#USA, #Wastewater Data for Avian #Influenza #H5 (#CDC, March 27 '26)

 

{Excerpt}

(...)

Time Period: March 15, 2026 - March 21, 2026

-- H5 Detection: 9 site(s) (2.0%)

-- No Detection: 436 site(s) (98.0%)

-- No samples in last week: 130 site(s)

(...)

Source: 

Link: https://www.cdc.gov/nwss/rv/wwd-h5.html

_____

#UK, #England: Notified cases of invasive #meningococcal disease - Updated 27 March 2026 (UKHSA, edited)

 

{Excerpt}

(...)

Daily case figures

-- The number of confirmed and probable cases can change when:

- a case is laboratory confirmed

- when the clinical assessment changes, including when new laboratory results are available

- when further epidemiological information is available

-- The figures in Table 1 cannot be used to identify the number of new confirmed or probable cases from one day to the next. This also applies to total cases.

Table 1. Cases of invasive meningococcal disease linked to Canterbury, Kent by day from 16 March 2026

[Date - Total outbreak confirmed cases - Outbreak confirmed MenB cases (subset of total outbreak confirmed cases) - Outbreak confirmed MenB cases with outbreak strain (subset of outbreak confirmed MenB cases) - Outbreak probable cases - Total outbreak cases]

* 26 March 2026 - 20 [note 2] - 20 - 17 - 1 - 21

* 25 March 2026 - 20 [note 2] - 20 - 17 - 2 - 22

* 24 March 2026 - 20 [note 2] - 20 - 17 - 2 - 22

* 23 March 2026 - 20 [note 2] - 20 - 17 - 3 - 23

* 22 March 2026 - 20 [note 2] - 19 - [note 1] - 9 - 29

* 21 March 2026 - 20 [note 2] - 19 - [note 1] - 9 - 29

* 20 March 2026 - 23 - 18 - [note 1] - 11 - 34

* 19 March 2026 - 18 - 13 - [note 1] - 11 - 29

* 18 March 2026 - 15 - 9 - [note 1] - 12 - 27

* 17 March 2026 - 9 - 6 - [note 1] - 11 - 20

* 16 March 2026 - [note 1] - 4 - [note 1] - [note 1] - 1

__

Note 1: Information not reported

Note 2: A case initially classified as a confirmed case may be reclassified or discarded when further laboratory results and clinical information is available. This applies to situations where:

- further testing (including results from specialist reference laboratories) rules out meningococcal disease

and 

- there is an alternative diagnosis or where the clinical picture is no longer consistent with meningococcal infection

__

Note: The case numbers presented in Table 1 were confirmed at specific times of day for each of the releases: 16 March 2026 verified at 5:00pm, 17 March 2026 verified at 3:00pm, 18 March 2026 onwards verified at 12:30pm.

-- There have been 2 deaths since the start of the incident.

(...)

Source: 

Link: https://www.gov.uk/government/publications/invasive-meningococcal-disease-statistical-releases/notified-cases-of-invasive-meningococcal-disease

____

#Finland - #Influenza A #H5N1 viruses of high pathogenicity (Inf. with) (non-poultry including wild birds) (2017-) - Immediate notification

 

Two wild Canada Geese in the Lounais-Suomen aluehallintovirasto Region.

Source: 

Link: https://wahis.woah.org/#/in-review/7401

____

#Mpox - cMulti-country external #situation #report no. 64, published 26 March 2026 (#WHO, summary)

 

{Excerpt}

Highlights

• Transmission of mpox continues mostly within sexual networks, affecting both women and men, followed by household transmission, and in some historically endemic areas, affecting all age groups. 

- All clades of monkeypox virus (MPXV) continue to circulate. 

- Unless mpox outbreaks are rapidly contained and human-to-human transmission is interrupted, there is a risk of sustained community transmission in all settings. 

• In February 2026, 46 countries across all WHO regions reported a total of 1184 confirmed mpox cases, including four deaths (case fatality ratio [CFR] 0.3%). 

- Of these cases, 58.6% were reported in the WHO African Region. 

• Four WHO regions – the Region of the Americas and the African, South-East Asian and Western Pacific regions – reported a decline in confirmed cases in February, compared to January 2026, while the European Region reported an increase in confirmed cases. 

- The Eastern Mediterranean Region reported the same monthly case count in January and February 2026.

• Seventeen countries in Africa reported active transmission of mpox in the last six weeks (1 February – 15 March 2026), with 907 confirmed cases, including seven deaths (CFR 0.8%). 

- Countries reporting the highest number of cases in this period are Madagascar, the Democratic Republic of the Congo, Kenya, Burundi, and Liberia. 

• Three countries, Argentina, Austria, and the Central African Republic, have reported mpox due to clade Ib MPXV for the first time. 

• Outside Africa, community transmission of clade Ib MPXV continues in the WHO European Region, with Austria, Belgium, Portugal, Spain, and the United Kingdom of Great Britain and Northern Ireland reporting community transmission, including in sexual networks of men who have sex with men.  

• This report provides an update on mpox outbreak transmission dynamics across different clades and settings. 

• On 7 April 2026, World Health Day, WHO will join a One Health summit convened by the Government of France. 

- The Summit will foster international and interdisciplinary dialogue to highlight the interdependence of human, animal, plant and ecosystem health, and the need for coordinated, science-based approaches to address shared health threats, including for emergency response. 

(...)

Source: 

Link: https://www.who.int/publications/m/item/multi-country-outbreak-of-mpox--external-situation-report--64---26-march-2026

____

#UK, #England: Notified cases of invasive #meningococcal disease - Updated 26 March 2026 (UKHSA, edited)

{Excerpt}

(...) 

Daily case figures

-- The number of confirmed and probable cases can change when:

- a case is laboratory confirmed

- when the clinical assessment changes, including when new laboratory results are available

- when further epidemiological information is available

-- The figures in Table 1 cannot be used to identify the number of new confirmed or probable cases from one day to the next. This also applies to total cases.

Table 1. Cases of invasive meningococcal disease linked to Canterbury, Kent by day from 16 March 2026

[Date - Total outbreak confirmed cases - Outbreak confirmed MenB cases (subset of total outbreak confirmed cases) - Outbreak confirmed MenB cases with outbreak strain (subset of outbreak confirmed MenB cases) - Outbreak probable cases - Total outbreak cases]

* 25 March 2026 - 20 [note 2] - 20 - 17 - 2 - 22

* 24 March 2026 - 20 [note 2] - 20 - 17 - 2 - 22

* 23 March 2026 - 20 [note 2] - 20 - 17 - 3 - 23

* 22 March 2026 - 20 [note 2] - 19 - [note 1] - 9 - 29

* 21 March 2026 - 20 [note 2] - 19 - [note 1] - 9 - 29

* 20 March 2026 - 23 - 18 - [note 1] - 11 - 34

* 19 March 2026 - 18 - 13 - [note 1] - 11 - 29

* 18 March 2026 - 15 - 9 - [note 1] - 12 - 27

* 17 March 2026 - 9 - 6 - [note 1] - 11 - 20

* 16 March 2026 - [note 1] - 4 - [note 1] - [note 1] - 1

__

Note 1: Information not reported

Note 2: A case initially classified as a confirmed case may be reclassified or discarded when further laboratory results and clinical information is available. This applies to situations where:

- further testing (including results from specialist reference laboratories) rules out meningococcal disease

and 

- there is an alternative diagnosis or where the clinical picture is no longer consistent with meningococcal infection

__

Note: The case numbers presented in Table 1 were confirmed at specific times of day for each of the releases: 16 March 2026 verified at 5:00pm, 17 March 2026 verified at 3:00pm, 18 March 2026 onwards verified at 12:30pm.

-- There have been 2 deaths since the start of the incident.

(...)

Source: 

Link: https://www.gov.uk/government/publications/invasive-meningococcal-disease-statistical-releases/notified-cases-of-invasive-meningococcal-disease

____

#Italy, First European imported #Human Case of an #H9N2 avian #influenza virus infection discovered in #Lombardy (Press Release, March 25 '26)

 

"Thanks to the epidemiological surveillance network active in the region, the first European {imported} case of avian influenza of the H9 subtype has been identified in a patient arriving from abroad," said the Regional Councilor for Welfare.

The Lombardy Region immediately activated coordination procedures with the Ministry of Health and the Istituto Superiore di Sanità (ISS) to ensure the utmost rigor in managing the case and monitoring contacts.

The councilor added: 

"The patient is currently hospitalized in isolation at San Gerardo Hospital in Monza. In addition to treatment for the viral infection, the medical team is managing other comorbidities the patient is suffering from. The epidemiological investigation was promptly conducted by ATS Brianza, while the molecular analyses that allowed for the precise identification of the virus were performed by the University of Milan and confirmed by the Regional Center for Infectious Diseases (composed of the Directorate General for Welfare – Prevention Unit of the Lombardy Region, ASST Fatebenefratelli-Sacco and San Matteo di Pavia) and the ISS."

"The identification of the first European case of H9 influenza in Lombardy," ​​emphasized, "shouldn't be a cause for alarm for the public, but it is tangible proof that our prevention system is working with extreme precision. We acted very quickly." (LNews)

Source: 

Link: https://www.lombardianotizie.online/comunicato-stampa/lombardia-influenza-h9/

____

#UK, #England: Notified cases of invasive #meningococcal disease - Updated 25 March 2026 (UKHSA, edited)

 

{Excerpt}

(...)

Daily case figures

-- The number of confirmed and probable cases can change when:

- a case is laboratory confirmed

- when the clinical assessment changes, including when new laboratory results are available

- when further epidemiological information is available

__

The figures in Table 1 cannot be used to identify the number of new confirmed or probable cases from one day to the next. This also applies to total cases.

Table 1. Cases of invasive meningococcal disease linked to Canterbury, Kent by day from 16 March 2026

[Date - Total outbreak confirmed cases - Outbreak confirmed MenB cases (subset of total outbreak confirmed cases) - Outbreak confirmed MenB cases with outbreak strain (subset of outbreak confirmed MenB cases) - Outbreak probable cases - Total outbreak cases]

* 24 March 2026 - 20 [note 2] - 20 - 17 - 2 - 22

* 23 March 2026 - 20 [note 2] - 20 - 17 - 3 - 23

* 22 March 2026 - 20 [note 2] - 19 - [note 1] - 9 - 29

* 21 March 2026 - 20 [note 2] - 19 - [note 1] - 9 - 29

* 20 March 2026 - 23 - 18 - [note 1] - 11 - 34

* 19 March 2026 - 18 - 13 - [note 1] - 11 - 29

* 18 March 2026 - 15 - 9 - [note 1] - 12 - 27

* 17 March 2026 - 9 - 6 - [note 1] - 11 - 20

* 16 March 2026 - [note 1] - 4 - [note 1] - [note 1] - 1

__

Note 1: Information not reported

Note 2: A case initially classified as a confirmed case may be reclassified or discarded when further laboratory results and clinical information is available. This applies to situations where:

- further testing (including results from specialist reference laboratories) rules out meningococcal disease

and 

- there is an alternative diagnosis or where the clinical picture is no longer consistent with meningococcal infection

__

Note: The case numbers presented in Table 1 were confirmed at specific times of day for each of the releases: 16 March 2026 verified at 5:00pm, 17 March 2026 verified at 3:00pm, 18 March 2026 onwards verified at 12:30pm.

- There have been 2 deaths since the start of the incident.

(...)

Source: 

Link: https://www.gov.uk/government/publications/invasive-meningococcal-disease-statistical-releases/notified-cases-of-invasive-meningococcal-disease

____

#UK, #England: Notified cases of invasive #meningococcal disease - Updated 24 March 2026 (UKHSA, edited)

 

{Excerpt}

(...)

Daily case figures

-- The number of confirmed and probable cases can change when:

- a case is laboratory confirmed

- when the clinical assessment changes, including when new laboratory results are available

- when further epidemiological information is available

-- The figures in Table 1 cannot be used to identify the number of new confirmed or probable cases from one day to the next. This also applies to total cases.

Table 1. Cases of invasive meningococcal disease linked to Canterbury, Kent by day from 16 March 2026

[Date - Total confirmed cases - Confirmed MenB cases (subset of total confirmed cases) - Probable cases - Total cases]

* 23 March 2026 - 20 [note 2] - 20 - 3 - 23

* 22 March 2026 - 20 [note 2] - 19 - 9 - 29

* 21 March 2026 - 20 [note 2] - 19 - 9 - 29

* 20 March 2026 - 23 - 18 - 11 - 34

* 19 March 2026 - 18 - 13 - 11 - 29

* 18 March 2026 - 15 - 9 - 12 - 27

* 17 March 2026 - 9 - 6 - 11 - 20

* 16 March 2026 - [note 1] - 4 - [note 1] - 15

__

Note 1: The distinction between a confirmed case and a probable case was not reported

Note 2: A case initially classified as a confirmed case may be reclassified or discarded when further laboratory results and clinical information is available. This applies to situations where:

- there are other negative results, for example, reference unit results 

and 

- there is an alternative diagnosis or where the clinical picture is no longer consistent with meningococcal infection

__

Note: The case numbers presented in Table 1 were confirmed at specific times of day for each of the releases: 16 March 2026 verified at 5:00pm, 17 March 2026 verified at 3:00pm, 18 March 2026 onwards verified at 12:30pm.

There have been 2 deaths since the start of the incident.

(...)

Source: 

Link: https://www.gov.uk/government/publications/invasive-meningococcal-disease-statistical-releases/notified-cases-of-invasive-meningococcal-disease

____

#Nepal - #Influenza A #H5N1 viruses of high pathogenicity (Inf. with) (non-poultry including wild birds) (2017-) - Immediate notification

 

There is an observation of death of several numbers (30) of crows in the jungle of Tribhuvan University premises.

Source: 

Link: https://wahis.woah.org/#/in-review/7387

____

#Nepal - High pathogenicity avian #influenza #H5N1 viruses (Inf. with) (#poultry) - Immediate notification

Frequent sightings of wild birds were reported in the vicinity of the farm. The farm comprises multiple poultry sheds having birds of different age (4-56 weeks) groups. On 15 March, a sudden mortality event occurred in one shed, where approximately 100 commercial layer birds died acutely. Since that incident, mortality has been observed across all sheds on the farm.

Commercial Layers of various age (4-56 weeks) group affected since 15 March, 2026 and a large number of chicken appear slightly droopy or depressed, and die suddenly.

Source: 

Link: https://wahis.woah.org/#/in-review/7386

____

#Denmark - #Influenza A #H5N5 viruses of high pathogenicity (Inf. with) (non-poultry including wild birds) (2017-) - Immediate notification

 

{A black headed gull. By © Hans Hillewaert, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=5548312}

__

According to article 10.4.1.4 of the Terrestrial Animal Health Code, Member Countries should not impose bans on the trade in poultry commodities in response to notification on the presence of any influenza A virus in birds other than poultry

A wild black-headed gull.

Source: 

Link: https://wahis.woah.org/#/in-review/7385

____

#UK, #England: Notified cases of invasive #meningococcal disease - Updated 23 March 2026 (UKHSA, edited)

 

{Excerpt}

(...)

Daily case figures

-- The number of confirmed and probable cases can change when:

- a case is laboratory confirmed

- when the clinical assessment changes, including when new laboratory results are available

- when further epidemiological information is available

-- The figures in Table 1 cannot be used to identify the number of new confirmed or probable cases from one day to the next. This also applies to total cases.

Table 1. Cases of invasive meningococcal disease linked to Canterbury, Kent by day from 16 March 2026

[Date - Total confirmed cases - Confirmed MenB cases (subset of total confirmed cases) - Probable cases - Total cases]

* 22 March 2026 - 20 [note 2] - 19 -9 - 29

* 21 March 2026 - 20 [note 2] - 19 - 9 - 29

* 20 March 2026 - 23 - 18 - 11 - 34

* 19 March 2026 - 18 - 13 - 11 - 29

* 18 March 2026 - 15 - 9 - 12 - 27

* 17 March 2026 - 9 - 6 - 11 - 20

* 16 March 2026 - [note 1] - 4 - [note 1] - 15

__

Note 1: The distinction between a confirmed case and a probable case was not reported

Note 2: A case initially classified as a confirmed case may be reclassified or discarded when further laboratory results and clinical information is available. This applies to situations where:

- there are other negative results, for example, reference unit results 

and 

- there is an alternative diagnosis or where the clinical picture is no longer consistent with meningococcal infection

__

Note: The case numbers presented in Table 1 were confirmed at specific times of day for each of the releases: 16 March 2026 verified at 5:00pm, 17 March 2026 verified at 3:00pm, 18 March 2026 onwards verified at 12:30pm.

-- There have been 2 deaths since the start of the incident.

(...)

Source: 

Link: https://www.gov.uk/government/publications/invasive-meningococcal-disease-statistical-releases/notified-cases-of-invasive-meningococcal-disease

____

#UK, #England: Notified cases of invasive #meningococcal disease (UKHSA, Updated 22 March 2026)

{Excerpt}

(...)

Table 1. Cases of invasive meningococcal disease linked to Canterbury, Kent by day from 16 March 2026

[Date - Total confirmed cases - Confirmed MenB cases (subset of total confirmed cases) - Probable cases - Total cases]

* 21 March 2026 - 20 [note 2] - 19 - 9 - 29 {-5} 

* 20 March 2026 - 23 - 18 - 11 - 34 {+5} 

* 19 March 2026 - 18 - 13 - 11 - 29 {+2}

* 18 March 2026 - 15 - 9 - 12 - 27 {+7}

* 17 March 2026 - 9 - 6 - 11 - 20 {+5}

* 16 March 2026 - [note 1] - 4 - [note 1] - 15

__

Note 1: The distinction between a confirmed case and a probable case was not reported

Note 2: A case initially classified as a confirmed case may be reclassified or discarded when further laboratory results and clinical information is available, that is:

- where there are other negative results, for example, reference unit results 

and 

- where there is an alternative diagnosis or where the clinical picture is no longer consistent with meningococcal infection

The case numbers presented in Table 1 were confirmed at specific times of day for each of the releases: 16 March 2026 verified at 5:00pm, 17 March 2026 verified at 3:00pm, 18 March 2026 onwards verified at 12:30pm.

There have been 2 deaths since the start of the incident.

(...)

Source: 

Link: https://www.gov.uk/government/publications/invasive-meningococcal-disease-statistical-releases/notified-cases-of-invasive-meningococcal-disease

____

#UK, #England: Notified cases of invasive #meningococcal #disease - Updated 21 March 2026 (UKHSA)

 

Overview

-- The UK Health Security Agency (UKHSA) has been investigating an invasive meningococcal disease (IMD) outbreak first detected in March 2026.

-- This release provides an up-to-date count of confirmed or probable notified cases connected to the incident, and will be updated regularly.

-- Case numbers will be recorded at 12:30pm each day, and will include only those defined as either confirmed or probable. These figures will be published the following day at 9:30am.

-- As this is a live incident, there will be additional suspected cases notified to UKHSA, which need to be actively investigated. These will not be reported until the investigation determines that they should be included as either confirmed or probable cases, or discarded as not related to the incident.

-- Case counts attached to the incident are provisional and subject to change (upwards or downwards) as intelligence about their connection to the incident improves, clinical assessment changes, or further microbiological characterisation becomes available. In outbreaks, case definitions are updated as new intelligence comes to light, which may affect the counts.

Notified cases of invasive meningococcal disease linked to Canterbury, Kent

-- As of 12:30pm on 20 March 2026, UKHSA has been notified of 23 confirmed and 11 probable cases of invasive meningococcal disease with epidemiological links to Canterbury, Kent.

- 18 of the 23 confirmed cases are meningococcal group B (MenB).

- All cases have been hospitalised.

- There have been 2 deaths since the start of the incident.

Daily case figures

-- The number of probable cases can change when:

- a case is laboratory confirmed

-- when the clinical assessment changes, including when new laboratory results are available

- when further epidemiological information is available

-- The figures in Table 1 cannot be used to identify the number of new probable cases from one day to the next. This also applies to total cases.

Table 1. Cases of invasive meningococcal disease linked to Canterbury, Kent by day from 16 March 2026

[Date - Total confirmed cases - Confirmed MenB cases (subset of total confirmed cases) - Probable cases - Total cases]

* 20 March 2026 - 23 - 18 - 11 - 34

* 19 March 2026 - 18 - 13 - 11 - 29

* 18 March 2026 - 15 - 9 - 12 - 27

* 17 March 2026 - 9 - 6 - 11 - 20

* 16 March 2026 - [note 1] - 4  - [note 1] - 15

__

Note 1: The distinction between a confirmed case and a probable case was not reported

- The case numbers presented in Table 1 were confirmed at specific times of day for each of the releases: 16 March 2026 verified at 5:00pm, 17 March 2026 verified at 3:00pm, 18 March 2026 onwards verified at 12:30pm.

- There have been 2 deaths since the start of the incident.

Definitions

-- Confirmed MenB case

- For the purposes of the official counts related to the outbreak detected in Kent, a confirmed MenB case is counted only where an individual meets the following criteria:

* a clinical diagnosis of meningitis, sepsis, or other invasive disease (for example orbital cellulitis, septic arthritis)

and at least one of the following:

* Neisseria meningitidis isolated from a normally sterile site

* Gram-negative diplococci identified in a normally sterile site

* meningococcal DNA in a normally sterile site

* meningococcal antigen in blood, cerebrospinal fluid (CSF) or urine

and

* a confirmed meningococcal group B result from the Meningococcal Reference Unit (MRU), UKHSA or accredited laboratory

and

* an onset of infection since 1 March 2026

and

* an epidemiological link to the outbreak (see definition below)

-- Confirmed case (awaiting microbiological group)

- As above, awaiting microbiological group result.

-- Probable case

- For the purposes of the official counts related to the outbreak detected in Kent, a probable case is counted only where an individual meets the following criteria:

* a clinical diagnosis of meningitis or sepsis or other invasive disease where a doctor and/or microbiologist considers that meningococcal infection is the most likely diagnosis

and

* an onset of infection since 1 March 2026

and

* an epidemiological link to the outbreak (see definition below)

-- Epidemiological link to the outbreak

- For the purposes of the official counts related to the outbreak detected in Kent, a case is considered to have an epidemiological link to the outbreak only where the individual meets any of the following criteria:

* lived in or visited Canterbury, Kent since 1 March 2026

or

* close contact with an outbreak confirmed or outbreak probable case

or

* close contact with an individual who, since 1 March 2026, has lived in or visited Canterbury, Kent

or

* close contact with an individual who falls into one or more groups who have been offered chemoprophylaxis as part of this outbreak

-- Data quality assurance

- Data quality was assured via a manual checking process. Case counts attached to the incident are provisional and subject to change (upwards or downwards) as intelligence about their connection to the incident improves, clinical assessment changes or further microbiological characterisation becomes available.

(...)

Source: 

Link: https://www.gov.uk/government/publications/invasive-meningococcal-disease-statistical-releases/notified-cases-of-invasive-meningococcal-disease

____

Rapid #risk #assessment, acute event of potential public health concern: #Diphtheria, #Africa Region (#WHO, March 20 '26)

{Summary)

Risk statement

-- This WHO Rapid Risk Assessment (RRA, v2) aims to assess the risk of diphtheria at the regional level, considering the public health impact, the risk of geographical spread and the risk of insufficient control capacities with available resources. 

-- Diphtheria is a major public health problem in the WHO African Region (AFR) despite significant efforts on immunization in the past decades (e.g. introduction of DTP vaccine in the Expanded Program on Immunisation in 1974). 

-- Between 2000 and 2024, 75 789 diphtheria suspected cases were reported across the Region with an average 3 500 cases per year.    

-- Between the beginning of 2025 and as of 1 March 2026, over 29 000 suspected diphtheria cases with 1 420 deaths (CFR 4.9%) have been reported across these eight countries: Algeria, Chad, Guinea, Mali, Mauritania, Niger, Nigeria and South. 

-- This represents a 67% increase in the number of suspected cases (11 749 additional cases) and a 59.4% increase in the number of deaths (529 additional deaths) reported since the last WHO RRA (v1) conducted in October 2025, Nigeria continues to account for the majority of suspected cases (62.6%) and deaths (66%) in the Region. 

-- Of the 18 130 total confirmed cases (clinically compatible, laboratory-confirmed and epidemiologically linked) across the eight affected countries, 752 (4%) cases were recorded as laboratory-confirmed: Algeria (8), Chad (1), Guinea (48), Mali (66), Mauritania (12), Niger (313), Nigeria (211) and South Africa (93).     

-- Case data trends from 2026 have been difficult to interpret, with extremely delayed case reporting from countries (both to the national and regional levels), and instances of under-reporting also being notified, particularly from humanitarian settings. 

-- However, a lower number of cases are being consistently reported than earlier in the outbreak and thus it appears that new cases continue to decline or plateau, as seen in half of the affected countries (Chad, Mali, Mauritania, and Nigeria).    

-- Since the first WHO RRA (v1) conducted in October 2025, the regional CFR remains around 5%. 

-- While Guinea continues to report among the highest CFRs in the region at 19%, South Africa’s CFR has increased since the last WHO RRA (v1) to 19%.  

-- Children aged 5–14 yrs (57%) and females (63%) are the most affected; where information is available on the vaccination status of cases, most cases are unvaccinated, under-vaccinated, or with unknown vaccination status.   

-- While the overall risk was previously assessed as “HIGH” at the regional level in October 2025, it is now considered “MODERATE” due to:  

• Overall declining trend in number of weekly cases regionally, with country-specific trends also declining in half of the affected countries (Chad, Mali, Mauritania and Nigeria), and only sporadic cases reported from South Africa. 

• Strengthened coordination of public health response through the activation of an Incident Management System (IMS) in most of the affected countries. A joint Regional Office for Africa (AFRO) and WHO headquarters (HQ) IMS structure was activated to support the regional coordination of the response, with high-level ministerial commitment to controlling the outbreaks in the affected countries.  

• Implementation of immunization activities as part of the outbreak response in most of the affected countries. 

• Strengthening of surveillance, case management, community sensitization, through capacity building activities, and the provision of diphtheria antitoxin (DAT), antibiotics, laboratory supplies, etc.  

-- Nonetheless, some challenges continue to prevent the effective containment of these outbreaks:  

• The complex humanitarian situation in many of the affected countries continues to contribute to poor access to immunization and healthcare services for internally displaced persons (IDPs), nomads, miners, and migrants. Unsanitary living conditions (in displacement camps) are also favouring the transmission of diphtheria. These increase the exposure risk of vulnerable groups (particularly women and children) to diseases.   

• Limited laboratory confirmation due to lack of reagents, sample transportation challenges and limited available of laboratory capacity.  

• In most of the affected countries, the annual coverage for routine diphtheria vaccination remains below the national targets thereby contributing to the resurgence of cases and outbreaks.  

• Global scarcity of DAT for the treatment of affected persons. 

• High internal and cross-border movements of susceptible individuals (unvaccinated or not fully vaccinated). 

• Persistent funding challenges across most affected countries exacerbated by the current challenging international funding landscape.  

-- The overall risk at the global level remains ‘’LOW’’ due to: 

- The global risk of diphtheria outbreaks from the ongoing multi-country diphtheria outbreak in the African region is assessed as low, given the existence of routine immunization programs in most countries. 

- Nonetheless, the risk posed by international travel of susceptible populations from the WHO African Region cannot be overlooked, highlighting the need to strengthen risk communication, demand generation and reactive immunisation, as well as the need for enhanced data sharing and surveillance globally. 

(...)

Source: 

Link: https://www.who.int/publications/m/item/who-rapid-risk-assessment---diphtheria--african-region-v.2

____

14th Meeting of #WHO #Expert Working Group of the Global #Influenza #Surveillance and Response System (GISRS) for Surveillance of #Antiviral Susceptibility (March 20 '26)

Weekly epidemiological record 

20 MARCH 2026, 101th YEAR, No 12, 2026, 101, 53–56

http://www.who.int/wer 

Executive Summary 

The WHO Expert Working Group on Surveillance of Influenza Antiviral Susceptibility (AVWG) supports the WHO GISRS by providing practical guidance for monitoring antiviral susceptibility of seasonal and emerging influenza viruses through global surveillance efforts. 

The 14th WHO-AVWG meeting was held in virtual format on 10-12 June 2025. 

Update on susceptibility of seasonal influenza viruses to approved antiviral agents 

From approximately May 2024 to May 2025, five WHO Collaborating Centres (CCs) and two National Influenza Centres (NICs) reported co-circulation of influenza A(H1N1) pdm09, A(H3N2), and B/Victoria viruses. 

A(H1N1)pdm09 dominated in Eastern Asia{1}. Elevated frequency of influenza neuraminidase (NA) inhibitor (NAI) reduced inhibition/ highly reduced inhibition (RI/HRI) was identified among A(H1N1)pdm09 viruses, largely conferred by the NA-H275Y substitution. 

Reporting frequency was 3.8% in China, lower (≤1%) in other reporting regions, but still measurable and were in some cases a result of prior antiviral use or specific local outbreaks (e.g., a hospital in Iceland with a NA-H275Y+S247N cluster, a primary school classroom outbreak in Japan{2}. The NA-S247N substitution (≤3.3%) was also noted by three centres, but these viruses exhibited normal inhibition (NI) by NAIs when available isolates were tested. 

Incidence of RI/HRI or NA-associated markers were less frequently reported for A(H3N2) and B/Victoria viruses than A(H1N1)pdm09 viruses. 

Markers and incidence of reduced susceptibility to baloxavir was detected at low frequencies of 0.07 to 2.2%, where the latter value represented a small sample set of only 2 of 89 viruses in Japan. 

Reduced susceptibility or amino acid markers indicative of reduced susceptibility were observed only in influenza A viruses and not influenza B. 

Update on susceptibility of zoonotic and animal influenza viruses  to approved antiviral agents 

From approximately May 2024 to May 2025, global surveillance data from WHO CCs, NICs, and associated partners including WHO Essential Regulatory Laboratories and the OFFLU (WOAH/FAO Network of Expertise on Animal Influenza) network reported that most zoonotic and avian influenza viruses, particularly circulating A(H5N1/x) HA clade 2.3.4.4b and 2.3.2.1a/e viruses, were broadly susceptible to NAIs and baloxavir. 

A(H5N1) 2.3.4.4b virus oseltamivir inhibitory concentrations remain elevated vs. seasonal N1 viruses. 

Small and isolated incidence of NAI associated RI/HRI or markers included: NA-D199G mediated oseltamivir/zanamivir RI detected in A(H5N1) 2.3.4.4b poultry in the Russian Federation (February 2024, reported June 2025), NA-N295S in poultry in India A(H5N1) 2.3.2.1a isolates, and 8 poultry farms in British Columbia, Canada exhibiting A(H5N1) 2.3.4.4b with NA-H275Y. 

Only two viruses with reduced baloxavir susceptibility were identified, 1 human virus with PA-I38M (California, USA) and 1 environmental virus isolate with PA-V100I (China, Hong Kong Special Administrative Region). 

Beyond A(H5N1/x), nearly 30 avian influenza subtypes including A(H9N2), A(H7N2), A(H7N7), and A(H7N9), and A(H10N7) were analysed across surveillance sites in the Bangladesh, Egypt, the Netherlands and the United States of America (USA). 

They generally lacked NA or PA genotypic markers of reduced drug susceptibility and when available for phenotypic testing, were susceptible to both NAIs and baloxavir. 

A(H7N2) and A(H7N7) viruses from the Netherlands displayed oseltamivir RI compared to human seasonal references, but this may be due to foldchange comparison to a mismatched NA subtype. 

Swine-origin variant viruses (A(H1N1)v, A(H1N2)v, A(H3N2)v) tested across the USA and Europe were largely free of genotypic or phenotypic indicators of reduced susceptibility/inhibition to NAIs or baloxavir. 

Some viruses (the  Netherlands) showed slightly higher NAI median inhibitory concentrations to historical or human seasonal baselines, but all remained below NAI RI thresholds. 

Update of protocols and guidance for GISRS laboratories 

Both genotypic and phenotypic assays may be used as tools to monitor susceptibility of influenza viruses to NAIs and baloxavir. 

The WHO-AVWG routinely reviews and updates influenza NA and PA amino acid substitutions associated with reduced susceptibility to NAIs and baloxavir; updated tables for the previous reporting period were included on the WHO website{3–5}. 

The US CDC continues to update and ship reference virus panels that can be used for NAI and baloxavir susceptibility testing, available via the International Reagent Resource{6} 

Further guidance on baloxavir and other PA inhibitor testing included the Influenza Replication Inhibition Neuraminidase-based Assay (IRINA), published by the Centers for Disease Control and Prevention, USA{7} and included on the WHO website{8}. 

The WHO AVWG continues to develop algorithms for NICs to aid in influenza response planning (zoonotic, pandemic, and antiviral resistance-specific events), guidance to aid in decisions making for testing strategies (genotypic vs. phenotypic), and guidance for consideration of baloxavir and PA inhibitor specific amino acid substitutions associated with reduced drug susceptibility{9}. 

Additionally, the WHO-AVWG has worked with GISAID to continue to refine and implement modifications to existing tools to facilitate identification of NA and PA substitutions upon sequence submission. 

Outbreak and pandemic preparedness with clinicians’ perspectives 

Two physicians, Profs. Prof. David Hui and Bin Cao, were invited to present recently updated WHO guidance on clinical practice guidelines for influenza{10}. 

Significant updates and discussion surrounded inclusion of baloxavir, which was conditionally recommended for non-severe disease high-risk patients and post-virus exposure prophylaxis (PEP) including influenza viruses associated with high mortality. 

Conditional recommendation against any NAI or baloxavir intervention remains for non-severe disease low-risk patients or seasonal virus PEP. 

Data was presented on multiple PA inhibitors rapidly moving through late-stage clinical trials in China which may have implications on expanded usage of this newer class of influenza drugs. 

Review of External Quality Assessment Programme (EQAP) panels 

EQAP was initiated in 2007 to monitor the quality of GISRS, NICs, other national influenza reference laboratories’ capacity for influenza diagnosis and detection. 

An optional antiviral phenotypic NAI panel was introduced in 2013, and genotypic baloxavir susceptibility was introduced in 2020. 

Results for the 2024 Global EQAP panel were reported during the 14th WHO-AVWG meeting. 

Of the 194 participating laboratories, 26.3% participated in NAI susceptibility testing. 

Results and subsequent discussion from this year’s panel were used by members of WHO-AVWG to assess the training needs of NICs. 

Way forward 

The 2020–2023 Annual Global Update on the Susceptibility of Influenza Viruses (Global AVS) manuscript was published{11} and drafting of a 2023–2025 publication is underway. The next WHO-AVWG meeting will be held in June 2026.

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{1} World Health Organization. Influenza Transmission Zones. 2026. https://cdn.who.int/media/docs/ default-source/influenza/influenzaupdates/2025_09_24_influenza-transmission-zones. pdf?sfvrsn=22361408_3&download=true. 

{2} Takashita E, Shimizu K, Usuku S, Senda R, Okubo I, Morita H, et al. An outbreak of influenza A(H1N1) pdm09 antigenic variants exhibiting cross-resistance to oseltamivir and peramivir in an elementary school in Japan, September 2024. Euro Surveill. 2024;29(50).

{3} World Health Organization. Summary of neuraminidase (NA) amino acid substitutions assessed for their effects on inhibition by neuraminidase inhibitors (NAIs). 2025. https://cdn.who.int/media/docs/default-source/ influenza/laboratory---network/quality-assurance/human-nai-marker-table_ for-publication_final_20240918.pdf. 

{4} World Health Organization. Summary of neuraminidase (NA) amino acid substitutions assessed for their effects on inhibition by NA inhibitors (NAIs) among avian influenza viruses of Group 1 (N1, N4, N5, N8 subtypes) and Group 2 (N2, N3, N6, N7, N9 subtypes) NAs. 2025. https://cdn.who.int/media/ docs/default-source/influenza/avwg/avian-nai-marker-whotable__10-10-2025.pdf?sfvrsn=bc0d1e9a_10 

{5} World Health Organization. Summary of polymerase acidic protein (PA) amino acid substitutions assessed for their effects on PA inhibitor (PAI) baloxavir susceptibility. 2025. https://cdn.who.int/media/docs/default-source/influenza/ laboratory---network/quality-assurance/antiviral-susceptibility-influenza/ pa-marker-who-table_28-11-2025_updated.pdf?sfvrsn=5307d6fe_4. 

{6} International Reagent Resource. 2026. https://www. internationalreagentresource.org/. 

{7} Patel MC, Flanigan D, Feng C, Chesnokov A, Nguyen HT, Elal AA, et al. An optimized cell-based assay to assess influenza virus replication by measuring neuraminidase activity and its applications for virological surveillance. Antiviral Res. 2022;208:105457. 

{8} World Health Organization. Baloxavir Susceptibility Assessment using Influenza Replication Inhibition Neuraminidase-based Assay (IRINA). https:// cdn.who.int/media/docs/default-source/influenza/avwg/cdc-phenotypic-lp492rev01d---baloxavir-susceptibility-assessment-using-irina.pdf? 

{9} Patel MC, Nguyen HT, Mishin VP, Pascua PNQ, Champion C, Lopez-Esteva M, et al. Antiviral susceptibility monitoring: testing algorithm, methods, and f indings for influenza season, 2023-2024. Antiviral Res. 2025;244:106299. 

{10} World Health Organization. Clinical practice guidelines for influenza 2024. https://www.who.int/publications/i/item/9789240097759.

{11} Hussain S, Meijer A, Govorkova EA, Dapat C, Gubareva LV, Barr I, et al. Global update on the susceptibilities of influenza viruses to neuraminidase inhibitors and the cap-dependent endonuclease inhibitor baloxavir, 2020-2023. Antiviral Res. 2025:106217.

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Source: 

Link: https://iris.who.int/server/api/core/bitstreams/1ea408da-cd90-438b-b80c-b00aaf4e7315/content

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#USA, #Wastewater Data for Avian #Influenza #H5 (#CDC, March 20 '26)

 

{Excerpt}

Time Period: March 08, 2026 - March 14, 2026

-- H5 Detection: 8 site(s) (1.8%)

-- No Detection: 444 site(s) (98.2%)

-- No samples in last week: 120 site(s)

(...)

Source: 

Link: https://www.cdc.gov/nwss/rv/wwd-h5.html

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#UK, #England: Expansion of #Meningitis B #vaccination offer to #Kent #Students (UKHSA, March 19 '26)

 

The Meningitis B vaccine will now be offered to everyone who has been offered preventative antibiotic treatment as part of this outbreak.

-- Vaccination will now be extended to everyone who has been offered preventative antibiotic treatment as part of this outbreak.

-- Preventative antibiotics – and vaccination – will also now be offered to the 6th form students (years 12 and 13) in schools and colleges in Kent where confirmed or probable cases are identified.

-- On a case-by-case basis, future risk assessment may also support use in other year groups or settings.

-- Students can, and should, continue to attend schools and colleges as normal. 

-- The NHS Kent and Medway website will be updated shortly with vaccination sites for those eligible.

-- The key intervention to protect people and halt the spread remains for people to come forward for antibiotic treatment. A single course of antibiotics is highly effective in preventing the contraction and spread of this disease in 90% of cases.

-- As a further precautionary measure, we are extending the offer of antibiotic prophylaxis and vaccine to any individuals who attended Club Chemistry from the 5 March until it closed voluntarily on 15 March.

-- 20,000 vaccines from the NHS supply will be made available to the private market, to ease current demand experienced by pharmacies. These will enter the private market within around 48 hours.

In response to the ongoing Meningitis B (MenB) outbreak in Kent, the UK Health Security Agency (UKHSA) is expanding the offer of preventative antibiotic treatment and vaccination to control the outbreak. 

Preventative antibiotic treatment and vaccination will now be offered to 6th sixth form students (years 12 and 13) in schools and colleges in Kent with confirmed or probable cases On a case-by-case basis, following risk assessment by the local health protection team, antibiotics and vaccination may also be made available to additional year groups. Students can, and should, continue to attend schools and colleges as normal.

In addition to the approximately 5,000 students who were initially contacted, vaccination will now be extended to everyone who has been offered preventative antibiotic treatment as part of this outbreak. This includes University of Kent students who live on the Canterbury Campus and other relevant halls of residence; close contacts of confirmed or suspected cases, and students in four education settings in Kent where cases have been confirmed. Anyone who visited Club Chemistry in Canterbury between 5 and 15 March will also be offered a vaccine and antibiotics as a precaution after one suspected case revisited the nightclub before it shut voluntarily.

This extension ensures that those most likely to have been in close contact with confirmed or suspected cases are offered longer term protection as early as possible.

The NHS Kent and Medway website will be updated shortly with vaccination sites for those eligible.

Patients eligible for antibiotics will now be able to request a vaccination and antibiotics from their local GP immediately – wherever they are in England.

While preventative antibiotics remain the key intervention to protect people and halt the spread of infection, vaccination is being offered as an additional measure to provide longer term protection for those at increased risk.

Given current demand on the private MenB vaccine market, 20,000 doses will also be released from NHS supply to support continuity of private provision, enabling up to 2,000 pharmacies to receive vaccines in the next 48 hours.

Professor Susan Hopkins, Chief Executive of the UK Health Security Agency, said: 

''By extending the vaccination programme to everyone who has been offered preventative antibiotics, we are taking an important additional step to protect those most likely to have been exposed. The message is simple: if you have had the antibiotic, you are also eligible for the vaccination.

People are reminded to remain alert to the signs and symptoms of invasive meningococcal disease and to seek urgent medical attention if they or someone they know becomes unwell.

Background 

Meningococcal disease (meningitis and sepsis) is an uncommon but serious disease caused by meningococcal bacteria. Very occasionally, the meningococcal bacteria can cause serious illness, (inflammation of the lining of the brain) and sepsis (blood poisoning), which can rapidly lead to sepsis. 

The onset of illness is often sudden and early diagnosis and treatment with antibiotics are vital. 

Early symptoms, which may not always be present, include: 

- a rash that doesn’t fade when pressed with a glass

- sudden onset of high fever

- severe and worsening headache

- stiff neck

- vomiting and diarrhoea

- joint and muscle pain

- dislike of bright lights

- very cold hands and feet

- seizures

- confusion/delirium

- extreme sleepiness/difficulty waking

Young people going on to university or college for the first time are particularly at risk of meningitis because they newly mix with so many other students, some of whom are unknowingly carrying the bacteria at the back of their nose and throat. 

There are numerous strains of the meningococcal infection.

There are numerous strains of the meningococcal infection. The MenACWY vaccination gives good protection against MenA, MenC, MenW, and MenY and is routinely offered to teenagers in school Years 9 and 10. However, this vaccine does not protect against all forms of meningococcal infection. Other strains such as MenB can circulate in young adults, which is why it’s important to know how to spot the symptoms of meningitis and sepsis as early detection and treatment can save lives. 

Further information on meningococcal disease 

Meningitis, The Meningitis Research Foundation, Monday to Friday, 9am to 5pm, UK: 080 8800 3344  -  Republic of Ireland: 1800 41 33 44  

Meningitis Now - 0808 80 10 388 (9am to 4pm Monday to Thursday and 9am to 1pm Friday)

Source: 

Link: https://www.gov.uk/government/news/expansion-of-meningitis-b-vaccination-offer-to-kent-students

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