar, staffed by western-trained doctors and offering consultations at around $US200. While most basic drugs are available without a prescription (albeit with Chinese- or Russian-language labels), western drugs are generally in short supply and travellers are advised to bring adequate supplies with them as part of a well-stocked first-aid kit (see below).
PRE-TRAVEL VACCINATIONS
(Please note, to determine which vaccines are right for you and your particular trip, discuss your itinerary with a travel medicine specialist, or your GP.)
REQUIRED: There are no mandatory vaccinations to travel to Mongolia. Yellow fever is NOT a requirement, unless you travel from an endemic country of Africa or South America.
RECOMMENDED: The following vaccinations are recommended for short stays of less than 1 month:
Childhood vaccinations should be up-to-date before any overseas trip. These include: measles-mumps-rubella (MMR), diphtheria-tetanus-pertussis, and chickenpox, along with influenza, the most common vaccine-preventable illness among international travellers. (Polio is recommended only if you have not had basic immunisations.)
Hepatitis A is widespread – 97% of adults in Mongolia are seropositive for the liver disease, meaning they are, or have been, infected – typically in childhood. There is a moderate risk of infection for all travellers and vaccination is recommended – regardless of the length of stay or type of accommodation. Hep A is spread by contaminated food or water, but can also be passed from person to person by handling everyday objects. The Hep A vaccine is highly effective and long-lasting, as is the Hep A-B combination vaccine. RISK FACTOR: Medium-High
Hepatitis B vaccination is routine for kids these days and worthwhile for all travellers. Unlike Hepatitis A, Hep B and C are blood-borne viruses, but only Hep B is preventable through vaccination. It is especially relevant for travellers planning adventure activities in remote regions with few medical facilities, such as Mongolia. It is estimated that as much as 40% of the population are infected with Hep B, while rates of Hep C are slightly higher. RISK FACTOR: Medium-High
Typhoid is also rated a moderate risk in Mongolia and vaccination is recommended for even short stays (less than 1 month), especially for those visiting smaller cities, villages, or rural areas. A food- and water-borne bacterial disease, typhoid fever typically occurs in regions where levels of sanitation and personal hygiene are low. RISK FACTOR: Medium
LONGER STAYS
For stays of longer than 1 month, also consider:
Rabies – Rabies occurs in Mongolia, chiefly in dogs, bats, and other mammals. It is not uncommon to see unrestrained and, at time, vicious dogs in the countryside. Rabies vaccination is generally recommended for people travelling in remote areas where treatment for bites is not readily available, as well as for those individuals with an occupational risks (such as veterinarians) or long-term travellers and expatriates. Travellers involved in any activities that might bring them into direct contact with bats, carnivores, and other mammals should consider vaccination. Children are often at higher risk of exposure.
Those staying or working in Mongolia for an extended period should discuss their potential exposure to Tick-borne encephalitis. Cases occur occasionally in rural areas near the Russian border and around the capital.
Tuberculosis (TB): Vaccination is usually reserved for long-stay expats living in countries where the disease is common. Rather than being vaccinated, long-stay travellers are usually recommended to have a TB skin test before and after travel. Vaccination with the BGC vaccine offers life-long protection and should be considered for children under 5 spending more than 3 months in Mongolia or other countries in the region, including China.
FOOD AND WATER
All food should be well cooked and only water that’s been bottled, boiled, or treated (with a filter or chemical agent) should be consumed – without ice cubes.
Fruits and vegetables: wash, dry and peel them yourself.
Beware: raw salads, cold cuts, raw or slightly cooked/grilled seafood, mayonnaise, ice cream, cream or butter, and other dairy products.
Hand washing: Always wash your hands thoroughly after using the toilet and before eating.
Brucellosis: Mongolia is considered to have the world’s highest incidence of brucellosis, which generally affects cattle, yaks, camels and sheep, but can also affect humans. The most likely way for humans to contract this disease is by drinking unboiled milk or eating home-made cheese, although cases among travellers are rare. RISK FACTOR: Low
Traveller’s diarrhoea: Traveller’s diarrhoea (TD) is one of the most common travel-related illnesses. TD often clears up without specific treatment; however oral rehydration solution should be on hand to replace lost fluids and electrolytes. Travellers who pass three or more loose bowel motions in an eight-hour period, especially if there are other symptoms like nausea, vomiting, abdominal cramps, fever, or blood in stools should consider taking a course of antibiotics. Ask about the appropriate medication and dosages during your pre-travel medical consultation. If diarrhoea persists despite therapy, see a doctor – the cause may be a parasitic infection. Learn more about traveller’s diarrhoea. RISK FACTOR: Medium-High
INSECTS
Malaria is not present in Mongolia, nor are the more familiar tropical mosquito-borne viruses, such as dengue and Chikungunya. In addition, a number of more exotic diseases occur in Mongolia, but they present a low risk to most travellers.
Plague makes an appearance in remote parts of Mongolia in late summer. On average 40 cases are reported each year, mainly in August and September. There are 2 types; the bubonic form of the disease is transmitted to humans by bites from fleas living on infected small mammals, while Pneumonic Plague is transmitted from person to person by coughing. During outbreaks, travel to infected areas is prohibited and trains, buses and cars travelling into Ulaanbaatar from infected areas are thoroughly checked, and vehicles are disinfected.
An estimated 5% of the Mongolian people are seropositive for alveolar hydatid disease, an infection caused by larval stages of a tapeworm. These destructive larvae invade the infected organ, usually the liver. Transmission generally occurs through contaminated food or water and travellers should especially avoid drinking untreated water from streams, canals, lakes, or rivers, and observe food and water precautions.
Tularemia is a bacterial disease of animals and humans. Humans generally become infected through: Tick and deer fly bites, skin contact with infected animals, or by drinking contaminated water.
WHAT TO PACK
First-aid kit – In case of an accident, it’s reassuring to know you have a travel first-aid kit containing syringes, needles, sutures etc. that local medical personnel can use, along with basic first-aid items you might need from day to day. Travelvax offers a range of travel first aid kits.
Insect repellent – Fleas and ticks are the main sources of infections, but flies may be a nuisance. Apply repellent containing an active ingredient, such as DEET, Picaridin, IR3535, or oil of lemon eucalyptus when outdoors. Read moreabout insect repellents.
Sunscreen – Take a 50+ sunscreen and when outdoors apply it to all exposed skin as directed. Despite its extremes of temperatures – winter temperatures can fall to a bitterly cold -32°C in places, while the summer maximums generally remain in the low 20°Cs – travellers should beware the UV factor and apply sunscreen.
CONSULAR ASSISTANCE: Australian Consulate-General in Mongolia is located at 4F, Naiman Zovkhis (“Eznis”) Building, 21 Seoul Street, Ulaanbaatar 14251. Tel: +976 7013-3001; fax: +976 7013-3014. In a consular emergency travellers who are unable to contact the above mission, should contact the 24-hour Consular Emergency Centre on +61 2 6261 3305 or 1300 555 135 within Australia.
For more expert advice on staying healthy overseas, or to book your pre-travel medical consultation at a Travelvax Australia clinic, please call 1300 360 164 (toll-free for landlines).