Informational update only. The WHO has partnered with the International Olympic Committee to develop a surveillance and mitigation plan to minimize the risk of infectious diseas...read morees related to the Olympics. Mass gatherings, such as the Olympics, pose a risk of a super spreader event, especially with multiple diseases surging globally. [Confidence: Very High]

Human cases of highly pathogenic avian influenza in poultry farm workers exposed to infected birds are not unexpected. No human-to-human spread of H5N1 has been detected. Businesses should continue to follow the recommendations provided in the PHC analysis on April 26. Colorado reported 3 new human cases of H5N1 in poultry farm workers, totaling 10 human cases of H5N1 in Colorado this year. All 3 new cases had mild d...read moreisease and worked at the same poultry farm in Weld County. This is the 2nd poultry farm in Weld County that has identified human cases of H5N1 (see PHC alerts 7/15 and 7/22 for info on previous cases). [Confidence: Very High]

Informational advisory only; no expected business impact. Person-to-person transmission is not believed to occur. Travelers to Brazil should prevent mosquito and midge bites by wearing protective clothing and using insect repellent. Brazil reported the world's first ever recorded deaths from Oropouche virus. Both cases lived in Bahia state. See PHC analysis 7/26 and alerts 5/30 and 6/12 for more details. [Confidence: Very High]

As the measles outbreak continues, businesses should anticipate worker absenteeism due to illness and caregiving responsibilities. Businesses should provide flexible work schedules for employees making vaccine appointments for themselves or family members. Romania's national measles outbreak, which started in Dec 2023, continues with 501 new cases identified in the last week. A total of 21,634 cases and ...read more21 deaths have occurred during the current outbreak, the most of any country in Europe. Low vaccination rates contribute to the outbreak. See PHC alert 7/3 for more info. [Confidence: Very High]

A cluster of COVID-19 on an Olympics team is unlikely to impact enterprise businesses, but serves as a reminder that COVID cases are currently high in many countries, and the Olympics may lead to increased transmission due to the mass gathering of individuals from around the world. Australia reported that 5 members of their women's Olympic water polo team have tested positive for COVID-19 in the past 3 days. The ill players are i...read moresolating and the entire team has been tested. No new or additional restrictions are in place. [Confidence: Very High]

Colorado has reported avian flu outbreaks among dairy herds, poultry farms, and human cases who work with infected animals. Increased surveillance for avian flu is likely to identify additional infected herds and farms. The Colorado Department of Agriculture is mandating highly pathogenic avian flu (HPAI) testing of all commercial dairy cow bulk-tanks. Colorado has re...read moreported 2 spillover events in July involving an HPAI strain in dairy cows being detected in commercial poultry farms. [Confidence: Very High]

Businesses in Buenasbodas in Toledo, Spain with employees working outdoors in grassy or wooded areas should remind them that tick bite prevention is important for minimizing exposure risk. Wearing long-sleeve shirts, pants, and boots can help prevent tick bites, and light-colored clothing can make it easier to spot ticks. Spain reported a case of Crimean-Congo hemorrhagic fever (CCHF) in a Madrid resident bitten by a tick while visiting the municipality of Buenasbodas. ...read moreCCHF is a tick-borne disease, but can also spread from person to person through contact with bodily fluids. Most person-to-person spread occurs in households or healthcare settings. Non-healthcare business transmission is unlikely. [Confidence: Very High]

Businesses in France should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. France's High Authority for Health issued vaccination recommendations amidst high whooping cough cases and deaths. 17 whooping cough-related deaths ha...read moreve been reported so far in 2024, the highest number since the last peak in 2017. The recommendations include the vaccination of pregnant women and their family members and healthcare personnel who interact with young infants if they have not received a whooping cough booster vaccine in the past 5 years. [Confidence: Very High]

Human cases of highly pathogenic avian influenza in poultry farm workers exposed to infected birds is not unexpected. No human-to-human spread of H5N1 has been detected. Businesses should continue to follow the recommendations provided in the PHC analysis on April 26. Colorado reported a new human case of H5N1 in a poultry farm worker and confirmed a previously suspected case (see PHC alert 7/15 for info). So far, 1...read more0 human cases of H5 avian flu have been identified in the US, 4 exposed to sick cows and 6 to sick poultry. [Confidence: Very High]

Israel's West Nile virus season started early, and case rates are higher than in the past 24 years. Businesses should reduce mosquito populations at their facilities by eliminating standing water, even in relatively dry months. Employees can prevent mosquito bites by wearing protective clothing, using insect repellent, and eliminating standing water near their homes. Israel reported an early start to their West Nile virus (WNV) season and the highest number of cases in over 24 years. In the last 5 days, 80 new case...read mores and 5 deaths have been identified, totaling 566 cases and 38 deaths in 2024. WNV cases in Israel are rising rapidly; see PHC analysis on 7/2 and alerts 6/28, 7/1, 7/10, 7/12, and 7/17 for more info. WNV occurs all year in Israel, but most cases occur between July - Sept. [Confidence: Very High]

Informational update. Businesses should continue to promote COVID-19 vaccination for employees. PHC recommends that those without medical contraindications receive the COVID-19 vaccine in consultation with their healthcare provider. Findings from a new study indicate that receiving the COVID-19 vaccine was associated with a lower risk of developing long COVID. Long COVID can contribute to prolonged worker absenteeism. [Confidence: Very High]

Businesses in India with employees working outdoors should remind them that sandfly bite prevention is important for minimizing exposure risk. Chandipura virus has been confirmed in Gujarat, India as cases and deaths climb. So far, 29 cases and 14 suspected deaths have been identified in the ...read morepast week. See PHC alert 7/16 for more info about Chandipura virus in India. [Confidence: Very High]

This outbreak appears limited to a single farm where a storm reportedly damaged the farm. Sustained spread of Newcastle among poultry could impact poultry prices as Brazil is the world's largest poultry exporter. Brazil reported an outbreak of Newcastle disease in a commercial poultry flock, the first in 18 years. The poultry farm is located in Anta Gorda, Rio ...read moreGrande do Sul. Rio Grande do Sul has temporarily halted export of poultry and poultry products. The outbreak may be tied to the collapse of a coop roof, potentially exposing the flock to wild birds. Newcastle disease spreads easily among birds, but does not affect humans. [Confidence: Very High]

Colorado has had H5N1 outbreaks in both dairy herds and poultry farms. Businesses should continue to follow the recommendations provided in the PHC analysis on April 26. Colorado officials reported 5 more dairy herds infected with H5N1, totaling 116 infected herds across 13 states so far. No new human cases have been identified. [Confidence: Very High]

Businesses in Worcester County, Massachusetts should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Worcester County, Massachusetts reports a measles case in an individual who had recently traveled internationally, the 1st measles case in the state since 2020. [Confidence: Very High]

Businesses 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. Benishangul-Gumuz, Ethiopia reported a widespread malaria outbreak involving 22 districts, with 10,526 cases and 5 deaths since July 1. The Dibate and Bulen districts in the Metekel Zone report 3 of the 5 deaths. [Confidence: Very High]

Employers can support at-risk 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. Chad's Ministry of Health issued an alert after identifying 6 suspected mpox cases. Testing and outbreak investigation are underway. Surveillance is being increased. [Confidence: Very High]

West Nile virus is seasonal in New York City (NYC), but detection of infected mosquitos occurred earlier this year than ever before. Businesses in NYC 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. New York City, New York reported detecting mosquitos infected with West Nile virus (WNV) for the first time in 2024, earlier than in any previous year...read more. The first detection was in a sample collected on June 5. WNV has been detected in 325 pools of mosquitos so far this year. [Confidence: Very High]

Israel's West Nile virus season started early, and case rates are higher than in the past 24 years. Businesses should reduce mosquito populations at their facilities by eliminating standing water, even in relatively dry months. Employees can prevent mosquito bites by wearing protective clothing, using insect repellent, and eliminating standing water near their homes. Israel reported an early start to their West Nile virus (WNV) season and the highest number of cases in over 24 years. Last week, 130 new cases and 14...read more deaths were reported, totaling 486 cases and 33 deaths in 2024. WNV cases in Israel are rising rapidly; see PHC analysis on 7/2 and alerts 6/28, 7/1, 7/10, and 7/12 for more info. WNV occurs all year in Israel, but most cases occur between July - Sept. [Confidence: Very High]

Employers can support at-risk 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. Altamira, in Tamaulipas, Mexico reported a case of mpox, the first case identified in this state in 2024. The case is a healthcare professional with n...read moreo known exposure source. Health officials are investigating. This is the first mpox case in Altamira. [Confidence: Very High]

Businesses in Galicia, Spain should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Galicia, Spain reported 2 measles cases so far in 2024, the first cases in the region since 2020. The Ministry of Health is urging parents to vaccinat...read moree their children because immunization rates have fallen below the target of 95% coverage. [Confidence: Very High]

Businesses in India with employees working outdoors should remind them that sandfly bite prevention is important for minimizing exposure risk. Gujarat, India suspects Chandipura virus in 12 cases and 6 deaths in the past week. Chandipura virus is spread primarily by the bite of sandflies, and cases occur annually in India. Lab confirmation is pending. [Confidence: Very High]

Human cases of highly pathogenic avian influenza in poultry farm workers exposed to infected birds is not unexpected. No human-to-human spread of H5N1 has been detected. Businesses should continue to follow the recommendations provided in the PHC analysis on April 26. Colorado reported 4 confirmed and 1 probable human cases of H5N1 among poultry workers exposed to infected birds. All cases are tied to a single poult...read morery farm in northeast Colorado that is responding to an avian flu outbreak among the birds. All of the human cases have conjunctivitis and respiratory symptoms. [Confidence: Very High]

Businesses in the greater New York City area should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. New York reported 2 measles cases in residents of a Brooklyn shelter for the newly arrived. Close contacts are being identified. [Confidence: Very High]

Hantavirus is rare, but expected in Arizona. Businesses in Arizona should take measures to ensure rodent-free facilities. Any 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. Coconino County, Arizona reported 3 cases and 2 deaths from hantavirus during the past 15 months, the first cases in the County since 2016. Arizona ha...read mores reported an increase in cases across the state, with 7 cases and 3 deaths so far in 2024. [Confidence: Very High]

April milk samples from a farm in Oklahoma were recently submitted for testing when the business sought reimbursement for lost milk production. These cows are the first known H5N1 cases in Oklahoma. Businesses should continue to follow the recommendations provided in the PHC analysis on 4/26. Oklahoma reported detection of H5N1 in a dairy herd, making it the 13th state to have H5N1-infected dairy cows. The samples were collected in April 20...read more24, but not sent for testing until July. The delay underscores the significant gaps in H5N1 surveillance. Oklahoma has not reported any H5N1-infected birds in the state in 2024. No human cases have been identified with this new outbreak. [Confidence: Very High]

Informational update only. This event involves low-risk exposures to patients in healthcare settings which should not impact enterprise businesses. Two healthcare systems in Portland, Oregon reported that poor infection prevention practices may have led to patient exposures to HIV and Hepatitis B ...read moreand C. The exposures are tied to an anesthesiologist, consisting of ~ 2,400 surgeries. The exposures are considered to be low-risk for transmission. [Confidence: Very High]

Israel's West Nile virus season has started early this year, and case rates are higher than in the past 6 years. Businesses should reduce mosquito populations at their facilities by eliminating standing water, even in relatively dry months. Employees can prevent mosquito bites by wearing protective clothing and using insect repellent and eliminating standing water near their homes. Israel reported an early start to their West Nile virus (WNV) season and the highest number of cases since 2018. So far, 356 cases and 19 deaths have ...read moreoccurred in 2024. WNV cases in Israel are rising rapidly; see PHC analysis on 7/2 and alerts 6/28, 7/1, and 7/10 for more info. WNV occurs all year in Israel, but most cases occur between July - Sept. [Confidence: Very High]

Businesses in the UK should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. United Kingdom's whooping cough outbreak continues, with cases now surpassing all annual case totals since 2012. In May, 2,591 new cases occurred, tot...read morealing 7,599 cases in 2024. Nine deaths have occurred since the outbreak started in Nov 2023. [Confidence: Very High]

Benton County, Minnesota has had H5N1 outbreaks in dairy herds and birds, so this newest dairy herd outbreak is not unexpected. Businesses should continue to follow the recommendations provided in the PHC analysis from April 26. Benton County, Minnesota reported a dairy herd infected with H5N1 avian flu, totaling 9 infected herds in the state this year. This is the 4th infected herd in Benton County. [Confidence: Very High]

Michigan and Minnesota have had H5N1 outbreaks in dairy herds and birds, so infected domestic cats in the affected areas are not unexpected. Businesses should continue to follow the recommendations provided in the PHC analysis from April 26. 3 cats tested positive for H5N1 avian influenza, 2 from Minnesota and 1 from Michigan. The 2 infected cats from Minnesota live on a dairy farm that ha...read mores reported H5N1 in their herd. The cat from Michigan lives in the same county that has reported H5N1 in dairy herds. [Confidence: Very High]

Informational update only. This outbreak illustrates the potential infection risk posed by drinking raw milk. Salmonella, H5N1, and other pathogens have been found in raw milk. Pasteurization inactivates salmonella and H5N1, making pasteurized milk and milk products safe to consume. A 4-state salmonella outbreak has been linked to drinking raw milk, resulting in over 165 cases and 20 hospitalizations between fall 2023 - June 2024....read more Raw Farm LLC, formerly doing business as Organic Pastures, is the producer of the raw milk involved in the outbreak [Confidence: Very High]

Gratiot County has had H5N1 outbreaks in both dairy herds and poultry farms, so this newest dairy herd outbreak is not unexpected. Businesses should continue to follow the recommendations provided in the PHC analysis on April 26. Gratiot County, Michigan reported a new H5N1 avian influenza outbreak in a dairy herd, the first dairy herd outbreak in the state since June 7 and the...read more 26th Michigan herd affected. No human cases have been identified with this new outbreak. [Confidence: Very High]

Businesses with eggs sourced from Colorado should assess their supply chains. H5N1 in poultry presents low risk to humans. Colorado declared a state emergency after identifying an H5N1 avian influenza outbreak in a large commercial poultry farm in Weld County. About 1.8 mi...read morellion chickens will be culled, the 2nd largest in the state's history. Poultry quarantine and movement ban have been implemented. [Confidence: Very High]

Businesses 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. Montpellier-Pérols, France reported a dengue case in an individual without recent travel, indicating the first locally acquired dengue case this year on mainland France. 22 locally acquired dengue cases occurred in 2023. [Confidence: Very High]

Germany has previously detected avian influenza in birds, but this is the first time the H7N5 strain has been detected. The current risk of human disease is low. Bad Bentheim, Germany reported an outbreak of H7N5 highly pathogenic avian influenza on a bird farm, the first time this strain has been identified in...read more Germany or associated with any known outbreak globally. 6,000 out of 90,879 birds on the farm were infected. This is not the same avian flu strain (H5N1) that has been infecting US dairy herds and workers. [Confidence: Very high]

Employees should avoid live-animal markets and not have contact with or consume diseased poultry. Cambodia reported 2 human cases of H5N1 avian influenza in household members who both had exposure to infected birds, totaling 7 cases in 2024. H5N1 i...read morenfluenza is typically spread between birds (both domestic and wild) and can occasionally spread from birds to humans, but human-to-human transmission is extremely rare. Viral mutations could increase the potential for human-to-human transmission. The clade has not been published, but it is likely H5N1 2.3.2.1c which has caused human cases this year; it is likely not H5N1 2.3.4.4b which is the clade spreading globally and in dairy cattle. [Confidence: Very High]

Cryptosporidiosis can cause severe GI symptoms. Businesses in Australia should encourage employees with symptoms to stay home to avoid the potential for workplace transmission and high subsequent absenteeism. Australia has been reporting very high numbers of cryptosporidiosis cases in 2024, with case rates now exceeding those of the past 20 years. So far, 1...read more1,785 cases have occurred in 2024 more than double any past annual case totals (previous highest yearly total was 5,421 cases in 2016). Most cases have been identified in Queensland (5,796), New South Wales (2,872), and Victoria (1,748). Many infections are tied to public pools as Australia experienced its eighth-warmest year in 2023. In summer (early 2024), record temperatures were also seen. See PHC alert 3/21 for more info. [Confidence: Very High]

Another human case of highly pathogenic avian influenza in a dairy worker exposed to infected cows is not unexpected. No human-to-human spread of H5N1 has been detected. Businesses should continue to follow the recommendations provided in the PHC analysis on April 26. A 4th human case of avian flu tied to the US dairy industry has been identified, the first case in Colorado. The case works at a dairy farm with cows ...read morewho have tested positive for H5N1. Preliminary testing indicates the case's strain is H5 and is likely to be H5N1 given exposure to infected cows, but full genetic testing is pending. The case only has eye symptoms. [Confidence: Very High]

Many European countries are reporting high numbers of whooping cough cases this year. Businesses in Sweden should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Sweden issued a health alert regarding the high number of whooping cough cases identified in 2024, with a sharp rise that began in May. So far, 448 ca...read moreses have occurred, with more cases expected throughout the summer and into fall. [Confidence: Very High]

Businesses should reduce mosquito populations at their facilities by eliminating standing water even in relatively dry months. Employees can take steps to prevent mosquito bites by wearing protective clothing and using insect repellent and eliminating standing water near their homes. Monroe County, Florida reports 2 cases of locally acquired dengue in residents of the Florida Keys. No additional details have been provided about the...read more cases, but the Florida Department of Health is conducting continued surveillance and mosquito abatement work. The mosquitos that carry dengue are found in Florida, and the state typically sees several locally acquired dengue cases each year. [Confidence: Very High]

This newest study provides further evidence that drinking raw milk may pose an infection risk. Pasteurization inactivates the H5N1 virus, making pasteurized milk and milk products safe to consume. The FDA reported results from a study indicating that 14% of raw milk samples tested were found to contain infectious H5N1 avian flu. The study involv...read moreed testing raw milk from 4 states with dairy herds infected with H5N1 avian flu. This is the same study described in PHC alert on 7/1. [Confidence: Very High]

The egg shortage in Australia due to poultry avian flu outbreaks is not unexpected. See PHC alert 5/24 and analysis 4/26 predicting this outcome. Egg shortages and price increases are likely to continue to occur. McDonald's announced that they will shorten breakfast hours by 90 minutes in their Australian restaurants due to the egg shortage tied to avian influenza outbreaks among poultry. [Confidence: Very High]

Employees working or traveling in Comoros should avoid questionable water and food sources. PHC will continue to monitor the cholera situation in Comoros and alert businesses to relevant cases or outbreaks. Comoros' cholera outbreak that started in Feb 2024 has started to slow following a large-scale vaccination initiative. Last week, 31 new cases and zer...read moreo deaths were reported. Since the start of the outbreak, 10,142 cases and 147 deaths have been recorded, and 407,841 individuals have been vaccinated, with a goal to vaccinate 872,301. See PHC alert 6/14 for more info. [Confidence: Very High]

EEE is highly severe, often with neurological complications. Businesses in Massachusetts 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. Massachusetts reported identifying eastern equine encephalitis virus (EEE) in mosquitos for the first time in 2024. EEE was detected in mosquito sampl...read morees collected in Carver within Plymouth County. The last outbreak of EEE in this area was in 2019-2020. No human cases of EEE have been identified in MA since then. [Confidence: Very High]

Businesses in Europe should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Employees who travel to places where chikungunya is endemic, such as South America or Africa, should consult a travel medicine specialist about the new vaccine. European residents in areas experiencing chikungunya outbreaks may also want to consider vaccination. The European Commission approved the use of chikungunya vaccine in Europe. The vaccine recently received approval for use in the US and Canada. [Confidence: Very High]

Businesses in France should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. France reported 17 whooping cough deaths so far in 2024 amidst rising rates. Cases have increased 15-fold in the last 4 months compared to the first 2...read more months of 2024. Wider community spread is now detected, a change from the localized clusters identified during the first quarter of 2024. [Confidence: Very High]

Businesses in Bulgaria should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Varna, Bulgaria reported 11 measles cases so far in 2024, the first cases in the region since 2018. Across Bulgaria, measles cases are higher this yea...read morer than the previous 2 years. 13 cases have occurred in 2024 compared to 2023 (none) and 2022 (1). [Confidence: Very High]

Israel has West Nile virus cases every year, but the season is starting earlier this year and case rates are higher than they have been in the past 6 years. Businesses should reduce mosquito populations at their facilities by eliminating standing water even in relatively dry months. Employees can prevent mosquito bites by wearing protective clothing and using insect repellent and eliminating standing water near their homes. Israel reported an early start to their West Nile virus (WNV) season and the highest number of cases since 2018. So far, 81 cases and 7 deaths have oc...read morecurred in 2024. WNV cases in Israel are rising rapidly; see PHC alert 6/28 for more info. WNV occurs all year in Israel, but most cases occur between July - Sept. [Confidence: Very High]

This newest study provides further evidence that pasteurization inactivates the H5N1 virus, making pasteurized milk and milk products safe to consume. The FDA reported results from a study confirming that pasteurization kills H5N1 avian flu in milk and milk products. The study involved inoculating ho...read moremogenized raw milk with higher levels of H5N1 virus than those found in samples of contaminated raw milk, pasteurizing it using typical pasteurization time and temperature requirements, and then checking for live virus. Results indicate that pasteurization inactivated the virus. [Confidence: Very High]

Businesses in greater Boston should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Brookline, MA has identified 15 whooping cough cases, which are associated with two schools. Whooping cough is a vaccine-preventable disease; vaccination is recommended for adults every 10 years as protection wanes over time. [Confidence: Very High]

Low risk to businesses. Caregivers of young children in The Hague should notify their healthcare provider if they or their children experience signs or symptoms of measles, including high fever, cough, runny nose, and watery eyes. The rash typically appears 3 to 5 days after symptoms start. A local outbreak of measles has spread to 17 children in The Hague. The cases are linked through school and daycare contacts; parents of potentially e...read morexposed children have been contacted. Measles has been expanding globally in part due to low vaccination rates. The Dutch National Institute for Public Health and the Environment (RIVM) reports that a measles vaccination rate of 78.5% for older children, well below the recommended 95% target. [Confidence: Very High]

Businesses in South Korea should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. South Korea joins the list of countries with rapid increases in whooping cough cases. To date, 73 cases have been detected in 2024, compared with 4 ca...read moreses reported during 2023. Nearly all cases are among elementary and middle school children. [Confidence: Very High]