Pacific Syndromic Surveillance System Weekly Bulletin / Système de Surveillance Syndromique dans le Pacifique - Bulletin Hebdomadaire: W47 2024 (Nov 18-Nov 24) [EN/FR]

Alerts : AFR - Samoa (2)

Respiratory virus epidemiology in the Pacific Island Countries for EPI – WK 47, 2024

• PSSS, EPI -WK47, 2024 Influenza-like Illness (ILI), Severe Acute Respiratory Illness (SARI), and COVID-19-like cases are compared to WK46 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 WK45 & WK46 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 Fiji, New Caledonia and Vanuatu for the week. SARI cases increased in CNMI, Samoa, Solomon Islands, Tonga, and Vanuatu for the week. Increased COVID-19 cases seen in Fiji for the week. The increased ILI /SARI cases seen in Samoa 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 Cook Islands, RMI, CNMI, Palau and Tonga for the week. Furthermore, the number of SARI cases decreased in Fiji for the week. Decreased COVID-19 cases seen in CNMI for the week.
• No ILI cases reported in Pitcairn Islands, no SARI cases reported from Cook Islands, RMI, Niue, New Caledonia, Palau and Pitcairn Islands. Furthermore, no COVID-19 cases were identified in Cook Islands, RMI, Nauru, New Caledonia, Pitcairn Islands, Samoa, Solomon Islands, Tonga and Vanuatu for the week.
• No reports were available from French Polynesia, Kiribati, Guam, Niue, Tokelau, Wallis & Futuna and Tuvalu 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 47, the CNMI reported zero (0) new COVID-19 cases, reflecting a 100% decrease compared to the previous three weeks, with no hospitalization. Laboratory tests confirmed eight (8) cases of influenza A and one (1) Flu B from 161 samples and 2 SARI case for the week. Additionally, 2 clinical pneumonia cases were reported, and 5 cases of Respiratory Syncytial Virus (RSV) were detected. (Situation Report WK47, 2024).
• In week 47, Fiji tested 69 flu samples, identifying 23 positive cases of influenza A/H3 positive cases and seven (7) new SARS-CoV-2 for the week.
• In week 46, French Polynesia sentinel doctors reported 144 consultations for acute respiratory infections (ARI), showing a slight increase after weeks of decline, particularly in the Windward Islands and the Marquesas. Other respiratory viruses, including RSV, common coronaviruses (OC43), rhinoviruses/enteroviruses, and Parainfluenza 3, are circulating. One new case of influenza A was reported among 49 tests, while no new COVID-19 cases or hospitalizations were recorded from 51 tests. Source: Bulletin de surveillance sanitaire Polynésie française N° 46, 2024.

Pertussis

Pertussis, Samoa

• Samoa's Ministry of Health has declared a whooping cough outbreak, with six confirmed cases, mostly in children under one year. The first case, a seven-week-old baby, has recovered. Additional suspected cases are awaiting confirmation. The outbreak declaration follows a rise in cases at Moto'otua hospital, highlighting the disease's infectious nature and public health risk.

Pertussis, New Zealand

• New Zealand: In week 47, New Zealand's ESR reported 77 weekly pertussis cases, a slight decrease from 89 cases the previous week, bringing the total for the year to 1,008. Despite this, case numbers are showing an overall increasing trend compared to October 2004 and previous years.
• New Zealand health officials have declared a whooping cough epidemic, with 263 cases reported in the four weeks to November 15—the highest monthly total in 2024. The worst-affected regions are Wairarapa (25.4 cases per 100,000 people), Southern (11.6), Whanganui (11.4), and Capital and Coast (10.4). Babies are particularly at risk, with around 50% of infected infants under 12 months requiring hospitalization, and 1-2% of those hospitalized dying. While no deaths have occurred this year, three infants died from the infection in 2023. Te Whatu Ora is urging vaccination to protect vulnerable populations and prevent further fatalities.

Pertussis, United States

• Pertussis cases have surged in the United States in 2024, with reported cases nearly six times higher than the same period in 2023, according to the CDC. This sharp increase reflects a return to pre-pandemic transmission patterns, as mitigation measures like masking and remote learning, which had previously suppressed cases, are no longer in widespread use.

Pertussis, French Polynesia

• From June 14 to November 10, 340 confirmed cases of pertussis have been reported. In week 46, 27 new cases were confirmed, with 26 from Tahiti and 1 from Moorea. Cases included 3 infants under 11 months, 3 children aged 1-4 years, 15 individuals aged 5-19 years, and 6 adults aged 20-79 years. Two infants under 5 months were hospitalized in week 46, and one infant under 3 months diagnosed in week 45 was hospitalized and died in week 46—the first case with complications and the first fatality. Since the outbreak began, 14 hospitalizations have been recorded, including 11 infants under 8 months. Pertussis remains actively circulating in Tahiti. Authorities urge immediate medical consultation for symptoms, vaccination updates, adherence to hygiene measures, and isolation for suspected cases.

The incidence of pertussis has been decreasing over the past three weeks, with a stable positivity rate. School-aged children represent the largest group affected(44%), while 12.1% of cases involve infants under one year old. Source: Bulletin de surveillance sanitaire Polynésie française N° 46, 2024.

• As of 22 November 2024, New Caledonia has reported 104 pertussis out of 755 tests. since April, with 31 cases in October and 27 in September. 26 cases have been reported so far in November. – Source

Avian Influenza Weekly Update : (attached)

• From 22 to 28 November 2024, no new case of human infection with avian influenza A(H5N1) virus was reported to WHO in the Western Pacific Region.
• Canada:On November 9, British Columbia reported a human case of avian influenza A(H5N1); the infection source is unknown, and no additional cases have been identified.
• United States:Three new avian influenza A(H5) human cases were reported in California, involving two adults exposed to cattle and one child with no known animal exposure. In 2024, 55 human cases have been recorded across seven states, primarily linked to exposure to infected dairy cattle (32 cases) and poultry farm outbreaks (21 cases), with two cases having no known animal exposure.
• Milk Contamination: On November 24, avian influenza A(H5) virus fragments were detected in a retail sample of raw milk in California. No illnesses have been reported, and authorities confirmed pasteurized milk remains safe for consumption.

COVID -19

• Refer Monthly update (06 November 2024). Q3 vaccination data collection began on 15 October 2024.
• Please refer to the linksituation-reports where disaggregated data is available for download.
• The CDC recently reported a shift in COVID-19 variant proportions, with a decline in KP.3.1.1 from 57% to 52% over the past two weeks, while the recombinant XEC variant increased from 17% to 28%. Another variant, MC.1, also showed rising proportions. The CDC noted that MC.1 is a descendant of KP.3.1.1, and the updated vaccine is expected to be effective against emerging variants like XEC and MC.1.
• 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.

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 (113), Vanuatu (3), Solomon Islands (7) and FSM (1) reported dengue-like-illness (DLI) cases for the week.
• French Polynesia Dengue updates: In week 46, 33 new cases were reported out of 93 tests conducted, with cases distributed across Tahiti (20), Bora Bora (4), Rangiroa (2), Raiatea (2), Moorea (1), Ua Pou (1), Fakarava (1), and Tikehau (1). A first local case was identified on Tikehau without recent travel history. The latest cluster in Tahiti was reported in Tuauru, Mahina. Since the outbreak began on November 27, 2023, a total of 306 cases have been reported, with a rising trend, particularly in the Windward Islands, where over 10 weekly cases have been reported for a month. The positivity rate has also increased, reaching 35.5% in week 46, prompting the declaration of an epidemic phase (3a) for Tahiti and Moorea. No hospitalizations, severe cases, or deaths have been reported. Of the 230 serotyped samples, DENV-1 accounts for 70% of cases, making it the predominant serotype since July, and the only serotype detected in the Marquesas. Cases occur as isolated instances or clusters, mainly affecting children and young adults, with 36% under 20 years old and a median age of 30. NS1 antigen tests are now recommended as the first-line diagnostic tool in Tahiti and Moorea due to the declared epidemic phase. Source: Bulletin de surveillance sanitaire Polynésie française N° 46, 2024.Source: Bulletin de surveillance sanitaire Polynésie française N° 46, 2024.

Global events:

MPXV Clade I and Clade II

Global situation update based on available data:

Since 1 January 2022 to 31 October 2024, there have been 115,101 laboratory confirmed mpox cases and 2 probable cases including 255 deaths across 126 countries according to WHO data, Published on 21 November 2024.

• Cases of mpox caused by MPXV clade Ib have been reported outside Africa in several countries: Canada reported the first mpox clade 1b on 22nd November. Sweden and Thailand (August 2024), India (September 2024), Germany and the UK (October 2024), and the US (November 2024). Cases in Sweden, Thailand, Germany, the UK, and the US were linked to travel to Africa, while the case in India was associated with travel to the United Arab Emirates. Secondary transmission of mpox due to MPXV clade Ib outside Africa has been documented only in the UK.
• Health officials in the UK have confirmed a fifth case of mpox Clade 1b strain. The latest patient, from Leeds, has no connections to the previous four cases. link
• On 13 August 2024, Africa CDC declared mpox a Public Health Emergency of Continental Security, followed by WHO's declaration of the Clade I outbreak as a public health emergency of international concern on 14 August 2024.
• Updated public health emergency of international concern: Despite progress in controlling mpox, the rising number of cases, particularly from monkeypox virus clade Ib, highlights ongoing challenges and the need for stronger national and international response efforts. The Committee advises that the event still meets the criteria for a Public Health Emergency of International Concern (PHEIC).

Multi-country outbreak of cholera

• From January to October 2024, 486,760 cholera and acute watery diarrhea cases and 4,018 deaths were reported across 33 countries, with deaths increasing by 54% compared to 2023 despite fewer cases. Conflict, displacement, natural disasters, and climate change have exacerbated outbreaks, particularly in rural and flood-affected regions with poor infrastructure. Recent outbreaks were reported in Iraq, Lebanon, and South Sudan. While record production of Oral Cholera Vaccines (OCVs) was achieved in November, emergency stockpile levels remain critically low, with less than 600,000 doses available—far below the required five million—hindering effective outbreak responses. WHO report #20 - 20 November 2024