Building the Future of Biodefense

Recommendation: Influenza and other respiratory infections can impact employee absenteeism due to illness or caregiving duties. Organizations in New York and throughout the US should provide flexible work schedules to support employees making vaccine appointments for themselves or family members.

Situation: New York health officials declared that influenza is now prevalent in the state. The declaration requires health care facilities and agencies to ensure that their personnel who have not received this year's flu vaccine wear masks in areas where patients and residents may be present. Officials stated that a total of 17,783 positive influenza cases were reported across 62 counties in New York this season as of 11/22. Week-over-week, lab-confirmed influenza cases more than doubled statewide, rising 114% outside New York City (1,688 to 3,619) and 119% within the city (1,890 to 4,146), while influenza-related hospitalizations increased 99% statewide (208 to 413). The US CDC also reported that influenza activity is increasing nationwide, but remains low. Lab positivity rose from 2.9% to 5% in the past week, and respiratory-related outpatient visits climbed from 2.2% to 2.5%. Influenza A(H3N2) accounted for 82% of all influenza A viruses detected in the US. [Confidence: Very High]

Recommendation: This confirmed case of avian influenza infection in a domestic cat underscores the need for organizations to maintain their preparedness plans. 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.

Situation: The Netherlands reported its 1st ever detection of H5N1 in a domestic cat this week. A kitten that lived at a dairy goat farm tested positive for the virus and later died. The kitten's mother brought a wild bird carcass to the nest, which was likely the source of infection. 7 other kittens from the litter that were adopted off the farm all died, with avian influenza suspected as the cause of death. The remaining cats on the farm and dairy goats did not test positive for avian influenza, and no humans have tested positive or developed symptoms. Health officials assessed the risk of HPAI H5N1 infection to be Very Low for the general public, but increased the risk level to Average from Low-Average for individuals who are in contact with infected animals in occupational settings. Enhanced restrictions were announced after this detection, including a more restrictive ban on visitors to commercial poultry farms. Several other countries, including the US, previously reported avian influenza infections in domestic cats (see PHC alert on 9/26). [Confidence: Very High]

Recommendation: Organizations in the Dominican Republic should reduce mosquito habitats by eliminating standing water and applying insecticides to outdoor storage containers, as well as encouraging employees to prevent mosquito bites. Enhanced health screenings at airports may lead to travel delays.

Situation: Media sources reported the detection of 3 imported chikungunya in the Dominican Republic over the weekend. The cases were imported from Cuba, where widespread chikungunya transmission is ongoing (see PHC alert on 11/13). In response, health officials from the Dominican Republic implemented enhanced screenings of travelers arriving at Joaquin Balaguer airport. [Confidence: Very High]

Recommendation: Informational update only.

Situation: The Democratic Republic of the Congo declared the end of the Ebola virus disease outbreak in Kasai Province, after no new cases were reported in the past 42 days since the last patient tested negative and was discharged from the treatment centre on 10/19. In total, 64 cases (53 confirmed, 11 probable) and 45 deaths (case fatality rate of 70.3%) were recorded in the outbreak. Additionally, more than 47,500 people were vaccinated against Ebola, with vaccination initially targeting contacts of confirmed cases and later expanded to communities in and around Bulape. Health officials will now shift their efforts to maintaining surveillance to rapidly identify and respond to any re-emergence of the disease. The outbreak was the country’s 16th since the disease was identified in 1976. Previous outbreaks in Kasai Province were in 2007 and 2008. [Confidence: Very High]