Pacific Syndromic Surveillance System Weekly Bulletin / Système de Surveillance Syndromique dans le Pacifique - Bulletin Hebdomadaire: W42 2024 (Oct 14-Oct 20) [EN/FR]

Alerts :

• AFR : Solomon Islands (1)

Respiratory virus epidemiology in the Pacific Island Countries for EPI – WK 42, 2024

• PSSS, EPI -WK42, 2024 Influenza-like Illness (ILI), Severe Acute Respiratory Illness (SARI), and COVID-19-like cases are compared to WK 41 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 WK 41 & WK42 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 CNM, Niue, and Vanuatu for the week. SARI cases increased in FSM and Tonga for the week and increased COVID-19 cases seen in Fiji and Tonga for the week.
• The reduction in the number of ILI cases has been seen in Fiji, Kiribati, FSM, New Caledonia, Palau, Solomon Islands and Tonga for the week. Furthermore, the number of SARI cases decreased in Fiji, Solomon Islands and Vanuatu for the week. Decreased COVID-19 cases seen in and CNMI for the week. The decreased ILI cases seen in Fiji, FSM and New Caledonia may be due to the decreased number of sites reporting for the week.
• No ILI cases reported in Cook Islands and Pitcairn Islands, no SARI cases reported from Cook Islands, CNMI, New Caledonia, Palau, Pitcairn Islands Tokelau and Vanuatu. Furthermore, no COVID-19 cases were identified in Cook Islands, Kiribati, FSM, New Caledonia, Palau, Solomon Islands and Vanuatu for the week.
• No reports were available from French Polynesia, Guam, RMI, Nauru, Samoa, Tuvalu and Wallis & Futuna for the week.
• American Samoa has 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 42, the CNMI reported one (1) new COVID-19 cases, reflecting a 75% increase compared to the previous three weeks, with no hospitalization. Laboratory tests confirmed 8 cases of influenza A and 2 (two) Flu B from 171 samples and 5 (RSV) cases for the week. Additionally, Four(4) clinical pneumonia cases were reported, and no cases of Respiratory Syncytial Virus (RSV) were detected. (Situation Report WK42, 2024).
• In week 42, Fiji tested 44 flu samples, identifying 11 positive cases of influenza A/H3 and 4 new positive cases of SARS-CoV-2 for the week.
• In week 41, French Polynesia's sentinel sites recorded 216 consultations for acute respiratory infections (ARI), increased from the previous week especially in the Marquesas and Leeward Islands. This increase isn't linked to influenza or COVID-19, though CHPF notes the circulation of other respiratory viruses, including metapneumovirus, rhinovirus, enterovirus, parainfluenza 3, and RSV. Additionally, probable cases of whooping cough are emerging. No new influenza cases were confirmed out of 90 tests, while 2 new COVID-19 case was confirmed from 85 tests. The number of confirmed cases is stable compared to the previous week. No new hospitalizations were reported. Source: Bulletin de surveillance sanitaire Polynésie française N° 41, 2024.
• As of October 23, 2024, Samoa CHOGM (21-26 October) reported that 17 of its 27 inpatients were pediatric pneumonia cases, with four confirmed positive for respiratory syncytial virus (RSV). The surveillance team is investigating and will collect samples from the remaining cases and the RSV-positive ones.
• FYI: Broad-spectrum antibiotics for pneumonia linked to increased risk of adverse events

Avian Influenza Weekly Update : (attached)

• From 18 to 24 October 2024, no new case of human infection with avian influenza A(H5N1) virus was reported to WHO in the Western Pacific Region.
• On October 15, highly pathogenic avian influenza (HPAI) detected in birds at a Washington egg farm. Link on October 24, 2024 CDC reported two human A(H5) cases reported in Franklin County, WA, both related to infected bird contact; no severe illness or human-to-human spread observed. Link
• On October 18, US CDC confirms California A(H5N1) cases belong to clade 2.3.4.4b with no increased human transmissibility. Link . The six virus sequences are genetically similar to those causing infections in dairy cattle. Whole genome sequencing on two California cases confirmed the B3.13 genotype, while partial sequences were also obtained from samples of four additional individuals in California.
• On 24 September, CDC reports no human-to-human spread in Missouri H5N1 patient contacts. The CDC conducted serological testing on seven individuals, including healthcare workers, a family member, and a Missouri H5N1 patient, to check for prior exposure to avian influenza. No signs of human-to-human transmission were found among healthcare workers. The Missouri patient and a household contact showed potential signs of a common bird flu exposure rather than person-to-person spread. As of October 24, 2024, the US has reported 31 A(H5) human cases, with most linked to infected animals at dairy farms and egg farms. The CDC assesses the public health risk of A(H5N1) as low. Link

COVID -19

• Please refer to the linksituation-reports where disaggregated data is available for download.
• Global WHO Coronavirus (COVID-19) Dashboard 2024**.** Refer here
• WHO is currently tracking several SARS-CoV-2 variants, including:
• Two variants of interest (VOIs): BA.2.86 and JN.1
• Variants under monitoring (VUMs): JN.1.7, JN.1.18, KP.2, KP.3, KP.3.1.1, LB.1, and XEC.
• As of September 24th, a new variant named XEC, which is a recombinant of KS.1.1 and KP.3.32, has been classified as a VUM.
• It is highly transmissible. It has already spread to multiple countries, including the US, UK, Spain, France, and Germany. Current vaccines remain effective against XEC, with health authorities recommending vaccination and booster shots. Experts anticipate that XEC could become the dominant strain this winter due to its transmission advantage.
• FYI : Study: XEC characteristics position COVID variant to become dominant

Dengue

• Latest Dengue Situation Updates for the Western Pacific from PSSS weekly report here. Out of 21 Pacific Island Countries and Areas (PICs) who provided surveillance data, Fiji (118), Solomon Islands (1) reported dengue-like-illness (DLI) cases.
• French Polynesia : In Week 41, 14 new cases of dengue were reported from 46 samples across various islands in French Polynesia, with no travel history for cases on Ua Pou and Fakarava, indicating local transmission. Since November 2023, 188 cases have been reported, with an increasing positivity rate (30% in week 41) and a rising trend since week 35. DENV-2 and DENV-1 serotypes are circulating, mainly affecting children and young adults. Tahiti remains under an alert phase, showing more intense transmission, but no severe cases, hospitalizations, or deaths have been reported. Source: Bulletin de surveillance sanitaire Polynésie française N° 41, 2024.

Global events:

MPXV Clade I and Clade II

Global situation update based on available data:

• On October 22, 2024, Germany reported a confirmed case of mpox clade Ib linked to international travel, marking the first importation of this clade in the country. Confirmed
• On October 18, all contacts were deemed low-risk, and further investigations are underway.
• As of October 25, no secondary transmission of mpox clade Ib has been reported in other affected countries outside Africa, such as Sweden, Thailand, or India.
• Since 1 January 2022 to 31 August 2024, there have been 109,699 laboratory confirmed mpox cases and 236 deaths across 123 countries, according to WHO data.

Situation in Africa:

• Since January 1, 2022, 11,724 laboratory-confirmed mpox cases and 57 deaths have been reported to WHO from 22 African countries.
• In 2024, 15 countries reported 43,799 suspected and confirmed cases, including 1013 deaths. Many suspected mpox cases remain untested due to limited diagnostic capacity in some African countries.
• As of October 20, 2024, 18 countries reported 9,320 confirmed cases and 34 deaths in 2024. The three countries with the most cases in 2024 are Democratic Republic of the Congo (7,534 cases), Burundi (1,287 cases), Uganda (153 cases)
• In past six weeks, 2881 new cases have been confirmed, and two (2) new deaths of mpox were reported from 22 countries: DRC (1743), Burundi (902), Uganda (130), Nigeria (35), Cote dlvoire (28), Central Africa Republic (14 and 1 death ), Congo (1), Liberia (10), Kenya (9 and one death), Rwanda (2), Morocco (2), Ghana (2) Zimbabwe (2 Zambia (1).
• The circulation of mpox clades across several African countries shows distinct patterns. Clade Ib is found in Burundi, Kenya, Rwanda, and Uganda, while Clade Ia is reported in the Central African Republic, Congo. The Democratic Republic of the Congo (DRC) have a mix of both Clade Ia and Ib. Clade II (a and/or b) is more prevalent in West African nations such as Benin, Côte d’Ivoire, Ghana, Nigeria, and Mozambique, with Cameroon also reporting both Clade Ia and Clade II (a and/or b) according to the weekly report (October 06, 2024)