Building the Future of Biodefense

Recommendation: Organizations in Dourados, Brazil, should reduce mosquito habitats by eliminating standing water and applying insecticides to outdoor storage containers, as well as encouraging employees to prevent mosquito bites. Organizations should support pregnant employees who opt not to travel to areas reporting elevated chikungunya circulation. Employees should consult a doctor about vaccination against chikungunya before traveling to affected areas. Vaccine eligibility and availability may vary by country.

Situation: Dourados declared a public health emergency as chikungunya cases rose to 648 confirmed infections over an unspecified period, with 4 deaths reported. According to media sources, the outbreak, which began in an Indigenous Reserve, has spread to urban neighborhoods. Officials intensified mosquito control efforts and urged residents to eliminate standing water and help curb the spread of the disease. While chikungunya activity in Dourados is much higher so far this year compared to levels observed over the same period in 2025 and 2024, national activity is lower than in previous years. Nationally, Brazil reported 16,558 probable chikungunya cases so far this year, including 10 confirmed deaths and 13 additional deaths under investigation. [Confidence: Very High]

Recommendation: Several countries across Africa have experienced a resurgence in diphtheria starting in 2023, exacerbated by the global shortage in diphtheria antitoxin. Respiratory diphtheria can be a severe disease requiring both antibiotics and antitoxin, but there is an effective vaccine. Organizations in Africa should provide flexible work schedules to support employees who need to make vaccine appointments for themselves or their family members.

Situation: Between 1/1/25 and 3/1/26, over 29,000 suspected diphtheria cases and 1,420 deaths were reported across 8 African countries, with Nigeria accounting for most cases (62.6%) and deaths (66%). Many cases involve unvaccinated or under-vaccinated individuals. While reporting delays and underreporting persist in 2026, overall case trends appear to be declining or stabilizing in 4 countries (Chad, Mali, Mauritania, and Nigeria). The WHO downgraded the regional risk level from High to Moderate due to the declining weekly cases regionally and improved outbreak response efforts. However, ongoing challenges, such as vaccination coverage being below national targets, limited laboratory capacity, humanitarian crises, cross-border movement, and treatment supply shortages, hinder containment. Globally, the risk remains low. [Confidence: Very High]

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]