The following syndromes have been flagged:
· Influenza-like Illness: Federated States of Micronesia (FSM)
· Diarrhoea: FSM, Nauru, Northern Marianna Islands, Samoa.
· Prolonged fever: Kiribati, Niue
Tropical Cyclone Winston
· Category 5 Tropical Cyclone Winston hit Fiji on 20-21 February causing widespread damage to infrastructure, buildings and loss of communication. There have been 43 reported deaths and approximately 54,700 people that are currently seeking shelter in evacuation centres.
· A study in French Polynesia published in the Lancet (online 29 February 2016) provides the strongest evidence to date for Zika virus infection causing Guillain- Barré Syndrome (GBS )- a severe form of limb paralysis that is often accompanied by respiratory impairment. Figures from this outbreak show about 1 in 4,000 people infected with Zika virus went on to develop GBS. The authors found no signal that previous dengue infection was associated with the development of GBS, as there was concurrent circulation of dengue serotype-1 and 3 during the outbreak of Zika. Source:** Lancet**
· **American Samoa: **As of 26 February 2016; there have been 10 confirmed cases, including 3 pregnant women. For further information, please refer to Ms Fesili Niumata-Foifua’s PacNet post on 2 March 2016.
· There have been two lab-confirmed cases of Zika disease in Majuro, Marshall Islands- one with onset of illness on Nov 22, 2015 and the second on January 21, 2016 (reported on PacNet on 14 February 2016) . The Nov 22 case was in a traveller who was tested off island and did not come to the attention of the MOH until late January. Twelve suspected cases have been identified since expanded surveillance for Zika was begun on January 29 2016. All except the Jan 21 case tested negative. An additional suspected case on Mejit island is being investigated. Source: Marshall Islands MoH.
The President of the Marshall Islands, Dr Hilda Heine has declared a state of health emergency to push the country's response to the Zika virus into high gear. Dr Heine says although only one case of Zika has been confirmed in the Marshalls, Zika cases reported in the Pacific region are rapidly increasing and the Marshall Islands is highly vulnerable. The declaration activates the Ministry of Health's Epidemiology Network as the focal point for action to provide direction, updates and advice to the government's National Disaster Committee. Source: Media
· In the period 20 -26 Feb 2016 there were 2 cases in returned travellers from Fiji and one case in returned traveller from the Solomon Islands reported by the New Zealand ESR (Institute of Environmental Science and Research Ltd).
· French Polynesia: there were 50 confirmed cases and one death for week ending 21 February 2016. Dengue serotype 1 is in circulation. Source: French Polynesia Ministry of Health.