Due to an anthrax outbreak, organizations in eastern Democratic Republic of Congo (DRC) and western Uganda, organizations should caution employees to avoid contact with animals in the region, ensure any water from nearby sources is boiled before consumption, and not to consume meat obtained from sick animals or animals that died suddenly. The US State Department lists the DRC under a Level 4: Do Not Travel advisory and Uganda as a Level 3: Reconsider Travel advisory. From March to April 2025, concurrent anthrax outbreaks in the DRC and Uganda affected both wildlife and humans. In the DRC, North Kivu reported 17 hum...read morean cases and 1 death, with some cases linked to handling or consuming infected animals or with cross-border cattle movement from Uganda. In Uganda, 30 human cases were reported, tied to the handling of dead livestock. In addition to unsafe animal handling practices, the outbreak was compounded by low public awareness, cultural beliefs linking livestock deaths to witchcraft, cross-border animal movement, and limited veterinary services for sick animals. Response efforts are ongoing. See PHC alert 5/01 for earlier info. [Confidence: Very High]

The chikungunya mosquito vector, Aedes albopictus, is present in France. Chikungunya is not considered endemic in the country, though locally transmitted cases have occurred. Organizations in France can support mosquito control measures at their facilities by eliminating standing water. Employees should eliminate sources of standing water around their property and prevent mosquito bites by wearing protective clothing and using insect repellent. Mainland France confirmed the detection of its 1st locally acquired chikungunya case this year. The case was detected in La Crau commune of the Var De...read morepartment. Vector control measures were implemented. The case follows high levels of imported vector-borne diseases this year, including chikungunya (see PHC alert 5/29). [Confidence: Very High]

COVID-19 is highly contagious and can be spread in the workplace and schools, leading to worker absenteeism due to illness or caregiving duties. Organizations in Taiwan should advise employees to proactively protect themselves against respiratory illnesses by wearing masks, practicing hand hygiene, avoiding crowded areas, and getting vaccinated. Organizations should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Taiwan health officials announced that the COVID-19 growth rate slowed down. They estimated that the disease reached its peak last week, though the nu...read morembers of severe cases, hospitalizations, and deaths in people over the age of 50 are still increasing. Public compliance with mask wearing and vaccination uptake likely contributed to the changing disease trends. Similar declines were noted in China and Hong Kong as well. [Confidence: Very High]

Organizations in Canada should not sell or serve recalled Rea brand Genoa salami and Bona brand Genova salami while a Salmonella outbreak investigation is ongoing. Anyone with these salami products at their workplace or home should dispose of them, including salami products that are not easily identifiable. People at high risk of salmonella-related complications may wish to avoid all salami products while this investigation is ongoing. Canada is investigating a Salmonella outbreak linked to salami, with 57 reported cases in Alberta (44) and Ontario (13) and 7 hospitalizations. No dea...read moreths have been reported. A food recall was issued for Rea brand Genoa Salami Sweet (Lots: 5035 226 and 5049 226), Rea brand Genoa Salami Hot (Lots: 5020 228 and 5035 228), and Bona brand Mild Genova Salami (Lot: 5035 226). The products were distributed to grocery stores, specialty markets, restaurants and cafes, delis, and butcher shops. Consumers were advised to discard or return any recalled products. [Confidence: Very High]

West Nile virus (WNV) activity in the US typically occurs in the summer and can extend into the fall. 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 that covers skin, using mosquito repellents, and emptying standing water. The WNV season has started in the US. 10 WNV human cases were reported nationally so far this year, including 5 neuroinvasive cases. Affected states i...read morenclude: Alabama (1), Georgia (1), Louisiana (2), Nebraska (1), Oklahoma (1), Tennessee (3), and Virginia (1). Additional states have detected non-human virus activity. [Confidence: Very High]

Enhanced COVID-19 health screenings at Bangladesh ports of entry may lead to travel delays. COVID-19 is highly contagious and can be spread in the workplace and schools, leading to worker absenteeism due to illness or caregiving duties. Organizations should advise employees to proactively protect against respiratory illness by wearing masks, practicing hand and cough hygiene, avoiding crowded areas, and getting vaccinated. Organizations should provide flexible work schedules to support employees who need to make vaccine appointments for themselves or their family members. Bangladesh heightened health screenings at all airports, land, and sea ports amid a rise in COVID-19 cases in neighboring countries. Health officials ...read moreissued an advisory for residents and travelers to take respiratory precautions to minimize infections and to avoid traveling to countries with increasing COVID-19 infections, including India. [Confidence: Very High]

Informational update only. The World Health Organization (WHO) extended the Public Health Emergency of International Concern (PHEIC) for mpox after its 4th emergency committee m...read moreeeting. The PHEIC was first declared in August 2024 following the upsurge in mpox in the DRC and other African nations, partially driven by transmission of the deadlier mpox 1b clade. 25 countries in Africa are now affected, with recent outbreaks in West Africa, including an expanding one in Sierra Leone. WHO slightly revised its set of temporary recommendations regarding emergency coordination, clinical care, vaccination, community protection, governance and financing, research gaps, and reporting. See PHC alert 2/28 for earlier info. [Confidence: Very High]

West Nile virus (WNV) activity typically occurs between June and November in Israel. 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 that covers skin, using mosquito repellents, and emptying standing water. Israeli health officials confirmed the 1st detection of WNV in mosquitoes in the Eilot Regional Council, and the 1st human case in central Israel this...read more year. In response, local authorities were instructed to intensify mosquito monitoring, public awareness, and pest control efforts. The public was also urged to take steps to prevent mosquito bites. In 2024, Israel reported an unusually large number of human cases of WNV. [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. Arizona reported a 4th detection of HPAI in a commercial table egg facility in Maricopa County this year, affecting approximately 342K birds. Over 5.5...read more million birds have been impacted by avian influenza in the county's 4 outbreaks over the past 2 months. There have been no human cases. See PHC alerts on 6/4, 5/29, and 5/21 for earlier info. [Confidence: Very High]

Organizations in the US should not sell or serve recalled August Egg Company eggs while a multi-state outbreak investigation is ongoing. Anyone with eggs at their workplace or home who can’t tell where they are from should dispose of them. The CDC is investigating a multistate Salmonella outbreak linked to eggs, with 79 reported cases across 7 states and 21 hospitalizations. No deaths ha...read moreve been reported. On 6/6, August Egg Company recalled multiple egg brands sold to restaurants and retailers in 9 states: Arizona, California, Illinois, Indiana, Nebraska, New Mexico, Nevada, Washington, and Wyoming. The recall includes all types of chicken eggs, including organic and cage-free. Consumers were advised to discard or return any recalled eggs. [Confidence: Very High]

Crimean-Congo hemorrhagic fever (CCHF) is endemic in Afghanistan and Iraq. Employees observing Eid al-Adha sacrifice rituals should ensure safe slaughtering techniques, avoid consuming meat from unverified vendors, and practice proper food preparation during the holiday period. Health officials from Afghanistan and Iraq issued communications warning of the increased CCHF risk from livestock sacrifice rituals common during Eid...read more al-Adha. Officials cautioned against slaughtering animals in public areas and releasing blood and other remains in the open, as well as cooking meat at high temperatures. Media sources reported over 100 CCHF cases, including 16 deaths, in Iraq so far this year. In Afghanistan, CCHF cases are on the rise, totaling 259 suspected and 16 deaths this year. Eid al-Adha occurs from 6/5 to 6/9. [Confidence: Very High]

The Ivory Coast is prone to cholera outbreaks. Organizations in the Ivory Coast should ensure employees have access to potable water and encourage them to seek treatment if they develop symptoms. Health officials confirmed a cholera outbreak in Port Bouet Viridi, Ivory Coast. 45 cases were reported so far, including 7 deaths, since the outbreak...read more started at the end of May. No new cases were reported in the past 4 days, but officials advised the public on preventative measures to reduce risk during the ongoing rainy season. [Confidence: Very High]

Australia is certified as free of endemic malaria, but limited local transmission has occurred in areas with suitable mosquito vectors, like the Torres Strait Islands and mainland north Queensland. 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 that covers skin, using mosquito repellents, and emptying standing water. Queensland, Australia, reported 2 locally acquired malaria cases in the Torres Strait region in May. 71 malaria notifications were reported in the sta...read morete so far this year, of which 97% were imported. Infections of the imported cases were primarily acquired in Papua New Guinea and the Solomon Islands. [Confidence: Very High]

The new H5N1 human cases in Bangladesh do 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. The WHO reported 2 H5N1 human cases (clade 2.3.2.1a) from Bangladesh this year. The 2 cases were in children from Khulna Division, who both recovered....read more Both cases were reported to WHO in May, but a sample from one case was obtained in February, and a sample from the other case was obtained in April. There was a confirmed H5N1 outbreak in poultry in Jessore in March, the district of residence of the April case, but no information about potential sources of exposure was provided for the other case. These cases are the first human H5N1 cases reported from Bangladesh since 2015. [Confidence: Very High]

Since 2016, Spain has detected sporadic, locally acquired Crimean-Congo hemorrhagic fever (CCHF) cases in its northwestern and western regions during spring and summer months. Organizations in Castile and Leon, Spain, with employees working outdoors in grassy or wooded areas should remind them that tick bite prevention is important for minimizing exposure risk. Spain confirmed a CCHF case in the Salamanca Province of Castile and Leon. The source of infection was from a tick bite, and the individual was hospit...read morealized. Last year, Spain reported 4 CCHF cases, the highest number of annual cases since the 1st locally acquired CCHF case was confirmed in 2016. [Confidence: Very High]

The polio vaccine is more than 99% effective in preventing poliovirus infection. Travelers to Pakistan should verify their polio vaccination status before travel. Pakistan reported a new case of wild poliovirus type 1 in an individual from the District Diamer, Gilgit-Baltistan. The total number of polio cases in...read more 2025 now stands at 11 (5 in Khyber Pakhtunkhwa, 4 in Sindh, 1 in Punjab, and 1 in Gilgit-Baltistan). The 3rd nationwide polio vaccination campaign concluded on 6/1 and successfully reached over 45 million children under 5 in 159 districts, including high-risk areas of the country. See PHC alerts 5/22, 4/28, 4/24, 4/15, and 3/3 for earlier info. [Confidence: Very High]

Human anthrax cases are rare in Thailand, though the disease is more commonly detected in neighboring countries of Vietnam, Laos, and Myanmar. Organizations should caution employees working in or traveling to Thailand to avoid consuming meat from dead or improperly slaughtered cattle. Media sources reported that health officials confirmed a human anthrax case in an adult male from Tambon Tha Yaek, Muang district, Thailand, associate...read mored with eating raw beef. The individual was hospitalized. This is the 6th case for Thailand in 2025. Health officials are investigating the event to find the infection source and identify others exposed to the animal. Residents of Muang district and nearby areas were urged to avoid raw meat, wash their hands or bathe after handling livestock, and promptly report unusual animal deaths to authorities. [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 the Region of Americas should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Due to a sustained drop in whooping cough vaccination coverage and a global rise in cases in 2024 and in 2025 so far, with significant increases in se...read moreveral countries of the Region of the Americas, PAHO urged countries to strengthen case surveillance and closely monitor vaccination coverage, especially in children under 1 and 5 years of age. PAHO also recommended ensuring clinical care and improving public health communication. Enhanced control activities can help close the vaccination gap and prevent outbreaks. [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. Arizona detected HPAI in a commercial table egg layer facility in Maricopa County this week, affecting approximately 1.5 million birds. This is the 2n...read mored detection in a commercial poultry facility in Maricopa County this month (see PHC alert on 5/21). Arizona also reported an HPAI detection in a dairy cattle herd this month, suggesting ongoing HPAI transmission in commercial livestock facilities in the state. [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 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. Cambodia confirmed its 4th H5N1 human case in a child from Kampong Speu Province, who later died. There were sick and dead poultry near the child's re...read moresidence in Srey Sampoung Village of My Kraing Commune before the child's symptom onset. Tamiflu was distributed to close contacts as active case-finding efforts continue. This is the 13th H5N1 human case reported globally this year. See PHC alerts on 5/27, 3/24, 2/26, and 1/13 for earlier info. [Confidence: Very High]

Whooping cough (also known as pertussis) is highly contagious; a single case in the workplace can infect 15 others. Whooping cough deaths are a reminder that the disease can be deadly. The average worker absenteeism for whooping cough is 6 days. Organizations in Peru should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Peru reported 408 confirmed cases of whooping cough and 10 deaths so far this year. Loreto is the most affected region, with regional health officials...read more urging vaccination as regional coverage has not exceeded 80% in recent years, which is below the 95% herd immunity threshold. Media sources reported that the outbreak originated in Datem del Maranon Province and then spread to other provinces, primarily affecting indigenous communities. [Confidence: Very High]

This new H5N1 human case in China 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. Hong Kong reported a new H5N1 human case in Guangxi Zhuang Autonomous Region, China. The case was imported from Vietnam, and the individual recovered ...read moreand was discharged in April. No further info on the exposure source or the virus genotype was provided. This is the 12th H5N1 human case reported globally so far this year across 7 countries: Cambodia (3), China (1), India (1), Mexico (1), the UK (1), the US (4), and Vietnam (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. Ethiopia confirmed mpox in 2 individuals from Moyale City in the Oromia Region. The cases were a mother and her infant child. The father of the child ...read morerecently traveled to a neighboring country. These are the 1st mpox cases reported in Ethiopia, though cases have been detected in neighboring South Sudan and Kenya in the past 6 weeks. South Sudan and Kenya both detected clade 1b in sequenced cases. Ethiopian health officials stated the risk remains low given the limited number of cases. [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 the influenza vaccination from April onwards. Australia reported 84,541 influenza cases so far this year, over 10,000 cases higher than the 73,641 cases reported in the first 5 months of 2024. Exp...read moreerts noted that interseasonal influenza activity has been higher than usual, suggesting a possible change in influenza patterns since the start of the pandemic. In Queensland, cases are 36% higher than this time last year and over 2 times higher than the 5-year average. The increased incidence is partly due to a 4-fold rise in influenza B cases. See PHC alerts on 5/7 and 4/1 for earlier info. [Confidence: Very High]

Mass gatherings, such as the Hajj, create an ideal environment for disease transmission. Pilgrims undertaking the Hajj should review vaccination requirements, particularly for respiratory diseases, before entry to Saudi Arabia. Organizations should provide flexible work schedules to support employees who need to make vaccine appointments for themselves or their family members before the Hajj, and encourage employees to seek treatment if they develop respiratory symptoms during or after the Hajj. Indonesia reported that 99 Hajj pilgrims contracted pneumonia in Saudi Arabia, with 1 death reported. Cases were spread across various sectors and gro...read moreups. Health officials stated that extreme heat, physical fatigue, crowds, and comorbidities can increase the risk for respiratory infections during the Hajj. [Confidence: Very High]

Organizations in Sonora, Mexico, 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. Sonora, Mexico, reported 21 measles cases so far this year, all imported or related to imported cases. 19 of the cases are associated with a cluster i...read moren Cajeme of migrant farmers originally from Chihuahua, where there is an ongoing measles outbreak (see PHC alert 5/22). Health officials reported a measles death in a 1-year-old child associated with the cluster this week. The child was malnourished and unvaccinated. Officials stated that Sonora remains free of local measles transmission. [Confidence: Very High]

Informational update only. Lithuania's 2024-25 flu season officially ended the week of May 12-18 after a long, active season. The highest flu incidence rate of 1910.5 cases per ...read more100,000 people was recorded at the end of Jan, surpassing previous seasons. Hospitalizations were higher than in previous seasons, and a record high of 75 flu-related deaths were recorded (the previous record was 27 deaths in 2023–2024). The increase in cases and deaths is attributed to improved diagnostics, with rapid flu tests introduced in healthcare facilities in October 2024. Health officials still recommend good hygiene, ventilation indoors, cleaning surfaces, and consulting a doctor if symptoms develop. [Confidence: Very High]

Organizations in the US should not sell or serve whole cucumbers grown by Bedner Growers Inc. and distributed by Fresh Start Produce Inc. between 4/29 and 5/9 while a multi-state outbreak investigation is ongoing. Anyone with whole cucumbers at their workplace or home who can’t tell where they are from should dispose of them. Whole cucumbers grown by Bedner Growers Inc. and distributed by Fresh Start Produce Inc. were linked to a US multistate outbreak of Salmonella that be...read moregan on 4/29 and has continued to 5/19, with 26 cases and 9 hospitalizations linked to the outbreak across 15 states. The number of cases associated with the outbreak is likely much higher, and may not be limited to just the states with known illnesses. Cases reported buying and eating cucumbers from various locations, including grocery stores, restaurants, hospitals, and cruise ships. [Confidence: Very High]

Brazil exported $10 billion of chicken meat in 2024, comprising 35% of global trade. The country is one of the main poultry meat importers into the European Union. 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 in Brazil should contingency plan for price volatility. PHC recommends that continuity plans be reviewed and updated in preparation for high-consequence infectious disease threats. The European Commission announced an import ban on poultry and meat products from Brazil due to the detection of highly pathogenic avian influenza in ...read morea commercial poultry facility. The ban applies to all poultry from Brazil, as EU regulations require exporters to be free from avian influenza. No timeline for lifting the ban was given. Other countries also imposed bans (see PHC alerts 5/19 and 5/16). Brazil's Agriculture Ministry implemented measures to contain and eradicate the outbreak and restore exports. [Confidence: Very High]

COVID-19 is highly contagious and can be spread in the workplace and schools, leading to worker absenteeism due to illness or caregiving duties. Organizations in China should advise employees to proactively protect themselves against respiratory illnesses by wearing masks, practicing hand hygiene, avoiding crowded areas, and getting vaccinated. Organizations should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. In the most recent data covering April, China reported an upward trend in COVID-19 test positivity, though the overall epidemic situation of respirato...read morery diseases remains low. Test positivity increased from 7.5% to 16.2% for outpatient COVID-19 tests from the end of March to the start of May, and from 3.3% to 6.3% for hospitalized severe acute respiratory infection cases. Test positivity was higher in southern provinces than northern provinces. Other countries in the region reported similar increases in COVID-19 activity recently. [Confidence: Very High]

Cases of hantavirus are rare, but not unexpected in Nevada. Organizations in Washoe County 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. Nevada confirmed a hantavirus case in a woman in her 90s from Washoe County, who is currently hospitalized. It is believed that the exposure occurred ...read morethrough inhalation or direct contact with rodent droppings, urine, or nesting materials disturbed during carpentry work in her home in the weeks before the onset of symptoms. This is the 1st case of hantavirus in Washoe County since Aug 2023. [Confidence: Very High]

Dengue outbreaks have become increasingly common and severe in the Seychelles in recent years. Organizations in Seychelles 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 that covers skin, using mosquito repellents, and emptying standing water. Media sources reported a rise in dengue cases in the Seychelles, with 16 cases in Mahe and 36 in Praslin. 6 cases were hospitalized, and no deaths have been reported so far. [Confidence: Very High]

Brazil exported $10 billion of chicken meat in 2024, comprising 35% of global trade. 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 in Brazil should contingency plan for price volatility. PHC recommends that continuity plans be reviewed and updated in preparation for high-consequence infectious disease threats. Brazil reported its 1st detection of HPAI at a commercial poultry breeding farm in Rio Grande do Sul. Containment and eradication measures were implem...read moreented following the detection. Officials stated that the risk of human infection is low. The number of birds affected was not provided. Media sources reported that China implemented a country-wide trade ban for 60 days due to the detection, while Japan, the United Arab Emirates, and Saudi Arabia would activate state-specific bans. [Confidence: Very High]

Organizations with employees in or traveling to Colombia should check the country's yellow fever vaccination requirements before traveling within the country to avoid delays. Enhanced screening at health checkpoints may lead to travel delays. Organizations should provide flexible work schedules to support employees who need to get vaccinated at least 10 days before any travel. Officials announced that yellow fever vaccination is required before travel to high-risk areas in Colombia. Vaccination must occur at least 10 days be...read morefore the trip. Media sources reported that authorities established mandatory health checkpoints on driving and river routes, and individuals will need to provide proof of vaccination before purchasing tickets at land transportation terminals and digital platforms. All transportation companies will need to certify that personnel are vaccinated. As of 5/12, 87 yellow fever cases, including 39 deaths, were reported in Colombia so far since early 2024, with most in Tolima. See PHC alerts on 4/25 and 4/17 for earlier info. [Confidence: Very High]

Saskatchewan, Canada, reports sporadic anthrax cases and outbreaks in animals, with the last outbreak reported in 2022 in bison. Anthrax cases tend to garner media attention, but cases in a more rural, agricultural region do not pose a threat to organizations. Saskatchewan Agriculture confirmed anthrax as the cause of death in cattle on 5/13 in the Rural Municipality (RM) of Paynton No. 470. Officials urged ...read moreproducers to stay vigilant for signs of anthrax in animals, ensure annual animal vaccinations, and exercise caution when handling deceased or possibly infected animals. No human cases have been identified. [Confidence: Very High]