On 15 January 2019, due to the outbreak of Influenza A (H1N1) virus in Mongolia, the State Emergency Commission meeting was called. The Ministry of Health stated that Influenza A cases were confirmed to be H1N1 in the end of December 2018 and since then it had rapidly spread within a short period of time. By January 2019, 9 districts of Ulaanbaatar city and 11 provinces have been spread to outbreak, ranging from 11-23.5 per cent with a national average of 10.6 per cent of total outpatient examinations. From the total number of Influenza cases, 30.9 per cent are children aged 0-1 year, 26.5 per cent children aged 2-4 years and 14.1 per cent children aged 5-9 years. As of 3 January, the outbreak became higher than three years’ average and four deaths have been registered in January. The situation has worsened, and the risk of outbreak rapid increase is high in urban areas due to several factors including air pollution, high population density, extremely cold temperatures dropping lower than -40oC and socioeconomic situation of households. It must be emphasized that due to poor air conditions in Ulaanbaatar2, the infants and children in the city are most exposed and vulnerable to the outbreak3. The air pollution is mainly caused by coal combustion of individual households which mainly emits PM10, PM2.5 pollution that increases during the cold season that continues from October to April. The fatality risk is high due to the Ulaanbaatar City air quality is 133 times worse than WHO standard level. For the last 10 years, incidences of respiratory diseases increased 2.7-fold in respiratory infections per 10,000 population. Children aged 0-5 years are the most vulnerable, pneumonia becoming the second leading cause of death of children aged 0-5 years. In 2018, the pneumonia death among children increased by 40 Mongolia – 21 provinces and 9 districts
The operation aims to directly reach 30,935 (10 per cent of the total number of elementary school children, ages 6 to 10 years) through Influenza and pneumonia prevention and health promotion activities and 9000 parents of under 5 and kinder garden children will be reached through public awareness campaign. The indirect reach will be 111,366 parents and family members of the elementary school children.