On 10 January 2025, WHO received reliable reports from in-country sources regarding suspected cases of Marburg virus disease in the Biharamulo and Muleba  Kagera region of the United Republic of Tanzania. As of 11 January 2025, nine suspected cases were reported including eight deaths (case fatality ratio (CFR) of 89%) across two districts. The cases presented with similar symptoms of headache, high fever, back pain, diarrhoea, haematemesis (vomiting with blood), malaise (body weakness) and, at a later stage of disease, external haemorrhage (bleeding from orifices).  Samples from two patients have been collected and tested by the National Public Health Laboratory. Results are pending official confirmation. Contacts, including healthcare workers, are reported to have been identified and under follow-up in both districts. The Bukoba district in Kagera region experienced its first MVD outbreak in March 2023, and zoonotic reservoirs, such as fruit bats, remain endemic to the area. The outbreak in March 2023 lasted for nearly two months with nine cases including six deaths.  Kagera region in Tanzania with possible Marburg virus disease outbreak: 

According to media, since 25 November 2020, 16 cases of diphtheria have been reported in the Western Cape province, mainly in the capital, Cape Town (94% of cases). 

The following countries have reported new confirmed cases of clade I infections within the past 6 weeks: Democratic Republic of the Congo: n.a. | 2024: cumulative 9’513 cases (clade Ia and Ib)Burundi: 798 cases | 2024: cumulative 3’035 cases of clade IbUganda: 767 cases | 2024: cumulative 1’552 cases of clade IbCentral African Republic: 4 cases| 2024: cumulative 90 cases of clade IaRwanda: 17 cases | 2024: cumulative 69 cases of clade IbKenya: 12 cases | 2024: cumulative 31 cases of clade IbCongo: 1 case |2024: cumulative 23 cases of clade IaCameroon: n.a. |2024: cumulative 9 cases of clade Ia and IbZambia: 2 cases | 2024: cumulative 3 cases of clade IbNo new cases have been reported within 6 weeks from Zimbabwe (2 clade Ib cases). A significant number of suspected mpox cases, that are clinically compatible with mpox remain untested due to limited diagnostic capacity in some African countries and thus never get confirmed. For updates, details, suspected cases, epidemic curves, see WHO LINK. New imported mpox cases clade Ib outside of Africa:Belgium: Two cases – first case in an adult traveler returning from Africa (country not specified), second case was a household contact.France: first case (7 Jan 2025). The case did not have a travel history to Central Africa, but had been in contact with two individuals who had returned from a country in Central Africa. Investigations into the source of the infection are ongoing. China: 5 confirmed clade Ib mpox cases, which involve a foreigner who had lived in the Democratic Republic of the Congo (DRC) and four close contacts. Previously, imported clade Ib cases have also been reported in Canada (1), Germany (6), India (1), Pakistan (1), Sweden (1), Thailand (1), the United Kingdom (5), and the United States (1).  Weekly trends in Africa: 

The Lunar New Year is celebrated in different ways in many countries and cultures throughout Asia and worldwide and is variously also known as Chinese New Year, the Spring Festival, Tet and Seollal.  Celebrations officially start on 29 January 2025, with the festival likely to attract big crowds and international visitors.

On 29 November, an alert was raised by local health zone authorities of Panzi health zone in Kwango province after an increase in deaths, particularly among children under five years of age, following febrile illness. Enhanced epidemiological surveillance was rapidly implemented, which in the absence of a clear diagnosis was based on the detection of syndromic cases of febrile illnesses with cough, body weakness, with one of a number of other symptoms compatible with acute respiratory and febrile illnesses. This resulted in a rapid increase in the number of cases meeting the definition, with a total of 891 cases reported as of 16 December 2024. However, the weekly number of reported deaths (48 deaths reported over the period) has remained relatively stable. As of 16 December, laboratory results from a total of 430 samples indicated positive results for malaria, common respiratory viruses (Influenza A (H1N1, pdm09), rhinoviruses, SARS-COV-2, Human coronaviruses, parainfluenza viruses, and Human Adenovirus). While further laboratory tests are ongoing, together these findings suggest that a combination of common and seasonal viral respiratory infections and falciparum malaria, compounded by acute malnutrition led to an increase in severe infections and deaths, disproportionally affecting children under five years of age.

There have been several cases of East African sleeping sickness among travelers returning from safari areas in Zambia and Zimbabwe (see map). Regions highlighted within Zambia and Zimbabwe depicting the approximate risk area for the disease.  African trypanosomiasis, also called sleeping sickness, is endemic in many Subsaharan countries. It is transmitted by Tsetse flies. These flies are mainly attracted by bright, dark (especially blue) colours. They inhabit rural areas, including forests and savannah areas, and areas of thick vegetation along rivers and waterholes, depending on the fly species. Tsetse flies bite during the day, <1% are infected. Risk for infection in travelers increases with the number of fly bites, which does not always correlate with duration of travel. People most likely to be exposed to African trypanosomiasis infection are hunters and villagers with infected cattle herds. Tourists and other people working in or visiting game parks are at risk for contracting African trypanosomiasis if they spend long periods in rural areas where the disease is present. Travelers to urban areas are at minimal risk, although transmission has been observed in some urban settings in the past. 

The Cuban Ministry of Public Health (MINSAP) has issued an alert for tourists planning to visit the island due to the increase in cases of hepatitis A.

On 26 Dec 2024, the Colombian Agricultural (ICA) Institute declared a state of health emergency in the department of La Guajira and dictated measures to prevent and control the outbreak in the department. The outbreak was detected in a field owned by a Wayuu community in La Guajira where more than 20 goats died. Anthrax was confirmed in 2 patients who presented skin leasions. Anthrax - caused by the spore-forming bacterium Bacillus anthracis, present on all continents, causes high mortality in ruminants. It is highly dangerous, both for animals and for public health, and has a rapid capacity to spread.

The Chinese Centre for Disease Control and Prevention (CDC) has reported a sharp increase in respiratory viral infections, including human metapneumovirus (hMPV) infections, in northern China since December 2024.  Human metapneumovirus can affect all age groups and normally causes mild-to-moderate respiratory illness but sometimes the infection can be severe in young children, older adults, and immunocompromised individuals. In the EU/EEA, hMPV is most active during late winter and spring, often circulating alongside other respiratory viruses. There is no vaccine or specific antiviral treatment available for hMPV. For more information: LINK.

The HealthyTravel team wishes you a Merry Christmas and a happy 2025 with travel in good health.