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Tick-borne encephalitis virus (TBEV) causes neurological disease in humans, with varied clinical severity influenced by the viral subtype. TBEV is endemic to Mongolia, where both Siberian and Far-Eastern subtypes are present. Ixodes persulcatus is considered the main vector of TBEV in Mongolia; although, the virus has also been detected in Dermacentor species. To further characterize the disease ecology of TBEV within the endemic Selenge province of Mongolia, 1300 Ixodes persulcatus ticks were collected in May 2020 from regions outside Ulaanbaatar. Pooled tick samples (n = 20–50) were homogenized and the supernatant was inoculated into Vero cells. Two RT-PCR assays were conducted on the cell supernatant following an observed cytopathic effect: one for TBEV detection and the second for viral subtyping. Lysed cell cultures were processed for next-generation sequencing (NGS) using Illumina technology. TBEV was detected in 10.7% of tick pools (3/28), and isolates were identified as the Siberian subtype. Phylogenetic analysis showed PQ479142 clustering within the Siberian subtype and sharing high similarity with published isolates collected in Selenge in 2012 from Ixodes persulcatus. Subtype analysis of circulating TBEV isolates and sequencing analytics to track viral evolution in ticks are vital to continued understanding of the risk to local populations. [ABSTRACT FROM AUTHOR]

Simple Summary: In Mongolia, where nomadic pastoralism is still commonly practiced, a majority of reported human rabies exposure is attributed to dogs, with this case study highlighting an atypical exposure via horse bite occurring in an urban setting. The infected horse had been attacked by stray dogs prior to biting a 6 year old, which likely was the source of the rabies infection. This report highlights a successful response by the National Center for Zoonotic Diseases in conducting a thorough rabies investigation following a suspected exposure event and PEP initiation. Also discussed are common challenges in managing rabies in Mongolia, including limited access to vaccinations for domestic animals and wildlife due to financial constraints. Prompt and indiscriminate PEP initiation in rabies-endemic regions will need to be readily available across Mongolia, not just within proximity to Ulaanbaatar. Furthermore, integrated rabies management in Mongolia will need to be paired with community outreach and require coordination between veterinarians, health professionals, and policymakers to ensure proper access to care following exposure events from atypical sources such as livestock and horses. Rabies is a highly fatal zoonotic disease that causes an estimated 60,000 human deaths each year, many of which occur in Africa and Asia where the disease is likely underreported. Uncontrolled transmission of rabies presents a major threat to public health in countries such as Mongolia, where 26% of the population lives a pastoralist lifestyle characterized by increased interaction with livestock animals. Here, we report a case of rabies exposure in a six-year-old male after being bitten by a horse in both the head region and the leg. At the suspicion of rabies, post-exposure prophylaxis (PEP) was initiated, with the patient receiving four doses of PEP vaccine as well as a single treatment of rabies immunoglobulin. The horse was later confirmed to be rabies-positive through rapid antigen testing and RT-PCR. Human rabies exposure from horses is unusual within Mongolia, given that historically over 70% of human rabies cases within the country are attributed to dogs, wolves, or foxes. This case further emphasizes the need for more routine vaccination of domestic animals within Mongolia. Additionally, animal bites, even from animals not frequently associated with rabies, should be treated as possible rabies exposure events. [ABSTRACT FROM AUTHOR]