## Monitoring Public Health Across the Pacific The vast and diverse Pacific region is currently navigating a complex landscape of public health challenges, with health authorities diligently monitoring various epidemic and emerging disease threats. From persistent mosquito-borne illnesses like dengue fever to highly contagious respiratory diseases such as measles and whooping cough, alongside the emergence of avian influenza in wildlife, health agencies are actively implementing surveillance and control measures to protect communities. These ongoing efforts underscore the critical importance of regional cooperation and public awareness in managing disease spread. ## Dengue Fever: A Persistent Mosquito-Borne Challenge Dengue, often referred to as 'breakbone fever' due to its severe muscle and joint pain, remains a significant health concern across the Pacific. This viral infection, spread by Aedes mosquitoes, presents with symptoms ranging from high fever and headaches to skin rashes and bleeding. The region is experiencing different trends in dengue activity, highlighting the dynamic nature of such outbreaks. In **American Samoa**, a dengue outbreak declared in July 2025 has seen over a thousand laboratory-confirmed cases. While the transmission continues, health officials report a sustained downward trend in new cases since the start of the year. The infection predominantly affects children and adolescents under 20, who, thanks to early medical intervention, have largely recovered without severe complications. Both DENV-1 and DENV-2 serotypes are present, keeping a blue alert in effect, indicating ongoing but controlled transmission. **New Caledonia** has recorded over 2,200 dengue cases since January 2026. Fortunately, the epidemic is now in a declining phase, a trend consistent with the cooler season, which typically reduces mosquito activity. Only DENV-1 has been identified as circulating, and a blue alert remains. Similarly, **Samoa** has seen a significant decrease in dengue cases, with reports indicating a 22% drop in new infections from the previous week. Since January 2025, over 20,000 clinically diagnosed and 5,500 laboratory-confirmed cases have been reported, alongside nine dengue-related deaths. Both DENV-1 and DENV-2 are co-circulating, with the majority of cases on Upolu and children under 15 being the most affected group. A blue alert is also maintained here. In contrast, **Wallis and Futuna** is experiencing an increase in dengue cases, with 47 confirmed and probable cases reported since the beginning of 2026, and the epidemic showing progression since late June. The average age of those affected is 31 years, and about 9% have required hospitalization. This escalation has prompted a red alert for DENV-1, signaling a heightened level of concern and emphasizing the need for intensified vector control measures at the community level. Public health campaigns focusing on eliminating mosquito breeding sites and personal protection are crucial for managing these outbreaks. ## The Resurgence of Measles: A Call for Vaccination Vigilance Measles, a highly contagious viral disease, continues to pose a threat, particularly in communities with lower vaccination rates. Known for its characteristic rash, fever, and respiratory symptoms, measles can lead to severe complications such as pneumonia, ear infections, and, in rare cases, brain inflammation. The disease spreads easily through the air when an infected person coughs or sneezes, making robust vaccination programs essential. **Australia** is currently grappling with ongoing measles activity, with cases stemming from individuals who contracted the virus overseas and subsequently spread it locally. Multiple states have reported significant numbers of cases in 2026, prompting public health alerts from authorities. Health officials are strongly advocating for all individuals born in or after 1966 to ensure they have received two doses of a measles-containing vaccine, especially before international travel. This situation highlights a global trend of measles resurgence, making high vaccination coverage critical for community protection. A red alert for measles remains in effect across Australia. ## Pertussis (Whooping Cough) Concerns and Prevention Pertussis, commonly known as whooping cough, is a highly contagious respiratory infection caused by bacteria. It is characterized by severe, uncontrollable coughing fits that often end with a distinctive "whooping" sound as the person tries to inhale. While it can affect anyone, whooping cough is particularly dangerous for infants, who may suffer from life-threatening complications. **New Zealand** has been in the midst of a national pertussis epidemic since late 2024, although recent surveillance indicates a continued decrease in case numbers. Over a thousand cases have been reported in 2026, but weekly notifications are trending downwards. Despite the decline, a blue alert for pertussis remains, signifying the ongoing need for vigilance. In **Palau**, health authorities are also monitoring a small number of pertussis cases, emphasizing the importance of tracing contacts and ensuring appropriate medical care. Vaccination, particularly for pregnant individuals (maternal vaccination) and young children, is the most effective way to prevent pertussis and protect vulnerable populations. ## Other Arbovirus Detections and Avian Influenza Vigilance Beyond dengue, other mosquito-borne viruses, known as arboviruses, are also under surveillance. **New Zealand** reported several imported cases, including dengue, Zika virus, and chikungunya, among travelers returning from destinations like Samoa, Sri Lanka, and Fiji. These cases highlight the importance of travel health precautions and robust border surveillance, as symptoms can sometimes overlap, requiring careful laboratory investigation to accurately identify the specific virus. Meanwhile, **Highly Pathogenic Avian Influenza (H5N1)**, commonly known as bird flu, has been detected in wild seabirds in both **Australia** and **New Zealand**. Australia has confirmed 17 detections in wild seabirds across multiple states, corresponding to the globally circulating H5N1 clade 2.3.4.4b. Critically, there have been no detections in commercial poultry, native birds, or other animals, and no evidence of large-scale bird mortality. Similarly, New Zealand recorded its first-ever detection of H5N1 in a wild seabird, with two confirmed detections nationally. For both countries, the risk to human health is considered very low, as H5N1 rarely affects humans unless there is direct, close, and prolonged contact with a large number of sick birds. These detections, however, underscore the persistent risk of H5N1 introduction into the Pacific region via migratory and ocean-going birds. Health and agricultural authorities are stepping up surveillance and response activities, including testing birds reported by the public and targeted wildlife surveillance. New Zealand has even initiated a vaccination program for some of its most endangered bird species. This proactive approach is vital for biosecurity and ensuring early detection should the situation change. ## Continuing Respiratory Health Management in Palau **Palau's** Ministry of Health and Human Services is actively responding to an increase in COVID-19 activity, alongside ongoing monitoring of tuberculosis (TB) and pertussis cases. They have reported dozens of COVID-19 cases, some requiring hospitalization, and continue to manage a number of TB cases, diligently evaluating close contacts to prevent further spread. The ministry reinforces crucial public health advice: practice good respiratory hygiene, stay home when feeling unwell, wear masks if symptomatic, ensure vaccinations are up-to-date, and seek medical attention if respiratory symptoms develop. These measures are fundamental to containing the spread of respiratory illnesses in any community. ## Community Action and Preparedness The collective efforts of public health agencies, healthcare providers, and the community are paramount in responding to these diverse health threats. Continued surveillance, robust vaccination programs, effective vector control strategies, and rapid public health communication are key. Individuals play a vital role by practicing good hygiene, staying informed, seeking medical advice when necessary, and adhering to vaccination schedules. These combined actions help safeguard the health and well-being of communities across the Pacific.