The Pacific region, known for its vibrant communities and stunning natural beauty, is currently a focal point for several ongoing public health concerns. From mosquito-borne illnesses like dengue fever sweeping across islands to the resurgence of vaccine-preventable diseases and food-related intoxications, health authorities are diligently working to protect populations. Further afield, a serious Ebola outbreak in Central Africa has garnered international attention, reminding us of the interconnectedness of global health. ## Dengue Fever: A Widespread Concern in the Pacific Dengue fever, a viral infection transmitted by mosquitoes, remains a significant health challenge across many tropical and subtropical regions, including the Pacific. Characterized by sudden high fever, severe headache, pain behind the eyes, muscle and joint pains, and a rash, dengue can sometimes progress to a more severe form requiring urgent medical care. The virus has several different types, or serotypes (DENV-1, DENV-2, DENV-3, DENV-4), and infection with one type offers no protection against the others, meaning individuals can be infected multiple times. ### New Caledonia's Ongoing Dengue Challenge New Caledonia is currently grappling with a persistent dengue outbreak, with transmission actively continuing. Since January, the territory has reported 1,710 cases, leading to 53 hospitalizations, though thankfully no deaths have occurred. The predominant circulating strain is DENV-1. Health officials observe that the outbreak is likely approaching its seasonal peak, with numerous affected communities reporting high case numbers. Regions like Boulouparis, Canala, Ouegoa, and Thio are experiencing particularly high incidence rates. Seasonal heavy rainfall and standing water create ideal breeding grounds for the Aedes aegypti mosquito, which transmits dengue, while frequent movement of people between communes contributes to the virus's spread. Authorities are emphasizing early medical consultation for symptoms and reinforcing mosquito control and personal protection measures. A 'red alert' for DENV-1 remains in place, signaling a high level of concern. ### Samoa and Tonga Fight Dengue Samoa continues to battle ongoing dengue transmission, reporting 132 new cases in a recent week, a decrease from the prior week but still significant. Seven new hospital admissions were noted, with no intensive care cases or deaths. Both DENV-1 and DENV-2 serotypes are circulating, affecting the islands of Upolu and Savai‘i. Alarmingly, children under 15 years old account for a large majority (74%) of cases. Since January 2025, Samoa has recorded nearly 19,000 clinically diagnosed cases and over 5,400 laboratory-confirmed cases, with nine cumulative dengue-related deaths. Public health campaigns promoting community awareness, mosquito control, and prompt medical attention are ongoing. A 'blue alert' for both DENV-1 and DENV-2 is still active, indicating continuous moderate to high transmission. Tonga, too, is experiencing an active dengue outbreak, declared in April, with 62 laboratory-confirmed cases reported so far, including two new cases recently. One patient is currently hospitalized, and no deaths have been linked to the outbreak. DENV-2 is the identified serotype, primarily affecting children aged 11–14 years and male individuals, with most cases originating from Tongatapu. Response efforts are underway, focusing on community awareness and mosquito control, urging the public to take preventive steps and seek early care. A 'red alert' for DENV-2 indicates serious ongoing transmission. ### Dengue in Wallis and Futuna & New Zealand's Imported Cases On Futuna, part of Wallis and Futuna, 14 confirmed or probable dengue cases suggest active local transmission. Investigations point to Alofi island as a significant exposure site, and surveillance and mosquito control have been stepped up. Most affected individuals are males, with an average age of 33. While no additional cases have been reported in Wallis, authorities remain vigilant. Meanwhile, New Zealand reported six imported dengue cases, five from Samoa and one from New Caledonia, underscoring the risk of travel-related spread from affected regions. ### Understanding Dengue and Its Prevention Preventing dengue primarily involves controlling the Aedes mosquito population and protecting oneself from bites. This means regularly emptying and cleaning containers that can hold water (like flower pots, old tires, and pet water dishes) to eliminate breeding sites. Personal protection includes using insect repellent, wearing long-sleeved shirts and pants, and sleeping under mosquito nets, especially when traveling to or residing in dengue-prone areas. Early recognition of symptoms and seeking medical help are crucial to manage the disease and prevent severe outcomes. ## Whooping Cough (Pertussis) On The Rise Pertussis, commonly known as whooping cough, is a highly contagious respiratory infection caused by bacteria. It spreads easily through airborne droplets when an infected person coughs or sneezes. The disease can cause severe, uncontrolled coughing fits, making it difficult to breathe, eat, or sleep. While it can affect people of all ages, it is particularly dangerous for infants and young children who are not fully vaccinated, often leading to hospitalization and, in severe cases, death. ### Guam and New Zealand's Pertussis Battle Guam continues to experience pertussis transmission, with 25 cases (23 confirmed, 2 probable) detected since EpiWeek 15 of 2025, and 15 of those occurring in 2026. One new probable case was recently linked to an earlier confirmed case. No deaths have been reported, and currently, no patients are hospitalized, though six required hospitalization during the outbreak. Cases span various age groups, including infants, children, and adults, with a notable proportion among those unvaccinated or partially vaccinated. Public health authorities are strongly advocating for vaccination across all age groups, advising against close contact with sick individuals, and encouraging symptom-based care-seeking. A 'red alert' for pertussis remains in effect. New Zealand is also navigating an ongoing national pertussis epidemic. Weekly case numbers continue to fluctuate, with 43 cases reported in the week ending May 8, 2026, bringing the cumulative total for 2026 to 684 cases. A 'blue alert' for pertussis remains active, indicating persistent moderate transmission. These situations highlight the importance of maintaining high vaccination coverage to protect communities from this preventable disease. ### The Power of Vaccination Vaccination is the most effective way to prevent pertussis. Childhood vaccination schedules typically include several doses, and booster shots are recommended for adolescents and adults, especially pregnant women, to protect newborns who are too young to be vaccinated. Beyond vaccination, practicing good hand hygiene and covering coughs and sneezes can help limit the spread of respiratory illnesses. ## Ciguatera Fish Poisoning: A Seafood Hazard in Vanuatu Ciguatera fish poisoning is a foodborne illness caused by eating reef fish that have accumulated toxins produced by microalgae. These toxins, called ciguatoxins, are potent and can build up in the food chain without harming the fish themselves. When consumed by humans, even in small amounts, they can cause a range of neurological, gastrointestinal, and cardiovascular symptoms. There is no antidote, and treatment focuses on managing symptoms. ### Vanuatu's Situation with Ciguatera Vanuatu is currently experiencing a concerning increase in ciguatera fish poisoning. An additional 38 cases were reported recently, bringing the total for the year to 173 cases, with no reported deaths. The number of cases is above the typical alert threshold, indicating elevated activity. Cases have been identified across 10 islands, with Efate accounting for nearly half (48%) of reported incidents. Other affected provinces include Shefa, Penama, Malampa, and Sanma. Males constitute the majority of cases (61%), and individuals aged 15–34 years are the most affected age group. The poisoning has been linked to various fish species, including common reef fish, karosol, red fish, shellfish, and trevally. Health authorities are closely monitoring the situation and intensifying public health messages to help communities reduce their risk of exposure. ### Navigating Ciguatera Risks To reduce the risk of ciguatera poisoning, it is essential to be aware of local advisories regarding which fish species and sizes to avoid, especially in areas known for outbreaks. Generally, larger reef fish and older fish are more likely to contain higher levels of toxins. Avoiding the consumption of fish organs (liver, intestines, head, roe) is also often recommended, as toxins can concentrate there. If symptoms of ciguatera poisoning (nausea, vomiting, diarrhea, numbness, tingling, muscle weakness, temperature reversal sensation) occur after eating fish, immediate medical attention is necessary. ## Ebola Outbreak: A Global Public Health Emergency Ebola disease is a rare but severe and often fatal illness in humans and nonhuman primates. Caused by viruses belonging to the Ebolavirus genus, it is transmitted through direct contact with blood, bodily fluids, or tissues of infected animals or people. The symptoms typically include fever, fatigue, muscle pain, headache, and sore throat, followed by vomiting, diarrhea, rash, and impaired kidney and liver function. In some cases, both internal and external bleeding can occur. The current outbreak involves the Bundibugyo virus species of Ebola, which is less common but still highly lethal. ### DRC and Uganda: Urgent Response to a Public Health Emergency An outbreak of Ebola caused by the Bundibugyo virus is actively unfolding in the Democratic Republic of Congo (DRC) and Uganda. This situation has been declared a Public Health Emergency of International Concern (PHEIC) by the World Health Organization (WHO), signaling a serious global health risk that warrants a coordinated international response. In DRC, the outbreak is centered in Ituri Province, where eight laboratory-confirmed cases, 246 suspected cases, and 80 suspected deaths have been reported across multiple health zones. Disturbing reports of community deaths and infections among healthcare workers highlight challenges in infection prevention and control. Uganda has identified two imported laboratory-confirmed cases, including one death, among individuals who traveled from DRC, although there is no evidence of local transmission in Uganda so far. ### Why a Public Health Emergency of International Concern (PHEIC)? The declaration of a PHEIC reflects the high risk of regional spread due to significant population movement, ongoing insecurity, and challenging humanitarian conditions in the affected areas. There are currently no licensed vaccines or specific treatments available for the Bundibugyo virus strain of Ebola. Therefore, the response focuses intensely on robust surveillance, meticulous contact tracing, stringent infection prevention and control measures, comprehensive case management, and proactive community engagement. The WHO and its partners are providing critical support to manage this severe public health crisis. ### Community Action for Health Security These ongoing health alerts across the Pacific and globally underscore the critical importance of strong public health systems and informed community participation. For individuals, this means staying updated with local health advisories, practicing good hygiene, taking preventive measures against disease vectors like mosquitoes, seeking early medical consultation for symptoms, and adhering to vaccination schedules. Collective effort and prompt action are vital in mitigating the impact of these health threats and protecting communities.