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In Mozambique, an outbreak of cholera has been growing exponentially since December 2022. The World Health Organization (WHO) recently reported heavy rainfall in the first weeks of February 2023 threatens to further worsen the situation with geographic spread to new districts.

The WHO confirmed on February 23, 2023, the first case of cholera in the current outbreak was reported from the Lago district in Niassa province in mid-September 2022.

And as of February 19, 2023, a cumulative total of 5,237 suspected cholera cases and 37 deaths (Case Fatality Ratio (CFR) 0.7%) have been reported in 29 districts from six out of 11 provinces in the country.

The WHO considers the risk of further disease spread as very high at the national and regional levels. 

For example, the neighboring African country of Malawi is facing the deadliest cholera outbreak in its history.

A request for approximately 700,000 doses of Oral Cholera Vaccine was approved by the International Coordinating Group on Vaccine Provision, and a vaccination campaign in affected districts in Gaza, Niassa, Sofala, and Zambezia provinces is in preparation and will start in late February 2023.

Additionally, the U.S. CDC recommends people visiting Mozambique should be vaccinated against measles and polio in 2023.

These travel vaccines are generally available at certified travel; clinics and pharmacies in the U.S.

The Florida Health Department recently reported nine cases of dengue in persons with international travel. As of February 18, 2023, 25 travel-associated dengue fever cases have been reported in Florida.

In 2022, 906 travel-associated dengue cases were reported.

Regarding local dengue cases, only one person has been confirmed this year.

During 2022, 68 cases of locally acquired were reported in Florida.

Dengue is the primary cause of acute febrile illness in US travelers returning from South-central and Southeast Asia, South America, Mexico, and the Caribbean.

According to the World Health Organization, dengue is now endemic in over 100 countries. As many as 3.6 billion people, or 40% of the world's population, reside in dengue-endemic areas. Each year, an estimated 21,000 deaths are attributed to dengue.

While one dengue vaccine (Dengvaxia) is approved, the U.S. Centers for Disease Control and Prevention (CDC) is reviewing a second vaccine with an acceptable safety profile.

On February 24, 2023, the CDC vaccine committee discussed the QDENGA® Tetravalent Dengue Vaccine Candidate (TAK-003) from Takeda.

Currently, Qdenga is approved for use in Indonesia, the EU, and the UK.

Learn more about dengue...how to prevent it, and what to do if you think you are infected atCDC'ss dengue page for travelers.

The U.S. Influenza Hospitalization Surveillance Network (FluSurv-NET) recently reported as of February 18, 2023, this flu season's weekly hospitalization rate was abnormal.

This week's cumulative hospitalization rate is the second-highest rate observed in week #7 during previous seasons, going back to 2010-2011, followed by the 2017-2018 season.

However, this in-season cumulative hospitalization rate is still lower than end-of-season hospitalization rates for five flu seasons going back to 2010-2011.

When examining rates among 2,485 hospitalized adults with information on underlying medical conditions, 96.7% had at least one reported underlying medical condition.

The most commonly reported were hypertension, cardiovascular disease, metabolic disorder, and obesity. 

Among 1,019 hospitalized children with information on underlying medical conditions, 65.6% had at least one reported underlying medical condition.

The most commonly reported condition was asthma, followed by neurologic disease and obesity.

Additionally, the CDC confirmed there has been 115 influenza-associated pediatric fatalities (about 30% were vaccinated) during the 2022-2023 flu season.

And a recent CDC analysis published on February 22, 2023, and in a related MMWR on February 24, 2023, stated 2022-2023 influenza vaccine preliminary effectiveness was about 68% protective of pediatric patients.

And it protected about 43% of adults against influenza-related hospitalization. 

Updated flu season news is posted at PrecisionVaccinations.

The World Health Organization (WHO today reported the cumulative number of Marburg virus disease (MVD) cases in Equatorial Guinea is nine, including one confirmed case, four probable cases, and four suspected cases.

All these viral hemorrhagic fever cases have died as of February 21, 2023.

MVD previously had a case-fatality ratio of up to 88%. 

These MVD cases occurred between early January and February 7, 2023, in two villages in the Nsock Nsomo, eastern province of Kie-Ntem, Río Muni Region. 

And the Ministry of Health and Social Welfare of Equatorial Guinea confirmed one fatality was in a health facility, and there are no cases among healthcare workers.

However, thirty-four close contacts are currently under follow-up as of February 25, 2023.

Additionally, other African countries are on alert for MVD cases.

WHO assesses the risk posed by the MVD outbreak as high at the national level, moderate at the regional level, and low at the global level.

To notify international travelers of their health risks, the U.S. CDC issued a Watch - Level 1, Practice Usual Precautions notice regarding Equatorial Guinea's MVD outbreak.

The CDC says Marburg virus disease symptoms include fever, chills, headache, muscle pain, rash, sore throat, diarrhea, vomiting, stomach pain, chest pain, and unexplained bleeding or bruising.

And there are no specific treatments or approved vaccines for MVD, says the WHO.

Recent news indicates Marburg vaccine candidates are accelerating their clinical research as of February 25, 2023.