PHC Global Alerts
For informational purposes only. PHC monitors reports of unknown illnesses and deaths; PHC will communicate any actionable developments. Media sources reported at least 2 deaths and additional hospitalized students amidst an outbreak of an unknown illness affecting students at the Zaria...read more Military School in Kaduna, Nigeria. Data from the media sources is inconsistent, with no official statement from the school nor a government agency. [Confidence: Moderate]
This outbreak warrants greater attention from enterprise businesses in this area, especially given the continued increase in cases and measles deaths reported in other Vietnam provinces. Businesses in Nghe An, Vietnam should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. People traveling to Nghe An should check their measles vaccination status. Nghe An, Vietnam reported a recent surge in measles activity, with 361 cases total this year. The province first reported measles in March, with some ...read moreactivity between April - July before decreasing in Aug and Sept. Cases surged starting in Oct (67 cases) and continued in Nov (117). The province recently implemented an immunization campaign which increased vaccination rates from 79% - 89%, but still remains below the target rate of 95%. [Confidence: Very High]
This outbreak warrants greater attention from enterprise businesses in this area, especially given the continued increase in cases and measles deaths reported in Dong Nai and in neighboring Ho Chi Minh. Businesses in Dong Nai, Vietnam should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. People traveling to Dong Nai should check their measles vaccination status. Dong Nai's measles cases continue to increase rapidly, with 959 new cases identified in the last week and 4,000 total this year. Districts with the mo...read morest cases include Bien Hoah (> 1,500), Thang Bom (839), Nhon Trach (386), and Long Thanh (302). 2 measles deaths have occurred in Dong Nai this year. See PHC alert 12/2 for earlier info. [Confidence: Very High]
Evidence of additional dairy herds infected with H5N1 is not surprising. Businesses should follow the recommendations provided in the PHC analysis on October 22, including lowering barriers to seasonal flu vaccines for their employees. The CDC is offering free seasonal flu vaccine to farmworkers in high-risk states. Pasteurization inactivates H5N1, making pasteurized milk and milk products safe to consume. Raw milk is illegal in Nevada. Nevada is the 15th state to report evidence of H5N1 avian influenza in dairy cattle. The affected herd is in Nye County. Confirmatory testing is underway. No human cases have been reported in this event. [Confidence: Very High]
Arizona previously reported avian flu in poultry flocks in Pinal County and a backyard flock in Maricopa County earlier this year. No human-to-human spread of avian flu has been detected. Businesses should follow the recommendations provided in the PHC analysis on October 22, including lowering barriers to seasonal flu vaccines for their employees. Arizona reported its 1st human cases of H5 avian flu in 2 workers at a commercial poultry farm in Pinal County. The exact strain has not been identifi...read moreed. Both cases were mild. No human-to-human transmission has been identified in this event. [Confidence: Very High]
Businesses in Montreal should inform employees about the possible measles exposure and 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. Montreal reported a measles case who was on Air Canada Flight AC417 from Montreal to Toronto and Air Canada Flight AC890 from Toronto to Rome on Nov 2...read more6, attended the NATO parliamentary assembly in Montreal Nov 23 - 25, and visited multiple hotels and private events (see alert source for details). This is the city's 1st measles case since its large outbreak ended in July. [Confidence: Very High]
Given the wide media coverage around this study, businesses may receive questions regarding this case. The scenario presented in the paper doesn't mean imminent human-to-human transmission is certain, but it highlights the virus's potential adaptability. This study does not change PHC's recommendations. Businesses should follow the guidance provided in the PHC analysis on October 22, including lowering barriers to seasonal flu vaccines for their employees. Researchers reported that H5N1 could be "one mutation away" from becoming highly transmissible among humans. Influenza viruses mutate every year, but ...read morea specific genetic modification would be required to enable more efficient human-to-human transmission. [Confidence: Very High]
PHC will monitor the event and provide updates as needed. No human-to-human spread of H5N1 has been identified. Businesses should follow the recommendations provided in the PHC analysis on October 22, including lowering barriers to seasonal flu vaccines for their employees. Marin County Public Health reported an ongoing investigation into a possible bird flu case. The county has not shared other details except it is worki...read moreng with the California Department of Public Health and the Centers for Disease Control and Prevention to confirm the case and investigate further as needed. [Confidence: Very High]
This imported case underscores the broader risk posed by Vietnam's large measles outbreak. Businesses in Victoria, Australia should inform employees about the possible measles exposure and 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. Victoria, Australia reported a measles case in an individual who had recently traveled to Ho Chi Minh. The case was on Vietnam Airlines Flight VN781 from Ho Chi Minh City to Melbourne Dec 3 - 4. [Confidence: Very High]
Businesses in LA County, California should inform employees about the possible measles exposure and 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. Los Angeles County reported a measles case in a non-resident who traveled through LAX over Thanksgiving. The case was on Qatar Airways flight QR 0739 at the Tom Bradley International Airport on Nov 27. [Confidence: Very High]
This outbreak warrants greater attention from enterprise businesses in this area, especially given the continued increase in cases and measles deaths reported in other provinces, such as Dong Nai and Ho Chi Minh. Businesses in Can Tho City, Vietnam should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. People traveling to Vietnam should check their measles vaccination status. Can Tho City's measles cases have more than doubled since early Oct, from over 300 suspected cases on 10/7 to 772 suspected cases on Nov 15. No measle...read mores deaths have occurred in Can Tho. Can Tho City reported just 1 measles case in 2023. [Confidence: Very High]
Businesses and individuals should dispose of any affected products. H5N1 avian flu and other pathogens have been found in raw milk. Pasteurization inactivates H5N1, making pasteurized milk and milk products safe to consume. California has again expanded the recall of raw milk-related items from Raw Farm of Fresno County. Raw Farm milk products have tested positive for avi...read morean influenza at retail and dairy storage and bottling sites. The affected lot numbers are 20241109 through 20241127. No illnesses have been identified tied to the contaminated product. [Confidence: Very High]
Businesses in Orange County, California should inform employees about the possible measles exposure and 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. Orange County, California reported a measles case in an infant with recent travel to Ho Chi Minh who visited the Children’s Hospital of Orange Count...read morey on Nov 30, and Dec 2-3. This same case traveled through LAX (see PHC alert 12/6 for details). [Confidence: Very High]
California's proactive testing is expected to detect additional H5N1 cases in dairy herds. No human-to-human spread of H5N1 has been identified. Businesses should follow the recommendations provided in the PHC analysis on October 22, including lowering barriers to seasonal flu vaccines for their employees. The CDC is offering free seasonal influenza vaccines to farmworkers in high-risk states. California has confirmed H5N1 avian influenza in additional dairy herds, bringing the total to 504 infected herds and approaching half of the state's ...read moredairy herds. See PHC alerts from 11/22, 11/21, and 11/15 for information about earlier totals. [Confidence: Very High]
North Dakota has previously detected avian influenza in birds, but it is rare. No human-to-human spread of avian flu has been detected. Businesses should follow the recommendations provided in the PHC analysis on October 22, including lowering barriers to seasonal flu vaccines for their employees. North Dakota reported avian influenza outbreaks in 2 backyard and 1 commercial poultry flocks, the state's 1st cases of highly pathogenic avian flu th...read moreis year. The affected backyard flocks were in McHenry (chickens) and Bottineau (chickens and turkeys) counties; the affected commercial turkey flock was in Ransom County. [Confidence: Very High]
Businesses in Fukuoka, Japan should inform employees about the possible measles exposure and 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. Fukuoka, Japan reported a measles case in a child who had recently traveled internationally. This is the 1st measles case in the prefecture in 3.5 yea...read morers. The case was on Vietjet Air Flight VJ 958 on Nov 23 and traveled through the Hanoi Noi Bai International and Fukuoka airports. [Confidence: Very High]
Infectious disease outbreaks can lead to healthcare surges, increasing the risk for negative health outcomes and the inability to provide healthcare to all patients. The hospital surge in Vietnam serves as a reminder that measles can be a severe disease. Businesses in Vietnam should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. People traveling to Vietnam should check their measles vaccination status. Vietnam's measles outbreak has led to overcrowding in the Dong Nai Children's Hospital. In the last day, 214 measles cases were evaluated, including 7...read more who required emergency care and 30 who were admitted. Currently, 20% of the hospital's patients have measles, consisting of 228 cases, 12 of whom are in intensive care. [Confidence: Very High]
Update to DRC's outbreak of an unknown illness: the Ministry of Health has reported the number of cases and deaths, with fewer confirmed deaths than media sources identified yesterday. No disease has been identified yet. PHC monitors reports of unknown illnesses and deaths; PHC will communicate any actionable developments. The DRC's Ministry of Health issued a communique reporting the number of cases and deaths tied to an unknown illness. 79 deaths have been confirmed, most of which were children over 15 years old. Another 376 were ill. [Confidence: Very High]
Given California's proactive testing, the detection of an additional H5N1 case in a dairy worker is not unexpected. Businesses should follow the recommendations provided in the PHC analysis on October 22, including lowering barriers to seasonal flu vaccines for their employees. The CDC is offering free seasonal influenza vaccines to farmworkers in high-risk states. California reported another case of H5N1 avian influenza in a dairy worker, totaling 31 dairy industry-related cases and 32 H5N1 cases in the state this year. No human-to-human spread of H5N1 has been detected. [Confidence: Very High]
Locally acquired dengue is unusual in the Torres Strait Islands, but multiple islands have had outbreaks this year. Businesses 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. Torres Strait Islands alerted residents of Erub Island after detecting its 1st locally acquired dengue case since 2019. Dengue outbreaks were identifi...read moreed on Mer, Warraber, and Masig islands earlier this year. Public health officials are investigating and implementing mosquito control measures. [Confidence: Very High]
For informational purposes only. PHC monitors reports of unknown illnesses and deaths; PHC will communicate any actionable developments. Health authorities are investigating a cluster of 143 deaths in Nov due to an unknown illness in Panzi, Democratic Republic of the Congo. Symptoms inc...read morelude flu-like illness, and most cases have occurred among women and children. [Confidence: Very High]
The importation of a deadlier clade 1b mpox case is a reminder that the outbreak is not contained and international spread remains a risk. The case does not change PHC's recommendations to businesses. Businesses 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. The United Kingdom reported a case of the deadlier clade 1b mpox in a Leeds resident with recent travel to Uganda. This is the UK's 5th clade 1b mpox ...read morecase this year. The imported case is not connected to the previous UK cluster of cases. See PHC alert 11/4 for info about earlier clade 1b cases in the UK. [Confidence: Very High]
The death of an infant from measles serves as a reminder that measles can be a severe disease. Businesses in Binh Duong Nai, Vietnam should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. People traveling to Vietnam should check their measles vaccination status. Binh Duong, Vietnam reported a measles death in an infant amidst high cases in the province. Vietnam has identified almost 20,000 measles cases this y...read moreear, with Binh Duong being one of the 11 provinces with high activity. The province averages 40 measles cases per week. The Ministry of Health has implemented a large catch-up vaccination campaign in affected provinces. [Confidence: Very High]
Whooping cough is highly contagious; a single case in the workplace can infect 15 others. The average worker absenteeism for whooping cough is 6 days. Businesses in Samoa should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. The Samoa Ministry of Health declared a whooping cough outbreak after detecting an increase in whooping cough-related visits to a hospital. 6 confirmed cases have been identified. Additional suspected cases have pending tests. [Confidence: Very High]
This outbreak warrants greater attention from enterprise businesses in this area, especially given the continued increase in cases and measles deaths reported in other provinces, such as Dong Nai and Ho Chi Minh. Businesses in Dak Lak, Vietnam should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. People traveling to Vietnam should check their measles vaccination status. Dak Lak reported a large rise in measles activity this fall, increasing from 69 cases on 9/4 to now nearly 650 cases (see PHC alert 9/4 for earlier in...read morefo about measles in the province). Almost half of Dak Lak's measles cases were in Buon Ma Thuot city (316). Affected districts include Lak (65), Krong Pac (59), Cu M'gar (38), and Cu Kuin (33). [Confidence: Very High]
No cases have been identified tied to these contaminated eggs. Cooking eggs thoroughly can kill Salmonella, but businesses and individuals should dispose of any affected products. FDA recalled 10,800 units of Kirkland Signature organic pasture-raised 24-count eggs due to potential Salmonella contamination. The affected lots were...read more distributed to Costco stores in Alabama, Georgia, North Carolina, South Carolina, and Tennessee and include those labeled Julian code 327 with a "use by" date of Jan 5. [Confidence: Very High]
This continuing outbreak warrants greater attention from enterprise businesses in this area. Businesses in Ho Chi Minh City, Vietnam should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. People traveling to Ho Chi Minh City should check their measles vaccination status. Ho Chi Minh City reported another measles death, totaling 3 this year in the city alone. Ho Chi Minh also reported its highest number of measles cases...read more in a week, with 319 new cases identified from Nov 25 - Dec 2, totaling 1,305 for the year. See PHC alerts 12/2 and 11/20 for earlier info about measles in Ho Chi Minh. [Confidence: Very High]
Businesses 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. Canada reported its 1st case of the deadlier clade 1b mpox in an individual who recently traveled internationally. The case lives in Manitoba. [Confidence: Very High]
This outbreak warrants greater attention from enterprise businesses in this area, especially given the continued increase in cases and measles deaths reported in Dong Nai and in neighboring Ho Chi Minh. Businesses in Dong Nai, Vietnam should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. People traveling to Dong Nai should check their measles vaccination status. Dong Nai, Vietnam's measles outbreak continues, with 1,050 measles cases reported in the last 2 weeks, including over 100 cases reported in a single d...read moreay. Cases have been increasing every week since late June. In total, over 3,000 cases and 2 deaths have occurred in Dong Nai this year. [Confidence: Very High]
The growing measles outbreaks in Vietnam warrant greater attention from enterprise businesses. While Ho Chi Minh City has the largest outbreak, Hanoi’s cases continue and have been rising for the past few weeks. Businesses in Vietnam should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. People traveling to Hanoi should check their measles vaccination status. Hanoi's measles cases continue to rise, with 25 new cases reported in the last week and spread into 3 new districts. Hanoi has reported 140 measles ca...read moreses across 26 districts this year. Hanoi has not reported any measles deaths, but across Vietnam, 5 measles deaths have occurred this year (see PHC alerts 11/19 and 11/18 for more info). [Confidence: Very High]
This continuing outbreak warrants greater attention from enterprise businesses in this area. Businesses in Ho Chi Minh City, Vietnam should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. People traveling to Ho Chi Minh City should check their measles vaccination status. Ho Chi Minh's very high measles activity continues, with 238 new cases reported in the last week, totaling 2,104 cases and 3 deaths this year. Distric...read morets with the highest cases in the past week were Binh Tan, Binh Chanh, and Thu Duc city. See PHC alert 11/20 for earlier info about measles in Ho Chi Minh. [Confidence: Very High]
Given California's proactive testing, the detection of additional H5N1 cases in dairy workers is not unexpected. Businesses should follow the recommendations provided in the PHC analysis on October 22, including lowering barriers to seasonal flu vaccines for their employees. The CDC is offering free seasonal influenza vaccines to farmworkers in high-risk states. California reported 2 new cases of H5N1 avian influenza in dairy workers, totaling 30 dairy industry-related cases and 31 H5N1 cases in the state this year. No human-to-human spread of H5N1 has been detected. [Confidence: Very High]
This rapidly escalating outbreak warrants greater attention from enterprise businesses in this area. Businesses in New Brunswick, Canada should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Measles outbreaks can lead to absenteeism due to employee illness, caregiving to sick family members, or temporary school closures. New Brunswick's measles outbreak continues to grow, with 50 cases connected to the outbreak. The cases are tied to the Fredericton and upper Saint Joh...read moren River Valley areas and were all linked to an international traveler (see PHC alerts from 11/19, 11/15, 11/6, 11/4, and 11/1 for earlier info). [Confidence: Very High]
Businesses in Germany should inform employees about the vaccination requirement and provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Measles outbreaks can lead to absenteeism due to employee illness, caregiving to sick family members, or temporary school closures. Germany reported a 9-fold increase in measles cases, with 629 cases this year compared to 2023's annual total of 71. Most cases are in North Rhine-Wes...read moretphalia (240), Berlin (94), Bavaria (70), and Lower Saxony (50). Measles vaccination is a legal requirement in Germany, with parents facing a €2,500 fine for noncompliance. [Confidence: Very High]
Businesses should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Measles outbreaks can lead to absenteeism due to employee illness, caregiving to sick family members, or temporary school closures. Bermuda confirmed a 2nd measles case, its first cases since 1990. The two cases are linked, with the 1st case having recent international travel. See ...read morePHC alerts 11/21 and 11/18 for earlier information about this situation. Close contacts are being monitored, with additional cases likely due to the low vaccination rate in Bermuda (~ 75% overall and < 40% among children). [Confidence: Very High]
Businesses in the LA County area who used Buffalo Wild Wings in Monterey Park for catering or event services may wish to notify employees of this exposure. Employees who ate food from the restaurant and are not vaccinated against hepatitis A or experience gastrointestinal symptoms should consult with a healthcare provider. Los Angeles County, California health officials confirmed a hepatitis A case in a restaurant worker. Those who ate at Buffalo Wild Wings in Monterey P...read moreark 11/13 - 11/22 may have been exposed and prompt post-exposure vaccination can prevent infection. The hepatitis A vaccine is over 95% effective in preventing disease in people who have received two shots. A single shot of the hepatitis A vaccine can prevent hepatitis A if given within 14 days of exposure. [Confidence: Very High]
Businesses and individuals should dispose of any affected products. H5N1 avian flu and other pathogens have been found in raw milk. Pasteurization inactivates H5N1, making pasteurized milk and milk products safe to consume. California issued an alert regarding a second recalled batch of cream top, whole raw milk from Raw Farm of Fresno County found to be contaminated with...read more H5N1 avian flu. The affected milk is lot code 20241119 with a "best by" date of Dec 7. No illnesses have been identified tied to the contaminated product. [Confidence: Very High]
Businesses and individuals should dispose of any affected products. H5N1 avian flu and other pathogens have been found in raw milk. Pasteurization inactivates H5N1, making pasteurized milk and milk products safe to consume. California issued an alert regarding one recalled batch of cream top, whole raw milk from Raw Farm of Fresno County found to be contaminated with H5N1...read more avian flu. The affected milk is lot code 20241109 with a "best by" date of Nov 27. No illnesses have been identified tied to the contaminated product. [Confidence: Very High]
PHC will monitor the event and provide updates as needed. No human-to-human spread of H5N1 has been identified. Businesses should follow the recommendations provided in the PHC analysis on October 22, including lowering barriers to seasonal flu vaccines for their employees. The CDC confirmed an infection with avian influenza A (H5N1) in a child in California, the first such infection in a child in the United States. The c...read morehild's family members have tested negative, and the source of the infection has not been identified. The child has no known animal exposure.
Whooping cough is highly contagious; a single case in the workplace can infect 15 others. The average worker absenteeism for whooping cough is 6 days. Businesses in Baja California should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Baja California, Mexico reported 40 new whooping cough cases in recent days, with Tijuana seeing the highest number of infections. Baja California Hea...read morelth Secretary Adrián Medina Amarillas stated the cases are among unvaccinated individuals. [Confidence: Very High]
This rapid rise in cases warrants greater attention from enterprise businesses in this area. Businesses in Southwest England should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Employees living in or traveling to the area should check their measles vaccination status. The UK issued an alert after identifying 15 measles cases in Bristol and Gloucestershire in the last 2 weeks. Before these cases were identified, Sout...read moreh West England had 46 measles cases from Jan 1 - Nov 18, bringing their total to 61 cases. South West England residents were encouraged to check their vaccination status amidst a rapid rise in cases. [Confidence: Very High]
The recalled ground beef fresh products have a use by date of Nov 14 and the frozen products have a production date of Oct 22. Businesses that provide food services to their employees should confirm they do not have the recalled ground beef products in their kitchens. Though the items are past their fresh by date, USDA is concerned that some product may be in restaurant refrigerators or freezers. The Wolverine Packing Co. recalled over 167,000 lbs of ground beef products amidst an E. Coli O157 outbreak that had sickened 10 customers who had eat...read moreen at two restaurants in Minnesota (see PHC alert 11/18 for more info). An investigation found that illness was linked to ground beef products distributed beyond the restaurants, with 5 new cases (15 total) identified. [Confidence: Very High]
For information only. Pennsylvania's decision to test milk for H5N1 is a proactive step in a state with no known cases. Businesses should follow the recommendations provided in the PHC analysis on October 22, including lowering barriers to seasonal flu vaccines for their employees. Pennsylvania now requires bulk testing of milk for H5N1 from its farms. The decision is prompted by the steady increase of infected farms nationally; ...read morePennsylvania has not found H5N1 in dairy herds. Farmers will not be responsible for the cost of testing, reducing a potential barrier to compliance. [Confidence: Very High]
An outbreak in a single factory should have limited impact on supply chains, but businesses with ties to Sri Lanka (particularly to the possible manufacturer) should confirm the reliability of their supply chain, especially in light of the coming holiday season. This situation also serves as a reminder that outbreaks are more likely to occur when sick leave is unpaid. Media reports 133 chickenpox cases in workers at a factory in Minuwangoda. Media reported the lack of paid sick leave has contributed to the spread of...read more the outbreak. The factory is reportedly owned by Brandix; Brandix Apparel Limited is an apparel manufacturer headquartered in Sri Lanka. It has international branches and it is a major employer in Sri Lanka. [Confidence: Moderate]
Businesses should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Measles outbreaks can lead to absenteeism due to employee illness, caregiving to sick family members, or temporary school closures. Bermuda confirmed 1 measles case in an individual with recent travel, the second suspected case's tests are still pending (see PHC alert 11/18 for ear...read morelier information about this situation). This is Bermuda's 1st measles case since 1990. Close contacts are being monitored, with additional cases likely due to the low vaccination rate in Bermuda (~ 75%). The Ministry of Health recommends vaccination. [Confidence: Very High]
This outbreak warrants greater attention from enterprise businesses in this area, especially given the rapid rise in cases and recent reporting of a measles death in the province. Businesses in Dong Nai, Vietnam should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. People traveling to Vietnam should check their measles vaccination status. Dong Nai's measles outbreak continues, with 193 new cases identified in the last week. In total, 2,086 cases and 1 death have been reported in Dong Na...read morei in 2024, a huge increase compared to 2023's annual total of 3 cases. 2024's cases are now the highest in over 5 years. See PHC alerts 11/20, 11/18 and 10/31 for earlier info about measles in Dong Nai. [Confidence: Very High]
For information only. Mpox has been declared a Public Health Emergency of International Concern twice in recent years (2022 and 2024). The more recent declaration was made for the more severe clade 1b strain. Children make up ~ 60% of clade I mpox cases; vaccinating children should help slow transmission. The World Health Organization has authorized the first mpox vaccine for children. It will be used as a single dose in children over 1 year of age. Chi...read moreldren are particularly susceptible to mpox; successful vaccination will protect children from severe disease and should help to control this public health emergency. [Confidence: Very High]
This outbreak warrants greater attention from enterprise businesses in this area, especially given the rapid rise in cases and recent reporting of 4 measles deaths in neighboring Ho Chi Minh. Businesses in Binh Thuan, Vietnam should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. People traveling to Vietnam should check their measles vaccination status. Binh Thuan, Vietnam reported an increase in measles, with 140 of the province's 157 cases this year identified since Oct 1. Early measles cases in Bin...read moreh Thuan were tied to hospital visits in Ho Chi Minh, where a measles outbreak has occurred since May. Once introduced into Binh Thuan, measles spread quickly, with many of the cases linked through schools, communes, and wards within the province. See PHC alert 11/20 for info about measles in Ho Chi Minh. [Confidence: Very High]
This continuing outbreak warrants greater attention from enterprise businesses in this area. Businesses in Ho Chi Minh City, Vietnam should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. People traveling to Ho Chi Minh City should check their measles vaccination status. Ho Chi Minh City, Vietnam reported 211 new measles cases in the last week, totaling 1,858 cases this year. Districts with the highest cases in the pas...read moret week were Binh Tan, Binh Chanh, and Thu Duc city. Ho Chi Minh's outbreak has spread into other provinces through hospital exposures in Ho Chi Minh (see PHC alert 11/20 for info about measles in Binh Thuan province). [Confidence: Very High]
PHC will monitor the event and provide updates as needed. No human-to-human spread of H5N1 has been detected. Businesses should follow the recommendations provided in the PHC analysis on October 22, including lowering barriers to seasonal flu vaccines for their employees. California identified a possible H5N1 avian influenza case in a child with mild upper respiratory symptoms. The child has no known exposure to animals...read more. All of California's 27 confirmed H5N1 avian influenza cases had direct contact with infected dairy cows. See PHC alert 11/15 for earlier info about H5N1 in CA. [Confidence: Very High]
Given California's proactive testing, the detection of additional H5N1 cases in dairy workers is not unexpected. Businesses should follow the recommendations provided in the PHC analysis on October 22, including lowering barriers to seasonal flu vaccines for their employees. The CDC is offering free seasonal influenza vaccines to farmworkers in high-risk states. Fresno County reported a case of H5N1 avian influenza in a Fresno County resident who had contact with infected cattle at a dairy farm in the Central ...read moreValley. This case is the 1st in Fresno County, and 24th in California. No human-to-human spread of H5N1 has been detected. [Confidence: Very High]
This rapidly escalating outbreak warrants greater attention from enterprise businesses in this area. Businesses in New Brunswick, Canada should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. New Brunswick, Canada reported a new measles case tied to outbreak in the Fredericton and upper Saint John River Valley areas (Zone 3), now totaling 4...read more4 cases. The outbreak is escalating quickly, with cases almost doubling within the past week. All of the cases are linked to a measles case who had traveled internationally (see PHC alerts from 11/15, 11/6, 11/4, and 11/1 for earlier info). [Confidence: Very High]
The death of an infant from measles is Vietnam's 5th measles death this year and serves as a reminder that measles can be a severe disease. Businesses in Dong Nai, Vietnam should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. People traveling to Dong Nai should check their measles vaccination status. An infant in Dong Nai, Vietnam died from measles amidst a measles outbreak in the province, with 1,893 cases this year. See PHC alerts 11/18 and 10/31 for earlier info about measles in Dong Nai. [Confidence: Very High]
The growing measles outbreaks in Vietnam warrant greater attention from enterprise businesses. While Ho Chi Minh City has the largest outbreak, Hanoi’s cases continue and have been rising for the past few weeks. Businesses in Vietnam should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. People traveling to Hanoi should check their measles vaccination status. Hanoi's measles cases continue to rise, with 25 new cases reported in the last week and spread into a 23rd district. Hanoi has reported 87 measles cas...read morees this year. Hanoi has not reported any measles deaths, but across Vietnam, 5 measles deaths have occurred this year (see PHC alerts 11/19 and 11/18 for more info). [Confidence: Very High]
Businesses in the Milwaukee area who used Beans & Barley for catering or event services may wish to notify employees of this exposure. Employees who ate food from the restaurant and are not vaccinated against hepatitis A or experience gastrointestinal symptoms should consult with a healthcare provider. Milwaukee health officials confirmed a hepatitis A case in a restaurant worker. Those who ate at Beans & Barley 10/31 - 11/13 may have been exposed. T...read morehe hepatitis A vaccine is over 95% effective in preventing disease in people who have received two shots. A single shot of the hepatitis A vaccine can prevent hepatitis A if given within 14 days of exposure. [Confidence: Very High]
Whooping cough is highly contagious; a single case in the workplace can infect 15 others. The average worker absenteeism for whooping cough is 6 days. Businesses in San Diego County, CA should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. San Diego County is encouraging residents to stay up-to-date with whooping cough vaccination as this year's 547 cases to date already exceed 2023's to...read moretal of 329 cases. The most affected age group is 11–17-year-olds, indicating the greatest impact to business is likely caregiving-related absenteeism. [Confidence: Very High]
This outbreak warrants greater attention from enterprise businesses in this area, especially given the continued increase in cases and recent reporting of 4 measles deaths in neighboring Ho Chi Minh. Businesses in Dong Nai, Vietnam should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. People traveling to Dong Nai should check their measles vaccination status. Dong Nai, Vietnam's measles outbreak continues, with 447 new cases identified in the past week and 1,893 total this year. Cases have been increasing e...read morevery week since late June. Areas with high cases this past week were Xuan Loc, Tan Phu, Long Thanh, Vinh Cuu, and Bien Hoa. The province recently completed a measles vaccination campaign (see PHC alert 10/31). [Confidence: Very High]
Businesses that provide food services to their employees should confirm they do not have the recalled carrots in their kitchens, vending machines, etc. The items are now past their fresh by date so no longer available for purchase but could still be in homes and businesses. Grimmway farms has recalled multiple brands of whole bagged carrots and baby carrots in connection to a multistate outbreak of E. coli O121. CDC repor...read morets 39 cases: 15 hospitalized, and 1 fatal. The true number of infected is likely much higher, as not all individuals seek healthcare. The carrots were sold through many stores including Kroger, Target, Trader Joe's, and Wegmans. [Confidence: Very High]
H5N1 exposure to the public may attract media attention, but the risk in this instance is very low. No human-to-human spread of H5N1 has been detected. Businesses should follow the recommendations provided in the PHC analysis on October 22, including lowering barriers to seasonal flu vaccines for their employees. Last week, Hawai'i announced its first ever detection of H5N1 avian influenza. Prior to symptoms, some of the birds in the affected flock were present...read more at the Mililani Pet Fair held on Nov 2. Since the birds were not yet sick, the transmission risk is very low, but participants at the fair who later experienced conjunctivitis or flu-like symptoms should contact their healthcare provider. [Confidence: Very High]
Informational update. A single case of mpox in a traveler does not pose a significant risk to business. PHC will continue to monitor the situation and provide updates as needed. See PHC mpox critical threat for more information about the growing mpox clade 1b situation. California reported the US's 1st case of mpox clade 1 in a traveler with recent travel to areas where clade 1 mpox has been circulating in Central and...read more Eastern Africa. Health authorities are conducting contact tracing. The exact clade has yet not been identified, but is likely to be the deadlier and more transmissible clade 1b that has been imported to other countries this year. [Confidence: Very High]
The detection of an H5N1 case in a poultry worker on an affected farm is not unexpected. No human-to-human spread of H5N1 has been detected. Businesses should follow the recommendations provided in the PHC analysis on October 22, including lowering barriers to seasonal flu vaccines for their employees. Oregon reported its 1st human H5N1 case, in a farm worker from Clackamas County who had exposure to infected birds (see PHC alert 10/25 about the H5N1...read more outbreak on this farm). The case had mild symptoms and has since recovered. This is not the same H5N1 strain that has been circulating among dairy cattle and workers, and close contacts of this Oregon case have not developed symptoms. [Confidence: Very High]
Given California's proactive testing, the detection of additional H5N1 cases in dairy workers is not unexpected. No human-to-human spread of H5N1 has been detected. Businesses should follow the recommendations provided in the PHC analysis on October 22, including lowering barriers to seasonal flu vaccines for their employees. The CDC is offering free seasonal influenza vaccines to farmworkers in high-risk states. Madera County, CA reported 2 human cases (1 confirmed and 1 presumptive) of H5N1 in workers with exposure to infected dairy cows. These are Madera County's 1st H5N1 human cases and CA's 22nd and 23rd. [Confidence: Very High]
The continuing expansion of mpox 1b is concerning, but these cases do not change the recommendations for businesses. Businesses 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. Update on the mpox cases reported in Zambia (PHC alert 10/11) and Zimbabwe (PHC alert 10/15): All of the cases were the more severe mpox clade 1b and ...read moretravel-related. Zimbabwe reported two cases: one with travel history to South Africa and one with travel history to Tanzania. No details on the travel history fo Zambia's case have been shared. [Confidence: Very High]
This rapidly escalating outbreak warrants greater attention from enterprise businesses in this area. Businesses in New Brunswick, Canada should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. New Brunswick reported 6 new measles cases in 24 hours, totaling 43 cases tied to an outbreak that began in late Oct. The outbreak is escalating quick...read morely, with cases almost doubling within the past week. All of the cases are linked to a measles case who had traveled internationally (see PHC alert 10/25). [Confidence: Very High]
Communicable disease cases often rise when school resumes after a break. Both whooping cough and chickenpox can easily spread in school settings and can lead to worker absenteeism due to caregiving for sick family members, temporary school closures, or exclusion of unvaccinated children for 21 days after an exposure. Businesses should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Clark County, Washington reported a surge in two communicable diseases since the start of the school year 2 months ago. 168 whooping cough cases have ...read morebeen identified in the last 2 months, totaling 406 this year, the highest county in WA. 50 chickenpox cases have been reported this year, with 23 tied to outbreaks in 3 schools. [Confidence: Very High]
Eastern equine encephalitis (EEE) risk in Michigan decreases as temperatures drop, but the recent discovery of an infected bird is a reminder that businesses should eliminate standing water until mosquito season is over (when nighttime temperatures are consistently below freezing). EEE can cause severe neurological complications in humans. The Marquette County Health Department urged residents of Michigan's Upper Peninsula to continue avoiding mosquito bites after a bird recently tested ...read morepositive for EEE. EEE has a high fatality rate and can cause permanent neurologic damage to survivors. Climate change has led to longer mosquito seasons and delayed freezing temperatures, requiring the extension of mosquito precautions into later fall. [Confidence: Very High]
Measles is highly contagious and can quickly spread among unvaccinated individuals in a work environment. Businesses in Italy should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Italy reported 33 measles cases in Oct, totaling 935 cases in 2024. Cases began increasing in Dec 2023 and peaked in April (181 cases), but monthly cases still approach 2023's annual total (46 cases). [Confidence: Very High]
The confirmation of H5N1 in the earlier reported case does not change the current risk to business. PHC will update recommendations if the public health investigation produces relevant information. Businesses should follow the recommendations provided in the PHC analysis on October 22, including lowering barriers to seasonal flu vaccines for their employees. Canada's National Microbiology Laboratory confirmed the previously presumptive avian influenza infection in a teenager is due to the H5N1 strain circu...read morelating in commercial poultry flocks in British Columbia's Fraser Valley. See PHC alert 11/12 for earlier information. [Confidence: Very High]
Hawaii has been the only state without confirmed H5N1. PHC will monitor the event and provide updates as needed. No human-to-human spread of H5N1 has been detected. Businesses should follow the recommendations provided in the PHC analysis on October 22, including lowering barriers to seasonal flu vaccines for their employees. Hawaii officials reported detection of H5 avian flu from a wastewater sample collected from O'ahu earlier this month as part of routine surveillance. ...read moreThis is HI's 1st H5 identification. Wastewater testing cannot determine if the sample was H5N1, or if the source was human or an animal. An investigation is underway. [Confidence: Very High]
Whooping cough is highly contagious; a single case in the workplace can infect 15 others. The average worker absenteeism for whooping cough is 6 days. Businesses in Washington should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Spokane County, Washington health officials declared a whooping cough outbreak. 123 cases have been identified this year, marking the County's 3rd hig...read morehest annual total since 2005. Only 2019 (178 cases) and 2012 (198 cases) had higher cases. Across the state, whooping cough is surging (see PHC alert 11/8). [Confidence: Very High]
Influenza-related worker absenteeism can be due to employee illness or caregiving duties. Businesses in Taiwan can support employees in obtaining seasonal flu vaccinations by providing flexible work schedules. Information on the availability of vaccines can also be included in employee wellness communication. Taiwan reported 202 severe flu cases and 26 deaths this season, the highest in the same time period in a decade. All 26 deaths occurred in individuals...read more who had not received the seasonal flu vaccine this year. Health authorities are advising citizens to get vaccinated. [Confidence: Very High]
South Korea's first whooping cough death serves as a reminder that whooping cough can be deadly. Whooping cough is also highly contagious; a single case in the workplace can infect 15 others. The average worker absenteeism for whooping cough is 6 days. Businesses in South Korea should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. South Korea reported its 1st ever whooping cough death since whooping cough-related mortality surveillance began in 2011. South Korea has reported rec...read moreord-breaking whooping cough cases this year (30,332 cases and 1 death). Health officials urged vaccination, especially for pregnant women, household members of infants, and caregivers. See PHC alert 10/4 for earlier info about whooping cough in South Korea. [Confidence: Very High]
Queensland's high whooping cough cases continue; this outbreak warrants greater attention from enterprise businesses in this area. Whooping cough is highly contagious; a single case in the workplace can infect 15 others. The average worker absenteeism for whooping cough is 6 days. Businesses in Australia should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Queensland, Australia's record-breaking whooping cough cases continue, with 2,267 new cases identified between 10/1 - 11/11, and 11,992 total this yea...read morer. Queensland's previously highest year was 2011 with 8,997 cases. See PHC alerts 10/1 and 8/23 for earlier info about whooping cough in Queensland. [Confidence: Very High]
The growing measles outbreaks in Vietnam warrant greater attention from enterprise businesses. While Ho Chi Minh City has the largest outbreak, Hanoi’s cases continue. Businesses in Vietnam should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Hanoi reported 16 new measles cases in the last week, the highest weekly total since the outbreak's start. Hanoi has reported 62 measles cases across ...read more22 districts this year. Last week's cases occurred in Chuong My (4), Dong Da (2), Hoang Mai (2), Ha Dong (2), Nam Tu Liem (2), Hoai Duc (1), Quoc Oai (1), Phuc Tho (1), and Thanh Xuan (1). [Confidence: Very High]
This outbreak warrants greater attention from enterprise businesses in this area. Dong Nai is adjacent to Ho Chi Minh, the epicenter of Vietnam's measles outbreaks. Businesses in Dong Nai, Vietnam should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. People traveling to Dong Nai should check their measles vaccination status. Dong Nai, Vietnam's measles outbreak continues, with 291 new cases identified in the past week and 1,097 total this year. The province recently comple...read moreted a measles vaccination campaign (see PHC alert 10/31). Areas with cases this past week were Bien Hoa, Long Thanh, Trang Bom, Vinh Cuu, Nhon Trach, Cam My, and Long Khanh. [Confidence: Very High]
PHC will monitor the event and provide updates as needed. No human-to-human spread of H5N1 has been detected. Businesses should follow the recommendations provided in the PHC analysis on October 22, including lowering barriers to seasonal flu vaccines for their employees. Canada’s 1st presumptive locally acquired human H5 avian influenza case is a teenager from the Fraser Health Region of British Columbia. The provinc...read moreial health officer stated the case is in critical condition and has no known connection to farms or poultry. Health authorities are investigating and identifying contacts; no other cases have been detected. BC recently detected H5N1 in 22 commercial poultry flocks in Fraser Valley. [Confidence: Very High]
