Building the Future of Biodefense

Recommendation: Employers can support employees in obtaining mpox vaccinations by providing flexible work schedules. Information on the availability of mpox vaccines and treatment can also be included in employee wellness communication.

Situation: The WHO issued an update on a recombinant strain of clade 1b and 2b mpox. Genomic analysis identified 2 closely related sequences from a case in England and a case in India. The England case was previously reported in December 2025 in an individual who recently traveled to Southeast Asia in October (see PHC alert on 12/8). The case in India was detected in September 2025 and retrospectively reclassified as a closely-related recombinant strain. The individual had recently traveled from a country in the Arabian Peninsula. Both cases had similar clinical presentations, symptom onset within weeks of each other, and neither experienced severe outcomes, though any assessment of the strain's severity or transmissibility based on the 2 cases is premature. No secondary cases linked to either case were detected, making these the only known cases of this recombinant virus. The origin of the strain remains unknown, and transmission of the virus involves at least 4 countries, suggesting that the strain may be more widespread than documented. The WHO stated that all countries should remain alert to the possibility of mpox genetic recombination, but the risk assessment remained unchanged, staying as Moderate for men who have sex with men or with new or multiple partners, or sex workers, or others with multiple casual sexual partners, and Low for the general public. [Confidence: Very High]

Recommendation: This new H5N1 case in Cambodia does not change PHC's recommendations for organizations. No human-to-human spread of avian influenza has been detected. Organizations should follow the recommendations provided in the PHC analysis on 1/10/25 and 2/13/25, including lowering barriers to seasonal flu vaccines for their employees. Employees should avoid live-animal markets and not have contact with or consume diseased poultry.

Situation: Cambodia confirmed a new H5N1 human case in a 30-year-old man from the Meanrith Village in the Teuk Chhou district, and the case has since recovered. The investigation revealed that there was a dead chicken in the case's house, and it was cooked 3 days before the individual started having symptoms. Health officials are searching for suspected cases and contacts to prevent further transmission, including distributing Tamiflu to close contacts and conducting health campaigns among residents in affected villages. [Confidence: Very High]

Recommendation: Organizations in New York City should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Measles is highly contagious and can quickly spread among unvaccinated individuals in a work environment.

Situation: New York City health officials confirmed the city’s and the state's 1st measles case of the year in an unvaccinated infant with recent international travel history. Officials are identifying and notifying potential contacts. Health officials advised the public to review their vaccination status and to get vaccinated, amid rising measles cases globally and in the United States. [Confidence: Very High]