Infectious disease surveillance and monitoring for animal and human health: summary November 2024
Updated 24 April 2025
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Interpreting this report
The UK Health Security Agency’s (UKHSA) Emerging Infections and Zoonoses (EIZ) team uses an integrated horizon scanning approach, which combines information on both human and animal health, to identify and assess outbreaks and incidents of new and emerging infectious diseases globally. For further information about the EIZ team’s horizon scanning process, please see our Epidemic intelligence activities.
This summary provides an overview of incidents (new and updated) of public health significance, which are under close monitoring. The incidents are divided into 2 sections: Notable incidents of public health significance and Other incidents of interest. For each notable incident of public health significance, an incident assessment is provided, based on the EIZ team’s interpretation of the available information.
The report also includes a section that focuses on Novel pathogens and diseases and a final Publications of interest section, which contains new publications relevant to emerging infections.
Epidemiological updates for diseases classified as a high consequence infectious disease (HCID) are published in UKHSA’s HCID monthly summary, unless they are considered a notable incident of public health significance, in which case a more detailed summary will be provided in this report.
For more information, or to sign up to the distribution list to receive an email alert when new reports are published, please contact epiintel@ukhsa.gov.uk
Notable incidents of public health significance
Summary of incidents
| Disease or infection | Location | New or update since the last report |
|---|---|---|
| Avian influenza A(H5N1) | Canada | New |
| Mpox | United Kingdom | Update |
Avian influenza A(H5N1) – Canada
Event summary
On 9 November 2024, the British Columbia Centre for Disease Control in Canada reported a presumptive positive case of avian influenza A(H5) in a teenager from the Fraser Health region. On 13 November 2024, the case was confirmed by the Public Health Agency of Canada as being infected with avian influenza A(H5N1), signifying the first locally acquired human case in Canada.
The case experienced severe symptoms, requiring hospitalisation in intensive care. Epidemiological investigations were initiated to identify the source of exposure, however a source could not be determined. Contact tracing was carried out to identify individuals with potential exposure to the case, and amongst those detected none developed symptoms and all tested negative for avian influenza A(H5N1) infection.
Genetic analysis of the virus isolated from the case identified the clade 2.3.4.4b strain, genotype D1.1, which is currently circulating amongst wild birds and poultry in British Columbia. Outbreaks due to this strain amongst poultry have been reported in Canada in 2024. The strain was also found to closely resemble the strain detected amongst wild birds in Fraser Valley Region during October 2024.
Incident assessment
This case represents the first locally acquired human case of avian influenza A(H5N1) reported in Canada. Globally, between 1 January 2003 to 28 November 2024, 953 cases of human infection with avian influenza A(H5N1) virus and 464 deaths (case fatality rate (CFR) of 48.7%) were reported from 24 countries. Whenever avian influenza viruses are circulating in animals, there is a potential risk of sporadic human cases following exposure to infected animals or their contaminated environments. Human cases of avian influenza A(H5) are rare and there is limited evidence of human-to-human transmission of these viruses. The WHO has published interim genetic and antigenic characteristics of avian influenza A(H5N1) clade 2.3.4.4b virus.
Since 2021, 5 human cases of avian influenza A(H5N1) clade 2.3.4.4b have been reported in the UK. These cases were associated with poultry exposures and were either asymptomatic or had mild symptoms. The D1.1 and B3.13 genotypes are not circulating in the UK. For further information on avian influenza viruses, see the UKHSA’s avian influenza webpage.
Mpox – United Kingdom
Event summary
In response to the increase in clade I mpox cases in the Democratic Republic of the Congo (DRC) and other countries in the African Region, the World Health Organization (WHO) declared a public health emergency of international concern under the International Health Regulations (2005) on 14 August 2024. Following the detection of the first travel associated case of clade Ib mpox in London, England, on 30 October 2024, 3 additional clade Ib mpox cases were identified amongst household contacts between 4 and 6 November 2024. The cases were isolated in hospital and contact tracing was carried out. All contacts were offered testing and vaccination as necessary. This is the first time secondary transmission of clade I mpox has been reported outside of the African Region.
On 29 November 2024, the UKHSA reported another travel associated case of clade Ib mpox in Leeds, England. The case had recently travelled to Uganda which has been experiencing community transmission of clade Ib mpox. Contacts of the case were offered testing and vaccination as necessary. This brings the total number of clade Ib mpox cases reported in the UK to 5.
Incident assessment
The WHO has assessed the risk associated with mpox in the eastern DRC and neighbouring countries to be high. This assessment is based on several factors. The majority of cases and deaths in endemic regions occur among children, with the disease causing a significant impact on this vulnerable group. Clade I mpox is also being transmitted through sexual contact within populations such as sex workers in mining towns. The spread of clade I MPXV to countries neighbouring the DRC with international travel connections (for example Rwanda, Kenya, Burundi, and Uganda), increases the risk of further geographical expansion.
In countries experiencing community transmission, the spread of clade I MPXV had predominantly been driven within young adults through sexual contact. As clusters expanded, transmission dynamics shifted to increased transmission within households and communities through close direct physical contact. This had led to a shift in the distribution of cases with an increased proportion of cases among children.
Obstacles associated with the control of the outbreak in some areas of the African Region include a lack of adequate resources to effectively respond (for example vaccines and diagnostic capacity), compounded by limited public awareness about the disease and its transmission. Insufficient information regarding animal reservoirs complicates understanding of transmission pathways and the implementation of responses.
As of 29 November 2024, a total of 5 clade Ib mpox cases have been reported in the UK. The risk of clade Ib mpox importation in the UK is considered to be low to medium, as is the risk of onwards transmission in the UK. There are well established public health, clinical and infection prevention and control procedures available in the UK to respond to clade I mpox cases. This includes processes for the isolation and contact management of clade I mpox in the UK, to reduce further transmission.
Summary of other incidents
| Disease or infection | Location |
|---|---|
| Cholera | African Region |
| Oropouche fever | Region of the Americas |
| Polio | Multi-country |
| Yellow fever | Colombia and the Republic of the Congo |
Cholera
Between 1 January and 22 November 2024, 196,835 cholera cases (including 24,747 confirmed cases) and 3,324 deaths (CFR of 1.7%) were reported across 20 African Union member states, according to the Africa Centres for Disease Control and Prevention (Africa CDC). Most cases have been reported from Sudan (40,068 cases and 838 deaths), the Democratic Republic of the Congo (DRC) (28,618 cases and 385 deaths) and Ethiopia (26,052 cases and 255 deaths). To compare, during 2023, a total of 638,942 cholera cases (including 21,751 confirmed cases) and 6,453 deaths (case fatality rate of 1.0%) were reported across 28 African Union member states.
On 25 November 2024, Mozambique’s Ministry of Health declared a cholera outbreak. Between 17 to 30 November 2024, 200 confirmed cholera cases and 7 deaths were reported from Nampula Province. This brings the total number of cholera cases reported in 2024 to 8,383 confirmed cases and 24 deaths across all 10 provinces of the country. In 2023, 1,342 cholera cases (no deaths) were reported in Mozambique.
On 12 November 2024, Zimbabwe’s Ministry of Health declared a cholera outbreak in Kariba District, Mashonaland West Province. Since the index case was detected on 4 November 2024, a total of 70 cases (5 confirmed cases) and one death has been reported in Kariba District up to 22 November 2024. Nationally, 19,482 cholera cases (2,467 confirmed cases) and 387 deaths have been reported in Zimbabwe in 2024. This is similar to the total number of cases and deaths reported during 2023 (19,442 cases and 387 deaths).
Oropouche fever
Between 1 January and 25 November 2024, a total of 11,634 confirmed Oropouche cases and 2 deaths have been reported in the Region of the Americas. Most cases have been reported from Brazil (9,563 cases, 2 deaths), Peru (936 cases), Cuba (603 cases) and Bolivia (356 cases). On 15 November 2024, the first locally acquired Oropouche case in Panama was reported. Prior to the geographical spread of Oropouche virus (OROV) during 2024, outbreaks had predominantly been reported in the Amazon region. A recent publication details the first reports of vertical transmission of OROV and its associated outcomes on foetal development.
Polio
Wild poliovirus type 1 (WPV1)
During November 2024, 13 new WPV1 cases were reported by the Pakistan Polio Eradication Programme. This brings the total number of WPV1 cases reported in 2024, up to 27 November, to 56. Most cases have been recorded in Balochistan (26 cases), followed by Khyber Pakhtunkhwa (15 cases), Sindh (13 cases), and one each from Punjab and Islamabad. In 2023, 6 cases of WPV1 were reported from Pakistan.
Circulating vaccine derived polio virus (cVDPV)
During November 2024, the Global Polio Eradication Initiative (GPEI) reported 2 cases of cVDPV1 from Tshopo and Haut Lomami provinces in the DRC. In 2023, 106 cVDPV1 cases were reported in the DRC.
During November 2024, the GPEI reported cases of cVDPV2 from: Chad (7 cases), Ethiopia (one case), Niger (one case), Nigeria (15 cases), Senegal (one case) and Yemen (2 cases). A total of 395 cases were reported across 22 countries in 2023 with most reported from the DRC (120 cases), Nigeria (87 cases) and Chad (55 cases).
On 28 November 2024, the WHO reported the detection of cVDPV2 from environmental wastewater samples taken in Spain (Barcelona), Poland (Warsaw), and Germany (Cologne, Bonn, Hamburg and Munich). Genetic analysis has found these detections to be genetically linked to a strain which had emerged in Nigeria. Polio vaccine coverage ranges between 85 and 93% in Spain, Poland and Germany. No associated human cases have been detected in these countries. The WHO European Region has been polio-free since 2002.
Yellow fever
On 25 November 2024, the Government of Tolima Department in Colombia reported 12 confirmed yellow fever cases and 5 deaths. 75% of cases have been reported amongst males, with the 40 to 59 age group being most affected. To note, no yellow fever cases were reported from Colombia between 2019 – 2022, while 2 cases were reported in 2023.
In 2024, up to 25 November 2024, the Africa CDC reported a total of 436 yellow fever cases (16 confirmed cases) and no deaths from 6 out of 12 departments in the Republic of the Congo. This is an increase in cases compared to the total number of cases reported nationally in 2023 (389 cases and 2 deaths).
Publications of interest
Antimicrobial resistance
A recent global systematic review and meta-analysis published in the Lancet found that refugees and asylum seekers are at a higher risk of antimicrobial resistance (AMR) carriage and infection. Common pathogens identified in this population included multidrug-resistant Gram-negative bacteria (prevalence ranged from 4.2% to 60.8%), methicillin-resistant Staphylococcus aureus (0.92% to 73%) and extended-spectrum β-lactamase-producing Gram-negative bacteria (1.6% to 61.1%). The likelihood of AMR carriage or infection in this population compared to the host-country population was also higher (odds ratio 2.88, 95% confidence interval 2.61 to 3.18). This study highlights the impact of conditions such as overcrowded camps and barriers to healthcare on AMR prevalence amongst refugees and asylum seekers.
Arboviruses
The results of an entomological study surveying the distribution of mosquito arboviruses identified chikungunya virus, Banna virus, and Usutu virus for the first time in Algeria. Additional confirmation of these viruses was detected in serological investigations in animals. This was also the first detection of Banna virus outside of the Asian region. The authors emphasize the importance of surveillance of circulating arboviruses in mosquitoes and animals to predict future incidents, particularly if there is a risk of zoonotic transmission to humans.
Infectious diseases
By utilizing data from the International Health Regulations State Party Self-Assessment Annual Reporting submissions, a study compared the epidemic preparedness and response capacity against infectious disease outbreaks globally between 2018 to 2022. An overall increase in the functional capacity across 186 countries was observed in their prevention (from 58.4% in 2018 to 66.5% in 2022), detection (from 74.7% to 78.3%), response (from 56.5% to 67.8%), enabling resources and coordination (from 63.0% to 68.3%), and ensuring operational readiness (from 62.8% to 69.9%). The authors report a lack of functional competence development in these capacities in the Global South, highlighting vulnerabilities and the continued risk of epidemics.
Oropouche virus
There has been a recent spread in the geographical distribution of Oropouche virus (OROV) outside of the endemic Brazil Amazon region. An epidemiological study comparing cases of OROV in the endemic Amazon region, and non-endemic regions of Brazil was carried out. Results showed OROV case frequency outside of the Brazilian Amazon region was 3.9 times higher in small municipalities compared to large municipalities. Furthermore, agricultural areas such as banana plantations and cassava planted areas were positively correlated with OROV cases. The authors highlight that these ecological conditions favour competent vector occurrence, which may be an important factor increasing the expansion of OROV in Brazil.
Further reading
Immune history shapes human antibody responses to H5N1 influenza viruses
Global burden of zoonotic infectious diseases of poverty, 1990–2021
Related resources
1. High consequence infectious diseases monthly summaries
2. National flu and COVID-19 surveillance reports
3. Avian influenza (influenza A H5N1): technical briefings
4. Avian influenza (bird flu) in Europe, Russia and the UK reports
5. Bird flu (avian influenza): latest situation in England updates
6. Human Animal Infections and Risk Surveillance (HAIRS) group risk assessments and statements
7. Animal and Plant Health Agency (APHA) monitoring of disease in livestock and poultry monthly reports
Authors of this report
UKHSA’s Emerging Infections and Zoonoses team epiintel@ukhsa.gov.uk