Building the Future of Biodefense

Recommendation: The average worker absenteeism for mumps is 5 days. Organizations in Maryland should provide flexible work schedules to support employees making vaccine appointments for themselves or family members.

Situation: Maryland Department of Health reported an uptick in mumps-related inquiries due to individuals with parotitis, which is inflammation of the salivary glands, presenting to acute care settings in late January. Media sources reported 14 mumps cases were recorded so far this year, mostly in adults in the Baltimore metropolitan area, which is higher than the 6 or fewer mumps cases typically reported in the state annually. [Confidence: Very High]

Recommendation: Organizations in the United States (US) should not eat or sell Rosabella brand moringa powder capsules while a Salmonella outbreak investigation is ongoing. Anyone with these products at their workplace or home should dispose of them. People at high risk of Salmonella-related complications may wish to avoid all products of the Rosabella brand moringa powder capsules while this investigation is ongoing.

Situation: The US CDC reported a new multistate outbreak of extensively drug-resistant Salmonella Newport linked to certain lots of Rosabella brand moringa powder capsules and distributed by Ambrosia Brands LLC. 52 lot codes with expiration dates in 2027 were affected and can be found via the source link. The product is available nationwide primarily online on the company's website (tryrosabella.com), Amazon, TikTok Shop, Shein, and eBay. 7 people from 7 states were infected so far, with 3 people hospitalized, but there are likely more unrecognized cases. The Salmonella strain in this outbreak is resistant to all first-line and alternative antibiotics commonly recommended for treatment. Onset of illnesses ranged from 11/7/25 to 1/8/26. No deaths have been reported. [Confidence: Very High]

Recommendation: Employers can support employees in obtaining mpox vaccinations by providing flexible work schedules. Information on the availability of mpox vaccines and treatment can also be included in employee wellness communication.

Situation: The WHO issued an update on a recombinant strain of clade 1b and 2b mpox. Genomic analysis identified 2 closely related sequences from a case in England and a case in India. The England case was previously reported in December 2025 in an individual who recently traveled to Southeast Asia in October (see PHC alert on 12/8). The case in India was detected in September 2025 and retrospectively reclassified as a closely-related recombinant strain. The individual had recently traveled from a country in the Arabian Peninsula. Both cases had similar clinical presentations, symptom onset within weeks of each other, and neither experienced severe outcomes, though any assessment of the strain's severity or transmissibility based on the 2 cases is premature. No secondary cases linked to either case were detected, making these the only known cases of this recombinant virus. The origin of the strain remains unknown, and transmission of the virus involves at least 4 countries, suggesting that the strain may be more widespread than documented. The WHO stated that all countries should remain alert to the possibility of mpox genetic recombination, but the risk assessment remained unchanged, staying as Moderate for men who have sex with men or with new or multiple partners, or sex workers, or others with multiple casual sexual partners, and Low for the general public. [Confidence: Very High]

Recommendation: This new H5N1 case in Cambodia does not change PHC's recommendations for organizations. No human-to-human spread of avian influenza has been detected. Organizations should follow the recommendations provided in the PHC analysis on 1/10/25 and 2/13/25, including lowering barriers to seasonal flu vaccines for their employees. Employees should avoid live-animal markets and not have contact with or consume diseased poultry.

Situation: Cambodia confirmed a new H5N1 human case in a 30-year-old man from the Meanrith Village in the Teuk Chhou district, and the case has since recovered. The investigation revealed that there was a dead chicken in the case's house, and it was cooked 3 days before the individual started having symptoms. Health officials are searching for suspected cases and contacts to prevent further transmission, including distributing Tamiflu to close contacts and conducting health campaigns among residents in affected villages. [Confidence: Very High]