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Burkina Faso: More than 3,100 suspected dengue cases are reported weekly across the country, a significant increase from the average number of new cases. More than 11,500 cases have been reported since January 2023, mainly in the Centre and Hauts-Bassins regions.Côte d'Ivoire: According to the WHO Regional Office, more than 2,400 cases of dengue fever (of which > 230 were laboratory-confirmed) were reported between mid-June and 19 August 2023; this is also a significant increase. Cases have been registered throughout the country, but mainly in the autonomous district of Abidjan.

In the Indian state of Assam (north-eastern part of the country), 432 cases of Japanese encephalitis (JE) were reported by the end of August, 24 of which were fatal. Cases have increased almost tenfold since the beginning of August 2023.Ranchi district in Jharkhand state in northern India has also reported an increase in JE cases, although the numbers are still modest, with 12 cases in recent weeks.

The number of reported tick-borne encephalitis (TBE) cases in Sweden has risen sharply this year. According to the health authority, 170 cases were confirmed in the month of August alone. In Sweden, the ticks had favourable conditions this year, as the weather alternated between high temperatures and a lot of precipitation.

According to media reports, a case of canine rabies has been reported in the city of São Paulo in Brazil. The infection was confirmed by the Pasteur Institute. This is the first case of canine rabies since 1983. The case is still under investigation and has already led to surveillance measures in the region and 367 animals have been vaccinated with rabies vaccine.

Five cases of Nipah virus infection, including two deaths, have been reported in Kozhikode, Kerala, since late August. The index case was hospitalized in Kozhikade district on August 28, 2023; the other four cases are either family members or hospital contacts of the index case.Restrictions such as lockdowns were announced to prevent the spread of the virus. Some schools, colleges and offices have been closed and 7 villages have been declared a containment zone. Wearing masks and using disinfectants were made mandatory in the containment zone. The source of the infection is still under investigation. The last documented case of NiV infection in India occurred in 2021, also in Kozhikade district.Nipah virus (NiV) is a highly pathogenic virus belonging to the family Paramyxoviridae, genus Henipavirus. It was first isolated and identified in 1999 during an outbreak in Malaysia and Singapore. Since then, several outbreaks have been reported in South and Southeast Asia. NiV is most commonly transmitted via fruit bats, a species of bat that is the natural reservoir, through direct or indirect contact with their excreta. Tree fruits or sap produced from them contaminated with bat droppings are often considered a source of infection. Human-to-human transmission has been reported during the care of infected patients. In addition, pigs may also be infected. The spectrum of disease ranges from (usually) asymptomatic courses to flu-like symptoms with high fever, headache, and muscle pain to encephalitis with severe neurologic or even pulmonary complications. Mortality is high (40-70%).

In Bordeaux, in southwestern France, fifteen people were diagnosed with suspected botulism, including 1 death. At least ten persons were hospitalized and eight were treated in intensive care. Type B botulism toxin was detected in serum samples from some of the affected individuals, and sardines tested were positive for Clostridium botulinum type B. All patients reported eating at the same restaurant that served locally produced canned sardines, which were confirmed as the source of infection. The patients were individuals of U.S., British, Canadian, English, French, German, Irish, and Spanish nationality. The product was immediately withdrawn from circulation and control measures are being implemented in the restaurant.

Since the first week of August and until September 11, 2023, 14 cases of locally acquired (autochthonous) dengue fever infection have been registered in the Italian regions of Lombardy and 5 cases in the region of Lazio, including Rome. All cases were laboratory-confirmed, and all patients have recovered or are on the road to recovery. Since the beginning of the year, 146 imported dengue cases have been registered in Italy.

In August 2023 alone, 15 cases of leptospirosis were registered in the Lviv region. This is five times more than in the first half of 2022, and 21 cases have been reported since the beginning of the year. According to epidemiological investigations, the infections occurred in the following ways: during contact of damaged skin with infected objects, surfaces (12 cases), through water contact (swimming in reservoirs, fishing) (8 cases) and during consumption of infected food (1 case).

Since the first week of August and as of 11 September 2023, 19 locally acquired dengue fever cases have been detected in the Lombardy (14) and Lazio (5) regions in Italy. The cases are grouped in three clusters:in the province of Lodi, Lombardy region (14 cases)in the metropolitan city of Rome (3 cases) and in the province of Latina (2 cases), Lazio region (Circero). All cases were laboratory confirmed by PCR and all cases have recovered or are improving. A DENV-1 serotype virus was identified in the cases in Lombardy and in the metropolitan city of Rome, Lazio region. Epidemiological investigations have not identified any link between the cases in Lombardy and the cases identified in the Lazio region. A DENV-3 serotype was detected in the cluster of cases in the province of Latina, Lazio region, indicating that this outbreak is independent from the other two in Italy. Response and control measures are being implemented by Italian public health authorities. These include case finding, vector control activities, information to healthcare providers and the general public, and preventive measures for donors of substances of human origin (e.g. blood and organs). So far, 146 imported dengue cases have been registered in Italy in 2023, most of them in the Lombardy region (50 imported cases) and Lazio region (28 imported cases).For more details of the outbreak in Italy, see Rapid Communication of Eurosurveilance.

Between late July and early September, 10 autochthonous (locally acquired) dengue cases were reported in Italy. The affected regions are Lombardy (7 cases, province of Lodi and Lake Garda) and Lazio (1 case in Rome, 2 cases in Latina). According to media reports, an autochthonous dengue case in Parma is also under investigation. A total of 122 imported dengue cases have been diagnosed in Italy since the beginning of the year.

Since January 2023, a total of 8'455 diphtheria cases (2'507 confirmed; 5'948 suspected) and 230 deaths have been recorded in four African countries: Algeria: (80 cases, 10 deaths), Guinea (90 cases, 22 deaths), Niger (272 cases, 8 deaths), and Nigeria (8,013 cases, 190 deaths). Immunization rates in the region are low, and this is in an environment where mining causes large population movements. In addition, the local health system is fragile and has limited resources to respond to this outbreak. Other ongoing outbreaks in the region, particularly pertussis, polio, and rabies, are straining the limited resources available.

An outbreak of 4 autochthonous (locally transmitted) cases of dengue fever was detected in Gardanne in the department of Bouches-du-Rhône. Symptoms of the cases occurred between the second half of July and early August 2023.At least 47 autochthonous cases were recorded in France in 2022. The affected regions were Occitania (9 cases) and Provence-Alpes-Cote d'Azur (36 cases).

Virginia state health officials are reporting an outbreak of meningococcal disease. Since June 2022, a total of 27 cases of meningococcal disease caused by the bacterium Neisseria meningitides, type Y, have been reported in adults aged 30 to 65 years. 5 patients have died. A total of 26 patients were not vaccinated. The strain associated with this outbreak is known to be common in the United States.

Since the beginning of the year, 1,785 hepatitis A cases have been registered in Lebanon, 204 of them in the Baalbek district in the east of the country. Last year, there were fewer than 600 hepatitis A cases nationwide.

Globally, nearly 1.5 million new COVID-19 cases and over 2500 deaths have now been reported from 10 July to 6 August 2023, representing an 80% increase and a 57% decrease, respectively, from the previous 28 days. By 6 August 2023, over 769 million confirmed cases and over 6.9 million deaths have been reported globally. The current reported cases do not accurately reflect infection rates as the number of tests and reports have decreased worldwide.

The Democratic Republic of Congo (DRC) is facing its worst cholera epidemic in six years due to an increase in conflict and displacement in the east of the country. The United Nations Children's Fund (UNICEF) warns The UN agency reports that 31,342 suspected or confirmed cases of cholera and 230 deaths were reported across the country in the first seven months of this year, many of them children. North Kivu is the most affected province.

According to media reports, 47 chikungunya cases were reported in the Kedougou region of southeastern Senegal in the first half of August. The last chikungunya outbreak in Senegal occurred in 2015.