Countries: Fiji, American Samoa, Cambodia, China, Cook Islands, French Polynesia (France), Guam, India, Kiribati, Marshall Islands, Micronesia (Federated States of), Nauru, New Caledonia (France), New Zealand, Niue (New Zealand), Northern Mariana Islands (The United States of America), Palau, Papua New Guinea, Pitcairn Islands, Samoa, Solomon Islands, Tokelau, Tonga, Tuvalu, Vanuatu, Wallis and Futuna (France) Source: World Health Organization Please refer to the attached file. Alerts:· 1 Acute Fever and Rash alert (CNMI)Respiratory virus epidemiology in the Pacific Island Countries for EPI – WK 32, 2025· PSSS, EPI -WK32, 2025 Influenza-like Illness (ILI), Severe Acute Respiratory Illness (SARI), and COVID-19-like cases are compared to WK31, 2025 and tabulated below for easy comparison (▼ Decreasing ▲ Increasing ● Stable). To provide additional context on the figures and trends, the percentage of sentinel sites reporting WK31 & WK32, 2025 is also included. Reporting below 80% is indicated as ▼low reporting and – is no report available.· Please refer Seasonal-influenza for Pacific Island Countries and Areas - ILI Surveillance.· Attached is the weekly bulletin for your reference and additional information.ILI: Compared to the previous epi week (week 31, 2025), overall, there was a decrease in the number of reported ILI cases with 6 PICs (Cook Islands, FSM, RMI, Palau, Wallis & Fatuna and Tonga) reporting increased numbers and 6 PICs (Nauru, CNMI, Tokelau, Niue, Vanuatu and New Caledonia) reporting reduced numbers. The number of reported ILI cases did not reach/exceed the alert threshold in any PIC. Wallis & Fatuna reported the highest number of ILI cases (173).· SARI: Compared to the previous epi week (week 31, 2025), overall, there was a decrease in the number of reported SARI cases. All PICs reported zero cases of SARI for the current epi week.· COVID-19: Compared to the previous epi week (week 31, 2025), there was an increase in the number of reported COVID-19 cases. CMNI, Palau and Niue reported 10, 2 and 1 COVID-19 cases respectively.Influenza and Other Respiratory viruses in PICs· Palau: There is an observed decline in the number of reported Influenza A cases with 4, 4, 24, 19 and 1 cases reported in epi weeks 32, 31, 30, 29 and 28 respectively while zero cases of Influenza B have been reported for 3 epi weeks now. Also, zero cases of RSV have been reported for epi weeks 29, 30, 31 and 32. The reported number of SARS-CoV-2 has gradually reduced from 7 cases in epi week 28 to 1 case in epi week 31 and 2 cases in epi week 32. Source: Situation report No 32, 2025.· Samoa: In the current epi week, 14 nasopharyngeal swabs (NPS) were collected from ILI cases, and 4 samples were collected from 4 SARI cases and referred to the TTMH Lab for testing of priority respiratory pathogens. From the ILI samples, 1 was positive for Influenza A and 1 positive for Influenza B. All SARI samples returned negative results for priority respiratory pathogens. Source: Syndromic Surveillance Report No 32.· CNMI: In epi week 32, CNMI reported 10 new cases of COVID-19 (compared to 8 in epi week 31) and a cumulative of 209 confirmed cases of COVID-19 since epi week 01, 2025. One case of Influenza (compared to 1 case in epi week 31) was also reported in the current epi week (32), and a cumulative of 269 cases of confirmed Influenza since epi week 01, 2025. Source: CNMI Weekly Syndromic Surveillance Report for Epi week 32.Pertussis in Tanna, Vanuatu· From 31st July to 11th August 2025, 8 suspected cases of Pertussis were reported. This brings the cumulative total (since 6th July 2025) to 16 suspected cases. All the suspected cases are from Lenakel hospital and are not fully vaccinated. Three (3) of the suspected cases died. Majority of the cases are 0-5 years, from EnviTanna. Samples have been shipped to Victorian Infectious Diseases Reference laboratory (VIDRL) for confirmatory diagnosis. As part of the public health response, RCCE teams have deployed across the 7 area councils in Tanna to promote immunization, messages are being shared through multiple media urging parents to take their children for vaccination, IEC materials are being distributed to health workers and communities to support awareness, and surveillance has been enhanced from hospitals and sentinel sites.Dengue in PICs· Latest Dengue Situation Updates for the Western Pacific from PSSS weekly report here. For week 32, 2025, a total of 5 PICs reported cases of DLI. These are Nauru (33), Tonga (6), Cook Islands (3), Wallis & Fatuna (1) and Palau (1). No DLI alert was triggered from any of the 12 PICs that reported their data.· Nauru: On 17th August, Nauru reported a total of 6 new confirmed cases of Dengue (compared to 8 new cases in SITREP No 37), and a cumulative of 366 confirmed. For the same duration, 20 new probable cases were reported and a cumulative of 1138 probable cases. Also, 2 new admissions were reported (compared to 1 new admission in SITREP No 37), resulting in a cumulative total of 98 admissions and 2 deaths. Majority of the confirmed cases are male (53%), aged 5-10 years (41%). Cases are distributed all over the Island. The most affected districts are Meneng, Denigomodu, Aiwo, Boe and Baitsi. As part of the response activities, public health zone nurses continue to visit the confirmed positive cases following up on their clinical status and providing awareness to the family on preventative measures. Environmental health teams are conducting thermal fogging and fumigation. Source: Nauru Dengue Fever Outbreak Situation Report Nos 37, 38.· Kiribati: On 11th August 2025, Kiribati reported a cumulative total of 1075 suspected Dengue cases (103 new suspected cases since the last report on 4th August 2025), a cumulative total of 406 confirmed cases of Dengue (9 new cases since the last report on 4th August 2025), a cumulative total of 67 hospitalizations (0 new hospitalizations since the last report on 4th August 2025) and a cumulative of 67 discharges (2 more discharges since the last report on 4th August 2025). The mean age of cases is 15 years. 54% of the cases are female while 46% are male. Source: Dengue Fever Situation reports No 14 and 15.· Palau: On 10th August, in their syndromic surveillance report No 32, 2025, Palau reported that from 1st July and 3rd August 2025, 6 cases of Dengue among residents had been confirmed. DENV-1 and DENV-2 have been detected in 2 of the submitted samples. No new cases were reported for the current epi week (week 32, 2025). Apart from the current cases, Palau had not reported any confirmed cases of Dengue in more than a decade. Source: Situation report No 32, 2025.· Samoa: In epi week 32, 116 laboratory confirmed cases of Dengue were reported compared to 342 and 521 laboratory confirmed cases of reported in epi weeks 31 and 30 respectively. This brings the cumulative number of confirmed cases (since January 2025) to 2743. Majority of the confirmed cases (85%) are serotype 1. Cumulatively, 5 deaths have been reported. In the previous 2 weeks (epi weeks 30 and 31), a decrease in the number of confirmed cases has been observed but this cannot be fully interpreted because data on test positivity is not available. Yet, the number of reported clinically diagnosed Dengue cases are increasing exponentially, with 1974 clinically diagnosed Dengue cases reported for the current epi week. The current interventions include collaboration with other sectors through a whole-of-government approach through the integrated vector control committee, source reduction and environmental sanitation, ongoing risk communication and tailored messaging for broader public awareness. Source: Syndromic surveillance report No. 32, 2025 and Dengue Fever outbreak Reports No 17.Global EventsAvian Influenza in China, Cambodia and IndiaFrom 1st to 7th August 2025, no new case of human infection was reported to WHO in the Western Pacific Region. No new case was reported from 25th to 31st July 2025, and no new case was reported the week before. Since epi week 01, 2025 to date, a total of 13 Influenza A (H5N1) including 6 deaths have been reported by 6 countries in the region. For the same reporting duration, no new cases of human infection with avian influenza A(H9N2) virus were reported to WHO in the Western Pacific Region. No new cases were also reported in the previous epi week. Also, no new cases of human infection with avian influenza A(H10N3) virus were reported in the current and previous week. For the same duration, one new outbreak of highly pathogenic avian influenza (HPAI) in animals was reported from China compared to 3 outbreaks reported from by Cambodia in the previous epi week. Sustained human-to-human transmission has not been reported from these cases, and the overall public health risk remains low. Source: WHO Avian Influenza weekly update in the Western Pacific Region; Update 1009 accessible here .mPoxAll clades of monkeypox virus (MPXV) continue to circulate in several countries. Nineteen countries in Africa have reported ongoing mpox transmission in the past six weeks; clade 11b reported in West Africa, both clade 1a and clade 1b reported in Central African countries, while clade 1b is reported in East African countries. From 7th to 20th July 2025, Gambia reported an mpox case for the first time (a young adult female) which has been identified as clade IIb MPXV by genomic sequencing analysis. Within the same duration, Mozambique also reported cases of mpox due to clade Ib MPXV for the first time. Since 11th July when the outbreak was declared in the Lago district of the Southwestern Niassa province, up to 20th July 2025, 13 confirmed cases have been reported. Prior to this, only one confirmed mpox case had been reported in 2022 in Mozambique, in an adult female with a history of international travel to a clade IIb-affected country. The current event, therefore, marks the first instance of clade Ib MPXV detection and local community transmission of mpox in Mozambique. During this reporting period, three countries (Australia, China and the United Kingdom) have reported additional cases of mpox due to clade Ib MPXV since the last situation report. These cases have been linked to travel, and community transmission of clade Ib MPXV continues to be reported only in countries in central and Eastern Africa. The recent overall downward trend of confirmed cases across the continent is driven by the decline in cases in Sierra Leone and the Democratic Republic of Congo. Source: WHO Mpox multi-country external situation report No 56 accessible here.Measles in United States of AmericaAs of 6th August 2025, a total of 1,356 confirmed measles cases (23 cases more than the cumulative number reported in the previous 7 days) were reported by 40 jurisdictions. By age, 386 (28%) are under 5 years, 501 (37%) between 5-19 years, 462 (34%) 20+ years and 7 (1%) whose age is not reported. By vaccination, the status of 92% of the cases is not known while 4% and 4% of the cases received one MMR doze and one MMR dose respectively. Thirteen percent of the cases (171 of 1333) are hospitalized, and a total of 3 deaths have been confirmed. There have been 29 outbreaks reported in 2025, compared to 16 outbreaks reported during 2024. Source: United States Centers for Disease Prevention and Control (US CDC) website accessible here. Measles remains a concern in the Pacific Islands. PSSS/EWARS monitors all Acute Fever and Rash cases, ensuring suspected cases are free from measles and rubella through blood testing.COVID-19For the previous 7 days up to 27th July 2025, globally, 22,452 new COVID cases were reported, 13,054 cases more than what was reported the week before. This included 12,670 from South East Asia, 6,555 from Europe, 3,227 from Americas, zero from Western Pacific, no data from Africa, and no data from Eastern Mediterranean. Source: WHO COVID-19 dashboard accessible here. WHO recommends Member States to: 1) maintain multi-source, multi-tiered collaborative surveillance systems for early detection, variant monitoring, and disease burden assessment, 2) ensure continued equitable access to and uptake of COVID-19 vaccines, particularly among high-risk groups, 3) strengthen healthcare delivery systems to ensure high-quality clinical management of COVID-19 and Post-COVID-19 Condition (PCC), 4) enhance risk communication and community engagement, and 5) institutionalize national and subnational coordination mechanisms, including those developed during the acute phase of the pandemic, into long-term respiratory disease threat management systems. Source: COVID-19 Global Situation accessible here .