On 27 September 2024, Rwanda reported its first Marburg virus disease outbreak (see EpiNews as of 3 Oct 2024).  As of 10 October 2024, 58 cases of MVD have been reported, including 13 deaths (case fatality rate: 22%); 30 patients are in isolation. So far, 12 patients have recovered. For updates, see LINK.The cases are reported from eight of the 30 districts in the country. Among the confirmed cases, over 80% are health care workers from two health facilities in Kigali. Contact tracing is underway and follow-up of more than 300 contacts is ongoing.On 6 October 2024, vaccinations for healthcare workers and high risk contacts started as part of a Phase 2 rapid response open-label study; vaccines have been provided by Sabin Vaccine Institute.Rwanda has been implementing a number of control measures including: entry and exit screening at the airport, measures in education settings and conferences, ban on patient visits to hospitals, strengthening infection prevention and control protocols in hospitals, and measures to limit contact with dead bodies.CDC has put Rwanda on alert level 3 (Reconsider nonessential travel to the Republic of Rwanda). On 7 October 2024, the US Department of Health and Human Services announced that on the week of 14 October 2024 US CDC will start public health entry screening for those entering the country after having been to Rwanda the past 21 days, see LINK.

In 2024, as of 06 October 2024, 16 countries have reported 7’524 confirmed cases (+770 new confirmed cases within 1 week), including 32 deaths. The three countries with the majority of the cases in 2024 (all clades) are Democratic Republic of the Congo (6’169), Burundi, (n = 987), and Nigeria, (n = 84). (Note: 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 therefore never got confirmed.)In 2024, 15 countries have reported both 31’527 suspected and laboratory tested cases (+5’160 within 1 week, all clades), including 998 suspected and confirmed deaths (+2 within 1 week). According to WHO, in 2024 as of 29 Sept 2024 the cumulative confirmed mpox cases (+ cases since last update 29 Sep 2024) were reported in the below mentioned countries (for updates, details, suspected cases, epidemic curves, see WHO LINK):  Clade Ia and b:D.R. Congo: according to WHO: 5’610 (+559 cases since 29 Sept 2024; note OV: in the week before the reported number was not conclusive) Clade IbBurundi: 987 confirmed cases (+134 cases since 29 Sept 2024, stable increase of confirmed cases) (plus hundreds of suspected cases)Uganda: 69 cases (+47 cases since 29 Sept 2024)Kenya: 12 cases (+4 since 29 Sept 2024)Rwanda: 6 cases (+0 cases since 29 Sept 2024)Outside Africa: Sweden (1 case, imported from Burundi), Thailand (1 case, imported from DRC), India (1 imported case) Clade Ia:Republic of the Congo: 21 confirmed cases (+0)Central African Republic: 57 confirmed cases (+2)Cameroon: 6 cases (+0), including unknown number of cases with clade IIa and IIb Clade II (a and/or b): Côte d’Ivoire: 67 cases (+15)Cameroon: 6 cases including unknown number of cases with clade 1aGhana: 1 caseGuinea: 1 case (+0)Morocco: 3 case (+1)Nigeria: 84 cases (+6)South Africa: 25 cases (+0) In addition, mpox cases have been reported in Africa in 2024 without specification of the clade: Gabon: 2 cases (+0) Liberia: 14 cases (+1)Epicurve for Ib clade cases as 6 October 2024:

At least 35 deaths due to rabies were reported in 2024. More than 50% of the victims are children under the age of 15.

On 13 September 2024, the IHR NFP for Barbados notified WHO of one confirmed human infection with West Nile Virus (WNV) in a child. This marks the first detected human case of WNV reported from Barbados. Additionally, no infections have been previously documented in birds or horses in this country, making this case both unusual and unexpected. However, the WNV has spread throughout the Caribbean, likely via infected migratory birds. It is possible that the virus is circulating in birds and horses undetected. West Nile viruses belong to the flavivirus family and are transmitted by Culex mosquitoes. The main hosts are birds; humans are false hosts. Most cases are asymptomatic; clinically symptomatic cases develop fever and meningitis or encephalitis. Elderly persons, pregnant women and immunosuppressed persons are at higher risk for a neuroinvasive form of the disease.

The number of people affected by leptospirosis and related deaths in Kerala is increasing. In the first 4 days of October 2024 alone, 45 people were diagnosed with the disease. According to the Health Department, from 1 Jan to 4 Oct 2024, a total of 2’512 people have been diagnosed with leptospirosis, including 155 confirmed deaths. Additionally, 1’979 people sought treatment for symptoms related to the illness. Similarly, 131 deaths suspected to be caused by leptospirosis symptoms were also reported. Health officials warn that the disease is now spreading during all seasons.

As of 3 October, 130 locally acquired dengue cases have been reported by the Italian National Public Health Authority. These are 63 more cases than reported in the previous week's update. The newly reported cases were from Marche (51 cases), Emilia Romagna (14 cases) and Lombardy (one case). According to local authorities in the Marche Region, there is a decreasing trend in case numbers reported from Fano.  For 129 cases NUTS2 regions were reported:Marche (102 cases) Emilia Romagna (19 cases) Lombardy (six cases) Tuscany (one case)Veneto (one case).  An additional case (onset of symptoms 18 August, DENV 2) was reported by the Abruzzo region. However, the place of infection is currently under investigation as the infection may have occurred in another region.

In 2024 and as of 2 October 2024, 18 countries in Europe have reported 1’202 locally acquired human cases of West Nile Virus (WNV) infection with known place of infection. The earliest and latest date of onset were respectively on 1 March 2024 and 26 September 2024. Locally acquired cases were reported by Italy (422), Greece (202), Spain (114), Albania (102), Hungary (101), Romania (71), Serbia (53), Austria (34), Türkiye (30), France (27), Croatia (20), Germany (8), Slovenia (5), Kosovo (4), Slovakia (4), Bulgaria (2), North Macedonia (2) and Czechia (1).  In Europe, 88 deaths were reported by Greece (31), Italy (16), Albania (13), Romania (10), Spain (10), Bulgaria (2), Serbia (2), Türkiye (2), France (1) and North Macedonia (1).  Case numbers reported this year are above the mean monthly case count for the past 10 years. During the same period in 2023, 681 cases had been reported. However, numbers are lower than in 2018, when 1 728 cases had been reported by this time of year. Distribution of locally acquired human West Nile virus infections in 2024 till 2 October 2024:Of note, further regions of infection were reported in 2023.

On 27 September 2024, the Rwanda Ministry of Health announced the confirmation of Marburg virus disease in patients in health facilities in the country. As of 3 October, 36 cases of MVD have been reported, including 11 deaths (Case fatality rate: 31%). The cases are reported from seven of the 30 districts in the country (Gasabo, Gatsibo, Kamonyi, Kicukiro, Nyagatare, Nyarugenge and Rubavu districts). Among the confirmed cases, over 70% are health care workers from two health facilities in Kigali. Contact tracing is underway with 410 contacts under follow-up. The source of the infection is still under investigation. One contact travelled to Belgium from Rwanda. WHO was made aware of this by the public health authorities in Belgium. They shared detailed information on the contact's situation, that they remained healthy, completed the 21-day monitoring period, did not present with any symptoms, and are not a risk to public health. This is the first time MVD has been reported in Rwanda. The Government of Rwanda is coordinating the response with support from WHO and partners. The Ministry of Health of Rwanda announced several control measures including a ban on patient visits to hospitals, strengthening protocols in hospitals, and measures to limit contact with dead bodies.Rwanda will start cinical trials of experimental vaccines and treatments for MVD in the next few weeks. Marburg virus disease (MVD) is a rare but severe hemorrhagic fever, caused by Marburg virus (MARV). Although MVD is uncommon, MARV has the potential to cause outbreaks with significant case fatality rates (up to 88%). All recorded MVD outbreaks have originated in Africa.Transmission: Fruit bats are the natural reservoir of MARV. The majority of MVD outbreaks have been connected to human entry into bat-infested mines and caves. Human can also get infected by direct contact with an infected animal (e.g., non-human primate).Person-to-person transmission occur by direct contact (through broken skin or mucous membranes) with infected blood, secretions, and body fluids or by indirect contact with contaminated surfaces and materials like clothing, bedding and medical equipment MVD is not an airborne disease, and a person is not  contagious before symptoms appear. As a result, if proper infection prevention and control precautions are strictly followed, the risk of infection is regarded as minimal. Incubation period: usually five to ten days (range 2-21 days) Symptoms: The onset of MVD is usually abrupt, with non-specific, flu-like symptoms such as a high fever, severe headache, chills and malaise. Rapid worsening occurs within 2–5 days for more than half of patients, marked by gastrointestinal symptoms such as anorexia, abdominal discomfort, severe nausea, vomiting, and diarrhea. In severe cases, a rash may develop, along with bleeding from various body areas. Treatment: There are several experimental drugs and vaccines for Marburg, but none has been licensed to date.Further information, see ECDC Factsheet Marburg Virus. CDC.

On 2 October 2024, Germany reported that two travellers returning from Rwanda were isolated at the University Medical Center Hamburg (UKE) on suspicion of Marburg virus disease (MVD). Both tested negative on 3 October. One of the cases is a medical student who worked in a hospital in Rwanda, where he was exposed to a patient infected with MVD around 25 September, while wearing appropriate protective equipment. He will continue to be monitored for his own safety until the end of the incubation period of up to 21 days. In the coming days, he is to remain in quarantine at the UKE's special unit for highly contagious infectious diseases, followed by home quarantine under the supervision of the responsible public health department. The companion also tested negative and is showing mild symptoms of another disease. The companion had no contact with MVD-infected persons in Rwanda. The accompanying person will also continue to be monitored at the UKE over the weekend.

According to WHO, between 29 to 1 September 2024 (week 31 to 35), 19 countries shared their meningitis epidemiological data. Epidemic: Benin: Zoe region (Abdomey health district, crossed epidemic threshold on weeks 33 and 34)D.R. Congo: Province Sud-Ubangui and province Sankuru Alert: Benin: Bargou region, Collines regionD.R. Congo: Haut – Lomami province, Ituri province, Lomami province, Maindombe provinceGhana: Savannah regionMali: Bamako region For previous epidemics and alerts, see EpiNews or news at www.healthytravel.ch. 

As of 27 September 2024, a total of 294 Zika virus cases across 40 provinces have now been reported for 2024. More than 750 Zika cases were reported in the whole of 2023. Due to an increased number of imported Zika cases in returning travellers (n=25), particularly with exposure in the second half of 2023 (n=21), ongoing transmission of Zika virus in Thailand was assumed, leading the Swiss ECTM to issue special recommendations in February 2024 (EpiNews 2 February 2024).

Die Zahl der in den USA im Jahr 2024 bisher gemeldeten Pertussis- oder Keuchhustenfälle ist nach den neuesten Daten der Centers for Disease Control and Prevention (CDC) mehr als viermal so hoch wie zum gleichen Zeitpunkt des letzten Jahres. Bis zum 14. September wurden 14’569 Pertussis-Fälle gemeldet. Dies entspricht einem Anstieg von 319 %.  Auch Australien verzeichnet einen deutlichen Anstieg der Pertussisfälle. Laut den dortigen Gesundheitsbehörden und Stand vom 21. September dieses Jahres wurde insgesamt 29’648 Fälle, die höchste Zahl seit 2011, als 38’748 Fälle gemeldet wurden, registriert.

Starting 1 October 2024, all visitors to Zanzibar (excluding residents) must have mandatory Inbound Travel Insurance from Zanzibar Insurance Corporation. 

Between epidemiological week (EW) 1 and EW 35 of 2024, 38 confirmed human cases including 19 deaths of yellow fever (YF) have been reported in 5 countries of the Americas Region: Bolivia (7 cases, including 4 with history of YF vaccination), Brazil (3 cases, including 1 case with history of YF vaccination in 2017), Colombia (8 cases, including 1 cases with history of YF vaccination), Guyana (2 cases), and Peru (18 cases). For details, see LINK. Geographical distribution of municipalities with occurrence of yellow fever cases in humans in Bolivia, Brazil, Colombia, Guyana, and Peru, years 2022, 2023, and 2024 (as of EW 35):

Mozambican health authorities have detected measles outbreaks in 4 districts of the northern province of Cabo Delgado, and warned that the outbreaks have worsened over the past 2 months.  Neighbouring Malawi has also issued an alert after detecting measles cases.

The number for Zika cases in Pune have increased to more than 100 cases, including 5 deaths. All deaths were in elderly people with co-morbidities. End of August 2024, the US CDC issued an alert on a Zika outbreaks in the state of Maharashtra.  

In 2024 and as of 4 September 2024, 15 countries in Europe have reported 715 locally acquired human cases of WNV infection. The earliest and latest date of onset were respectively on 1 March 2024 and 29 August 2024. Locally acquired cases were reported by Italy (287), Greece (138), Albania (74), Spain (54), Hungary (43), Romania (42), Serbia (27), Austria (18), France (15), Türkiye (7), Croatia (3), Bulgaria (2), Germany (2), Kosovo (2) and North Macedonia (1). In Europe, 51 deaths were reported by Greece (17), Albania (13), Italy (10), Spain (4), Romania (3), Bulgaria (2), France (1) and Serbia (1). In addition, Slovenia reported three human cases of WNV infection through EpiPulse in the Pomurska and Podravska regions. These cases had not been reported through TESSy by 4 September and are therefore not included in this monthly WNV report. Case numbers reported this year are above the mean monthly case count of the past 10 years. For instance, during the same period in 2023, 445 cases had been reported. Numbers are, however, lower than in 2018, when 1 048 cases had been reported by this time of year. Distribution of locally acquired human West Nile virus infections in 2024 till 11 September 2024:

According to media, The emergency room at Ben M'sik hospital in Casablanca experienced an unusual number of patients with severe diarrhea, fever, nausea and stomach aches. Dozens of people suffered from food poisoning, after having apparently consumed a "magic bread" sold by one of the snack bars in the Sbata district. 

The Limpopo Provincial Government declared an outbreak of Schistosomiasis in the Mopani district of Limpopo province. The villages areas of Nkowankowa, Khujwane, and Dan are especially affected. On 7 Aug 2024, over 140 students from Malwandla Primary School were diagnosed with schistosomiasis and are currently receiving treatment with anti-parasitic medication.

The Los Angeles County Public Health Department has confirmed a case of locally acquired dengue from a resident who has no history of travel to areas where dengue fever is endemic. According to a release from the health department, the infected person resides in Baldwin Park.  It is the third case of locally acquired dengue in California and the first reported by the Los Angeles County Department of Public Health. Cases of locally acquired dengue were previously confirmed by Long Beach and Pasadena in fall 2023.