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Global high consequence infectious disease events: summary November 2024

Updated 15 May 2025

Global high consequence infectious disease events: summary November 2024

Interpreting this report

The report provides updates on known, high consequence infectious disease (HCID) events around the world as monitored by UK Health Security Agency바카라 사이트™s (UKHSA) epidemic intelligence activities.

The report is divided into 2 sections covering all the defined HCID pathogens. The first section contains contact and airborne HCIDs that have been specified for the HCID programme by NHS England. The second section contains additional HCIDs that are important for situational awareness.

Each section contains information on known pathogens and includes descriptions of recent events. If an undiagnosed disease event occurs that could be interpreted as a potential HCID, a third section will be added to the report.

Events found during routine scanning activities that occur in endemic areas will briefly be noted in the report. Active surveillance, other than daily epidemic intelligence activities, of events in endemic areas will not be conducted (for example, actively searching government websites or other sources for data on case numbers).

The target audience for this report is any healthcare professional who may be involved in HCID identification, treatment and management.

Risk rating

Included for each disease is a current risk rating based on the probability of introduction to the UK and potential impact on the UK public. Past UK experience and the global occurrence of travel-associated cases are also considered. Currently, all diseases are classified into one of 3 categories: Low, very low and exceptionally low to negligible.

Incidents of significance of primary HCIDs

Contact HCIDs

Crimean-Congo haemorrhagic fever (CCHF)

 Geographical risk areas	Endemic in Africa, the Balkans, the Middle East and western and south-central Asia. Cases have also been reported in Russia and Georgia. Spain has previously reported locally acquired cases (, with the ). Portugal reported its first human case in with symptom onset in July 2024.
 Sources and routes of infection	바카라 사이트¢ bite from, or crushing of, an infected tick  바카라 사이트¢ contact with the blood, tissues or body fluids of infected humans or animals
 UK experience to date Â	Two cases have been reported in individuals who have travelled to the UK from and .
 Risk rating Â	Low 바카라 사이트“ rarely reported in travellers.
 Recent cases or outbreaksÂ	During November 2024, 31 new cases of CCHF and one associated death were reported in Afghanistan. Between 1 January and 30 November 2024, (case fatality rate (CFR) of 7.9%) were reported. On 27 November 2024, media reported that were registered in Senegal between 1 January and 27 November 2024, across 5 health districts.   In Uganda, were registered between 1 January and 27 November 2024. 7 fatalities were reported among cases.

Ebola virus disease (EBOD)

 Geographical risk areasÂ	Map of Ebola disease in Africa
 Sources and routes of infectionÂ	바카라 사이트¢ contact with blood, tissues or body fluids of infected animals, or consumption of raw or undercooked infected animal tissue 바카라 사이트¢ contact with infected human blood or body fluids
 UK experience to date	Four confirmed cases (one lab-acquired in the UK in 1976, 3 healthcare workers associated with West African epidemic 2014 to 2015).Â
 Risk ratingÂ	Very low 바카라 사이트“ other than during the West Africa outbreak, exported cases are extremely rare.Â
 Recent cases or outbreaksÂ	No confirmed or suspected human cases were reported in November 2024.

Lassa fever

 Geographical risk areasÂ	Endemic in sub-Saharan West Africa.
 Sources and routes of infectionÂ	바카라 사이트¢ contact with excreta, or materials contaminated with excreta from an infected rodent  바카라 사이트¢ inhalation of aerosols of excreta from an infected rodent  바카라 사이트¢ contact with infected human blood or body fluids
 UK experience to dateÂ	. Prior to this, 8 imported Lassa fever cases had been reported since 1980, all in travellers from West Africa.
 Risk ratingÂ	Low 바카라 사이트“ overall, Lassa fever is the most common imported viral haemorrhagic fever (VHF) but importations to the UK are still rare.Â
 Recent cases or outbreaks	Between 1 January and 24 November 2024, Nigeria reported (1,089 confirmed; 9,195 suspected; 17 probable). 179 deaths were reported amongst confirmed cases (CFR of 16.4%). This is a lower CFR compared to the same period in 2023 (17.1%). Confirmed cases were registered from 28 out of 36 states. 425 cases (46 confirmed) were reported during November 2024. In Liberia, between 1 January and 25 November 2024, (CFR of 29%) were registered across Liberia. In 2023, Liberia recorded 186 cases and 5 deaths.

Marburg virus disease (MARD)

 Geographical risk areas	Sporadic outbreaks have previously been reported in Central and Eastern Africa. Outbreaks were reported for the first time in (in 2021), (in 2022), and (in 2023) and (in 2024). Â
 Sources and routes of infection	바카라 사이트¢ exposure in mines or caves inhabited by Rousettus bat colonies 바카라 사이트¢ contact with infected human blood or body fluids
 UK experience to date	 No reported cases in the UK.
 Risk rating	Very low 바카라 사이트“ globally, 5 travel-related exported MARD cases have previously been reported in the literature.
 Recent cases or outbreaks	On 27 September 2024, Rwanda바카라 사이트™s Ministry of Health declared . As of 29 November 2024, , were reported. On 9 November 2024, the reported that health officials in Rwanda had discharged the last MARD patient, starting the mandatory 42-day countdown to declaring the end of the outbreak.

Airborne HCIDs

Avian influenza A(H7N9) virus

 Geographical risk areas	All reported human infections have been .	Â
 Sources and routes of infection	바카라 사이트¢ close contact with infected birds or their environments  바카라 사이트¢ close contact with infected humans (no sustained human-to-human transmission)	Â
 UK experience to date	No known cases in the UK.	Â
 Risk rating	 Very low (UKHSA risk assessment).	Â
 Recent cases or outbreaks	No confirmed or suspected human cases were reported in November 2024.	Â

Avian influenza A(H5N1) virus

 Geographical risk areas	Human cases have been predominantly reported in Southeast Asia, but also in Egypt, Iraq, Pakistan, Turkey and Nigeria. Since 2022, human cases of clade 2.3.4.4b have been reported in , the , and the UK, and . Since October 2023, 11 human cases of clade 2.3.2.1c have been reported in .
 Sources and routes of infection	바카라 사이트¢ Close contact with infected animals (notably birds) or their environments 바카라 사이트¢ Close contact with infected humans is a theoretical risk although there is currently no evidence of any human-to-human transmission having occurred).
 UK experience to date	Since December 2021, 7 detections were reported in the UK, , 4 in 2023, and one in 2024.
 Risk rating	 Very low (UKHSA risk assessment.
 Recent cases or outbreaks	On 13 November 2024, the Public Health Agency of Canada (PHAC) reported a confirmed . This is the first domestically acquired human case of avian influenza A(H5N1) in Canada. Genomic sequencing indicates that to the avian influenza A(H5N1) viruses detected in the ongoing outbreak in poultry in British Columbia (clade 2.3.4.4b, genotype D.1.1). The case was detected via hospital-based influenza surveillance. In United States, were reported between April 2024 and 18 November 2024. Of these, 21 cases reported exposure to infected poultry, while 30 cases were exposed to infected dairy cattle and the source of exposure in one case could not be determined. Most cases have been reported in California.

Middle East respiratory syndrome (MERS-CoV)

 Geographical risk areas	MERS has been concentrated in countries from the Arabian Peninsula, with the majority of cases having occurred in the Kingdom of Saudi Arabia. Other previously affected countries in the region include . MERS is transmitted from camels and has been detected in camels from the Arabian Peninsula and also parts of North, West and Eastern Africa.
 Sources and routes of infection	바카라 사이트¢ Transmission through the air 바카라 사이트¢Direct contact with contaminated environment 바카라 사이트¢ Direct contact with camels or consumption of raw camel milk 바카라 사이트¢ Working in or exposure to healthcare settings where outbreaks are occurring airborne particles
 UK experience to date	바카라 사이트“ 3 imported cases (2012, 2013 and 2018), 2 secondary cases in close family members of the case in 2013, 3 deaths.
 Risk rating	 Very low (UKHSA risk assessment).Â
 Recent cases or outbreaks	No confirmed or suspected human cases were reported in November 2024.

Mpox (Clade I only)

 Geographical risk areas	including , and .
 Sources and routes of infection	바카라 사이트¢ close contact with an infected animal (in an endemic country) or an infected person - including sexual contact 바카라 사이트¢ contact with clothing or linens (such as bedding or towels) used by an infected person 바카라 사이트¢ direct contact with mpox skin lesions or scabs 바카라 사이트¢ coughing or sneezing of an individual with an mpox rash 바카라 사이트¢ consumption of contaminated bushmeat
 UK experience to date	Five cases in total 바카라 사이트“ 3 imported cases (2024) and 2 secondary cases in household members of a case from 2024.
 Risk rating	 The importation risk of clade I mpox into the UK is considered . The risk of potential spread in the UK is considered low to medium. The risk of acquisition in the UK is considered low. Travel-associated cases of clade I mpox have been reported in , , , , and . Â
 Recent cases or outbreaks	In endemic countries where clade I mpox is known to circulate, access to subclade specific PCR or sequencing may be limited. Therefore, we report below all reported mpox cases from these countries, regardless of whether the samples have undergone specific subclade testing. A comprehensive list of mpox clade I affected countries is available from the UKHSA. Burundi declared an mpox outbreak on . As of 25 November 2024, and one death have been reported from 45 out of 49 health districts. The Central African Republic (CAR) reported and 2 deaths (CFR of 2.7%) between 1 January and 25 November 2024. Cases were reported in 6 of the 7 health regions. 52.7% of cases were in children under 15-years-old. Between 1 January and 25 November 2024, the Democratic Republic of the Congo (DRC) reported . Among the most affected provinces are South Kivu (14,627 cases and 38 deaths), followed by Equateur (7,989 cases and 392 deaths). Kenya reported its first confirmed case of clade Ib mpox on . As of 30 November 2024, . Uganda first identified 2 confirmed cases of clade Ib mpox on . As of 24 November 2024, (CFR of 0.3%) have been reported. 48 districts have reported at least 1 confirmed mpox case. Most cases have been reported from Kampala (307 cases), Wakiso (102 cases) and Nakasongola (66 cases). Rwanda declared an outbreak of clade Ib mpox on . As of 24 November 2024, have been reported.   During November 2024, 3 countries outside of the African region reported travel-associated cases of clade I mpox, including the United Kingdom, and the . The cases had a travel history to clade I mpox affected African countries.

Nipah virus

 Geographical risk areas	South East Asia, predominantly in . Cases have also been reported in Malaysia and Singapore.
 Sources and routes of infection	바카라 사이트¢ direct or indirect exposure to infected bats 바카라 사이트¢ consumption of contaminated raw date palm sap 바카라 사이트¢ close contact with infected pigs or humans
 UK experience to date	 No known cases in the UK.
 Risk rating	Exceptionally low to negligible 바카라 사이트“ no travel-related infections in the literature.Â
 Recent cases or outbreaks	No confirmed cases of Nipah virus infection were reported in November 2024.

Pneumonic plague (Yersinia pestis)

 Geographical risk areas	Predominantly . Endemic in Madagascar, Peru, and the DRC.
 Sources and routes of infection	바카라 사이트¢ flea bites  바카라 사이트¢ close contact with infected animals  바카라 사이트¢ close contact with human cases of pneumonic plague
 UK experience to date	Last outbreak in the UK was in 1918.
 Risk rating	Exceptionally low to negligible
 Recent cases or outbreaks	On 9 November 2024, media reported in Antananarivo province, Madagascar.

Severe acute respiratory syndrome (SARS)

 Geographical risk areas	Currently none. Two historical outbreaks originating from China in 2002 and 2004.
 Sources and routes of infection	바카라 사이트¢ airborne particles  바카라 사이트¢ direct contact with contaminated environment
 UK experience to date	related to the 2002 outbreak.Â
 Risk rating	Exceptionally low to negligible
 Recent cases or outbreaks	No confirmed or suspected human cases reported globally since 2004.

Incidents of significance of additional HCIDs

Argentine haemorrhagic fever (Junin virus)

 Geographical risk areas	(central). Endemic to the provinces of Buenos Aires, Córdoba, Santa Fe and La Pampa.
 Sources and routes of infection	바카라 사이트¢ direct contact with infected rodents  바카라 사이트¢ inhalation of infectious rodent fluids and excreta  바카라 사이트¢ person-to-person transmission has been documented
 UK experience to date	 No known cases in the UK.
 Risk rating	Exceptionally low to negligible 바카라 사이트“ was identified in Belgium in 2020.
 Recent cases or outbreaks	No confirmed or suspected human cases were reported in November 2024.

Bolivian haemorrhagic fever (Machupo virus)

 Geographical risk areas	Bolivia 바카라 사이트“ (Mamoré, Iténez and Yucuma provinces) and Cochabamba (Cercado province).
 Sources and routes of infection	바카라 사이트¢ direct contact with infected rodents  바카라 사이트¢ inhalation of infectious rodent fluids and excreta  바카라 사이트¢ person-to-person transmission has been documented
 UK experience to date	 No known cases in the UK.
 Risk rating	Exceptionally low to negligible 바카라 사이트“ travel-related cases have never been reported.
 Recent cases or outbreaks	No confirmed or suspected human cases were reported in November 2024.

Lujo virus disease

 Geographical risk areas	A single case acquired in Zambia led to a cluster in South Africa in 2008.
 Sources and routes of infection	바카라 사이트¢ presumed rodent contact (excreta, or materials contaminated with excreta of infected rodent)  바카라 사이트¢ person to person via body fluids
 UK experience to date	No known cases in the UK.
 Risk rating	Exceptionally low to negligible 바카라 사이트“ a single travel-related case has been reported. No cases have been reported anywhere since 2008.
 Recent cases or outbreaks	No cases have been reported anywhere since 2008.

Severe fever with thrombocytopenia syndrome (SFTS)

 Geographical risk areas	Mainly reported from China (south-eastern), Japan and Korea. Cases have also been reported in , , and . Serological evidence of SFTS in .Â
 Sources and routes of infection	바카라 사이트¢ presumed to be tick exposure  바카라 사이트¢ person-to-person transmission described in household and hospital contacts, via contact with blood or bloodstained body fluids
 UK experience to date	No known cases in the UK.
 Risk rating	Exceptionally low to negligible 바카라 사이트“ not known to have occurred in travellers.
 Recent cases or outbreaks	Between January and November 2024, the Korean Disease Control and Prevention Agency reported . This is a lower number of cases recorded during the equivalent 2023 period (198 cases).

Andes virus (Hantavirus)

 Geographical risk areas	 Chile and Southern Argentina.Â
 Sources and routes of infection	바카라 사이트¢ rodent contact (excreta, or materials contaminated with excreta from an infected rodent) 바카라 사이트¢ person-to-person transmission described in household and hospital contacts
 UK experience to date	 No known cases in the UK.
 Risk rating	 Very low 바카라 사이트“ rare cases in travellers have been reported.Â
 Recent cases or outbreaks	On 8 November 2024, media reported a fatal case of hantavirus in a 66-year-old male in Tartagal, Salta province, Argentina. Between 1 January and November 2024, have been reported in Salta province. In Bolivia, between 1 January and 17 November 2024. The cases were recorded in Santa Cruz (8 cases), Tarija (5 cases), La Paz (4 cases) and Cochabamba (one case). The type of hantavirus is not specified for the above cases.

Avian influenza A(H5N6) virus

 Geographical risk areas	Mostly China. New strain reported in , and subsequently found in Western Europe in birds.Â
 Sources and routes of infection	Close contact with infected birds or their environments.Â
 UK experience to date	 No known cases in the UK.Â
 Risk rating	Very low 바카라 사이트“ not known to have occurred in travellers (UKHSA risk assessment).
 Recent cases or outbreaks	No confirmed or suspected human cases were reported in November 2024.

Avian influenza A(H7N7) virus

 Geographical risk areas	Sporadic occurrence in birds across mainland Europe and the UK. in 1996, in 2003, and in 2013.
 Sources and routes of infection	바카라 사이트¢ close contact with infected birds or their environments  바카라 사이트¢ close contact with infected humans (no sustained human-to-human transmission reported)Â
 UK experience to date	 No known cases in the UK.
 Risk rating	 Very low 바카라 사이트“ human cases are rare, and severe disease even rarer.
 Recent cases or outbreaks	No confirmed or suspected human cases were reported in November 2024.

Authors of this report

Emerging Infections and Zoonoses Team, UKHSA