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Since an Acute Flaccid Myelitis patient was identified in Rockland County, New York (N.Y.) in July 2022, wastewater samples have been tested for poliovirus.

Polio is hard to detect when relying on clinical symptoms in humans, says the U.S. Centers for Disease Control and Prevention (CDC).

Therefore, wastewater testing for poliovirus is required to determine if there is a community health risk.

As of December 30, 2022, an updated sequencing analysis by the CDC confirmed the presence of poliovirus in a total of 99 positive samples of concern, with 92 samples genetically linked to the Rockland County resident.

Of the 92 samples, 44 samples were collected in Rockland County, 29 in Orange County, 13 in Sullivan County, and 5 in New York City, all of which were from Brooklyn (Kings County), with 4 of these in an area that contains an adjacent portion in Queens County.

The NY Department of Health Poliovirus Wastewater Surveillance Report, dated December 28, 2022, is posted at this link.

To quantify the extent of the poliovirus exposure, the CDC announced on November 30, 2022, it would expand wastewater testing in select jurisdictions such as Detroit and Philadelphia.

Globally, poliovirus type 2 isolates have been identified in sewage samples collected in London and Israel related to the N.Y. findings.

On November 1, 2022, a World Health Organization Committee unanimously agreed that the risk of the international spread of poliovirus remains a Public Health Emergency of International Concern and extended Temporary Recommendations into 2023.

To notify international visitors, the CDC updated its global polio Alert - Level 2, Practice Enhanced Precautions on November 30, 2022, regarding outbreaks and poliovirus detections in various countries.

Furthermore, the CDC suggests eligible people become and maintain their polio immunizations.

Various polio vaccines are available in the U.S. at clinics and pharmacies.

Other polio outbreak news is posted at PrecisionVaccinations.com/Outbreaks2022.

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According to the World Health Organization (WHO), the Republic of Indonesia recently joined an expanding list of countries deploying a new polio vaccine to curtail an active outbreak.

The WHO announced on December 19, 2022, Indonesia’s Ministry of Health had notified the WHO of a confirmed case of circulating vaccine-derived poliovirus type 2 (cVDPV2) with acute flaccid paralysis from Pidie district in Aceh province.

A rapid-response vaccination campaign with the novel oral poliovirus-2 (nOPV2) vaccine was launched in Aceh province for about 95,000 children on December 5, 2022.

And large-scale supplementary immunizations with nOPV2 are proposed for others in early 2023.

Overall, the WHO assesses the risk as high at the national level due to low polio vaccination coverage in Aceh and other provinces in Indonesia.

And the WHO continues recommending that people visiting polio-affected areas be fully vaccinated with any authorized polio vaccines.

However, the WHO did not recommend any travel and/or trade restrictions to Indonesia as of late December 2022.

To notify international travelers, the U.S. CDC issued an Alert Level 2, Practice Enhanced Precautions, on November 30, 2022, regarding various polio outbreaks, including in Indonesia.

The CDC suggests travelers speak with a healthcare provider or pharmacist about the inactivated poliovirus vaccine.

In the U.S., the CDC recently announced it would expand poliovirus wastewater testing outside New York to include areas in Michigan and Pennsylvania.

Other polio outbreak news is posted at PrecisionVaccinations.com/Polio

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Polio Outbreaks

Poliovirus Outbreaks September 2025

The World Health Organization (WHO) confirmed during the 42nd meeting of the IHR Emergency Committee for Polio in June 2025 that the spread of the poliovirus remained a Public Health Emergency of International Concern (PHEIC) and updated its polio outbreak map. As of September 2025, the Global Polio Eradication Initiative (GPEI) confirmed that various countries had reported cases of wild poliovirus type 1 (WPV1), circulating vaccine-derived poliovirus type 2 (cVDPV2), vaccine-derived poliovirus type 2 (VDPV2), and circulating vaccine-derived poliovirus type 1 (cVDPV1). 

The U.S. Centers for Disease Control and Prevention (CDC) reissued a Global Polio Alert—Level 2, Practice Enhanced Precautions Travel Health Notice on August 4, 2025, regarding polio outbreaks and poliovirus detections in 41 countries. The CDC published an MMWR on March 6, 2025, confirming that the Nigeria virus lineage had been detected in wastewater samples in 16 cities across five European countries. On October 17, 2024, the CDC announced (MMWR Vol. 73, No. 41) that from January 2023 to June 2024, 74 cVDPV outbreaks were detected in 39 countries, with 672 confirmed cases of acute flaccid paralysis (AFP) identified in 27 countries. Less than 1% of wild poliovirus infections result in Acute Flaccid Paralysis (AFP). In 2024, the GPEI reported 243 cases of AFP worldwide. 

Polio Cases in the Americas

The WHO / Pan American Health Organization (PAHO) issued an Epidemiological Update (Year 39, 51-52) - Poliomyelitis in the Americas Region and reported AFP Surveillance in 2024. The PAHO/WHO reminds Member States that the risk of the emergence of a cVDPV1 or circulating vaccine-derived poliovirus type 3 (cVDPV3) has increased due to low vaccination coverage. In addition, the PAHO/WHO reports a continuing risk of importing a WPV1 or VDPV, mainly cVDPV2. cVDPV2 cases peaked in 2020, with over 1,000 cases of paralysis in 24 countries. As of January 2025, the PAHO reported 1,856 AFP cases in 2024.  

Polio in the United States

The United States was added to a list identified with polio in 2022. The CDC reported (Volume 30, Number 11—November 2024) that wastewater surveillance for poliovirus identified ongoing transmission of poliovirus in Rockland County and adjacent New York counties in 2022. In June 2022, a case of paralytic polio caused by VDPV2 was identified in an unvaccinated adult in Rockland County, New York. In addition, poliovirus type 2, genetically linked to the VDPV2 isolated from the patient, was detected in wastewater samples from Rockland and several surrounding counties, indicating community transmission. This case was the first known case of paralytic polio in the U.S. since 2013 and the first documented instance of community transmission of poliovirus in the U.S. since 2005. The New York State Department of Health (NYSDOH) confirmed the presence of poliovirus in wastewater in March 2023  and October 2024. The CDC states that the detection of poliovirus in wastewater cannot be used to determine the total number of infected individuals in a community or the proportion of the infected population. The minimum number of infected individuals that can be reliably detected through wastewater testing is not known. 

The International Health Regulations classify the U.S. as a country or state infected with cVDPV2, with or without evidence of local transmission. Therefore, the U.S. is subject to Temporary Recommendations issued by the International Health Regulations Emergency Committee on Polio Eradication. 

Afghanistan Polio Outbreak

Afghanistan is affected by the ongoing endemic transmission of wild poliovirus. In 2024, 25 WPV1 cases were reported. In 2023, 18 WPV1-positive environmental samples were reported. According to the Ministry of Health, Afghanistan detected its initial human polio case in May 2023. As of June 2, 2023, local media reported four confirmed cases of polio in the province of Nangarhar. Two polio patients were confirmed in 2022, four in 2021, and 56 in 2020.

Africa Polio Outbreaks

Kenya's Ministry of Health announced on October 1, 2024, that five polio cases have been confirmed, and one positive environmental surveillance sample has been taken in Kamukunji Sub-County, Nairobi. In June 2024, Somalia launched a significant polio vaccination campaign for children. On May 24, 2024, Angola reported AFP and environmental detections. On May 14, 2024,  the closure of the WPV1 outbreaks in Malawi and Mozambique was announced. Over 100 million vaccine doses have been administered in the areas most at risk. Zimbabwe is inoculating more than 4 million children against polio in February 2024, following the detection of three cases caused by a rare mutation of the weakened virus in oral vaccines.

Australia Poliovirus Detections

On December 2, 2024, Australia's poliovirus surveillance program detected vaccine-derived poliovirus in pre-treated sewage from the Western Treatment Plant in Melbourne. This detection is likely linked to an individual who received a live polio vaccine and shed the virus in Victoria. Australia remains polio-free, as there has not been a detection of wild-type poliovirus.

South-East Asia Polio Outbreaks

Singapore reported one polio case in February 2025. Indonesia reported four instances of cVDPV2 from October 2022 to February 2023. In late December 2023, the Indonesian Ministry of Health notified WHO of two new confirmed cases of cVDPV2. Despite Indonesia having a strong capacity to respond to poliovirus outbreaks and West Java having a moderate to strong outbreak response capacity to interrupt transmission, the population remains highly susceptible to poliovirus type 2 after switching from trivalent to bivalent OPV. The ongoing polio outbreak in Indonesia poses a high risk at the national level, a moderate regional threat, and a low global risk as of 2024. The GPEI published a report of the Indonesia Polio Outbreak Response Assessment – July 2023. BMC Public Health published in March 2021 - Scaling up public health interventions: a case study of the polio immunization program in Indonesia.

Europe Polio Outbreaks

This Eureopen CDC dashboard provides an overview of the global poliovirus situation in April 2025. The European Centre for Disease Prevention and Control (ECDC) published an interactive map in 2025 displaying countries currently confirming polio or poliovirus cases. From September through December 2024, vaccine-derived poliovirus type 2 (VDPV2) was detected in wastewater systems of 14 cities in five European countries. The isolated VDPV2 viruses are linked to a lineage (NIE-ZAS-1) first detected in Nigeria in July 2020. Poliovirus has been detected in Germany, Finland, Poland, and Spain. Poland's health ministry confirmed that a sample of municipal sewage collected in Win 2024 Warsaw in 2024 revealed the presence of poliovirus type 2. The last poliovirus cases in Poland were recorded in 1982 and 1984. Finland's Institute for Health and Welfare identified VDPV2 in wastewater samples from Tampere in 2024. The WHO declared the European Region polio-free in 2002. 

India Polio Outbreaks

The World Health Organization declared India polio-free in 2014. National Immunization Days are held twice a year across India, and the government aims to administer two drops of OPV to every child under five, as reported by The Times of India in 2023. Polio vaccination campaigns for children are expected to continue in 2024.

Israel Polio Outbreaks

The Global Polio Eradication Initiative reported on August 4, 2025, that Israel confirmed six environmental samples of circulating vaccine-derived poliovirus type 1 (cVDPV1), five from Jerusalem and one from Center. On April 24, 2025, the Ministry of Health's Central Virus Laboratory in Israel detected poliovirus in an environmental sample in the Jerusalem area. In March 2025, Israel discontinued offering the live attenuated polio vaccine (oral). It now provides the IPV. As of March 2023, four VDPV3-positive polio cases in children were confirmed. On February 27, 2023, the Israeli Ministry of Health issued an official alert describing a local case of Acute Flaccid Paralysis (AFP). As of April 15, 2022, a total of seven VDPV3-positive cases were confirmed. A cluster of VDPV3 was previously detected in environmental samples from Jerusalem and Bethlehem city, collected between September 2021 and January 2022. 

Gaza Strip Polio Outbreak

In February 2025, the WHO confirmed a polio case that had occurred in August 2024. New environmental samples from Deir al Balah and Khan Younis, collected in December 2024 and January 2025, confirm the transmission of poliovirus, genetically linked to the poliovirus detected in the Gaza Strip in July 2024. 

Pakistan Polio Outbreaks

In 2025, 3 WPV1 cases were reported. In 2024, 73 WPV1 cases were confirmed, and numerous WPV1-positive environmental samples were reported this year. Of these, 27 were from Balochistan, 22 from Khyber Pakhtunkhwa, 22 from Sindh, and one from Punjab and Islamabad. In 2022, 20 WPV1 cases and 20 paralyzed children were reported in the southern KP province.

South America Poliovirus Detections

The Pan American Health Organization (PAHO) published an alert on October 14, 2024, confirming the detection of circulating vaccine-derived poliovirus type 3 (cVDPV3) in wastewater samples collected in Cayenne, French Guiana. Additional testing identified positive samples collected in Remire-Montjoly and Saint-Georges-de-l'Oyapock. In 2024, the PAHO identified Argentina, Haiti, and Peru as at very high risk for the reintroduction of polio. In 2024, the PAHO reported that 176 virus isolation test results were pending in the Americas.

Spain Poliovirus

In Spain, circulating vaccine-derived poliovirus type 2 (cVDPV2) was isolated from a single positive sample collected in Barcelona for the first time in September 2024.

United Kingdom Poliovirus 

In December 2024, one cVDPV2-positive environmental sample was collected in London. Five cVDPV2-positive environmental samples were collected in November 2024 from Yorkshire and the Humber, the South East, and London in the U.K. The UKHSA National Polio Guidelines outline public health actions to be taken when a cVDPV2 is detected in environmental samples. In May 2022, six positive samples were reported following the isolation of VDPV2 from ecological samples in London. U.K. public health authorities continue to intensify surveillance efforts, including for potential cases of paralysis, offering an additional dose of inactivated polio vaccine to all children across London.

Polio Vaccines

As of April 2025, various polio vaccines are available worldwide. Due to the high vaccination rate (93%), the CDC reports very few cases of polio. According to the CDC, the IPV has been the only vaccine in the U.S. since 2000. The New York City Health Department and the CDC recommend that adults who received polio vaccines as children receive a one-time lifetime IPV booster dose if traveling to an area with poliovirus transmission.

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Malaria Outbreaks

Malaria Outbreaks September 2025

According to the World Health Organization (WHO) Malaria Report 2024, eleven out of 83 malaria-endemic countries had the highest rates of infections and deaths in 2023. According to the WHO, despite an annual expenditure of $4 billion, malaria deaths and cases have not shown substantial change over the last decade. The WHO African Region bears the heaviest burden of malaria disease. The WHO's malaria report estimated 263 million malaria cases and 597,000 related fatalities worldwide in 2023. This data represents about 11 million more cases than in 2022.

On World Malaria Day 2025, the WHO calls for revitalized efforts at all levels, from global policy to community action, to accelerate progress towards malaria elimination. Malaria infections are often misdiagnosed; however, commercial lab testing services can detect malaria infections. As of June 2025, the WHO Guidelines for Malaria include updated recommendations for malaria vaccines, primaquine, and tafenoquine. The WHO recommends the use of malaria vaccines for the prevention of P. falciparum malaria in children living in malaria-endemic areas, such as Africa.

The Institute for Health Metrics and Evaluation publishes estimates of malaria-related mortality. The Atlasvisualdelamalaria.org is a project of the iO Foundation, which published malaria information in 2025.

Malaria Cases in the United States 2025

The U.S. Centers for Disease Control and Prevention (CDC) says millions of residents travel to countries where Malaria is present. As of week 14, ending April 5, 2025, the CDC confirmed 545 malaria cases in the United States, with New York City and Maryland leading the way. During 2024, the CDC confirmed 436 cases.

The CDC published MMWR Volume 30, Number 7—July 2024, Research Letter, which reported that about ten Plasmodium vivax malaria cases were confirmed at an institution in Los Angeles, California, in 2023. The CDC published a Report on September 8, 2023, confirming eight cases of autochthonous Malaria were reported by state health departments in Florida (Sarasota, seven) and Texas (one) in Cameron County from May 18 to July 17, 2023. On October 24, 2024, the CDC reported (73(42);946–949) nine local malaria cases from May to August 2023, followed by a 10th case of locally acquired Malaria diagnosed in Arkansas. On August 6, 2023, Maryland reported one local case of Malaria.

In March 2025, Florida reported eight cases of travel-related Malaria. As of December 2023, Florida Health reported over 71 cases of Malaria related to international travel. In 2003, 8 cases of locally acquired P. vivax malaria were identified in Palm Beach County, FL. The Texas Department of State Health Services (DSHS), Amira Bashadi, MPH, reported on February 16, 2024, that from 2013 to 2022, 1,239 cases of Malaria were reported in Texas. In 2022, there were 166 malaria cases in Texas. Of these, the majority (98%) were acquired from international travelers from Africa, Asia, and South America.

In 2019, 2,048 malaria cases, most associated with travel to 85 countries where Malaria remains endemic, were reported to the CDC.

Malaria Outbreaks in Africa

The WHO reports that four African countries are responsible for over 50% of all malaria deaths worldwide: Nigeria (31.3%), the Democratic Republic of the Congo (12.6%), the United Republic of Tanzania (4.1%), and Niger (3.9%).

Malaria Outbreaks in the Region of the Americas

In 2024, the Pan American Health Organization (PAHO) estimated that 41 million people live in 21 areas where the risk of infection by mosquito-carrying Malaria is considered moderate to high. Eighteen countries, including one territory in the Americas, are currently at risk of Malaria. Countries in the Region of the Americas reported 505,000 malaria cases in 2023, a 5% increase from 2022, when the PAHO reported 481,788 cases and approximately 92 deaths, and in 2023, around 520,000 cases and 120 deaths were reported.

In the Region Americas, during the construction of the Panama Canal, approximately 30,000 people lost their lives to infectious diseases common in the tropical environment, Malaria. Panama reported a total of 15,109 malaria cases in 2024, up from 11,659 cases in 2023.

The Argentine Republic Ministry of Health confirmed local malaria transmission in Santa Elena Town and Cristo Rey Village in the Cayo District in April 2025. In December 2023, the Costa Rica Health Surveillance Directorate of the Ministry of Health announced an increased risk of Malaria in Costa Rica, especially in coastal zones. Costa Rica reported over 544 malaria cases in 2022 and 406 locally acquired malaria cases in 2021. The CDC issued various outbreak alerts for malaria-endemic countries, including Costa Rica.

In 2023, the WHO certified Paraguay, Argentina, and El Salvador as malaria-free in 2018, 2019, and 2021, respectively. Additionally, the WHO certified Belize malaria-free on June 21, 2023.

The Trinidad and Tobago Ministry of Health reported eight cases of Malaria in 2025.

A study published by the Royal Society on February 15, 2023, indicates malaria-carrying mosquitoes are gaining an average of 6.5 meters (21 feet) of elevation per year, and the southern limits of their ranges are moving by 4.7 kilometers (nearly 3 miles) from the equator per year.

Malaria Outbreaks in Australia

Australia was certified by the World Health Organization (WHO) as malaria-free in 1981. However, the re-establishment of malaria and local transmission in Australia has occurred.

Malaria Outbreaks in China

China was declared malaria-free by the World Health Organization in 2021, and no indigenous cases of Malaria have been reported since 2016. In China, the malaria burden was reduced from 30 million cases per year in the 1940s to zero indigenous cases in 2017.

Malaria Outbreaks in Europe

As of April 2024, malaria-carrying mosquitoes have been detected in Greece (since 2021) and along Italy's southeastern coast. The European CDC published the Surveillance Atlas, which reported travel-associated malaria cases in Europe from 2018 to 2022.

Malaria Outbreaks in India

In 2022, 50 people died of Malaria across India. However, this was a drastic decrease from 2014, when 562 deaths were attributed to Malaria. The National Framework for Malaria Elimination in India (2016-2030) was launched in 2016, followed by the National Strategic Plan (2017-2022). According to the WMR 2019, India represents 3% of the global malaria burden. 

Malaria Mexico

On November 7, 2023, The Lancet published an article titled "The U.S.–Mexico border and falciparum malaria." The U.S. CDC recommends that travelers to certain areas of Mexico take prescription medicine to prevent Malaria. Depending on your medication, you must start taking this medicine multiple days before, during, and after your trip.

Malaria in South Korea

In April 2025, South Korean military personnel were treated for malaria infections. In 2024,  the Korea Disease Control and Prevention Agency issued a nationwide malaria alert. According to the Korea Disease Control and Prevention Agency, over 719 malaria cases were confirmed from January to mid-October 2023. This is the first time the annual number of malaria cases has topped 700 since 2011.

Malaria United Kingdom

Provisional UKHSA data indicate that imported malaria cases decreased to 1,812 in 2024, down from 2,106 in 2023. Most malaria cases were reported during peak summer travel months between July and October, and in the London area. 

Malaria 

Malaria is a curable disease caused by four species of protozoan parasites of the genus Plasmodium: P. falciparum, P. vivax, P. malariae, and P. ovale, and is transmitted to people by Anopheles mosquitoes.

Zoonotic Avian Malaria Outbreaks

Zoonotic forms of Malaria have been documented as causes of human infections and some deaths, especially P. knowlesi, a parasite of Old World (Eastern Hemisphere) monkeys in Southeast Asia. Avian Malaria is a disease caused by a species of protozoan parasites (Plasmodium) that infect birds. It has caused mortalities in captive penguins worldwide. A study published in 2021 concluded that penguins' susceptibility, translocation across institutions, and the wide distribution of avian Malaria make this disease a constant threat.

Malaria Vaccines 2025

Malaria vaccine information is posted on Vax-Before-Travel as of 2025.

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As 2022 comes to a close, searches for a U.S. Food and Drug Administration (FDA) herpes vaccine peaked in December.

According to PrecisionVaccination.com analyses, more website visitors sought the latest herpes vaccine news than any other disease, including COVID-19.

Unfortunately, most searchers were disappointed to learn that herpes vaccine development efforts continue in early-stage clinical trials.

However, there is optimism heading into 2023.

BioNTech SE recently announced its mRNA-based BNT163 herpes simplex virus vaccine candidate is currently under development to prevent genital lesions caused by Herpes Simplex Virus-2.

Announced on December 21, 2022, BioNTech's Phase 1 clinical trial is expected to enroll around 100 healthy adult volunteers without current or history of symptomatic genital herpes infections.

The U.S.-based study consists of a first dose escalation part focusing on safety evaluations and assessing the optimal dose-response.

The trial's second part is designed to expand the safety characterization for the selected dosing of BNT163 for a more comprehensive assessment of the impact of pre-existing herpes virus immunity on BNT163 vaccine-induced immune responses.

The World Health Organization says vaccines against sexually transmitted infections (STIs) are a significant priority.

The development of new STI vaccines is critical because of the many infections worldwide, the resulting adverse sexual, reproductive, and maternal-child health outcomes, and the known limitations of existing STI interventions.

Other herpes vaccine candidate news is posted at PrecisionVaccinations.com/Herpes.

 

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Since the start of the Mpox outbreak in May 2022, the U.S. Centers for Disease Control and Prevention (CDC) has endorsed vaccinations to prevent the spread of the disease.

Since the outbreak began, the CDC has confirmed 29,792 Mpox cases and 20 related fatalities.

On December 30, 2022, the CDC's new Morbidity and Mortality Weekly Report disclosed that one dose of the JYNNEOS® (MVA-BN) vaccine might attenuate the severity of illness and reduce hospitalization in persons who become infected after vaccination.

However, to optimize protection from Mpox, all eligible persons are recommended to complete the two-dose primary vaccination series.

The CDC confirmed peak immunity is expected to be reached 14 days after the second dose of JYNNEOS.

As of December 20, 2022, 1,152,073 JYNNEOS vaccine doses had been administered in 57 U.S. Jurisdictions.

Other Mpox outbreak information is posted at MpoxToday.

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The U.S. Food and Drug Administration (FDA) recently approved Sunlenca® (lenacapavir), a new type of antiretroviral medication for adults living with human immunodeficiency virus type 1 (HIV-1), whose HIV infections cannot be successfully treated with other available treatments due to resistance, intolerance, or safety considerations.

After the starting dose is completed, Sunlenca is administered as subcutaneous (under the skin) injections once every six months, allowing convenient dosing for patients.

However, Sunlenca is not an FDA-approved HIV-prevention vaccine.

“Today’s approval ushers in a new class of antiretroviral drugs that may help patients with HIV who have run out of treatment options,” said Debra Birnkrant, M.D., director of the Division of Antivirals in the FDA’s Center for Drug Evaluation and Research, in a press release on December 22, 2022.

“The availability of new classes of antiretroviral medications may help these patients live longer, healthier lives.”

Sunlenca is the first of a new class of drugs called capsid inhibitors to be FDA-approved for treating HIV-1.

Sunlenca works by blocking the HIV-1 virus’ protein shell (the capsid), thereby interfering with multiple essential steps of the viral lifecycle. Sunlenca’s starting dose is given as oral tablets and subcutaneous injections, followed by maintenance injections every six months; Sunlenca can be given in combination with other antiretrovirals.

Despite the significant advances in antiviral therapy, there remain numerous critical and pressing unmet needs for people living with HIV, stated Gilead Sciences, Inc.

This is particularly true for individuals who are heavily treatment-experienced, which accounts for an estimated 2% of adults living with HIV who are on treatment globally and are unable to maintain virologic suppression due to resistance, intolerance, or safety considerations. 

HIV vaccine development news is posted at PrecisionVaccinations.com/HIV.

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