Attachments
Highlights/updates since the last map was sent on PacNet on 25 November 2025:
Dengue
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Cook Islands: On 22 May 2025, the Cook Islands Ministry of Health declared a dengue outbreak in Rarotonga. As of 23 November 2025, 242 cases were reported, with 231 recovered and 12 still active. Most of the cases are in the 10-19 age group, and no fatalities or severe dengue cases have been reported. Of the 50 samples serotyped, 47 were DENV-1 and 3 were DENV-2, confirming co-circulation. Authorities are conducting clean-up and mass spraying campaigns, urging the public to eliminate mosquito breeding sites, use repellents, wear protective clothing, and seek medical care if symptoms appear. The blue alert for DENV-1 and DENV-2 remains in effect. – Source: Cook Islands 2025 Dengue Outbreak Situation Report #67 (23 November 2025) shared with PPHSN Coordinating Body focal point on 1 December 2025.
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Samoa: As of 16 November 2025, Samoa Ministry of Health has recorded a cumulative total of 15,962 clinically diagnosed dengue cases since January 2025, including 4,565 laboratory-confirmed cases, and seven dengue-related deaths. Children under 15 years account for 74% of the cases, and the circulating serotypes remain predominantly DENV-1 (91%) and DENV-2 (9%). Case numbers decreased by 34% compared to the previous EpiWeek, with 122 new clinical cases of which 14 are lab-confirmed. Hospital admissions also decreased by 57%, with 3 new admissions, none in ICU. The Ministry of Health continues its whole-of-government response through the Integrated Vector Control Committee, prioritizing source reduction, environmental sanitation, and widespread risk communication. The blue alert for DENV-1 and DENV-2 remains in effect. – Source: Dengue Fever Outbreak Situation Report in Samoa Issue No. 31, Epi-week 46: 10th – 16th November 2025 shared with PPHSN Coordinating Body focal point on 26 November 2025.
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Tuvalu: The Tuvalu Department of Health declared a dengue outbreak on 5 June 2025. As of 23 November 2025, 891 suspected cases were tested, with 1 new case reported since the last update on 18 November 2025. The total number of confirmed positive cases is 242. The dengue cases are widely distributed along Fongafale, one atoll, Amatuku and three outer islands, Nanumaga (9 cases) Nukufetau (14 cases) and Vaitupu (1 case). The outbreak is due to Dengue Virus Type 2 (DENV-2). Currently, 99% of cases have recovered, while 2 remain active. 12 patients (six children and six adults) have been hospitalised since the start of the outbreak, with no current admissions and no deaths reported. Children under 14 years account for 73% of cases ranging in age from 3 months to 68 years. Of the confirmed cases, 146 cases are males and 96 females. The Department of Health continues to implement control measures, including response team coordination, technical support and assistance from external partners (SPC, PacMOSSI, WHO and DFAT), targeted spraying and ongoing public awareness through talkback shows and community engagement. Due to the decrease in case numbers in the past three weeks, the red alert for DENV-2 is changed to blue. – Source: Dengue Fever Outbreak, Situation report #21 (23 November 2025) shared with PPHSN Coordinating Body focal point on 26 November 2025.
Pertussis/Whooping cough
- New Zealand: As of the week ending on 21 November 2025, weekly pertussis cases in New Zealand decreased to 43, as compared to 55 in previous week ending on 14 November, bringing the total reported cases since the beginning of 2025 to 2,396. According to the latest report from the New Zealand Institute for Public Health and Forensic Science (PHF Science), 3,434 confirmed, probable and suspect cases have been notified since the start of the national epidemic on 19 October 2024. Of these, 299 cases (9.3%) have required hospitalisation with one reported death. Out of the 288 cases in infants under 1 year, 146 (52%) have been hospitalised. The blue alert remains in effect. – Sources: Pertussis dashboard and Pertussis Report 18 October–14 November 2025 accessed on 2 December 2025.
Other Information:
Measles
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Canada: In Canada, for EpiWeek 47 (16 – 22 November 2025) there has been 40 new confirmed measles cases bringing the total to 5,262 cases (4,895 confirmed, 367 probable) making it the country with the highest number of reported cases in the Region of the Americas, with persistent transmission in provinces like Alberta, British Columbia and Manitoba. – Source: Government of Canada Measles and rubella weekly monitoring report Epi-week 47: 16 - 22 November 2025 accessed on 2 December 2025.
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Hawaii: The Hawaiʻi Department of Health (DOH) is monitoring the first-ever wastewater detection of measles in Maui County, found in samples collected on 18 November 2025, though no suspected cases have been identified. Wastewater testing, conducted through the National Wastewater Surveillance System, indicates possible presence of the virus but does not confirm active infection or community spread. DOH urges residents to stay up to date with the MMR vaccine as measles remains highly contagious, and international outbreaks continue. – Source: State of Hawaii Department of Health, Monitoring First Wastewater Detection Of Measles In Maui County 25 November 2025 accessed on 2 December 2025.
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New Zealand: In New Zealand (NZ), 22 confirmed measles cases have been reported, 21 of whom are no longer infectious. The new case is in Wellington and linked to an earlier case. Residents are urged to monitor for symptoms and to call their healthcare provider if unwell and check their immunisation status. – Sources: New Zealand Health: Measles outbreak update - Sunday 30 November 2025 accessed on 2 December 2025.
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United States: In the United States, the CDC reported a total of 1,798 measles cases across 43 U.S. jurisdictions as of 25 November 2025, with 87% of these cases linked to forty-six outbreaks. The majority of cases are among unvaccinated individuals (92%), and 12% of the cases have resulted in hospitalization. There have been three confirmed deaths. The 43 jurisdictions that have reported measles cases are: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Jersey, New Mexico, New York City, New York State, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Wisconsin, and Wyoming. – Source: CDC Measles Cases and Outbreaks Update as of 26 November 2025, accessed on 2 December 2025.