PHC Global Alerts
Businesses operating in Brixham, England should ensure access to bottled water. Employees may require absenteeism during school closures for caregiving duties. England's Alston and Hillhead area of Brixham are under a boil order after tests of South West Water's public water found traces of cryptosporidium. 2...read more2 crypto cases have been confirmed so far, but social media and news reports described hundreds of ill individuals in the region over the last few days. At least one school in the region has closed temporarily. South West Water says a faulty valve may be the cause of contamination. [Confidence: Very High]
Informational update only. The USDA reported that H5N1 has been detected in 3 new dairy herds, 2 in Michigan and 1 in Idaho. 9 states have detected H5N1 in dairy herds, with Michigan having the most outbreaks (14). [Confidence: Very High]
Detecting H5N1 in urban wild birds in NYC is not surprising since migratory birds interact with urban bird populations, but this has not been well documented. The current risk of human disease is low, but individuals should not interact with wild birds. Researchers reported that 6 of 1,792 samples collected from wild birds in New York City tested positive for H5N1. The positive samples were found in a...read more red tail hawk, Canadian geese, a Peregrine falcon, and a chicken. The H5N1 strains were a mix of Eurasian and North American avian flu viruses. [Confidence: Very High]
These test results indicate that H5N1 has not entered the Canadian dairy cattle population. The Canadian Food Inspection Agency reported that tests conducted on 142 samples of their commercial milk supply have all tested negative for H5N1. Tests conducted on Canadian dairy cows have also been negative. [Confidence: Very High]
Businesses in San Diego 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. San Diego County, California identified a new measles case in a child with recent travel, their third measles case in 2024. The case visited the Child...read moreren’s Primary Care Medical Group El Cajon and Rady Children’s Hospital on May 12-13. [Confidence: Very High]
Informational update only. 19 of 23 sewage samples collected in 9 Texas cities tested positive for highly pathogenic avian influenza (HPAI). Samples were collected from 10 citie...read mores over two months, with 9 cities having at least one positive sample. Tests cannot identify the virus source as coming from animals, humans, or milk. [Confidence: Very High]
Businesses in Hong Kong should inform employees about the possible measles exposure and provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Hong Kong reported a measles case in an infant with recent travel history. The case visited the Immigration and Personnel Registration-Yuen Long Office on May 6, where visitors and 40 staff may have been exposed. [Confidence: Very High]
Businesses in the greater Toronto area should inform employees about the possible measles exposure and provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Ontario's Toronto region reported a new measles case who visited Silver Creek Convenience, Health Care Medical Clinic, and Trillium Health Partners, all in Mississauga on May 10. [Confidence: Very High]
Raw milk sales are rising due to misinformation on H5N1. Businesses should not stock raw milk to avoid liability due to numerous diseases that can be transmitted in unpasteurized milk. Market research reports weekly sales of raw cow’s milk have increased 21% to 65% compared with the same period a year ago. Some social media influe...read morencers are promoting raw milk and making false statements about its safety and health benefits. [Confidence: Very High]
Employers can support at-risk employees in obtaining mpox vaccinations by providing flexible work schedules. South Africa reported a case of mpox in Gauteng province, the first case in South Africa since 2022. The case has no history of travel nor known exposure. [Confidence: Very High]
Enterprise businesses that have purchased Cue Health's COVID-19 tests should discard of them. Do not use these tests. The FDA announced that Cue Health's COVID-19 tests should not be used due to inaccurate test results. The FDA also issued a warning letter to Cue Health due to violations found during a recent inspection. [Confidence: Very High]
Businesses in Ireland should inform employees about the possible measles exposure and provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Individuals on Flight TK1977 that landed at Dublin Airport on Monday, May 5 may have been exposed to measles. Individuals born after 1978 and not vacc...read moreinated against measles should monitor for symptoms until May 28, 2024. Individuals who develop symptoms are advised to call their General Practitioner to receive a diagnosis and avoid exposing others in the waiting room. [Confidence: Very High]
Businesses in Ireland should inform employees about the possible measles exposure and provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Ireland issued an alert regarding a new measles case who may have exposed others while visiting the Emergency Department at the Midland Regional Hospital Portiaoise on April 26, and 28-29th. [Confidence: Very High]
Businesses in the greater Sacramento area should inform employees about the possible measles exposure and provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Sacramento, California reported a new measles case who may have exposed 200 individuals while visiting the UC Davis Medical Center on May 6-7. This is CA's 7th measles case in 2024. [Confidence: Very High]
Informational update only. News outlets are reporting a woman was infected with anthrax after exposure to an ill cow. Kyrgyzstan's Ministry of Agriculture reported that prelimin...read moreary tests from the cow were negative and that the cow had been vaccinated against anthrax. Additional tests are being conducted to identify the source of infection. [Confidence: Very High]
Businesses in the greater Melbourne area should inform employees about the possible measles exposure and provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Melbourne, Australia reported a new measles case in an individual with recent travel. The case visited MyClinic Prahran medical clinic, restaurants, and a retail pharmacy between May 3-9. [Confidence: Very High]
Informational advisory only. Hospital-based MERS CoV transmission should not impact enterprise business. Travelers should be encouraged to avoid drinking raw camel milk and eating undercooked camel meat. Kingdom of Saudi Arabia reported 3 new cases and 2 deaths of Middle East respiratory syndrome coronavirus (MERS CoV) in April, totaling 4 cases for 20...read more24. All of the April cases were linked to a single healthcare facility. Most MERS CoV cases are tied to camel exposures, but outbreaks have occurred involving person-to-person transmission. [Confidence: Very High]
Businesses in Europe should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Europe has been experiencing a surge in whooping cough cases during 2024. From January 1 to March 31, 32 037 cases occurred, a 10-fold increase over c...read morease rates during the past 4 years. Cases during the first quarter of 2024 are similar to annual totals for most previous years. Czechia, Austria, Luxembourg, and Slovenia are reporting the highest rates. Infants are at the highest risk of mortality, and the rise in cases underscores the need for vaccination. [Confidence: Very High]
Businesses in the UK should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. The UK has been experiencing high whooping cough activity since Dec 2023. Rates worsened in March, with 1,319 new cases that month. 2,793 cases and 5 ...read moredeaths have been identified in 2024 so far, a rate that exceeds those from the same period during the past 13 years. The surge is believed to be tied to lower vaccination rates and a return to pre-pandemic activities. [Confidence: Very High]
Businesses in Illinois with employees working outdoors in grassy or wooded areas should remind them that tick bite prevention is important for minimizing exposure risk. Illinois' Champaign-Urbana district reported the first case of Rocky Mountain Spotted Fever (RMSF) in 2024 and has issued a warning about all tickborn...read moree diseases. RMSF occurs every year in IL, with cases usually starting in early spring as the weather warms. The disease can be fatal if not treated. [Confidence: Very High]
Businesses in Comoros should ensure they have access to clean water and encourage them to seek treatment if they develop symptoms. Enterprise businesses should ensure employees access to potable water. Comoros' cholera outbreak continues, with 4,901 cases and 98 deaths so far in 2024. Cases have been increasing, with a new peak hit last week: 790 new...read more cases and 13 deaths reported in a single week. See PHC alerts 4/12 and 4/24 for more info. [Confidence: Very High]
Businesses operating in Michigan should be aware of the new biosecurity protocols and have a plan for implementing them when applicable. Michigan's biosecurity mitigation strategies aimed at preventing spread of H5N1 among cattle and poultry go into effect today. These practices must be...read more implemented at all dairy farms and commercial poultry operations in Michigan until further notice. [Confidence: Very High]
Businesses in Mayotte should ensure they have access to clean water and encourage them to seek treatment if they develop symptoms. Enterprise businesses should ensure employees access to potable water. Mayotte reported their first ever cases of locally spread cholera earlier this year. Local spread is expanding, with 23 new cases identified in the pa...read morest week, totaling 58 this year. Nearby Comoros' cholera outbreak is also expanding, which increases the risk of continued locally spread cholera in Mayotte. See PHC alerts on 4/12, 4/24, and 4/26 for more info about Comoros' and Mayotte's cholera outbreaks. [Confidence: Very High]
On-site influenza vaccination clinics reduce barriers to employees getting vaccinated. Businesses can plan ahead for fall vaccine clinics to reduce influenza-related absenteeism in their workforce. Alberta, Canada's 2023/2024 flu season is ending with a record-breaking number of deaths. 167 flu-related deaths were reported this past season, a 15-...read moreyear high. Flu season started early this past year and vaccine uptake (25.1%) was lower than in the past 10 years. [Confidence: Very High]
New COVID-19 variants can cause a surge in cases. PHC recommends that those over 65 without medical contraindications receive a dose of the updated COVID-19 vaccine in consultation with their healthcare provider. A new family of COVID-19 variants are circulating in the US, nicknamed FLiRT after their mutations. Like other current and recently circulating strain...read mores, they are part of the Omicron family. KP.2 is the current dominant strain making up ~ 25% of all identified strains; KP1.1 accounts for ~ 7.5%. Early data indicate that they do not cause more severe disease than other Omicron variants, but may be more transmissible. [Confidence: Very High]
This situation illustrates the impacts beyond illness and deaths that can occur during a measles outbreak. Temporarily closing schools and other mitigation measures can have social and economic impacts on enterprise business. Nigeria's Ministry of Health postponed the school start date in Adamawa by one week due to the ongoing measles outbreak that has killed 42 individuals...read more. Classes will now begin Monday, May 13. See PHC alerts 4/30 and 5/3 for details about the measles outbreak in this region. [Confidence: Very High]
For information only. The Ministry of Health said in a press conference that Ebola has not been detected in Burundi. A child died on May 2nd with unexplained bleeding. PHC will update as needed. Media sources reported that a child died of Ebola-like symptoms at Burundi's Kamenge military hospital. The Burundi's Ministry of Health said that Ebo...read morela has not been confirmed, but tests have been submitted. PHC will monitor and report any relevant updates. [Confidence: Moderate]
Businesses in Israel should inform employees about the possible measles exposure and provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Israel reported a new measles case in an individual with recent travel, bringing their annual total to 24 cases. The case arrived in Israel at the Ben...read more-Gurion airport via the Hisky Europe flight (#H40235) that departed Bucharest on April 24. The case also visited the Clalit urgent care clinic in Haifa on April 26. [Confidence: Very High]
Employers can support at-risk employees in obtaining mpox vaccinations by providing flexible work schedules. New York City issued a health advisory about rising cases of mpox and the importation risk of the new mpox strain circulating in the DRC. There have b...read moreeen an average of 36 cases per month in NYC since Oct 2023, compared to only 2-20 per month for Jan -Sept 2023. Almost all of the NYC mpox cases (> 96%) have had mild disease, and all are clade II. The new mpox clade (clade I) in the DRC is associated with more severe disease, but the vaccine and treatment are the same as for clade II. Two doses of vaccine are effective at preventing severe illness for both clades. [Confidence: Very High]
Many Central and South American Countries are experiencing higher dengue cases in 2024, which increases the risk of imported cases into Ireland. Employees traveling to areas with dengue outbreaks should prevent mosquito bites by wearing protective clothing and using insect repellent. Ireland reported an increase in dengue cases, with 11 cases identified in 2024 compared to only 1 case during the same time period in 2023. All dengue...read more cases in Ireland are imported. The mosquitos that carry dengue are not present in Ireland, but individuals can get infected while traveling. The recent increase in imported dengue is tied to travel to the Americas, which have been experiencing a surge in dengue cases in 2024. [Confidence: Very High]
Businesses in England should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. England reported 82 new measles cases in the last week, totaling 1,082 for 2024, the highest rates reported in the past 10 years. During April, London had the highest number of new measles cases (95). [Confidence: Very High]
Despite widespread media coverage, no new information has emerged. See PHC analysis on 4/26 for earlier assessment. Increased surveillance is likely to identify more human H5N1 cases among dairy workers, but the risk of human-to-human spread still remains low. The first human case of H5N1 tied to cow-to-human interaction was identified on March 29, soon after H5N1 was found to have infected dairy cows in mul...read moretiple states. Since then, surveillance of poultry, cows, dairy products, and humans has increased. Investigation has found that multiple dairy workers had illnesses that may have been H5N1 around the time that dairy cows were testing positive, but before human surveillance activities had begun. [Confidence: Very High]
Informational update only. Businesses may want to remind their employees to avoid consuming raw milk or feeding it to their pets as it may contain harmful pathogens. Over half of the domestic cats on a Texas dairy farm who drank raw milk from cows infected with H5N1 died. The cats became sick one day after symptoms...read more were noted in the cows (March 16/17). Several cats died between March 19–20. Two cats who died were tested for H5N1; both were positive. Cats are known to be susceptible to severe illness from H5N1. [Confidence: Very High]
Businesses who purchased the involved walnuts for catering or event services should dispose of them. Any serving items or surfaces that came into contact with the walnuts should be disinfected with hot soapy water. Employees should be instructed to wash their hands with soap and water after handling the affected nuts or contaminated items. The CDC reported a multi-state outbreak of E. coli tied to organic walnuts produced by Gibson Farms. So far, 11 cases, 7 of whom required hospitalizat...read moreion, have been identified. Almost all cases are linked to CA and WA stores. The nuts (Lot codes 3325-043 and 3341-501) have been recalled. [Confidence: Very High]
These test results confirm that the commercial milk supply is safe. Today, the FDA released the anticipated results from the egg inoculation studies that confirmed pasteurization inactivates H5N1 in dairy products. [Confidence: Very High]
Businesses in Montreal, Quebec should inform employees about the possible measles exposure and provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Montreal, Quebec reported 2 new measles cases, totaling 22 in 2024. The new cases visited École Laberge School, Aréna Michel-Rochefort Arena, and Ce...read morentre médical des Trois Lacs between April 15 - 18. See analysis 3/14 for PHC's predictions about measles in Montreal and alerts on 3/19 and 4/25 for more info. [Confidence: Very High]
Businesses in Wisconsin should inform employees about the possible measles exposure and provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Wisconsin public health officials reported additional public exposure sites tied to the measles case residing in Dane County identified yesterday (see...read more PHC alert 4/29 for details). In addition to previously identified sites, the case visited a uBreakiFix store in Madison and Noodles & Company in Cottage Grove, both on April 22. [Confidence: Very High]
Informational update only. H5N1 has only been identified in dairy cows; beef cows are now being tested. Additionally, H5N1 has been proven to be killed by the cooking process with eggs and poultry; cooking beef is expected to be the same. See PHC analysis on 4/26 for more information and guidance on this outbreak. The USDA reported that they will conduct tests on beef to identify H5N1 avian influenza. 3 types of tests will be conducted: 1) sampling ground beef i...read moren grocery stores, 2) testing muscle tissue from sick cows culled from affected herds, and 3) testing cooked beef inoculated with a virus surrogate to see if it survives. [Confidence: Very High]
Businesses in Bahia State, Brazil should ensure they have access to clean water and encourage them to seek treatment if they develop symptoms. Enterprise businesses should ensure employees have access to potable water. Brazil reports their first case of locally spread cholera since 2005. The case lives in Salvador, Bahia State and has no travel history. Close contact...read mores were tested, with only one asymptomatic individual testing positive. Brazil's Ministry of Health is still investigating. PHC will monitor the situation and report updates as needed. [Confidence: Very High]
For awareness only. USDA's policy requiring a negative H5N1 test to transport lactating cows goes into effect today. This requirement may detect additional outbreaks outside those in the 9 known impacted states. The USDA now requires H5N1 testing of all lactating cows being transported across states. All lactating cows must be tested prior to travel, up to 30 cows per herd being transported. [Confidence: Very High]
This outbreak illustrates the importance of providing paid sick leave for employees and making staff aware of the benefit, especially in the food industry. Food service establishments should remind sick workers to stay home and not return to work for 48 hours after symptoms stop. Employees should be reminded to wash their hands with soap and water after using the bathroom and before eating or handling food. Other enterprise businesses can avoid norovirus outbreaks by encouraging sick people to stay home. A restaurant in NYC experienced an outbreak of norovirus among 4 staff and at least 2 patrons in Dec 2023. The event is believed to be tied to infecte...read mored staff who worked while symptomatic. Half of the restaurant staff interviewed did not know paid sick leave was available. [Confidence: Very High]
Employers, especially those near Stuttgart, should inform employees about the ongoing outbreak and instruct those who attended the festival and are experiencing gastrointestinal symptoms to not report to work until 24 hours after symptoms subside. Food handlers should not return to work until 48 hours after symptoms subside. More than 800 individuals have contracted norovirus at the Stuttgart spring festival. So far, the outbreak has been connected with the Göckelesmaier ...read moremarquee. Testing suggests the outbreak was not connected to food or drinks served within the tent, and person-to-person transmission is suspected. The festival remains open and will run through May. [Confidence: Very High]
Businesses in Mayotte should ensure they have access to clean water and encourage them to seek treatment if they develop symptoms. Enterprise businesses with employees operating outside should try to acquire bottled water for distribution to employees. Mayotte reported their first ever cases of locally spread cholera (3), with 13 cases total identified in 2024. The 3 locally spread cases in Mayotte a...read morell reside in different households. Nearby Comoros has been experiencing a recent cholera outbreak, which increases the risk of continued locally spread cholera in Mayotte. A large portion of the population does not have running water, and over 80% are below the poverty line. The potential for spread is concerning. See PHC alerts on 4/12, 4/24, and 4/26 for info about Comoros' cholera outbreak. [Confidence: Very High]
For information only. Powassan virus disease remains a rare disease, but this case is a reminder that climate change is leading to less predictable tick emergence and a broader geographic range for some diseases. Sharon, MA reported their first ever case of Powassan, a rare tick-borne disease. Powassan virus occurs mostly in the Northeast and Great Lakes region...read more of the U.S. and in eastern Canada, but is rare. On average, fewer than 30 cases of Powassan virus disease occur each year in the US. Infection resembles meningitis illness and can be severe. There is no vaccine or treatment. Tick bite prevention is important for minimizing risk of exposure. [Confidence: Very High]
Imported cases can start chains of transmission if local mosquitoes bite the infected person. Businesses in the UK can support mosquito control measures at their facilities by eliminating standing water. Employees living in or visiting areas with high malaria rates should prevent mosquito bites by wearing protective clothing and using insect repellent. The UK reported an increase in imported malaria cases, with 2,004 cases identified in 2023, the first time rates have been this high in over 20 years....read more Individuals are encouraged to take mosquito control measures during upcoming spring and summer travel and seek care right away if they become ill. Malaria was present in southern England in the early 1900s, and the mosquito vector remains present in the UK. [Confidence: Very High]
Businesses in West Virginia should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Update to measles case in West Virginia: 150 - 200 close contacts across West Virginia and Pennsylvania have been identified and are being monitored. ...read moreThis was West Virginia's first measles case in 15 years. PHC will continue to monitor the situation and report updates as needed. [Confidence: Very High]
Informational advisory only. Though Hawai'i typically has low numbers of pertussis cases, this new whooping cough case is likely due to local spread. Enterprise businesses are not expected to experience widespread absenteeism. Hawaiʻi reported a new whooping cough case, the 11th between March - April 2024. The case has not traveled recently and is not tied to previously identified cases, giving evidence of local spread on the island. [Confidence: Very High]
Receiving a flu shot reduces both the risk of contracting influenza and the likelihood of developing severe illness. PHC strongly recommends annual flu shot in consultation with a healthcare provider, especially for those at high risk of severe illness, such as being elderly, pregnant women, and those with underlying conditions. As flu season starts in Australia, local businesses should expect heightened absenteeism. Australia's New South Wales released a health alert encouraging flu vaccination after seeing an early rise in cases for the season. 4,700 flu cases we...read morere identified in the last four weeks, a 16% increase compared to the same time period in 2023. [Confidence: Very High]
France is increasingly hospitable to the mosquitoes that carry dengue. Imported cases can start chains of transmission if local mosquitoes bite the infected person. Businesses in France can support mosquito control measures at their facilities by eliminating standing water. Employees living in or visiting areas with high dengue rates, including the French West Indies should prevent mosquito bites by wearing protective clothing and using insect repellent. France reported an unprecedented number of imported dengue cases in 2024. So far, 1,679 cases have been identified in 2024 compared to only 131 cases ...read morein the same period in 2023. Most imported cases (60%) are tied to travel from the French West Indies, which has been experiencing a dengue outbreak since mid-2023. [Confidence: Very High]
Businesses in Vermont should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Vermont is reporting a measles case among individuals exposed to measles through their participation in a program with international visitors. A total...read more of 26 people in that program were exposed to a measles case earlier this month (see PHC alert 4/15 for more info). Other program participants are still being monitored for illness. PHC will continue to monitor and provide any relevant updates. [Confidence: Very High]
Businesses in the Netherlands should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Convening of the outbreak management team reflects the increasing risk related to measles in the Netherlands. Employees with unvaccinated children may have extended absenteeism due to infection or post-exposure quarantine. The Netherlands' high number of measles cases continues, with 8 new cases occurring in so far April and 64 total for 2024. An Outbreak Management Team...read more (OMT) was assembled to address the situation and develop a response plan, only the third OMT in the last ten years. The OMT recommended childcare attendance exclusions for siblings of measles cases to last through 21 days. See PHC 4/5 analysis and 4/4 alert for more info. [Confidence: Very High]
Businesses in West Virginia should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. West Virginia reported their first measles case since 2009 in a Monongalia County resident who had traveled recently. The individual visited a local h...read moreospital, but details about potential public exposures have not yet been released. West Virginia's measles vaccination rate for children is 95.6%, right at the target 95% rate. PHC will continue to monitor the situation and report updates as needed. [Confidence: Very High]
Businesses in the greater Indianapolis area should inform employees about the possible measles exposure and provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Marion County, IN reports possible measles exposure at the Indianapolis Children's Museum related to an out-of-town visitor. The case visited the muse...read moreum on April 8 for a solar eclipse viewing event. No measles cases have been identified in Marion County residents in 2024. [Confidence: Very High]
Businesses in Samoa can support mosquito control measures at their facilities by eliminating standing water. Employees living in or visiting the area should eliminate sources of standing water around their property and prevent mosquito bites by wearing protective clothing and using insect repellent. The Samoa Ministry of Health has declared a dengue outbreak after reporting increasing cases. 216 cases have occurred between Nov 2023 to April 14, 20...read more24, with 81 of the cases occurring in April. The Ministry of Health is urging individuals to implement mosquito control measures. [Confidence: Very High]
Businesses in Quebec should provide flexible work schedules to support employees making vaccine appointments for themselves or family members. Quebec, Canada reported 3 new measles cases in the past week. In total, 46 cases have occurred in Quebec in 2024, with most cases occurring in Montrea...read morel (18) and Montérégie (11). The new cases visited several public places, including two outpatient medical centers (CLSC de Côte-des-Neiges and ELNA Pediatrics). [Confidence: Very High]
Leptospirosis is getting media attention, but should not impact enterprise business. Businesses in NYC should take measures to ensure rodent-free facilities. Any rodent urine should be cleaned with bleach; wet the soiled area with bleach before wiping up. Employees should always wear gloves when handling rodents or their urine. NYC reported a high number of leptospirosis cases so far in 2024, with 6 cases identified. In comparison, NYC averaged only 3-4 cases a year between 2...read more001 - 2022, though in 2023, they had 24 cases. Leptospirosis is more common in dogs in NYC than humans; a canine vaccine that covers several serovars is available. Leptospirosis can be severe but is treatable. Infection is caused by exposure to water, soil, or food containing animal urine and is usually associated with outdoor activities in tropical areas. [Confidence: Very High]
