Building the Future of Biodefense

Recommendation: 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.

Situation: Health officials have confirmed 2 more clade I mpox cases in Los Angeles County, totaling 3 cases who appear unrelated with no history of recent international travel, indicating community transmission. The 1st case was reported in a Long Beach resident (see PHC alert 10/16). These are the 1st ever detections of a locally acquired clade 1 cases in the US. Transmission is occurring among gay, bisexual, and other men who have sex with men and their social networks. All 3 cases were hospitalized and are now recovering. Health officials are enhancing surveillance, conducting contact tracing, and performing genomic sequencing of the virus. While the overall risk to the general public remains low, vaccination is recommended for those at increased risk. [Confidence: Very High]

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

Situation: Media sources reported an uptick in influenza-like illness in Indonesia this month, including in Jakarta. Health officials noted that the seasonal activity is aligned with increases observed across the region recently (see PHC alert 10/15). In the most recent sentinel data covering until the end of September, influenza test positivity in the country was at 43%. [Confidence: Very High]

Recommendation: This new H5N1 case 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.

Situation: Cambodia confirmed its 16th H5N1 human case in a 3-year-old child from the Kampong Speu Province. The child is currently receiving intensive treatment. It was reported that chickens and ducks at the child's house and neighboring houses had been sick and dying for about a week before the child became sick. Health officials distributed Tamiflu to close contacts and conducted health campaigns among residents in affected villages. [Confidence: Very High]

Recommendation: Organizations can support employees in obtaining mpox vaccinations by providing flexible work schedules. Information on the availability of mpox vaccines and treatment can also be included in employee wellness communication.

Situation: California detected an mpox clade 1 case in a Long Beach resident. The individual did not have any recent travel history and was hospitalized. This Long Beach case is the 1st ever detection of a locally acquired clade 1 case in the US, suggesting undetected community transmission may be ongoing. 6 imported mpox clade 1 cases with international travel history were previously reported in the US so far, with 2 in California, and then 1 case each in Massachusetts, New York, Georgia, and New Hampshire. The 2 other imported mpox clade 1 cases in California were reported in September 2025 in an individual who resided in Riverside County and in November 2024 in an individual who received treatment in San Mateo County (see PHC alerts on 9/19 and 11/18/2024). Long Beach reported 6 other mpox cases so far this year, but none were clade 1. Health officials stated that the risk to the public remains low, and further investigation and contact tracing are ongoing to determine if there are additional cases in the area. [Confidence: Very High]