Countries: World, Australia, Fiji, Guam, Marshall Islands, Micronesia (Federated States of), New Caledonia (France), New Zealand, Niue (New Zealand), Palau, Papua New Guinea, Samoa, Tonga, Tuvalu, Vanuatu, Wallis and Futuna (France) Source: Pacific Community Please refer to the attached Map. Highlights/updates since the last map was sent on PacNet on 29 September 2026: Dengue • Marshall Islands: The 10th Outbreak Situation Report on dengue in Majuro and Ebeye, dated 28 September 2026 and covering 15 August to 25 September, records 297 specimens tested (Majuro 263, Ebeye 34) and 112 confirmed positive (Majuro 97, Ebeye 15), with no deaths and seven cumulative hospitalisations. Four cases had onset in the past seven days (Majuro 3, Ebeye 1). The confirmed-case attack rate is 4. 2 per 1, 000 in Majuro and 1. 5 per 1, 000 in Ebeye, and the Majuro positivity rate is 36. 8 percent. Only DENV-1 has been detected. The red alert for dengue (DENV-1) remains in effect. – Source: Republic of the Marshall Islands Ministry of Health and Human Services, Outbreak of Dengue Fever Cases in Majuro & Ebeye, 10th Outbreak Situation Report shared with the PPHSN Coordinating Body Focal point on 01 October 2026. • Samoa: The Dengue Fever Outbreak Situation Report Issue No. 76 for EpiWeek 39 (21 to 27 September 2026) reports 35 new cases, a 169 percent increase on the previous week, including five laboratory-confirmed cases, against one the week before. Two new admissions and no deaths were reported. Since 1 January 2025, 20, 308 clinically diagnosed cases, 5, 546 laboratory-confirmed cases and nine dengue-related deaths have been recorded. DENV-1 accounts for 52 percent and DENV-2 for 48 percent of serotyped cases, and children under 15 years for 73 percent of cases. The outbreak will be declared over after 28 days without a new laboratory-confirmed case. The blue alert for dengue (DENV-1 & DENV-2) remains in effect. – Source: Ministry of Health Samoa, Dengue Fever Outbreak Situation Report Issue No. 76, shared with the PPHSN Coordinating Body Focal point on 06 October 2026. • Vanuatu: Situation Report #14 on the dengue outbreak on Efate and Santo, dated 28 September 2026, reports 17 new laboratory-confirmed cases in EpiWeeks 38 and 39 (14 to 27 September), 10 from Efate and 7 from Santo, bringing the cumulative total to 169 confirmed cases. Weekly numbers remain above the outbreak threshold of four confirmed cases per week, although they have declined since the peak of EpiWeeks 33 to 35. In Santo, cases are now reported in Luganville, East Santo and Canal-Fanafo Area Councils. Sixteen dengue-associated hospitalisations have been reported, all discharged, with no severe dengue and no deaths. DENV-1 remains the only serotype detected. Tafea Provincial Health has also declared a dengue outbreak in Tafea Province, and its response team is investigating cases, tracing contacts and raising community awareness in the West Tanna Area Council. The red alert for dengue (DENV-1) remains in effect for Vanuatu. – Sources: Vanuatu Ministry of Health, Dengue Outbreak on Efate and Santo Island, Situation Report #14, shared with the PPHSN Coordinating Body Focal point on 1st October 2026, Official dengue press released for Tanna – Tafea Health Promotion official Facebook page and Tafea Provincial Health, Dengue response West Tanna accessed on 06 October 2026. • Wallis and Futuna: The Health Agency reported on 1st October 2026 that the dengue epidemic is continuing, with 11 new confirmed cases over weeks 37 to 39, four on Wallis and seven on Futuna, bringing the cumulative total for the territory to 95 confirmed or probable cases. The red alert for dengue remains in effect for Wallis and Futuna. – Source: Agence de Santé de Wallis et Futuna, epidemiological and health watch update for weeks 37 to 39 (1st October 2026) shared with the PPHSN Coordinating Body Focal point on 06 October 2026. Measles • Australia: NSW Health issued a measles alert for the Campbelltown area on 03 October 2026 after a confirmed case in a returned traveller from South-East Asia. While infectious, the person visited several sites in the Campbelltown area and locations in Concord and Rooty Hill. As of 06 October 2026, 119 measles notifications have been reported nationally in Australia in 2026, already exceeding the annual totals for each year from 2020 to 2024 (25, 0, 7, 26 and 57 respectively), following 181 notifications in 2025, the highest annual count since 2019 (285). In 2026, New South Wales has reported the largest number of notifications (n=55), followed by Victoria (n=30), Queensland (n=18), South Australia (n=9), Western Australia (n=5) and the Australian Capital Territory (n=2). No cases have been notified in the Northern Territory or Tasmania. The red alert for measles remains in effect for Australia. – Sources: NSW Health, Measles alert for Campbelltown area and National Notifiable Disease Surveillance Syestem – Australian Centre fo Disease Control accessed on 5 October 2026. • Papua New Guinea: The National Department of Health weekly bulletin for EpiWeek 39 (21 to 27 September 2026) reports 17 laboratory-confirmed measles cases in 2026, up from 13 the previous week: National Capital District 6, East Sepik 4, Western Highlands 2, and one each in the Autonomous Region of Bougainville, Central, Eastern Highlands, Enga and New Ireland. The last onset date is 15 September 2026. Rubella cases rose from 21 to 25, and ten patients are positive for both measles and rubella. Year to date, 361 acute fever and rash cases have been reported and 373 samples submitted. The measles-rubella vaccination campaign targets all children under seven in districts with a detected case. The red alert for measles remains in effect for Papua New Guinea. – Source: Papua New Guinea National Department of Health, Public Health Events Weekly Bulletin, EpiWeek 39 shared with the PPHSN Coordinating Body Focal point on 02 October 2026. Pertussis • Vanuatu: Situation Report 05 on the pertussis outbreak in Penama Province, dated 28 September 2026, reports 21 new cases on Ambae Island in EpiWeeks 38 and 39 (respectively 1 and 20), bringing the cumulative total to 605 cases, of which 4 are laboratory confirmed. The outbreak peaked in EpiWeeks 36 and 37 (266 and 307 clinically diagnosed cases) and case numbers have since declined substantially, but continued detection shows that community transmission has not been interrupted. Two cases have been hospitalised since the start of the outbreak and no death is reported. North Ambae accounts for 54 percent of cases and South Ambae for 43 percent. The red alert for pertussis remains in effect for Vanuatu. – Source: Vanuatu Ministry of Health, Pertussis Outbreak in Penama Province, Situation Report 5 shared with the PPHSN Coordinating Body Focal point on 01 October 2026. Respiratory diseases • New Caledonia: The Directorate of Health and Social Affairs (DASS) announced on 1st October 2026 that New Caledonia has entered an influenza epidemic phase. In week 39 (21 to 27 September), 115 new laboratory-confirmed cases were recorded, bringing the 2026 total to 238, 190 of them since week 33. A/H1N1pdm09 predominates and laboratory positivity reached 56 percent. Acute respiratory infections exceeded 15 percent of sentinel GP consultations in weeks 38 and 39. In week 39, 221 emergency department presentations were for acute respiratory infection (12 percent of all presentations, against 4 percent in week 37) and 54 patients were hospitalised, with a median age of 71 years. Since 27 September, bed occupancy in intensive care and continuous monitoring units has exceeded 75 percent. People aged 65 and over account for 36 percent of confirmed cases. The epidemic comes earlier than in 2024 and 2025. A red alert for influenza A is issued for New Caledonia. – Source: Direction des Affaires Sanitaires et Sociales de Nouvelle-Calédonie, Vigilance DASS bulletin 2026-#08, influenza epidemic, shared with the PPHSN Coordinating Body Focal point on 02 October 2026. • New Zealand: For the week ending 27 September 2026, the all-cause SARI hospitalisation rate in the Auckland region has decreased into the low activity band, and the influenza-positive SARI rate decreased for the fourth week in a row and is now low. Influenza remained the most commonly detected virus among SARI patients, with test positivity stable at 32. 9 percent, while positivity among sentinel GP influenza-like illness cases fell from 34. 3 to 27. 3 percent. A/H1 and A/H3 are detected at similar levels. Twenty-eight influenza-positive SARI patients have been admitted to intensive care in 2026, all since 27 July. Since 1st January, 5, 296 influenza-positive specimens have been reported nationally (4, 912 influenza A and 384 influenza B), and circulating viruses match the 2026 vaccine. Pacific peoples have had the highest cumulative rates of influenza-, RSV- and SARS-CoV-2-positive SARI hospitalisation in 2026. The red alert for influenza A is changed to a blue alert for New Zealand. – Sources: PHF Science, New Zealand Acute Respiratory Illness dashboard, accessed on 5 October 2026 and PHF Science, Virology Weekly Report, week 39, accessed on 5 October 2026. Rotavirus • Federated States of Micronesia: Situation Reports #18 and #19 on the diarrhoeal outbreak in Yap State, dated 25 September and 1st October 2026, report one new case on 25 September and nine between 28 September and 1st October, two of them from Ifalik Dispensary in the Outer Islands, bringing the cumulative total to 240. There have been 14 admissions since the outbreak began, 12 of them children, and no deaths. Rotavirus remains predominant, mostly as co-infections with E. coli, adenovirus, Salmonella, Giardia and, newly, Clostridioides difficile, and a laboratory-confirmed rotavirus reinfection was detected in a two-year-old. Children aged 0 to 11 years account for 66 percent of cases. Case counts have declined to low single digits since mid-September but remain above the alert threshold. The red alert for rotavirus is changed to a blue alert for the Federated States of Micronesia (Yap State). – Source: Yap State Diarrhoeal Outbreak Situation Reports #18 and #19 shared with the PPHSN Coordinating Body Focal point on 29 September and 02 October 2026. • Vanuatu: Situation Report No. 6 on the rotavirus outbreak in Tafea Province, dated 30 September 2026, reports 123 acute watery diarrhoea cases in EpiWeek 39 (21 to 27 September), bringing the cumulative total to 1, 140 cases, three of them laboratory confirmed. Case numbers declined in EpiWeeks 38 and 39 but remain above the alert threshold of 34 cases per week. Cases have been reported on Aneityum Island for the first time, with 12 cases in EpiWeek 39. Children under five account for most cases. A total of 44 patients have been hospitalised since EpiWeek 33 and one death, in a one-year-old child, was reported in EpiWeek 35. Water testing detected E. coli contamination. The Ministry of Health has also declared a rotavirus outbreak in Sanma Province, on Santo, where more than 100 acute watery diarrhoea cases were reported between 24 August and 20 September and four confirmed cases in the latest week met the declaration criteria. The red alert for rotavirus remains in effect for Vanuatu. – Sources: Vanuatu Ministry of Health, Rotavirus Outbreak in Tanna and Aneityum Island, Situation Report No. 6 shared with the PPHSN Coordinating Body Focal point on 01 October 2026 and Vanuatu Daily Post, Water diarrhoea outbreak on Santo, accessed on 03 October 2026. Other Information: One Health – High pathogenicity avian influenza • Australia: The national H5 bird flu dashboard recorded 682 confirmed events in wildlife as of 02 October 2026, against 652 on 25 September: South Australia 325, Victoria 230, New South Wales 68, Tasmania 46, Western Australia 10, Queensland 2 and Jervis Bay Territory 1. H5 has not been reported from any Pacific Island country or territory to date. – Source: Australian Government Department of Agriculture, Fisheries and Forestry, H5 bird flu latest data accessed on 05 October 2026. • Pacific Island countries and areas: The WHO Western Pacific Region Avian Influenza Weekly Update No. 1064 (02 October 2026) presents a rapid joint One Health risk assessment of high pathogenicity avian influenza incursion into Pacific Island countries and areas. Following detections of H5N1 clade 2. 3. 4. 4b in Australia and New Zealand, entry through seabird and wild bird movements in the south-west Pacific is assessed as very high risk from August 2026 to January 2027, and entry through poultry trade and human movement as low. If introduced, establishment would be high risk in resident wild birds and very high risk in domestic poultry, given free-ranging backyard poultry and limited biosecurity. Human exposure is assessed as low under current conditions. No human avian influenza case was reported in the Region. – Source: WHO Western Pacific Region, Avian Influenza Weekly Update No. 1064 accessed on 06 October 2026. Respiratory diseases • Guam: The Communicable Disease Surveillance Dashboard, updated on 05 October 2026, shows the late-season influenza wave reaching its highest level of 2026 in EpiWeek 38 with about 151 influenza and influenza-like illness cases, against about 121 the previous week. In EpiWeek 38, there were 62 laboratory-confirmed influenza A cases. All influenza viruses subtyped in August and September were A(H1N1) with 44 percent of cases are aged 5 to 19 years. – Source: Guam Department of Public Health and Social Services, Communicable Disease Surveillance Dashboard accessed on 06 October 2026. • Nauru: The Naoero Medical Centre has observed an ongoing increase in influenza infections, with more people seeking care for influenza-like symptoms, and health authorities urge the public to remain vigilant and take preventive measures. – Source: Nauru health authorities accessed on 06 October 2026. • Niue: The Public Health Snapshot for 22 to 28 September 2026 reports 17 new confirmed influenza A cases, after 24 the previous week, bringing the total to 104 since 17 August 2026. Thirteen hospital admissions, all for influenza A, have been recorded since 17 August. No COVID-19 or influenza B case was reported. – Source: Niue Public Health Division, Public Health Snapshot, 22-28 September 2026 accessed on 06 October 2026. • Palau: The Ministry of Health and Human Services reported on 02 October 2026 a total of 53 influenza A cases in 2026, with activity increasing in recent weeks. – Source: Palau Ministry of Health and Human Services, Respiratory Disease Situational Update accessed on 06 October 2026. • Tonga: The weekly syndromic surveillance report for EpiWeek 39 (21 to 27 September 2026) records 73 influenza-like illness cases, the fifth consecutive weekly increase and the highest weekly count of 2026, with a sharp rise in positive respiratory samples, mostly influenza A. On 05 October, the Ministry of Health issued an influenza A alert asking the public to watch for symptoms, with particular care for children under five, people aged 65 and over, pregnant women and heavy smokers. – Sources: Tonga Ministry of Health, Weekly Communicable Diseases Syndromic Surveillance, EpiWeek 39 shared with the PPHSN Coordinating Body Focal point on 01 October 2026 and Ministry of Health Tonga accessed on 06 October 2026. • Vanuatu: The Ministry of Health reported on 30 September 2026 that it is closely monitoring increased influenza-like illness activity, particularly in Shefa, Tafea and Penama provinces, where case numbers have remained above provincial alert thresholds in recent weeks. More than 19, 000 ILI cases were reported nationally between EpiWeeks 1 and 37 of 2026. No outbreak has been declared. – Source: Vanuatu Ministry of Health, Health Promotion, ILI update accessed on 06 October 2026. • Wallis and Futuna: The Health Agency multi-source surveillance dashboard, updated on 05 October 2026, shows influenza-like illness rising steadily on Wallis since early September, reaching 69 consultations in the week ending of 21 September, the highest weekly level since January but below the alert threshold of 100. The Health Agency’s update of 01 October 2026 reports one influenza A case on Wallis in week 39 and two on Futuna in week 40, while rhinovirus (5 cases) and parainfluenza virus 3 (4 cases) have circulated actively on Wallis since week 37, causing mild respiratory infections and bronchiolitis in children. No indicator is above the vigilance thresholds on either island, and increased vigilance for influenza-like illness is advised in the coming weeks. – Sources: Agence de Santé de Wallis et Futuna, multi-source surveillance dashboard accessed on 06 October 2026, and Agence de Santé de Wallis et Futuna, epidemiological and health watch update for weeks 37 to 39 (1st October 2026) shared with the PPHSN Coordinating Body Focal point on 06 October 2026. Rotavirus • Tuvalu: Situational Report #9 on the rotavirus outbreak, covering 28 September to 04 October 2026, reports no new laboratory-confirmed case for the past four weeks. The cumulative total unchanged at 30, 28 on Funafuti and two on Nukufetau, the latest confirmed on 03 September. Genotyping confirmed an equine-like G3P[8] rotavirus. Two patients have been hospitalised and discharged, and 25 of the 30 cases are children under 15 years. A total of 389 suspected diarrhoea cases were reported between 04 August and 04 October, and weekly numbers have returned within the normal threshold. – Source: Tuvalu Ministry of Health, Outbreak of Rotavirus in Tuvalu, Situational Report #9 shared with the PPHSN Coordinating Body Focal point on 06 October 2026. • Wallis and Futuna: The Health Agency reported on 1st October 2026 that diarrhoeal syndromes on Wallis have been increasing since week 36 and have exceeded the vigilance threshold for three consecutive weeks, with four rotavirus cases reported. – Source: Agence de Santé de Wallis et Futuna, epidemiological and health watch update for weeks 37 to 39 (1st October 2026), shared with the PPHSN Coordinating Body Focal point on 06 October 2026.
World: Epidemic and emerging disease alerts in the Pacific as of 06 October 2026
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