Building the Future of Biodefense

Recommendation: The hepatitis A vaccine is over 95% effective in preventing disease in people who have received two shots. Organizations in Campania, Italy, should provide flexible work schedules to support employees making vaccine appointments for themselves or family members.

Situation: Italy reported an increase in hepatitis A cases, with 133 cases recorded since the start of the year in Campania. Media sources noted cases were concentrated in Naples, where the number of cases so far this year (84) was 10 times higher than the average number of cases for the same period in the past 10 years, and 41 times higher than in the past 3 years. The consumption of raw seafood was banned in public establishments in the city of Naples to prevent further spread of hepatitis A. Health officials intensified controls on the bivalve mollusk supply chain, expanded access to hepatitis A vaccination for those at high risk, including healthcare workers and food supply chain workers, and increased environmental sampling of restaurants, fishmongers, and markets. Bivalve mollusks include mussels, clams, and oysters, which can accumulate viral particles when filtered through contaminated water. [Confidence: Very High]

Recommendation: Dengue is endemic in the Maldives, with cases typically highest during the rainy season (April-September). Organizations in the Maldives should reduce mosquito populations at their facilities by eliminating standing water. Employees can take steps to prevent mosquito bites by wearing protective clothing and using insect repellent, and eliminating standing water near their homes.

Situation: The Maldives recorded higher-than-typical dengue incidence since March 2025, with a substantial increase from December 2025 to January 2026 (411 to 646 cases). In previous years, 74 cases were reported in the Maldives in January 2025 and 139 cases in January 2024. ECDC reported at least 46 imported dengue cases so far this year in individuals from 4 European countries who recently traveled to the Maldives. Imported cases in travelers can be a proxy indicator of the ongoing transmission when case data is limited. [Confidence: Very High]

Recommendation: Respiratory syncytial virus (RSV) and other respiratory illnesses are expected to impact employee absenteeism due to illness or caregiving duties. Organizations in Chicago, Illinois, should provide flexible work schedules to support employees making vaccine appointments for themselves or family members.

Situation: Health officials reported that RSV activity in Chicago increased from Moderate to High levels and is above typical seasonal levels. Wastewater viral activity levels are currently Very High. Emergency department visits and hospitalizations are also elevated, especially among children ages 0-4, where visit rates are more than 3 times higher than the same time last year. The weekly test positivity increased from 7.2% to 8.7%, and 2 pediatric deaths were reported this season. Healthcare providers were advised to continue RSV immunization for eligible infants < 8 months of age and high-risk infants ages 8–19 months. [Confidence: Very High]