Mongolia's measles response: a swift and proactive approach deploying experts from the Global Outbreak Alert and Response Network

In 2014, Mongolia was one of four countries to receive a Measles Elimination Certificate from the World Health Organization (WHO) Regional Office for the Western Pacific, marking a major public health achievement. Despite this success, the country faced a significant challenge when a nationwide measles outbreak occurred between March 2015 and December 2016. During this period, Mongolia reported 53,737 cases and 140 deaths, highlighting the ongoing vulnerability to infectious diseases.

Fast forward to August 2024, when a new measles threat emerged. A laboratory-confirmed case was reported in a person traveling to Mongolia from overseas, raising immediate concerns about the potential for community transmission. Mongolia's Ministry of Health (MOH) responded quickly by establishing an outbreak response incident management team, with technical support from WHO, prioritizing containment to prevent further spread.

The overall response strategy involved enhancing syndromic surveillance, implementing rigorous contact tracing, and launching an outbreak response immunization campaign targeting high-risk populations and areas. These efforts led to the identification of eight additional cases unrelated to the initial imported case, with community transmission detected in Bayan-Ölgii Province, located approximately 1,700 kilometers from Mongolia's capital, Ulaanbaatar, and bordering Kazakhstan.

Deploying outbreak response experts from the Global Outbreak Alert and Response Network (GOARN)

Recognizing the need for international expert support, the MOH, in collaboration with WHO, requested assistance from the Global Outbreak Alert and Response Network (GOARN). Dr. Socorro Escalante, WHO Representative in Mongolia, emphasized the urgency of the situation: "Even with one case, we need an aggressive response with a 'no-regrets' approach. Support from GOARN experts is critical to strengthen national response efforts to ensure consistent implementation of critical functions at the healthcare frontline, such as infection prevention and control and clinical management."

Within one week, two experts were deployed to Mongolia for a two-week mission: one focusing on clinical management of measles and the other in infection prevention and control (IPC).

Clinical management expert, Dr. Sapna P. Sadarangani, Senior Consultant, Infectious Diseases from the National Centre for Infectious Diseases in Singapore, highlighted the challenge faced by local health professionals: "Many physicians had not treated a measles case before, making training crucial for recognizing, diagnosing, and managing measles to help interrupt transmission and minimize complications."

Dr. Sadarangani conducted scenario-based training sessions for 752 physicians, nurses, ambulance doctors, and auxiliary health professionals. Pre-recorded training videos were prepared during Dr. Sadarangani's deployment for ongoing virtual training to ensure lasting impact.

Infection prevention and control expert Belinda Henderson, Chief Nurse at Queensland Infection Prevention Control Unit in Australia, was redeployed from Mongolia's capital to Bayan-Ölgii Province to prevent and control potential healthcare associated infections. There, she worked closely with healthcare workers to assess and strengthen IPC practices in local healthcare facilities throughout the province.

"The importance in outbreak response," Henderson said, "is that when you come as an international technical expert, you need to harness local engagement to adapt realistic solutions to the challenges faced."

Mongolia's swift response highlights the continued importance of vigilance and preparedness, even in countries that have previously achieved measles elimination. Through rapid action and expert surge support from WHO and GOARN, Mongolia averted a large-scale outbreak and strengthened its readiness to detect and respond to future imminent infectious disease outbreaks

Public link

Please use the above public link if you want to share this noodl on another website.