Legionnaires’ disease spreads through inhaling aerosolized contaminated water from sources like cooling towers, pools/hot tubs, showers, or fountains. Employees working in or visiting Sydney, Australia should seek medical attention if symptoms appear. Organizations that own or manage buildings in Sydney with cooling towers should stay up to date on testing and maintenance, as contaminated towers can infect a large number of people. The disease can range from mild to fatal. New South Wales issued an updated health alert for Legionnaires’ disease (see PHC alert 4/11). Cases of Legionnaires’ disease increased from 5 to ...read more12 confirmed cases in people who spent time in Sydney’s central business district and adjacent suburbs between 3/13 and 4/5. 11 of 12 cases were hospitalized, and 1 person died. The source of the exposure remains unidentified, and health officials are investigating potential causes, including inspecting and testing over 165 cooling towers. [Confidence: Very High]

Whooping cough (also known as pertussis) is highly contagious; a single case in the workplace can infect 15 others. The average worker absenteeism for whooping cough is 6 days. Organizations in Bogota, Colombia should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Bogota's Health Secretary published a social media post urging the public to vaccinate children under the age of 5 and pregnant women (starting from w...read moreeek 20) against whooping cough. Bogota reported 107 confirmed and 390 probable whooping cough cases so far this year, compared to the 11 cases confirmed during all of 2024. Earlier this year, the region confirmed an infant whooping cough-related death (see PHC alert 3/3). Nationally, 1,248 probable and 228 confirmed cases were reported so far this year. Other countries in the Americas region also issued alerts for elevated whooping cough activity (see PHC alerts 4/14, 4/9). [Confidence: Very High]

Samoa frequently reports cases of dengue-like illness. Dengue is likely underreported, though there was a widespread outbreak in the country from 2023-24. Organizations in Samoa should reduce mosquito habitats by eliminating sources of standing water and applying insecticides to outdoor water storage containers. Employees can reduce infection risk by wearing clothing covering skin, using mosquito repellants, and emptying standing water. Samoa's Ministry of Health declared a dengue outbreak this week after a surge in suspected and confirmed cases in the past 2 weeks, particularly in Up...read moreolu. 15 confirmed cases were reported since the start of the year, of which 9 were reported in the last 2 weeks. 1 death was reported. [Confidence: Very High]

The rapid banning of meat and dairy products is a reminder of the economic impacts of foot and mouth disease (FMD) at a country-wide level. Organizations traveling to the United Kingdom (UK) from other European Union (EU) countries should inform their employees about the ban on bringing personal meat and dairy products into the country. Due to rising FMD in Europe, the UK extended its ban on personal imports of meat (cattle, sheep, goat, and pig) and dairy products from all EU countri...read morees. Effective as of 4/12, this ban prohibits travelers from bringing in items like sandwiches, cheese, cured meats, raw meats, or milk, even if packaged or bought duty-free, to protect the UK food system and farmers. [Confidence: Very High]

The primary impact of highly pathogenic avian influenza (HPAI) outbreaks in commercial flocks is increased cost of eggs or poultry products when outbreaks become more widespread. Organizations sensitive to egg and poultry prices should contingency plan for price volatility. PHC recommends that continuity plans be reviewed and updated in preparation for high consequence infectious disease threats. Darke County, Ohio detected HPAI at a commercial table egg layer facility, affecting 292,000 birds. This detection ends a short lull in avian influenz...read morea detections in the county. The last detection confirmed in Darke County was in Feb when over 3 million birds were culled at a commercial table egg layer facility and a state of emergency was declared (see PHC alert 2/20). Ohio has been hard-hit by avian influenza outbreaks at commercial poultry facilities, particularly in Darke County (see PHC 3/21 and 1/28). [Confidence: Very High]

Organizations should reduce mosquito populations at their facilities by eliminating standing water. Employees can take steps to prevent mosquito bites by wearing protective clothing and using insect repellent and eliminating standing water near their homes. California reported 4 dead birds tested positive for West Nile virus in Alameda and Santa Clara Counties, an early indicator that the virus is circula...read moreting. No human cases have been reported in the state so far this year. With rising temperatures increasing time spent outside, California residents were advised to protect themselves from mosquito bites both at home and when traveling. Invasive mosquito species, Aedes aegypti and Aedes albopictus, are now established in many California areas, particularly southern California and the Central Valley, posing a public health threat due to their potential to spread diseases like West Nile virus, dengue, and other vector-borne diseases. [Confidence: Very High]

Poland is the 3rd largest exporter of poultry meat globally, exporting $4.01 billion in 2023. Its primary markets are Germany, the United Kingdom, and France. If an export ban were implemented by the European Commission (EC), organizations in Europe could see increased costs of poultry meat, eggs, or other poultry products. PHC will monitor and update as appropriate. Poland detected avian influenza in 78 commercial flocks in 9 provinces since the start of 2025 with H5N1 sequenced in some of the recent outbreaks. Of...read more the countries in the European Union, Poland has reported the most outbreaks, mostly in Wielkopolskie and Mazowieckie Provinces. Polish government officials are in negotiations with the EC to discuss emergency measures to control further spread. The EC assessed the current avian influenza situation in Poland as "unstable and risky." Poland says that the restrictions proposed by the EC could affect areas that comprise 50% of the Polish production potential. Media sources cite poultry export and transport bans and buffer zones as some of the measures under consideration. [Confidence: Very High]

Whooping cough (also known as pertussis) is highly contagious; a single case in the workplace can infect 15 others. The average worker absenteeism for whooping cough is 6 days. Organizations in Mexico should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Mexico issued another whooping cough alert for the increase in cases this year, following an earlier alert released in March (see PHC alert 3/4). This...read more year, 37 deaths and 2,549 probable cases were reported across 14 states so far. Of those cases, 696 were confirmed, compared to 463 confirmed cases for all of 2024. Aguascalientes, Chihuahua, Mexico City, and Nuevo Leon states had the highest incidence rates. Officials called for heightened surveillance, particularly of hospitalized children under the age of 1, and intensification of vaccination uptake in high-risk municipalities. [Confidence: Very High]

Dengue is endemic in Fiji, with cases highest between Oct - April, but cases are higher than usual this year. Organizations should reduce mosquito populations at their facilities by eliminating standing water. Employees can prevent mosquito bites by wearing protective clothing, using insect repellent, and eliminating standing water near their homes. Fiji's Ministry of Health declared a dengue outbreak for the Central Division on 4/11. The Central Division reported 1,090 confirmed cases from the st...read moreart of 2025 to mid-March, exceeding the outbreak threshold. Cases and hospital admissions surged in the past 3 weeks in Navau, Suva, Rewa, Tailevu, and Naitasiri. Fiji previously declared an outbreak for the Western Division, but cases have started to decline there (see PHC alert 4/2, 2/4). Additionally, at least 2 deaths due to dengue were confirmed - 1 in the Northern Division and 1 in the Western Division in Ba (see PHC alert 3/27). [Confidence: Very High]

Saudi Arabia issues health requirements for the Hajj and Umrah pilgrimages, including MenACWY vaccination to protect against invasive meningococcal disease (IMD). However, authorities estimate only 54% of international Umrah pilgrims complied with meningococcal vaccination requirements this year. If traveling to or working in Saudi Arabia, organizations should provide flexible work schedules to allow for vaccination of themselves or family members if not already vaccinated. Umrah and Hajj pilgrims should receive vaccination at least 10 days prior to travel. Enhanced screening is conducted at Saudi Arabia's points of entry during Hajj and Umrah seasons and may lead to travel delays. Saudi Arabia confirmed 11 IMD cases in individuals performing Umrah from Jan to March. The individuals were all unvaccinated and were from WHO Eastern...read more Mediterranean and South-East Asia Region countries. Additionally, the WHO received reports of 6 additional IMD cases in individuals who were diagnosed in their home countries in following Umrah. Many participating Hajj and Umrah pilgrims come from countries that are hyperendemic for meningococcal disease, like the meningitis belt countries, making these mass gathering events high risk for outbreaks. [Confidence: Very High]

Influenza-related deaths are a reminder that the illness can be severe or fatal. Organizations should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. North Carolina health officials announced that the state recorded the highest number of influenza deaths in a respiratory virus season this year since...read more 2009. 503 deaths were reported for the 2024-2025 season, of which 5 were pediatric deaths. Since the peak in Feb, influenza activity, including deaths, declined. Nationally, the 2024-25 influenza season was the 1st high severity season since 2017-18. [Confidence: Very High]

Legionnaires’ disease spreads through inhaling aerosolized contaminated water from sources like cooling towers, pools/hot tubs, showers, or fountains. Employees working in or visiting Sydney, Australia should seek medical attention if symptoms appear. Organizations that own or manage buildings in Sydney with cooling towers should stay up to date on testing and maintenance, as contaminated towers can infect a large number of people. The disease can range from mild to fatal. New South Wales issued a health alert for Legionnaires’ disease following 5 reported cases, all involving individuals who had visited Sydney’s cen...read moretral business district. The source of the exposure has not yet been identified, and health officials are actively investigating the situation to determine a possible source. Healthcare providers were advised to maintain a high level of suspicion for individuals showing signs of pneumonia and to collect samples for Legionnaires’ disease testing. [Confidence: Very High]

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. In this week's Africa CDC briefing, officials reported 5,538 suspected mpox cases and 37 deaths in Uganda since 2024. New cases increased in the most ...read morerecent week of data (247) compared to the previous week (190). Cases are spreading in slums, semi-urban, and urban cities. Uganda accounted for 50% of cases from Africa in the last 6 weeks. 100,000 vaccine doses were delivered to the country, and 20,000 individuals were vaccinated in a single week. See PHC alerts on 4/4, 3/19, 3/13, 3/6, and 3/3 for earlier info. [Confidence: Very High]

Malaria is endemic in South Korea, with June to October being the main period of mosquito vector activity and increased risk for infection. Organizations in South Korea can support mosquito control measures at their facilities by eliminating standing water. Employees living in or visiting the area should eliminate sources of standing water around their property and prevent mosquito bites by wearing protective clothing and using insect repellent. South Korea reported its first 2 malaria cases in recently discharged soldiers from Paju and Cheorwon. The country averages 600 cases annually, with a...read moreround 20% in active or former soldiers. Veterans showing symptoms can receive free rapid tests at public health centers for two years post-discharge, while military hospitals offer free tests and treatment for one year. South Korea, in partnership with the World Health Organization and Korea Disease Control and Prevention Agency, aims to eliminate malaria by 2030. [Confidence: Very High]

Whooping cough (also known as pertussis) is highly contagious; a single case in the workplace can infect 15 others. The average worker absenteeism for whooping cough is 6 days. Organizations in Japan should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Japan reported 4,771 whooping cough cases so far this year, 34-times higher than the number of cases reported at this time last year (140). Cases alre...read moready exceeded the total number of cases reported in all of 202. Disease activity shows signs of returning to pre-pandemic activity, which typically saw over 10,000 cases annually. [Confidence: Very High]

This new H5N1 death in Mexico 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 and 2/13, 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. Mexico's Ministry of Health confirmed the death of the H5N1 human case due to respiratory complications. The case was recently reported from Durango w...read moreith an unknown source of exposure (see PHC alert 4/7). No further information on the source was provided, but 38 human contacts were sampled and all tested negative. Officials stated that the risk of further human cases is low. [Confidence: Very High]

Organizations in Indiana 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. Indiana reported its 1st measles case of 2025 in an unvaccinated child from Allen County. Health officials advised the public to review their vaccination status. Infants aged 6 months or older can receive the vaccine. [Confidence: Very High]

Organizations in cholera prone areas should review and update emergency response plans for access to clean water. Organizations working in these areas should ensure employees have access to clean, potable water for drinking and washing and encourage them to seek treatment if they develop symptoms. The World Health Organization highlighted the sharp rise in global cholera cases and deaths, with over 100,000 cases and 1,300 deaths reported in earl...read morey 2025. Preliminary data from 2024 show 810,000 cases and 5,900 deaths, about a 50% increase from 2023, though the true numbers are likely higher due to underreporting. Military conflicts, mass displacement of people, and natural disasters have resulted in poor access to clean water and sanitation, worsening the crisis. International aid funding cuts have also hindered response efforts. [Confidence: Very High]

A new H5N1 human case in Mexico is the 2nd ever H5 human detection in the country following the detection of H5N2 human case in 2024. The detection 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 and 2/13, 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. Mexico confirmed the detection of a human H5N1 case in a child from Durango. The child was hospitalized in serious condition and the source of exposu...read morere is unknown. H5N1 has not been detected in any commercial products across the country, but biological surveys of wild birds and other animals near the residence of the case are ongoing. The Ministry of Health announced that it has a strategic reserve of 40,000 oseltamivir treatments and urged the public to seek medical attention if symptomatic following contact with sick or dead birds and animals. Earlier this year, India, Cambodia, the US, and the UK confirmed H5N1 human cases (see PHC alerts 4/2, 3/24, 2/17, 2/10, and 1/28). [Confidence: Very High]

Organizations with employees in states affected by recent flooding should include health and safety-related information in their communications. This should cover wearing personal protective equipment, protecting open wounds, ensuring access to clean water, and warning about flood hazards like mold and cuts from submerged metal. These floods could have potential for travel impacts and employee absenteeism. Organizations in impacted areas should prepare for multiple days or weeks of disruption and should urge employees to defer to local officials for warnings specific to their neighborhoods, especially as the situation evolves. States in the central part of the US experienced extreme weather on Thursday with severe thunderstorms expected on Friday that could trigger historic ...read morelevels of flooding. More than 200 flood warnings were issued on Friday morning across 14 states. Mississippi Valley states, including Arkansas, Missouri, Tennessee, and Mississippi are under a level 4 of 4 risk of flooding rain, which signifies extreme threat to life and property. Flooding can cause extensive damage and increase the risk of future outbreaks of water-borne and mosquito-borne diseases. [Confidence: Very High]

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. Tanzania almost doubled the number of new weekly mpox cases reported in the most recent week (100) compared to the previous week (55). The Africa CDC ...read morereported 157 suspected cases and 31 confirmed cases across 16 regions since the first case was confirmed on 3/9. Mpox clade 1b was sequenced in the country previously. See PHC alerts on 3/20 and 3/11 for earlier information. [Confidence: Very High]

Valley fever exists in desert areas of the U.S. Organizations in El Paso, Texas with employees working outdoors should limit dust exposure by providing masks, protective clothing and watering down soil before digging (unless drought restrictions prohibit it). Valley fever is a lung infection caused by breathing in spores from Coccidioides. Dry weather is associated with increased cases due to dustier conditions. Media sources reported that El Paso, Texas health officials reminded residents to take precautions against Valley fever, a serious fungal infection, a...read mores strong winds stir up dust. To prevent exposure, officials recommended staying indoors during dust storms and wearing dust masks and protective clothing if working outside cannot be avoided, particularly for individuals with chronic health conditions. [Confidence: Very High]

India mostly exports poultry products to other countries in southeast Asia and Africa. The primary impact of highly pathogenic avian influenza (HPAI) outbreaks in commercial flocks is increased cost of eggs or poultry products when outbreaks become more widespread. Organizations sensitive to egg and poultry prices should contingency plan for price volatility. PHC recommends that continuity plans be reviewed and updated in preparation for high consequence infectious disease threats. India reported 8 outbreaks of HPAI H5N1 in Andhra Pradesh this year, affecting 602,000 birds. The most impacted farms were located in West Godavari (5...read more00,000 birds) and East Godavari (92,000 birds). Other states reported new HPAI H5N1 poultry outbreaks on smaller farms this week including: Maharashtra (affecting 27,802 birds), Bihar (10,299), Jharkhand (6,204), and Karnataka (3,420). Outbreaks were reported in bulk and occurred throughout 2025. [Confidence: Very High]

South Sudan and Ethiopia are prone to cholera outbreaks. Organizations working in these areas should ensure employees have access to potable water, practice good hygiene, and encourage them to seek treatment if they develop symptoms. On both sides of the South Sudan-Ethiopia border, escalating conflict, the displacement of people, and inadequate healthcare infrastructure are contri...read morebuting to rising cases of cholera and other diseases. South Sudan reported cholera outbreaks across the country since Oct 2024. With cholera cases and fatalities rising in Ethiopia’s Gambela region, along with an influx of displaced individuals from South Sudan, the government has initiated a week-long vaccination campaign aimed at reaching one million people. For earlier updates, refer to the PHC alerts from 3/21, 3/13, 3/5, and 2/24. [Confidence: Very High]

Flu and other respiratory diseases are expected to impact employee absenteeism due to illness or caregiving duties. Organizations in Australia should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Australian health officials recommended receiving influenza vaccination from April onwards. Australia reported 1.5-times higher influenza activity in the first 3 months of 2025 compared to the same time period in 2024, confirming 47,219 cases...read more this year compared to 30,494 in 2024. Cases so far are higher than the previous 7 influenza seasons in the same time period. Media sources stated that the high activity may indicate an earlier start to the influenza season, aligning with high-intensity influenza season observed in the Northern Hemisphere. [Confidence: Very High]

Lassa fever is endemic in Nigeria with cases peaking during the dry season (Dec-Apr). Organizations in Nigeria should take measures to ensure rodent-free facilities. Evaluate existing pest control protocols if they are not regularly reviewed and updated. Any rodent droppings should be cleaned with bleach to limit infectious aerosol generation. Employees should always wear gloves and N95 (or equivalent) masks when handling rodents or their droppings. Nigeria intensified its Lassa fever public heath response by deploying rapid response teams to the 10 most high-burden states: Kogi, Plateau, Ondo, Ed...read moreo, Bauchi, Ebonyi, Taraba, Benue, Gombe, and Nasarawa. Nationally, 3,465 suspected cases were reported in 33 states, including 118 deaths. Patient self-medication, limited surveillance at local levels, and healthcare personnel shortages have impeded outbreak response efforts. [Confidence: Very High]

Oropouche virus disease (OVD) during pregnancy was found to have negative birth effects, reminiscent of Zika virus (See PHC alert 11/20). Organizations should consider informing employees with work-related planned travel to areas where Oropouche is circulating and support pregnant employees who choose not to travel. Pregnant employees or those planning to get pregnant in the next 3 months should consult with their medical provider about the Oropouche-related risks associated with travel to areas where Oropouche may be circulating. Venezuela confirmed its 1st detection of Oropouche virus this week when the National Public Health System reported 5 cases in March. Officials will ma...read moreintain screening at ports of entry as well as vector control measures to prevent further transmission. So far in 2025, 9 countries in the Americas reported imported or local OVD cases, with most detected in Brazil and Cuba. [Confidence: Very High]

Nigeria is part of the meningitis belt of sub-Saharan Africa, with northern parts of the country most affected. Meningitis incidence is highest during the dry season (Dec - Jun), often peaking in March and April. Organizations with employees traveling to or working in Nigeria should provide flexible work schedules to allow for vaccination of themselves or family members if not already vaccinated. The Nigerian Centre for Disease Control dispatched rapid response teams to control the rise in cerebrospinal meningitis cases and deaths in Kebbi, Kat...read moresina, and Sokoto states. Media sources reported 807 suspected cases and 74 deaths in Nigeria so far in 2025. [Confidence: Very High]

Yellow fever is endemic in regions of Central and South America. Employees traveling to yellow fever-risk areas in the Americas should consult their healthcare provider at least 10 days before departure about the vaccine. Organizations should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Employees can prevent mosquito bites by wearing protective clothing and using insect repellent. The Pan American Health Organization (PAHO) issued a health alert due to rising yellow fever cases in the Americas. In 2025, 131 confirmed cases of ye...read morellow fever have been reported in Brazil, Colombia, Peru, and Bolivia, of which 53 have been fatal. Unlike previous years, cases have been detected in regions outside the Amazon this year. [Confidence: Very High]

Organizations 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. Sierra Leone reported 108 mpox cases and 2 deaths across 8 districts from mid-Jan to mid-Mar. The rise in new cases may reflect enhanced surveillance ...read moreand active case search. Most cases were reported in Western Area Urban (79) and Western Area Rural (16), primarily affecting students and business persons. Africa CDC confirmed that the 2 deaths were in individuals with underlying comorbidities. Only clade 2b has been sequenced in cases so far. See PHC alerts on 3/13, 2/3, 1/14, and 1/13 for earlier info. [Confidence: Very High]

Cases of hantavirus are rare, but not unexpected in California. Organizations should take measures to ensure rodent-free facilities. Rodent droppings should be cleaned with bleach; wet the soiled area with bleach before wiping up droppings to limit infectious aerosol generation. Employees should always wear gloves and N95 (or equivalent) masks when handling rodents or their droppings. Mono County, California confirmed its 2nd hantavirus death in the Town of Mammoth Lakes (see PHC alert 3/4 for information on the 1st case). A 3rd pos...read moresible case is under investigation. The likely sources of exposure for the 2 confirmed cases are vacuuming rodent waste and a home infestation. Health officials state that the detection of 2 confirmed cases within a 3-week span during late winter is unusual, as the last time Mono County reported a hantavirus infection was in 2019 and peak season is typically during spring and summer. [Confidence: Very High]

Malaria is endemic in Ethiopia, but lack of healthcare infrastructure and ongoing conflict are contributing to the surge in cases. Organizations should continue to reduce mosquito habitats by eliminating sources of standing water and applying insecticides to outdoor water storage containers. Employees can reduce infection risk by wearing clothing covering skin, using mosquito repellants, and emptying standing water. Ethiopia reported 909,146 malaria cases and 34 deaths in the first 2 months of 2025, reaching epidemic levels. In the most recent week of data, 135,03...read more2 new cases and 3 new deaths were reported. Cases per population size is highest in the Gambella region. This year's trend follows the higher-than-typical malaria activity in 2024 with over 7 million cases detected (see PHC alert 12/19). [Confidence: Very High]

Detection of H5N1 in a sheep does not pose an immediate threat to organizations. It highlights the continued risk of highly pathogenic avian influenza (HPAI) spillover from birds to other mammals. Additional detections may occur following enhanced surveillance after this 1st detection. Organizations should review and update continuity plans in preparation for high consequence infectious disease threats, and should follow the recommendations provided in the PHC analyses on H5N1 published on 1/10 and 2/13. The UK announced the 1st HPAI H5N1 detection in a sheep in Yorkshire. The case was identified via milk testing after avian influenza was detected in n...read moreearby captive birds. The sheep was culled and further testing of the flock did not detect any other cases. This is the 1st detection of H5N1 in sheep, but the virus has been detected in cattle and pigs as well as other mammals. Officials state that there is no evidence to suggest an increased risk to the UK's livestock population. [Confidence: Very High]

Murray Valley encephalitis (MVE) occurs every year in Western Australia, usually in the rainy season between Dec - June. Organizations should reduce mosquito habitats by eliminating sources of standing water and applying insecticides to outdoor water storage containers. Employees can reduce infection risk by wearing clothing covering skin, using mosquito repellants, and emptying standing water. Health officials from Western Australia announced a suspected MVE human case in Pilbara. The individual was hospitalized. 2 other MVE cases were confi...read morermed in the state earlier this year in Kimberley and Pilbara regions, including 1 death. Queensland also reported a human case this year, while New South Wales detected the virus in mosquito populations. See PHC alert 2/7 and 1/9 for earlier info. [Confidence: Very High]

This new H5N1 case and death in an individual with exposure to sick birds 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 2/13, 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. Cambodia Ministry of Health reported the death of 3-year-old child in Chit Borei District, Kratie Province due to H5N1. Health officials reported that...read more the child's family had a backyard chicken flock where some birds recently died, and the family had cooked the dead chickens. This is Cambodia's 3rd H5N1 death of 2025, all deaths in children with exposure to infected birds (see PHC alerts 2/26 and 1/13). [Confidence: Very High]

Employees traveling to yellow fever-risk areas in Peru should consult their healthcare provider at least 10 days before departure about the vaccine. Organizations should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Employees can prevent mosquito bites by wearing protective clothing and using insect repellent. Peru health officials issued an alert about the increase in cases of yellow fever in areas of the Amazonas, Huánuco, and San Martín regions. 19 case...read mores of yellow fever were confirmed, a significant increase compared to the same period last year (2 cases). Health officials are conducting outreach activities in the affected communities and are encouraging establishment of vaccination points in strategic public locations. [Confidence: Very High]

The primary business impact of avian influenza outbreaks in commercial flocks is through increased cost of eggs or poultry products when outbreaks become more widespread. Businesses that are sensitive to egg and poultry prices should contingency plan for price volatility. PHC recommends that business continuity plans be reviewed and updated in preparation for high consequence infectious disease threats. Avian influenza was detected in a commercial turkey flock in Putten, Netherlands, resulting in the culling of 27,000 birds. A 10km transport ban was i...read moremplemented following the outbreak, affecting 74 poultry farms. No poultry, hatching, and consumption eggs can be transported from locations with birds in this zone. A ban on the removal of bird manure and litter as well as other animal products was also implemented. [Confidence: Very High]

South Sudan is prone to cholera outbreaks. Businesses in South Sudan should ensure employees have access to potable water and encourage them to seek treatment if they develop symptoms. South Sudan reported 40,231 cholera cases and 694 deaths since the outbreak started in Sept 2024. The outbreak was declining but cases started to rise...read more again during the past 3 weeks, with case numbers likely underreported due to delays in data collection and reporting. Cases are concentrated in Unity, Jonglei, and Northern Bahr el Ghazal. Inadequate water and healthcare infrastructure combined with population displacement contributed to the worsening situation. Officials implemented several vaccination campaigns but coverage varied by region. See PHC alerts 3/5, 1/14, 1/6, and 12/16 for earlier info.[Confidence: Very High]

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. Zambia has reported 7 mpox cases in the past 7 days and its 1st mpox-related death in an 8-month infant from Lusaka. Vaccination will begin in Lusaka to minimize further spread. [Confidence: Very High]

Detection of H5N1 genotype D1.3 avian influenza in a poultry worker does not change PHC's recommendations for enterprise business as there is no evidence of increased virulence or ineffectiveness against existing countermeasures. No human-to-human spread of avian influenza has been detected. PHC recommends that business continuity plans be reviewed and updated in preparation for high consequence infectious disease threats. Businesses should follow the recommendations provided in the PHC analysis on H5N1 published on 1/10 and 2/13. The CDC announced the identification of a new H5N1 clade 2.3.4.4b genotype. The genotype, D1.3, was sequenced in a Mercer County, Ohio poultry worker ...read morewho was previously reported as a probable H5 case (see PHC alert 2/13). The poultry worker was exposed to infected commercial poultry and was hospitalized. Western Ohio was heavily affected by avian influenza outbreaks in commercial poultry, with 2 counties declaring a state of emergency in Feb (see PHC alert 2/20). The CDC stated that there are no indications that existing antivirals or candidate vaccine viruses would be ineffective against this genotype, or that this genotype is better adapted to infect or transmit between mammals. Genotype D1.3 may have contributed to substantial poultry losses in Ohio and Indiana this year (see PHC alerts 3/5, 2/24, and 1/28). The detection of genotype D1.3 is the 3rd H5N1 clade 2.3.4.4b genotype circulating in the US this year, after B3.13 and D1.1. [Confidence: Very High]

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. Africa CDC announced that the mpox outbreak in Tanzania increased to 55 suspected cases and 22 confirmed cases so far in 2025. No deaths were reported...read more across the 16 regions that detected cases. Cases were first confirmed on 3/9 (see PHC alert 3/11). No clade information has been released yet. [Confidence: Very High]