Building the Future of Biodefense

Recommendation: Respiratory diphtheria can be a severe disease requiring both antibiotics and antitoxin, but there is an effective vaccine. Organizations in the Northern Territory, Australia, should provide flexible work schedules to support employees who need to make vaccine appointments for themselves or their family members.

Situation: Health officials are investigating a diphtheria outbreak in the Northern Territory, Australia, after 4 cases of respiratory diphtheria were reported in the last week (3 in Darwin and 1 in Alice Springs). Additionally, 33 cases of cutaneous diphtheria have been recorded since 2025. Health clinicians were urged to watch for suspicious skin sores, infected wounds, or upper respiratory illness in Darwin and Alice Springs, especially among under- or unvaccinated individuals or those with known contact with a case. [Confidence: Very High]

Recommendation: Avian influenza H9N2 human cases have been sporadically reported in Asia, mostly in China. Historically, the risk of an outbreak has been extremely low since human-to-human transmission does not usually occur. Organizations can lower barriers to seasonal flu vaccines for their employees. Employees in countries where H9N2 is commonly detected in animals should avoid live-animal markets and not have contact with or consume diseased poultry.

Situation: Italy reported Europe’s 1st ever human case of the low-pathogenicity avian influenza A(H9N2) in Lombardy. The infected individual, who is currently hospitalized but stable, is described as a frail person with concomitant illnesses who recently arrived in Italy from a non-European country. The source of infection was not provided, but H9N2 infection usually occurs through contact with infected poultry or contaminated environments. Officials activated routine surveillance and prevention measures, identified contacts, and are monitoring the situation. [Confidence: Very High]

Recommendation: Organizations in Dourados, Brazil, should reduce mosquito habitats by eliminating standing water and applying insecticides to outdoor storage containers, as well as encouraging employees to prevent mosquito bites. Organizations should support pregnant employees who opt not to travel to areas reporting elevated chikungunya circulation. Employees should consult a doctor about vaccination against chikungunya before traveling to affected areas. Vaccine eligibility and availability may vary by country.

Situation: Dourados declared a public health emergency as chikungunya cases rose to 648 confirmed infections over an unspecified period, with 4 deaths reported. According to media sources, the outbreak, which began in an Indigenous Reserve, has spread to urban neighborhoods. Officials intensified mosquito control efforts and urged residents to eliminate standing water and help curb the spread of the disease. While chikungunya activity in Dourados is much higher so far this year compared to levels observed over the same period in 2025 and 2024, national activity is lower than in previous years. Nationally, Brazil reported 16,558 probable chikungunya cases so far this year, including 10 confirmed deaths and 13 additional deaths under investigation. [Confidence: Very High]