Pacific Syndromic Surveillance System Weekly Bulletin / Système de Surveillance Syndromique dans le Pacifique - Bulletin Hebdomadaire: W27 2024 (Jul 01-Jul 07) [EN/FR]

Alerts :

• AFR: Wallis & Futuna (1)

Respiratory virus epidemiology in the Pacific Island Countries for EPI – WK 27, 2024

• PSSS, EPI -WK27, 2024 Influenza-like Illness (ILI), Severe Acute Respiratory Illness (SARI), and COVID-19-like cases are compared to WK26 and tabulated as below for easy comparison (▼ Decreasing ▲ Increasing ● Stable). To provide additional context on the figures and trends, the percentage of country sentinel sites reporting WK26 & WK27 are also included. Reporting below 80% is indicated as ▼low reporting and – is no report available.
• Please refer Seasonal Influenzafor Pacific Island Countries and Areas - ILI Surveillance
• Attached is the weekly bulletin for your reference and additional information.
• Actual increases in the number of ILI cases has been seen in Cook Islands, Niue, CNMI, Palau and Tonga . Additionally, the number of SARI cases increased in Kiribati and Tonga. Increased COVID-19 cases seen in Fiji, RMI, Niue. CNMI, Palau, Samoa and Tonga for the week. The increased ILI cases seen in New Caledonia and Solomon Islands may be due to the increased number of sites reporting for the week.
• The reduction in the number of ILI cases has been seen in Fiji, Kiribati, RMI, FSM, Samoa and Wallis & Futuna. The decreased ILI cases seen in Vanuatu may be due to the decreased number of sites reporting for the week. Furthermore, the number of SARI cases decreased in CNMI, Samoa and Solomon Islands for the week. Decreased COVID-19 cases seen in Cook Islands for the week.
• No SARI cases reported from Cook Islands, RMI, FSM, New Caledonia, Niue and Vanuatu and Wallis & Futuna. Furthermore, no COVID-19 cases were identified in Kiribati, RMI, FSM, New Caledonia, Solomon Islands, Vanuatu and Wallis & Futuna for the week.
• No reports were available from Pitcairn Islands, Tuvalu, Tokelau for the week.
• American Samoa, Nauru and Guam have not participated in the surveillance.
• Surveillance figures are not intended to capture all country cases but to describe trends over time and are invaluable when trends rise beyond country baselines which should then trigger alerts and timely actions to characterize the actual nature and magnitude of the disease.

Influenza and Other Respiratory Virus in PICs:

• In week 27, Palau conducted Biofire tests on 19 cases of respiratory viruses, with 12 (63%) returning positive for respiratory pathogens. The positive cases included one instance of influenza A/H12009, one case of Parainfluenza virus 3, and four cases of SARS-CoV-2. (Situation report WK 27, 2024).
• In week 27, Tonga reported 7 cases of influenza A and 3 positive cases of RSV out of 18 samples. Additionally, there were 2 new positive COVID-19 cases from 182 tests conducted (including 18 PCR and 214 RAT), along with one COVID-19 positive case identified from samples collected in the previous week (week 26). (Situation report WK27, 2024).
• In week 27, the CNMI reported 17 new COVID-19 cases, reflecting a notable 65% increase compared to the previous three weeks, with no cases requiring hospitalization. Laboratory tests confirmed three cases of influenza A from 83 samples, while one case of Severe Acute Respiratory Infection (SARI) required hospitalization, and two influenza-like illness (ILI) cases were clinically diagnosed as pneumonia. No cases of Respiratory Syncytial Virus (RSV) were detected. The country continues its flu vaccination campaign and promotes awareness through social media. (Situation report WK27, 2024).
• In week 27, French Polynesia, 3 new cases of influenza A were confirmed from 93 test results. Among these cases, all 3 were type A, with no cases of type B, and there was 1 new hospitalization. No new deaths have been reported, confirming the end of the epidemic. In same period, COVID-19 cases increased with 12 new confirmations from 81 tests and a positivity rate of 14.8%. Two individuals aged 70 or older were hospitalized, but no ICU visits occurred. Variants JN.1, KP.2, KP.3, and KS.1 have been circulating since May, and vaccines remain effective against them. A new epidemic wave seems to be beginning. It is advised that older and vulnerable individuals, including the immunocompromised, get vaccinated or receive a booster if they haven't been in contact with the virus for at least 6 months. Wearing masks is encouraged in confined spaces, on public transport, and around vulnerable individuals. Source: Bulletin de surveillance sanitaire Polynésie française N° 27 – 2024.
• In Week 27, in Fiji, a total of 25 flu samples were tested. Among these, 2 positive cases of Flu A/H1pdm were identified, The same 25 samples were tested for SARS-CoV-2, Flu A, Flu B, and RSV multiplex, resulting in 1 positive case for RSV.
• In week 27, Vanuatu reported zero positive cases of influenza, SARI, and COVID-19. However, there was an increase in reported cases of ciguatera fish poisoning, surpassing the threshold. Additionally, 5 samples tested positive for syphilis, resulting in a rise in the positivity rate from 3% in week 26 to 7% in week 27. Conversely, 8 samples tested positive for hepatitis B, showing a decrease in the positivity rate from 13% in week 26 to 10% in week 27. Tuberculosis cases also decreased, with positive samples dropping from 4 in week 26 to zero in week 27, leading to a reduction in the positivity rate from 20% to 0%. (Situation report WK27, 2024).

Avian Influenza Weekly Update : (attached)

• Between 5 to 11 July 2024, no new case of human infection with avian influenza A(H5N1) virus was reported to WHO in the Western Pacific Region.

On July 6, 2024, Cambodia reported an A(H5N1) case in a child in Takeo province. The child had contact with a dead chicken and is now in intensive care with improved symptoms. On July 8, a second case, the first child's cousin, was reported from the same location with mild symptoms after touching the same chicken. Both are receiving intensive care, and the virus clade is unknown. Cambodia has had 69 human A(H5N1) cases with 42 deaths since 2003. Health authorities are tracing contacts, providing oseltamivir, and advising proper poultry handling to prevent more infections. Source.

COVID -19

Global WHO Coronavirus (COVID-19) Dashboard 2024**.** Refer here

Please note that the COVID-19 Epidemiological Update will be provided every four weeks*.* Please refer to the linksituation-reportswhere disaggregated data is available for download.

WHO is currently tracking several SARS-CoV-2 variants, including:

• Five variants of interest (VOIs): XBB.1.5, XBB.1.16, EG.5, BA.2.86 and JN.1
• Variants under monitoring (VUMs): JN.1.7, JN.1.18, KP.2 and KP.3

The Pacific Island Countries COVID-19 situation report from the Pacific COVID-19 JIMT is attached herewith as a reference for operational purposes. The slides contain data that are subject to change as investigations are ongoing, and sources of data are noted within the slides. Also refer to Pacific dashboard COVID-19 .

Dengue Like Illness:

• Latest Dengue Situation Updates for the Western Pacific from PSSS weekly report here Dengue. Out of 18 Pacific Island Countries and Areas (PICs) who provided surveillance data, Fiji (104), FSM (1), Solomon Islands (7) and Samoa (3) reported dengue-like-illness (DLI) cases for the week 27.

Dengue:

• French Polynesia: In week 27, 7 new dengue cases were reported in French Polynesia, bringing the total to 77 since November 27, 2023. Most cases are in Tahiti, with some in Moorea and Nuku-Hiva. Four indigenous cases have been confirmed as DENV-1. Preventive measures are in place due to ongoing virus circulation, and no new hospitalizations have been reported. DENV-2 was identified in 85% of 54 serotyped samples. (Source: Bulletin de surveillance sanitaire Polynésie française N° 27- 2024).
• Samoa: Since November 2023, a total of 456 lab-confirmed dengue cases have been recorded. In week 26, 10 new cases were confirmed. No dengue-related deaths have been reported to date. The majority of cases are in the 20-29 age group. Dengue cases are densely distributed in the Apia Urban Area (AUA) and North West Upolu (NWU) regions. Serotype is still pending (Dengue Fever Outbreak Situation Report in Samoa - Epi-week 26: 24—30 June 2024 Issue No.18 )

Leptospirosis:

• In week 27, French Polynesia, 3 cases were reported out of 44 samples taken in week 27, with 2 confirmed and 1 probable case. The affected individuals live in Tahiti (2) and Huahine (1). Since the beginning of the year, 120 cases have been reported, with 95 investigated. Of these, 84.2% reported the presence of rats at home or work, and 60% practiced gardening or agricultural activities. Healthcare professionals are advised to prescribe an RT-PCR test immediately if leptospirosis is suspected, followed by probabilistic antibiotic therapy (amoxicillin). (Source: Bulletin de surveillance sanitaire Polynésie française N° 27- 2024).

Meningococcal Meningitis:

• In week 27, French Polynesia, A confirmed case of type B meningitis was reported in a 17-year-old. She was treated at Taravao Hospital and then transferred to CHPF. The 16 identified contacts received antibiotic prophylaxis. This is the third case diagnosed in 2024. (Source: Bulletin de surveillance sanitaire Polynésie française N° 27- 2024).

Acute Gastroenteritis (AGE) and food poisoning:

• French Polynesia reported a decrease in GEA syndrome cases in week 27 compared to the previous week. Salmonella and Campylobacter are the main identified germs. An invasive Salmonella case was reported in a patient hospitalized at CHPF in week 27, along with a TIAC case. Out of 103 smoked chicken and rice salad dishes delivered, 43 people became ill, with 5 requiring short-term hospitalization.
• In 2024, two cases of listeriosis, including one hospitalization, were reported in French Polynesia. Routine samples detected Listeria monocytogenes in locally produced and prepared raw fish dishes. As a result, the sale of these products has been temporarily halted. Vigilance is maintained due to the incubation period of up to 2 weeks, or 2 months for maternal-fetal forms. Listeriosis, caused by consuming contaminated food, can be mild but poses serious risks for immunocompromised individuals and pregnant women, who should avoid raw fish, raw milk cheeses, shellfish, cold meats, etc.
• Yersinia enterocolitica bacteria have been found in "Banon AOP 100g Etoile de Provence" cheese sold in French Polynesia between June and July. The bacteria cause gastroenteritis with fever, diarrhea, and abdominal pain, 2-7 days after consumption. The cheese is being recalled. Consumers with similar gastrointestinal symptoms should consult a doctor. If no symptoms appear within 10 days, there is no cause for concern.

Source : Bulletin de surveillance sanitaire Polynésie française N° 27- 2024.

Diphtheria

• In 2024, Vietnam reported five cases of diphtheria, resulting in one death, specifically an 18-year-old woman from Nghe An. Three cases were identified in Ha Giang, a former diphtheria hotspot. As of 9 July 2024, 134 individuals connected to the deceased have been quarantined. There is a risk of community transmission, and those in close contact are advised to quarantine and use antibiotics, with ample supplies of vaccines and antibiotics available. The rise in diphtheria cases is attributed to low vaccination coverage, currently at 93-95%. The outbreaks are primarily in remote areas with economic challenges and limited vaccination awareness, compounded by difficulties in accessing vaccines Source.

Mpox(monkeypox)

• On July 9 2024, South Africa reported 20 mpox cases between May 8 and July 2, 2024, including three deaths. Cases were in Gauteng, Western Cape, and KwaZulu-Natal provinces. Most affected men (aged 17-43) have advanced HIV, with 11 identifying as men who have sex with men (MSM). Sexual contact was the main exposure, and 18 required hospitalization. WHO and national health authorities are responding. The high HIV prevalence and lack of international travel history suggest ongoing community transmission. The risk is low for the general public but moderate for MSM, trans and gender-diverse people, and sex workers. The global mpox threat persists. Source

MERS-CoV

• Since the previous update on June 3, 2024, no new MERS-CoV cases have been reported by the World Health Organization (WHO) or national health authorities as of July 8, 2024. In 2024, Saudi Arabia has reported four MERS cases, including two fatalities, with two primary cases and two nosocomial infections. Since April 2012, health authorities worldwide have reported a total of 2,622 MERS cases, including 950 deaths. Source

Poliomyelitis:

· A joint Polio Independent Monitoring Board (IMB) and Transition Independent Monitoring Board (TIMB) meeting will take place in Geneva next week from the 15 – 19 July. The goal of the meeting is to assess the challenges of eliminating polio in the endemic and outbreak countries. The meeting documents are available here for pre-reading.

Summary of new poliovirus - WK 27

· Afghanistan: three WPV1 cases

· Pakistan: eight WPV1 positive environmental samples

· Angola: two cVDPV2 cases and one positive environmental sample

· Chad: one cVDPV2 case

· DR Congo: one cVDPV1 case and two cVDPV2 cases

· Guinea: one cVDPV2 case

· Mozambique: one cVDPV1 case

· Niger: one cVDPV2-positive environmental sample

· Senegal: two cVDPV2-positive environmental samples

· Yemen: six cVDPV2 cases and four positive environmental samples

· Zimbabwe: one cVDPV2-positive environmental sample