Pacific Syndromic Surveillance System weekly bulletin 2025

Pacific Syndromic Surveillance System Weekly Bulletin Système de Surveillance Syndromic dans le Pacifique Bulletin Hebdomadaire W1 2025 (Dec 30-Jan 05) WHO gratefully acknowledges the support of Ministries of Health and partners in the following Pacific Island Countries and areas for the contribution of data to this bulletin | L'OMS reconnaît avec reconnaissance le soutien des ministères de la santé et des partenaires dans les pays insulaires du Pacifique suivants pour la contribution des données à ce bulletin: W1 2025 to W1 2025 | S1 2025 à S1 2025 Pacific Island Countries | Pays insulaires du Pacifique W1 % n 162 61% 14 65% 106 Cumulative % n Indicator 82 1. Number of sentinel sites Nombre de sites sentinelles 33% 15 2. Number of PICs thatreported Nombre de PICs qui ont rapporté 66% 54 3. Number of sites thatreported Nombre de sites qui ont rapporté Key indicators & Highlights | Indicateurs clé & faits saillants 1 W1 2025 (Dec 30-Jan 05) 1 2 1 1 Country/Area No. sites No. reported % reported AFR PF Diarrhoea DLI ILI SARI COVID-19 ** AFR: Acute Fever and Rash; PF: Prolonged Fever; DLI:Diarrhoea-like Illness; ILI: Influenza-like Illness; SARI: Severe Acute Respiratory Infection New Table American Samoa 0 0 0% 0 0 0 0 0 0 0 Cook Islands 14 13 93% 0 0 0 0 11 0 1 Fiji 29 24 83% 0 0 759 115 448 5 0 French Polynesia 0 0 0% 0 0 0 0 0 0 0 Guam 0 0 0% 0 0 0 0 0 0 0 Kiribati 12 9 75% 0 5 112 0 151 2 0 Marshall Islands (the) 0 0 0% 0 0 0 0 0 0 0 Micronesia (Federated States of) 4 3 75% 0 0 15 0 45 0 0 Nauru 1 1 100% 0 0 7 0 1 0 0 New Caledonia 25 5 20% 0 0 9 0 44 0 0 New Zealand 0 0 0% 0 0 0 0 0 0 0 Niue 1 1 100% 0 0 0 0 0 0 0 Northern Mariana Islands (the) 9 9 100% 0 21 5 0 28 1 1 Palau 7 7 100% 0 0 22 0 1 0 0 Papua New Guinea 0 0 0% 0 0 0 0 0 0 0 Pitcairn Islands 1 1 100% 0 0 0 0 0 0 0 Samoa 12 8 67% 2 0 134 0 1167 36 0 Solomon Islands 23 18 78% 0 159 149 15 600 7 0 Tokelau 0 0 0% 0 0 0 0 0 0 0 Tonga 0 0 0% 0 0 0 0 0 0 0 Tuvalu 0 0 0% 0 0 0 0 0 0 0 Vanuatu 22 5 23% 0 7 81 35 257 1 0 Wallis & Futuna 2 2 100% 1 2 56 2 72 3 0 Total 162 106 65% 3 194 1349 167 2825 55 2 Figure 1a American Samoa | Samoa américaines Figure 1b N Mariana Isl. | Îles Mariannes du Nord Figure 1c Federated States of Micronesia Figure 1d Marshall Islands | Îles Marshall Figure 1e Guam | Guam Not reported Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1f | Palau Country trends | AFR and PF ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. **No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 10 20 30 40 50 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 10 20 30 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 0 5 10 15 20 25 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 Figure 1g Tonga | Tonga Figure 1h Samoa | Samoa Figure 1i Cook Islands | Îles Cook Figure 1j Niue | Niue Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1k Tokelau | Tokelau Figure 1l Wallis & Futuna | Wallis & Futuna Figure 1m New Caledonia | Nouvelle Calédonie Figure 1n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 2 4 6 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 05 2 02 4 W 48 2 02 4 W 01 2 02 5 0 5 10 15 20 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 0 2 4 6 W 01 2 02 4 W 02 2 02 4 W 03 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 5 10 15 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 50 100 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 Figure 1o Kiribati | Kiribati Figure 1p Nauru | Nauru Figure 1q Fiji | Fidji Figure 1r Solomon Islands | Îles Salomon Figure 1s Tuvalu | Tuvalu Figure 1t Vanuatu | Vanuatu Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) 5 W1 2025 (Dec 30-Jan 05) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 1 2 3 W 31 2 02 4 W 32 2 02 4 0 10 5 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 0 50 100 150 200 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 1 2 3 4 W 22 2 02 4 W 27 2 02 4 0 25 50 75 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 Figure 2a American Samoa | Samoa américaines Figure 2b N Mariana Isl. | Îles Mariannes du Nord Figure 2c Federated States of Micronesia Figure 2d Marshall Islands | Îles Marshall Figure 2f | Palau Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness Figure 2e Guam | Guam Country trends | Influenza like illness, SARI and Suspected COVID-19 ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 50 100 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 100 200 300 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 100 200 300 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 0 25 50 75 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 0 5 10 15 20 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 Figure 2g Tonga | Tonga Figure 2h Samoa | Samoa Figure 2i Cook Islands | Îles Cook Figure 2j Niue | Niue Legend SARI (Influenza-like illness that requires hospitalization) Suspected COVID-19 Influenza like illness Figure 2k Tokelau | Tokelau Figure 2l Wallis & Futuna | Wallis & Futuna Figure 2m New Caledonia | Nouvelle Calédonie Figure 2n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 50 100 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 1000 2000 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 0 10 20 30 40 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 10 20 30 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 0 50 100 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 150 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 50 100 150 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 200 400 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 Figure 2o Kiribati | Kiribati Figure 2p Nauru | Nauru Figure 2q Fiji | Fidji Figure 2r Solomon Islands | Îles Salomon Figure 2s Tuvalu | Tuvalu Figure 2t Vanuatu | Vanuatu Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness 5 W1 2025 (Dec 30-Jan 05) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 0 50 100 150 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 500 1000 1500 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 250 500 750 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 50 100 150 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 0 250 500 750 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 Figure 3a American Samoa | Samoa américaines Figure 3b N Mariana Isl. | Îles Mariannes du Nord Figure 3c Federated States of Micronesia Figure 3d Marshall Islands | Îles Marshall Figure 3e Guam | Guam Figure 3f | Palau Legend Dengue-like Illness (DLI) Diarrhoea Country trends | Diarrhoea and DLI ** Please note that X and Y axesvary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 20 40 60 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 25 50 75 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 10 20 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 0 2 4 6 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 0 10 20 30 40 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 Figure 3g Tonga | Tonga Figure 3h Samoa | Samoa Figure 3i Cook Islands | Îles Cook Figure 3j Niue | Niue Legend Dengue-like Illness (DLI) Diarrhoea Figure 3k Tokelau | Tokelau Figure 3l Wallis & Futuna | Wallis & Futuna Figure 3m New Caledonia | Nouvelle Calédonie Figure 3n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 20 40 60 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 100 200 300 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 1 2 3 4 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 0 5 10 15 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 0 10 20 30 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 25 50 75 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 50 100 150 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 Figure 3o Kiribati | Kiribati Figure 3p Nauru | Nauru Figure 3q Fiji | Fidji Figure 3r Solomon Islands | Îles Salomon Figure 3s Tuvalu | Tuvalu Figure 3t Vanuatu | Vanuatu Legend Dengue-like Illness (DLI) Diarrhoea 5 W1 2025 (Dec 30-Jan 05) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 250 500 750 1000 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 10 20 30 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 500 1000 1500 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 200 400 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 10 5 15 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 0 100 200 300 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 Case Definitions Syndrome Case Definition Alert Threshold Acute Fever and Rash (AFR) Fever plus rash(non-blistering) 1 case if there is a measles outbreak. Prolonged fever (PF) Fever for 3 days or more Twice the average number of cases seen in the previous 2 weeks Influenza-like illness (ILI) An acute respiratory infection with: measured fever of ≥ 38 C° and cough; with onset within the last 10 days. Twice the average number of cases seen in the previous 2 weeks Diarrhoea 3 or more loose or watery stools in 24 hours (non- bloody) Twice the average number of cases seen in the previous 2 weeks Suspected dengue Fever for at least 2 days, plus at least two of the following: i. Nausea or vomiting; ii. Muscle or joint pain; iii. Severe headache or pain behind the eyes; iv. Rash; v. Bleeding Twice the average number of cases seen in the previous 3 weeks Severe acute respiratory infection, requiring hospitalisation (SARI) Sudden onset of fever above 38°C, cough or sore throat, shortness of breath or difficulty breathing, and requiring hospitalization. Twice moving average in 2 weeks COVID - 19 Twice moving average in 2 weeks Alert thresholds Please note that the alert thresholds have been set in EWARS and you will receive instant email notification once you have surpassed the alert threshold. New Indicators ∙ ∙ COVID-19 one (1) case, this is as the case definition set to identify suspected COVID- 19 including Multi-system Inflammatory cases in children. In addition, use the EBS to report details. ∙ SARI The alert threshold for SARI is set at one (1) case to increase sensitivity for its investigation as a suspected COVID-19 case and hence require laboratory confirmation or exclusion. Once you do receive an alert, you need to follow the link to verify the alert – enter brief notes to say what the cases were, what has been done to the cases (investigation, treatment) or any other cases regarding the cases – age, gender, residence, hospitalized or not? The alerts are set to auto-discard after 2 days if no action has been taken. In addition, there are now forms available on EWARS for reporting Event Based Surveillance (EBS). Please use these to report any unusual disease patterns/symptoms, unexpected deaths, disease or deaths in animals or anything that is of concern For more help and support, please contact: SHAKILA, Naidu World Health Organization Division of Pacific Technical Support Suva, Fiji Email: shakilan@who.int Notes: The Pacific Syndromic Surveillance System (PSSS) was started in 2010. With the support of the Pacific Community, it collects sentinel surveillance data on 4 syndromes (including one optional), from 23 Pacific Island Countries and areas. The aim is to monitor trends and to trigger alerts to rapidly detect and respond to suspected outbreaks. In 2017, the system was moved to an online platform called EWARS. Data is entered online by country focal points and is then analysed using an online application. This bulletin has been published automatically from EWARS. Le système de surveillance de la syndromie du Pacifique (PSSS) a été lancé en 2010. Avec le soutien de la Communauté du Pacifique, il collecte des données de surveillance sentinelle sur 4 syndromes (dont un optionnel), provenant de 23 pays insulaires du Pacifique. L'objectif est de surveiller les tendances et de déclencher des alertes pour détecter et répondre rapidement aux épidémies présumées. En 2017, le système a été transféré vers une plate-forme en ligne appelée EWARS. Les données sont entrées en ligne par points focaux de pays et sont ensuite analysées à l'aide d'une application en ligne. Ce bulletin a été publié automatiquement à partir d'EWARS.

Pacific Syndromic Surveillance System Weekly Bulletin Système de Surveillance Syndromic dans le Pacifique Bulletin Hebdomadaire W2 2025 (Jan 06-Jan 12) WHO gratefully acknowledges the support of Ministries of Health and partners in the following Pacific Island Countries and areas for the contribution of data to this bulletin | L'OMS reconnaît avec reconnaissance le soutien des ministères de la santé et des partenaires dans les pays insulaires du Pacifique suivants pour la contribution des données à ce bulletin: W1 2025 to W2 2025 | S1 2025 à S2 2025 Pacific Island Countries | Pays insulaires du Pacifique W2 % n 166 57% 13 71% 118 Cumulative % n Indicator 177 1. Number of sentinel sites Nombre de sites sentinelles 42% 29 2. Number of PICs thatreported Nombre de PICs qui ont rapporté 72% 127 3. Number of sites thatreported Nombre de sites qui ont rapporté Key indicators & Highlights | Indicateurs clé & faits saillants 1 W2 2025 (Jan 06-Jan 12) 1 2 1 1 Country/Area No. sites No. reported % reported AFR PF Diarrhoea DLI ILI SARI COVID-19 ** AFR: Acute Fever and Rash; PF: Prolonged Fever; DLI:Diarrhoea-like Illness; ILI: Influenza-like Illness; SARI: Severe Acute Respiratory Infection New Table American Samoa 0 0 0% 0 0 0 0 0 0 0 Cook Islands 14 13 93% 0 0 0 0 20 0 0 Fiji 29 24 83% 0 0 597 162 140 1 0 French Polynesia 0 0 0% 0 0 0 0 0 0 0 Guam 0 0 0% 0 0 0 0 0 0 0 Kiribati 12 11 92% 0 1 120 0 246 1 0 Marshall Islands (the) 0 0 0% 0 0 0 0 0 0 0 Micronesia (Federated States of) 4 4 100% 0 0 31 3 101 2 0 Nauru 0 0 0% 0 0 0 0 0 0 0 New Caledonia 25 6 24% 0 0 9 0 36 0 0 New Zealand 0 0 0% 0 0 0 0 0 0 0 Niue 1 1 100% 0 0 0 0 0 0 0 Northern Mariana Islands (the) 9 9 100% 0 13 9 0 31 2 0 Palau 0 0 0% 0 0 0 0 0 0 0 Papua New Guinea 0 0 0% 0 0 0 0 0 0 0 Pitcairn Islands 1 1 100% 0 0 0 0 0 0 1 Samoa 11 9 82% 0 0 203 3 1866 30 0 Solomon Islands 23 19 83% 0 267 176 10 778 15 0 Tokelau 0 0 0% 0 0 0 0 0 0 0 Tonga 13 12 92% 0 0 13 0 28 3 0 Tuvalu 0 0 0% 0 0 0 0 0 0 0 Vanuatu 22 7 32% 0 0 57 5 202 1 0 Wallis & Futuna 2 2 100% 0 3 68 0 89 0 0 Total 166 118 71% 0 284 1283 183 3537 55 1 Figure 1a American Samoa | Samoa américaines Figure 1b N Mariana Isl. | Îles Mariannes du Nord Figure 1c Federated States of Micronesia Figure 1d Marshall Islands | Îles Marshall Figure 1e Guam | Guam Not reported Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1f | Palau Country trends | AFR and PF ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. **No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 20 40 60 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 10 20 30 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 0 5 10 15 20 25 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 Figure 1g Tonga | Tonga Figure 1h Samoa | Samoa Figure 1i Cook Islands | Îles Cook Figure 1j Niue | Niue Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1k Tokelau | Tokelau Figure 1l Wallis & Futuna | Wallis & Futuna Figure 1m New Caledonia | Nouvelle Calédonie Figure 1n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 2 4 6 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 4 0 5 10 15 20 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 0 1 2 W 02 2 02 4 W 03 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 5 10 15 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 50 100 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 Figure 1o Kiribati | Kiribati Figure 1p Nauru | Nauru Figure 1q Fiji | Fidji Figure 1r Solomon Islands | Îles Salomon Figure 1s Tuvalu | Tuvalu Figure 1t Vanuatu | Vanuatu Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) 5 W2 2025 (Jan 06-Jan 12) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 1 2 3 W 31 2 02 4 W 32 2 02 4 0 10 5 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 0 100 200 300 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 1 2 3 4 W 22 2 02 4 W 27 2 02 4 0 25 50 75 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 Figure 2a American Samoa | Samoa américaines Figure 2b N Mariana Isl. | Îles Mariannes du Nord Figure 2c Federated States of Micronesia Figure 2d Marshall Islands | Îles Marshall Figure 2f | Palau Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness Figure 2e Guam | Guam Country trends | Influenza like illness, SARI and Suspected COVID-19 ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 50 100 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 100 200 300 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 100 200 300 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 0 25 50 75 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 0 5 10 15 20 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 Figure 2g Tonga | Tonga Figure 2h Samoa | Samoa Figure 2i Cook Islands | Îles Cook Figure 2j Niue | Niue Legend SARI (Influenza-like illness that requires hospitalization) Suspected COVID-19 Influenza like illness Figure 2k Tokelau | Tokelau Figure 2l Wallis & Futuna | Wallis & Futuna Figure 2m New Caledonia | Nouvelle Calédonie Figure 2n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 50 100 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 4 0 1000 2000 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 0 10 20 30 40 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 10 20 30 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 0 50 100 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 150 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 50 100 150 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 200 400 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 Figure 2o Kiribati | Kiribati Figure 2p Nauru | Nauru Figure 2q Fiji | Fidji Figure 2r Solomon Islands | Îles Salomon Figure 2s Tuvalu | Tuvalu Figure 2t Vanuatu | Vanuatu Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness 5 W2 2025 (Jan 06-Jan 12) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 0 50 100 150 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 500 1000 1500 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 250 500 750 1000 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 50 100 150 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 0 250 500 750 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 Figure 3a American Samoa | Samoa américaines Figure 3b N Mariana Isl. | Îles Mariannes du Nord Figure 3c Federated States of Micronesia Figure 3d Marshall Islands | Îles Marshall Figure 3e Guam | Guam Figure 3f | Palau Legend Dengue-like Illness (DLI) Diarrhoea Country trends | Diarrhoea and DLI ** Please note that X and Y axesvary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 20 40 60 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 25 50 75 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 10 20 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 0 2 4 6 W 31 2 02 4 W 35 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 40 2 02 4 W 44 2 02 4 0 10 20 30 40 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 Figure 3g Tonga | Tonga Figure 3h Samoa | Samoa Figure 3i Cook Islands | Îles Cook Figure 3j Niue | Niue Legend Dengue-like Illness (DLI) Diarrhoea Figure 3k Tokelau | Tokelau Figure 3l Wallis & Futuna | Wallis & Futuna Figure 3m New Caledonia | Nouvelle Calédonie Figure 3n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 20 40 60 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 100 200 300 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 1 2 3 4 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 0 5 10 15 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 0 10 20 30 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 25 50 75 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 50 100 150 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 Figure 3o Kiribati | Kiribati Figure 3p Nauru | Nauru Figure 3q Fiji | Fidji Figure 3r Solomon Islands | Îles Salomon Figure 3s Tuvalu | Tuvalu Figure 3t Vanuatu | Vanuatu Legend Dengue-like Illness (DLI) Diarrhoea 5 W2 2025 (Jan 06-Jan 12) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 250 500 750 1000 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 10 20 30 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 500 1000 1500 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 200 400 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 10 5 15 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 0 100 200 300 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 Case Definitions Syndrome Case Definition Alert Threshold Acute Fever and Rash (AFR) Fever plus rash(non-blistering) 1 case if there is a measles outbreak. Prolonged fever (PF) Fever for 3 days or more Twice the average number of cases seen in the previous 2 weeks Influenza-like illness (ILI) An acute respiratory infection with: measured fever of ≥ 38 C° and cough; with onset within the last 10 days. Twice the average number of cases seen in the previous 2 weeks Diarrhoea 3 or more loose or watery stools in 24 hours (non- bloody) Twice the average number of cases seen in the previous 2 weeks Suspected dengue Fever for at least 2 days, plus at least two of the following: i. Nausea or vomiting; ii. Muscle or joint pain; iii. Severe headache or pain behind the eyes; iv. Rash; v. Bleeding Twice the average number of cases seen in the previous 3 weeks Severe acute respiratory infection, requiring hospitalisation (SARI) Sudden onset of fever above 38°C, cough or sore throat, shortness of breath or difficulty breathing, and requiring hospitalization. Twice moving average in 2 weeks COVID - 19 Twice moving average in 2 weeks Alert thresholds Please note that the alert thresholds have been set in EWARS and you will receive instant email notification once you have surpassed the alert threshold. New Indicators ∙ ∙ COVID-19 one (1) case, this is as the case definition set to identify suspected COVID- 19 including Multi-system Inflammatory cases in children. In addition, use the EBS to report details. ∙ SARI The alert threshold for SARI is set at one (1) case to increase sensitivity for its investigation as a suspected COVID-19 case and hence require laboratory confirmation or exclusion. Once you do receive an alert, you need to follow the link to verify the alert – enter brief notes to say what the cases were, what has been done to the cases (investigation, treatment) or any other cases regarding the cases – age, gender, residence, hospitalized or not? The alerts are set to auto-discard after 2 days if no action has been taken. In addition, there are now forms available on EWARS for reporting Event Based Surveillance (EBS). Please use these to report any unusual disease patterns/symptoms, unexpected deaths, disease or deaths in animals or anything that is of concern For more help and support, please contact: SHAKILA, Naidu World Health Organization Division of Pacific Technical Support Suva, Fiji Email: shakilan@who.int Notes: The Pacific Syndromic Surveillance System (PSSS) was started in 2010. With the support of the Pacific Community, it collects sentinel surveillance data on 4 syndromes (including one optional), from 23 Pacific Island Countries and areas. The aim is to monitor trends and to trigger alerts to rapidly detect and respond to suspected outbreaks. In 2017, the system was moved to an online platform called EWARS. Data is entered online by country focal points and is then analysed using an online application. This bulletin has been published automatically from EWARS. Le système de surveillance de la syndromie du Pacifique (PSSS) a été lancé en 2010. Avec le soutien de la Communauté du Pacifique, il collecte des données de surveillance sentinelle sur 4 syndromes (dont un optionnel), provenant de 23 pays insulaires du Pacifique. L'objectif est de surveiller les tendances et de déclencher des alertes pour détecter et répondre rapidement aux épidémies présumées. En 2017, le système a été transféré vers une plate-forme en ligne appelée EWARS. Les données sont entrées en ligne par points focaux de pays et sont ensuite analysées à l'aide d'une application en ligne. Ce bulletin a été publié automatiquement à partir d'EWARS.

Pacific Syndromic Surveillance System Weekly Bulletin Système de Surveillance Syndromic dans le Pacifique Bulletin Hebdomadaire W3 2025 (Jan 13-Jan 19) WHO gratefully acknowledges the support of Ministries of Health and partners in the following Pacific Island Countries and areas for the contribution of data to this bulletin | L'OMS reconnaît avec reconnaissance le soutien des ministères de la santé et des partenaires dans les pays insulaires du Pacifique suivants pour la contribution des données à ce bulletin: W1 2025 to W3 2025 | S1 2025 à S3 2025 Pacific Island Countries | Pays insulaires du Pacifique W3 % n 173 61% 14 73% 127 Cumulative % n Indicator 182 1. Number of sentinel sites Nombre de sites sentinelles 51% 47 2. Number of PICs thatreported Nombre de PICs qui ont rapporté 74% 134 3. Number of sites thatreported Nombre de sites qui ont rapporté Key indicators & Highlights | Indicateurs clé & faits saillants 1 W3 2025 (Jan 13-Jan 19) 1 2 1 1 Country/Area No. sites No. reported % reported AFR PF Diarrhoea DLI ILI SARI COVID-19 ** AFR: Acute Fever and Rash; PF: Prolonged Fever; DLI:Diarrhoea-like Illness; ILI: Influenza-like Illness; SARI: Severe Acute Respiratory Infection New Table American Samoa 0 0 0% 0 0 0 0 0 0 0 Cook Islands 14 13 93% 0 0 0 0 26 0 0 Fiji 29 23 79% 1 0 703 119 272 3 1 French Polynesia 0 0 0% 0 0 0 0 0 0 0 Guam 0 0 0% 0 0 0 0 0 0 0 Kiribati 12 11 92% 0 10 131 0 237 2 0 Marshall Islands (the) 0 0 0% 0 0 0 0 0 0 0 Micronesia (Federated States of) 4 4 100% 0 0 24 2 62 1 0 Nauru 1 1 100% 0 0 13 0 4 0 0 New Caledonia 25 9 36% 0 0 20 0 57 0 0 New Zealand 0 0 0% 0 0 0 0 0 0 0 Niue 1 1 100% 0 0 0 0 0 0 19 Northern Mariana Islands (the) 9 9 100% 0 11 7 0 28 1 3 Palau 7 7 100% 0 0 6 0 1 0 0 Papua New Guinea 0 0 0% 0 0 0 0 0 0 0 Pitcairn Islands 0 0 0% 0 0 0 0 0 0 0 Samoa 11 9 82% 0 0 129 0 1334 44 2 Solomon Islands 23 17 74% 0 150 146 8 610 9 0 Tokelau 0 0 0% 0 0 0 0 0 0 0 Tonga 13 12 92% 0 0 15 0 75 1 0 Tuvalu 0 0 0% 0 0 0 0 0 0 0 Vanuatu 22 9 41% 0 2 107 5 408 36 0 Wallis & Futuna 2 2 100% 0 5 37 3 64 0 0 Total 173 127 73% 1 178 1338 137 3178 97 25 Figure 1a American Samoa | Samoa américaines Figure 1b N Mariana Isl. | Îles Mariannes du Nord Figure 1c Federated States of Micronesia Figure 1d Marshall Islands | Îles Marshall Figure 1e Guam | Guam Not reported Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1f | Palau Country trends | AFR and PF ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. **No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 10 20 30 40 50 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 10 20 30 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 0 5 10 15 20 25 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 Figure 1g Tonga | Tonga Figure 1h Samoa | Samoa Figure 1i Cook Islands | Îles Cook Figure 1j Niue | Niue Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1k Tokelau | Tokelau Figure 1l Wallis & Futuna | Wallis & Futuna Figure 1m New Caledonia | Nouvelle Calédonie Figure 1n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 2 4 6 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 4 0 5 10 15 20 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 0 1 2 W 03 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 5 10 15 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 50 100 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 Figure 1o Kiribati | Kiribati Figure 1p Nauru | Nauru Figure 1q Fiji | Fidji Figure 1r Solomon Islands | Îles Salomon Figure 1s Tuvalu | Tuvalu Figure 1t Vanuatu | Vanuatu Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) 5 W3 2025 (Jan 13-Jan 19) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 1 2 3 W 31 2 02 4 W 32 2 02 4 0 10 5 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 100 200 300 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 1 2 3 4 W 22 2 02 4 W 27 2 02 4 0 25 50 75 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 05 2 02 4 W 01 2 02 5 Figure 2a American Samoa | Samoa américaines Figure 2b N Mariana Isl. | Îles Mariannes du Nord Figure 2c Federated States of Micronesia Figure 2d Marshall Islands | Îles Marshall Figure 2f | Palau Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness Figure 2e Guam | Guam Country trends | Influenza like illness, SARI and Suspected COVID-19 ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 50 100 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 100 200 300 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 4 0 100 200 300 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 40 2 02 4 W 44 2 02 4 0 25 50 75 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 0 5 10 15 20 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 Figure 2g Tonga | Tonga Figure 2h Samoa | Samoa Figure 2i Cook Islands | Îles Cook Figure 2j Niue | Niue Legend SARI (Influenza-like illness that requires hospitalization) Suspected COVID-19 Influenza like illness Figure 2k Tokelau | Tokelau Figure 2l Wallis & Futuna | Wallis & Futuna Figure 2m New Caledonia | Nouvelle Calédonie Figure 2n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 50 100 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 4 0 1000 2000 3000 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 20 24 0 10 20 30 40 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 10 20 30 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 5 10 15 20 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 150 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 50 100 150 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 200 400 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 Figure 2o Kiribati | Kiribati Figure 2p Nauru | Nauru Figure 2q Fiji | Fidji Figure 2r Solomon Islands | Îles Salomon Figure 2s Tuvalu | Tuvalu Figure 2t Vanuatu | Vanuatu Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness 5 W3 2025 (Jan 13-Jan 19) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 0 50 100 150 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 500 1000 1500 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 250 500 750 1000 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 50 100 150 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 05 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 0 250 500 750 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 Figure 3a American Samoa | Samoa américaines Figure 3b N Mariana Isl. | Îles Mariannes du Nord Figure 3c Federated States of Micronesia Figure 3d Marshall Islands | Îles Marshall Figure 3e Guam | Guam Figure 3f | Palau Legend Dengue-like Illness (DLI) Diarrhoea Country trends | Diarrhoea and DLI ** Please note that X and Y axesvary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 20 40 60 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 25 50 75 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 10 20 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 0 2 4 6 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 01 2 02 5 0 10 20 30 40 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 Figure 3g Tonga | Tonga Figure 3h Samoa | Samoa Figure 3i Cook Islands | Îles Cook Figure 3j Niue | Niue Legend Dengue-like Illness (DLI) Diarrhoea Figure 3k Tokelau | Tokelau Figure 3l Wallis & Futuna | Wallis & Futuna Figure 3m New Caledonia | Nouvelle Calédonie Figure 3n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 20 40 60 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 100 200 300 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 1 2 3 4 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 0 5 10 15 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 0 10 20 30 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 25 50 75 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 50 100 150 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 Figure 3o Kiribati | Kiribati Figure 3p Nauru | Nauru Figure 3q Fiji | Fidji Figure 3r Solomon Islands | Îles Salomon Figure 3s Tuvalu | Tuvalu Figure 3t Vanuatu | Vanuatu Legend Dengue-like Illness (DLI) Diarrhoea 5 W3 2025 (Jan 13-Jan 19) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 250 500 750 1000 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 10 20 30 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 500 1000 1500 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 200 400 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 10 5 15 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 0 100 200 300 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 Case Definitions Syndrome Case Definition Alert Threshold Acute Fever and Rash (AFR) Fever plus rash(non-blistering) 1 case if there is a measles outbreak. Prolonged fever (PF) Fever for 3 days or more Twice the average number of cases seen in the previous 2 weeks Influenza-like illness (ILI) An acute respiratory infection with: measured fever of ≥ 38 C° and cough; with onset within the last 10 days. Twice the average number of cases seen in the previous 2 weeks Diarrhoea 3 or more loose or watery stools in 24 hours (non- bloody) Twice the average number of cases seen in the previous 2 weeks Suspected dengue Fever for at least 2 days, plus at least two of the following: i. Nausea or vomiting; ii. Muscle or joint pain; iii. Severe headache or pain behind the eyes; iv. Rash; v. Bleeding Twice the average number of cases seen in the previous 3 weeks Severe acute respiratory infection, requiring hospitalisation (SARI) Sudden onset of fever above 38°C, cough or sore throat, shortness of breath or difficulty breathing, and requiring hospitalization. Twice moving average in 2 weeks COVID - 19 Twice moving average in 2 weeks Alert thresholds Please note that the alert thresholds have been set in EWARS and you will receive instant email notification once you have surpassed the alert threshold. New Indicators ∙ ∙ COVID-19 one (1) case, this is as the case definition set to identify suspected COVID- 19 including Multi-system Inflammatory cases in children. In addition, use the EBS to report details. ∙ SARI The alert threshold for SARI is set at one (1) case to increase sensitivity for its investigation as a suspected COVID-19 case and hence require laboratory confirmation or exclusion. Once you do receive an alert, you need to follow the link to verify the alert – enter brief notes to say what the cases were, what has been done to the cases (investigation, treatment) or any other cases regarding the cases – age, gender, residence, hospitalized or not? The alerts are set to auto-discard after 2 days if no action has been taken. In addition, there are now forms available on EWARS for reporting Event Based Surveillance (EBS). Please use these to report any unusual disease patterns/symptoms, unexpected deaths, disease or deaths in animals or anything that is of concern For more help and support, please contact: SHAKILA, Naidu World Health Organization Division of Pacific Technical Support Suva, Fiji Email: shakilan@who.int Notes: The Pacific Syndromic Surveillance System (PSSS) was started in 2010. With the support of the Pacific Community, it collects sentinel surveillance data on 4 syndromes (including one optional), from 23 Pacific Island Countries and areas. The aim is to monitor trends and to trigger alerts to rapidly detect and respond to suspected outbreaks. In 2017, the system was moved to an online platform called EWARS. Data is entered online by country focal points and is then analysed using an online application. This bulletin has been published automatically from EWARS. Le système de surveillance de la syndromie du Pacifique (PSSS) a été lancé en 2010. Avec le soutien de la Communauté du Pacifique, il collecte des données de surveillance sentinelle sur 4 syndromes (dont un optionnel), provenant de 23 pays insulaires du Pacifique. L'objectif est de surveiller les tendances et de déclencher des alertes pour détecter et répondre rapidement aux épidémies présumées. En 2017, le système a été transféré vers une plate-forme en ligne appelée EWARS. Les données sont entrées en ligne par points focaux de pays et sont ensuite analysées à l'aide d'une application en ligne. Ce bulletin a été publié automatiquement à partir d'EWARS.

Pacific Syndromic Surveillance System Weekly Bulletin Système de Surveillance Syndromic dans le Pacifique Bulletin Hebdomadaire W4 2025 (Jan 20-Jan 26) WHO gratefully acknowledges the support of Ministries of Health and partners in the following Pacific Island Countries and areas for the contribution of data to this bulletin | L'OMS reconnaît avec reconnaissance le soutien des ministères de la santé et des partenaires dans les pays insulaires du Pacifique suivants pour la contribution des données à ce bulletin: W1 2025 to W4 2025 | S1 2025 à S4 2025 Pacific Island Countries | Pays insulaires du Pacifique W4 % n 180 65% 15 81% 146 Cumulative % n Indicator 183 1. Number of sentinel sites Nombre de sites sentinelles 55% 63 2. Number of PICs thatreported Nombre de PICs qui ont rapporté 78% 142 3. Number of sites thatreported Nombre de sites qui ont rapporté Key indicators & Highlights | Indicateurs clé & faits saillants 1 W4 2025 (Jan 20-Jan 26) 1 2 1 1 Country/Area No. sites No. reported % reported AFR PF Diarrhoea DLI ILI SARI COVID-19 ** AFR: Acute Fever and Rash; PF: Prolonged Fever; DLI:Diarrhoea-like Illness; ILI: Influenza-like Illness; SARI: Severe Acute Respiratory Infection New Table American Samoa 0 0 0% 0 0 0 0 0 0 0 Cook Islands 14 13 93% 0 0 0 0 23 0 1 Fiji 29 26 90% 2 0 674 175 128 4 0 French Polynesia 0 0 0% 0 0 0 0 0 0 0 Guam 2 2 100% 0 10 2 0 48 34 4 Kiribati 12 12 100% 0 5 118 0 177 0 0 Marshall Islands (the) 0 0 0% 0 0 0 0 0 0 0 Micronesia (Federated States of) 4 4 100% 0 0 33 0 65 2 0 Nauru 1 1 100% 0 0 6 0 1 0 0 New Caledonia 25 9 36% 0 0 5 0 26 0 0 New Zealand 0 0 0% 0 0 0 0 0 0 0 Niue 1 1 100% 0 0 0 0 0 0 18 Northern Mariana Islands (the) 9 9 100% 0 22 8 0 38 1 2 Palau 7 7 100% 0 2 6 0 5 0 0 Papua New Guinea 0 0 0% 0 0 0 0 0 0 0 Pitcairn Islands 0 0 0% 0 0 0 0 0 0 0 Samoa 11 9 82% 1 0 125 0 1392 39 8 Solomon Islands 23 19 83% 0 167 178 4 652 7 0 Tokelau 0 0 0% 0 0 0 0 0 0 0 Tonga 13 13 100% 0 0 11 0 61 3 0 Tuvalu 0 0 0% 0 0 0 0 0 0 0 Vanuatu 27 19 70% 0 138 41 10 494 26 0 Wallis & Futuna 2 2 100% 0 4 25 2 67 1 0 Total 180 146 81% 3 348 1232 191 3177 117 33 Figure 1a American Samoa | Samoa américaines Figure 1b N Mariana Isl. | Îles Mariannes du Nord Figure 1c Federated States of Micronesia Figure 1d Marshall Islands | Îles Marshall Figure 1e Guam | Guam Not reported Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1f | Palau Country trends | AFR and PF ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. **No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 10 20 30 40 50 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 10 20 30 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 0 5 10 15 20 25 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 0 1 2 3 W 04 2 02 5 Figure 1g Tonga | Tonga Figure 1h Samoa | Samoa Figure 1i Cook Islands | Îles Cook Figure 1j Niue | Niue Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1k Tokelau | Tokelau Figure 1l Wallis & Futuna | Wallis & Futuna Figure 1m New Caledonia | Nouvelle Calédonie Figure 1n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 2 4 6 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 4 0 5 10 15 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 Wallis and Futuna, New Caledonia, French Polynesia 0 5 10 15 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 50 100 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 Figure 1o Kiribati | Kiribati Figure 1p Nauru | Nauru Figure 1q Fiji | Fidji Figure 1r Solomon Islands | Îles Salomon Figure 1s Tuvalu | Tuvalu Figure 1t Vanuatu | Vanuatu Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) 5 W4 2025 (Jan 20-Jan 26) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 1 2 3 W 31 2 02 4 W 32 2 02 4 0 2 4 6 8 10 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 100 200 300 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 1 2 3 4 W 22 2 02 4 W 27 2 02 4 0 50 100 150 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 05 2 02 4 W 01 2 02 5 Figure 2a American Samoa | Samoa américaines Figure 2b N Mariana Isl. | Îles Mariannes du Nord Figure 2c Federated States of Micronesia Figure 2d Marshall Islands | Îles Marshall Figure 2f | Palau Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness Figure 2e Guam | Guam Country trends | Influenza like illness, SARI and Suspected COVID-19 ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 50 100 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 100 200 300 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 4 0 100 200 300 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 40 2 02 4 W 44 2 02 4 0 25 50 75 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 0 5 10 15 20 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 Figure 2g Tonga | Tonga Figure 2h Samoa | Samoa Figure 2i Cook Islands | Îles Cook Figure 2j Niue | Niue Legend SARI (Influenza-like illness that requires hospitalization) Suspected COVID-19 Influenza like illness Figure 2k Tokelau | Tokelau Figure 2l Wallis & Futuna | Wallis & Futuna Figure 2m New Caledonia | Nouvelle Calédonie Figure 2n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 50 100 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 1000 2000 3000 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 0 10 20 30 40 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 10 20 30 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 10 5 15 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 150 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 50 100 150 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 200 400 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 Figure 2o Kiribati | Kiribati Figure 2p Nauru | Nauru Figure 2q Fiji | Fidji Figure 2r Solomon Islands | Îles Salomon Figure 2s Tuvalu | Tuvalu Figure 2t Vanuatu | Vanuatu Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness 5 W4 2025 (Jan 20-Jan 26) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 0 50 100 150 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 500 1000 1500 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 250 500 750 1000 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 50 100 150 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 05 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 0 250 500 750 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 Figure 3a American Samoa | Samoa américaines Figure 3b N Mariana Isl. | Îles Mariannes du Nord Figure 3c Federated States of Micronesia Figure 3d Marshall Islands | Îles Marshall Figure 3e Guam | Guam Figure 3f | Palau Legend Dengue-like Illness (DLI) Diarrhoea Country trends | Diarrhoea and DLI ** Please note that X and Y axesvary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 20 40 60 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 25 50 75 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 4 0 10 20 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 0 2 4 6 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 10 20 30 40 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 Figure 3g Tonga | Tonga Figure 3h Samoa | Samoa Figure 3i Cook Islands | Îles Cook Figure 3j Niue | Niue Legend Dengue-like Illness (DLI) Diarrhoea Figure 3k Tokelau | Tokelau Figure 3l Wallis & Futuna | Wallis & Futuna Figure 3m New Caledonia | Nouvelle Calédonie Figure 3n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 20 40 60 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 100 200 300 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 1 2 3 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 0 5 10 15 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 0 10 20 30 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 05 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 25 50 75 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 50 100 150 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 Figure 3o Kiribati | Kiribati Figure 3p Nauru | Nauru Figure 3q Fiji | Fidji Figure 3r Solomon Islands | Îles Salomon Figure 3s Tuvalu | Tuvalu Figure 3t Vanuatu | Vanuatu Legend Dengue-like Illness (DLI) Diarrhoea 5 W4 2025 (Jan 20-Jan 26) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 250 500 750 1000 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 10 20 30 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 500 1000 1500 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 200 400 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 10 5 15 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 0 100 200 300 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 Case Definitions Syndrome Case Definition Alert Threshold Acute Fever and Rash (AFR) Fever plus rash(non-blistering) 1 case if there is a measles outbreak. Prolonged fever (PF) Fever for 3 days or more Twice the average number of cases seen in the previous 2 weeks Influenza-like illness (ILI) An acute respiratory infection with: measured fever of ≥ 38 C° and cough; with onset within the last 10 days. Twice the average number of cases seen in the previous 2 weeks Diarrhoea 3 or more loose or watery stools in 24 hours (non- bloody) Twice the average number of cases seen in the previous 2 weeks Suspected dengue Fever for at least 2 days, plus at least two of the following: i. Nausea or vomiting; ii. Muscle or joint pain; iii. Severe headache or pain behind the eyes; iv. Rash; v. Bleeding Twice the average number of cases seen in the previous 3 weeks Severe acute respiratory infection, requiring hospitalisation (SARI) Sudden onset of fever above 38°C, cough or sore throat, shortness of breath or difficulty breathing, and requiring hospitalization. Twice moving average in 2 weeks COVID - 19 Twice moving average in 2 weeks Alert thresholds Please note that the alert thresholds have been set in EWARS and you will receive instant email notification once you have surpassed the alert threshold. New Indicators ∙ ∙ COVID-19 one (1) case, this is as the case definition set to identify suspected COVID- 19 including Multi-system Inflammatory cases in children. In addition, use the EBS to report details. ∙ SARI The alert threshold for SARI is set at one (1) case to increase sensitivity for its investigation as a suspected COVID-19 case and hence require laboratory confirmation or exclusion. Once you do receive an alert, you need to follow the link to verify the alert – enter brief notes to say what the cases were, what has been done to the cases (investigation, treatment) or any other cases regarding the cases – age, gender, residence, hospitalized or not? The alerts are set to auto-discard after 2 days if no action has been taken. In addition, there are now forms available on EWARS for reporting Event Based Surveillance (EBS). Please use these to report any unusual disease patterns/symptoms, unexpected deaths, disease or deaths in animals or anything that is of concern For more help and support, please contact: SHAKILA, Naidu World Health Organization Division of Pacific Technical Support Suva, Fiji Email: shakilan@who.int Notes: The Pacific Syndromic Surveillance System (PSSS) was started in 2010. With the support of the Pacific Community, it collects sentinel surveillance data on 4 syndromes (including one optional), from 23 Pacific Island Countries and areas. The aim is to monitor trends and to trigger alerts to rapidly detect and respond to suspected outbreaks. In 2017, the system was moved to an online platform called EWARS. Data is entered online by country focal points and is then analysed using an online application. This bulletin has been published automatically from EWARS. Le système de surveillance de la syndromie du Pacifique (PSSS) a été lancé en 2010. Avec le soutien de la Communauté du Pacifique, il collecte des données de surveillance sentinelle sur 4 syndromes (dont un optionnel), provenant de 23 pays insulaires du Pacifique. L'objectif est de surveiller les tendances et de déclencher des alertes pour détecter et répondre rapidement aux épidémies présumées. En 2017, le système a été transféré vers une plate-forme en ligne appelée EWARS. Les données sont entrées en ligne par points focaux de pays et sont ensuite analysées à l'aide d'une application en ligne. Ce bulletin a été publié automatiquement à partir d'EWARS.

Pacific Syndromic Surveillance System Weekly Bulletin Système de Surveillance Syndromic dans le Pacifique Bulletin Hebdomadaire W5 2025 (Jan 27-Feb 02) WHO gratefully acknowledges the support of Ministries of Health and partners in the following Pacific Island Countries and areas for the contribution of data to this bulletin | L'OMS reconnaît avec reconnaissance le soutien des ministères de la santé et des partenaires dans les pays insulaires du Pacifique suivants pour la contribution des données à ce bulletin: W1 2025 to W5 2025 | S1 2025 à S5 2025 Pacific Island Countries | Pays insulaires du Pacifique W5 % n 162 52% 12 76% 123 Cumulative % n Indicator 178 1. Number of sentinel sites Nombre de sites sentinelles 54% 75 2. Number of PICs thatreported Nombre de PICs qui ont rapporté 78% 139 3. Number of sites thatreported Nombre de sites qui ont rapporté Key indicators & Highlights | Indicateurs clé & faits saillants 1 W5 2025 (Jan 27-Feb 02) 1 2 1 1 Country/Area No. sites No. reported % reported AFR PF Diarrhoea DLI ILI SARI COVID-19 ** AFR: Acute Fever and Rash; PF: Prolonged Fever; DLI:Diarrhoea-like Illness; ILI: Influenza-like Illness; SARI: Severe Acute Respiratory Infection New Table American Samoa 0 0 0% 0 0 0 0 0 0 0 Cook Islands 0 0 0% 0 0 0 0 0 0 0 Fiji 29 28 97% 4 0 839 403 231 7 0 French Polynesia 0 0 0% 0 0 0 0 0 0 0 Guam 0 0 0% 0 0 0 0 0 0 0 Kiribati 12 12 100% 0 6 169 0 170 3 0 Marshall Islands (the) 0 0 0% 0 0 0 0 0 0 0 Micronesia (Federated States of) 4 3 75% 0 1 52 0 127 0 0 Nauru 1 2 200% 0 0 5 0 0 0 0 New Caledonia 25 8 32% 0 0 13 0 30 0 0 New Zealand 0 0 0% 0 0 0 0 0 0 0 Niue 1 1 100% 0 0 0 0 0 0 32 Northern Mariana Islands (the) 9 9 100% 0 25 9 0 39 1 2 Palau 7 7 100% 0 0 13 0 1 0 0 Papua New Guinea 0 0 0% 0 0 0 0 0 0 0 Pitcairn Islands 0 0 0% 0 0 0 0 0 0 0 Samoa 11 10 91% 2 0 89 1 1279 48 2 Solomon Islands 23 18 78% 0 138 134 10 514 5 0 Tokelau 0 0 0% 0 0 0 0 0 0 0 Tonga 13 12 92% 0 1 7 0 12 2 0 Tuvalu 0 0 0% 0 0 0 0 0 0 0 Vanuatu 27 13 48% 0 22 76 5 477 30 0 Wallis & Futuna 0 0 0% 0 0 0 0 0 0 0 Total 162 123 76% 6 193 1406 419 2880 96 36 Figure 1a American Samoa | Samoa américaines Figure 1b N Mariana Isl. | Îles Mariannes du Nord Figure 1c Federated States of Micronesia Figure 1d Marshall Islands | Îles Marshall Figure 1e Guam | Guam Not reported Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1f | Palau Country trends | AFR and PF ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. **No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 10 20 30 40 50 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 10 20 30 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 05 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 20 25 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 0 1 2 3 W 04 2 02 5 Figure 1g Tonga | Tonga Figure 1h Samoa | Samoa Figure 1i Cook Islands | Îles Cook Figure 1j Niue | Niue Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1k Tokelau | Tokelau Figure 1l Wallis & Futuna | Wallis & Futuna Figure 1m New Caledonia | Nouvelle Calédonie Figure 1n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 2 4 6 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 5 10 15 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 4 0 25 50 75 100 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 Figure 1o Kiribati | Kiribati Figure 1p Nauru | Nauru Figure 1q Fiji | Fidji Figure 1r Solomon Islands | Îles Salomon Figure 1s Tuvalu | Tuvalu Figure 1t Vanuatu | Vanuatu Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) 5 W5 2025 (Jan 27-Feb 02) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1 2 3 W 31 2 02 4 W 32 2 02 4 0 10 5 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 100 200 300 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1 2 3 4 W 22 2 02 4 W 27 2 02 4 0 50 100 150 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 05 2 02 4 W 01 2 02 5 W 05 2 02 5 Figure 2a American Samoa | Samoa américaines Figure 2b N Mariana Isl. | Îles Mariannes du Nord Figure 2c Federated States of Micronesia Figure 2d Marshall Islands | Îles Marshall Figure 2f | Palau Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness Figure 2e Guam | Guam Country trends | Influenza like illness, SARI and Suspected COVID-19 ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 50 100 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 05 2 02 4 0 100 200 300 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 4 W 05 2 02 5 0 100 200 300 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 40 2 02 4 W 44 2 02 4 0 25 50 75 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 5 10 15 20 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 Figure 2g Tonga | Tonga Figure 2h Samoa | Samoa Figure 2i Cook Islands | Îles Cook Figure 2j Niue | Niue Legend SARI (Influenza-like illness that requires hospitalization) Suspected COVID-19 Influenza like illness Figure 2k Tokelau | Tokelau Figure 2l Wallis & Futuna | Wallis & Futuna Figure 2m New Caledonia | Nouvelle Calédonie Figure 2n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 50 100 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1000 2000 3000 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 0 10 20 30 40 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 10 20 30 40 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 10 5 15 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 150 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 50 100 150 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 200 400 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 Figure 2o Kiribati | Kiribati Figure 2p Nauru | Nauru Figure 2q Fiji | Fidji Figure 2r Solomon Islands | Îles Salomon Figure 2s Tuvalu | Tuvalu Figure 2t Vanuatu | Vanuatu Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness 5 W5 2025 (Jan 27-Feb 02) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 0 50 100 150 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 500 1000 1500 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 05 2 02 4 0 250 500 750 1000 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 50 100 150 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 0 250 500 750 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 Figure 3a American Samoa | Samoa américaines Figure 3b N Mariana Isl. | Îles Mariannes du Nord Figure 3c Federated States of Micronesia Figure 3d Marshall Islands | Îles Marshall Figure 3e Guam | Guam Figure 3f | Palau Legend Dengue-like Illness (DLI) Diarrhoea Country trends | Diarrhoea and DLI ** Please note that X and Y axesvary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 20 40 60 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 25 50 75 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 20 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 0 2 4 6 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 10 20 30 40 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 05 2 02 4 W 09 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 Figure 3g Tonga | Tonga Figure 3h Samoa | Samoa Figure 3i Cook Islands | Îles Cook Figure 3j Niue | Niue Legend Dengue-like Illness (DLI) Diarrhoea Figure 3k Tokelau | Tokelau Figure 3l Wallis & Futuna | Wallis & Futuna Figure 3m New Caledonia | Nouvelle Calédonie Figure 3n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 20 40 60 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 100 200 300 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1 2 3 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 0 5 10 15 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 0 10 20 30 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 25 50 75 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 50 100 150 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 Figure 3o Kiribati | Kiribati Figure 3p Nauru | Nauru Figure 3q Fiji | Fidji Figure 3r Solomon Islands | Îles Salomon Figure 3s Tuvalu | Tuvalu Figure 3t Vanuatu | Vanuatu Legend Dengue-like Illness (DLI) Diarrhoea 5 W5 2025 (Jan 27-Feb 02) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 250 500 750 1000 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 10 20 30 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 500 1000 1500 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 200 400 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 0 100 200 300 W 05 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 Case Definitions Syndrome Case Definition Alert Threshold Acute Fever and Rash (AFR) Fever plus rash(non-blistering) 1 case if there is a measles outbreak. Prolonged fever (PF) Fever for 3 days or more Twice the average number of cases seen in the previous 2 weeks Influenza-like illness (ILI) An acute respiratory infection with: measured fever of ≥ 38 C° and cough; with onset within the last 10 days. Twice the average number of cases seen in the previous 2 weeks Diarrhoea 3 or more loose or watery stools in 24 hours (non- bloody) Twice the average number of cases seen in the previous 2 weeks Suspected dengue Fever for at least 2 days, plus at least two of the following: i. Nausea or vomiting; ii. Muscle or joint pain; iii. Severe headache or pain behind the eyes; iv. Rash; v. Bleeding Twice the average number of cases seen in the previous 3 weeks Severe acute respiratory infection, requiring hospitalisation (SARI) Sudden onset of fever above 38°C, cough or sore throat, shortness of breath or difficulty breathing, and requiring hospitalization. Twice moving average in 2 weeks COVID - 19 Twice moving average in 2 weeks Alert thresholds Please note that the alert thresholds have been set in EWARS and you will receive instant email notification once you have surpassed the alert threshold. New Indicators ∙ ∙ COVID-19 one (1) case, this is as the case definition set to identify suspected COVID- 19 including Multi-system Inflammatory cases in children. In addition, use the EBS to report details. ∙ SARI The alert threshold for SARI is set at one (1) case to increase sensitivity for its investigation as a suspected COVID-19 case and hence require laboratory confirmation or exclusion. Once you do receive an alert, you need to follow the link to verify the alert – enter brief notes to say what the cases were, what has been done to the cases (investigation, treatment) or any other cases regarding the cases – age, gender, residence, hospitalized or not? The alerts are set to auto-discard after 2 days if no action has been taken. In addition, there are now forms available on EWARS for reporting Event Based Surveillance (EBS). Please use these to report any unusual disease patterns/symptoms, unexpected deaths, disease or deaths in animals or anything that is of concern For more help and support, please contact: SHAKILA, Naidu World Health Organization Division of Pacific Technical Support Suva, Fiji Email: shakilan@who.int Notes: The Pacific Syndromic Surveillance System (PSSS) was started in 2010. With the support of the Pacific Community, it collects sentinel surveillance data on 4 syndromes (including one optional), from 23 Pacific Island Countries and areas. The aim is to monitor trends and to trigger alerts to rapidly detect and respond to suspected outbreaks. In 2017, the system was moved to an online platform called EWARS. Data is entered online by country focal points and is then analysed using an online application. This bulletin has been published automatically from EWARS. Le système de surveillance de la syndromie du Pacifique (PSSS) a été lancé en 2010. Avec le soutien de la Communauté du Pacifique, il collecte des données de surveillance sentinelle sur 4 syndromes (dont un optionnel), provenant de 23 pays insulaires du Pacifique. L'objectif est de surveiller les tendances et de déclencher des alertes pour détecter et répondre rapidement aux épidémies présumées. En 2017, le système a été transféré vers une plate-forme en ligne appelée EWARS. Les données sont entrées en ligne par points focaux de pays et sont ensuite analysées à l'aide d'une application en ligne. Ce bulletin a été publié automatiquement à partir d'EWARS.

Pacific Syndromic Surveillance System Weekly Bulletin Système de Surveillance Syndromic dans le Pacifique Bulletin Hebdomadaire W6 2025 (Feb 03-Feb 09) WHO gratefully acknowledges the support of Ministries of Health and partners in the following Pacific Island Countries and areas for the contribution of data to this bulletin | L'OMS reconnaît avec reconnaissance le soutien des ministères de la santé et des partenaires dans les pays insulaires du Pacifique suivants pour la contribution des données à ce bulletin: W1 2025 to W6 2025 | S1 2025 à S6 2025 Pacific Island Countries | Pays insulaires du Pacifique W6 % n 157 65% 15 83% 131 Cumulative % n Indicator 176 1. Number of sentinel sites Nombre de sites sentinelles 57% 92 2. Number of PICs thatreported Nombre de PICs qui ont rapporté 79% 139 3. Number of sites thatreported Nombre de sites qui ont rapporté Key indicators & Highlights | Indicateurs clé & faits saillants 1 W6 2025 (Feb 03-Feb 09) 1 2 1 1 Country/Area No. sites No. reported % reported AFR PF Diarrhoea DLI ILI SARI COVID-19 ** AFR: Acute Fever and Rash; PF: Prolonged Fever; DLI:Diarrhoea-like Illness; ILI: Influenza-like Illness; SARI: Severe Acute Respiratory Infection New Table American Samoa 0 0 0% 0 0 0 0 0 0 0 Cook Islands 14 13 93% 0 0 0 0 14 0 0 Fiji 29 27 93% 2 0 890 560 229 2 1 French Polynesia 0 0 0% 0 0 0 0 0 0 0 Guam 2 2 100% 0 9 1 0 36 21 1 Kiribati 12 11 92% 0 2 171 0 219 0 0 Marshall Islands (the) 2 2 100% 0 1 7 0 41 0 0 Micronesia (Federated States of) 4 4 100% 0 1 36 5 106 1 0 Nauru 2 2 100% 0 0 9 0 0 0 0 New Caledonia 25 6 24% 0 0 21 0 16 0 0 New Zealand 0 0 0% 0 0 0 0 0 0 0 Niue 1 1 100% 0 0 0 0 0 0 49 Northern Mariana Islands (the) 9 9 100% 0 22 4 0 49 2 1 Palau 7 7 100% 0 3 13 0 5 0 0 Papua New Guinea 0 0 0% 0 0 0 0 0 0 0 Pitcairn Islands 0 0 0% 0 0 0 0 0 0 0 Samoa 11 11 100% 0 0 88 0 1593 55 0 Solomon Islands 23 20 87% 0 164 120 8 515 11 0 Tokelau 3 3 100% 0 0 0 0 0 0 0 Tonga 13 13 100% 0 0 16 7 10 0 0 Tuvalu 0 0 0% 0 0 0 0 0 0 0 Vanuatu 0 0 0% 0 0 0 0 0 0 0 Wallis & Futuna 0 0 0% 0 0 0 0 0 0 0 Total 157 131 83% 2 202 1376 580 2833 92 52 Figure 1a American Samoa | Samoa américaines Figure 1b N Mariana Isl. | Îles Mariannes du Nord Figure 1c Federated States of Micronesia Figure 1d Marshall Islands | Îles Marshall Figure 1e Guam | Guam Not reported Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1f | Palau Country trends | AFR and PF ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. **No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 10 20 30 40 50 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 10 20 30 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 20 25 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1 2 3 4 W 04 2 02 5 W 05 2 02 5 W 06 2 02 5 Figure 1g Tonga | Tonga Figure 1h Samoa | Samoa Figure 1i Cook Islands | Îles Cook Figure 1j Niue | Niue Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1k Tokelau | Tokelau Figure 1l Wallis & Futuna | Wallis & Futuna Figure 1m New Caledonia | Nouvelle Calédonie Figure 1n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 2 4 6 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 4 W 14 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 5 10 15 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 50 100 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 Figure 1o Kiribati | Kiribati Figure 1p Nauru | Nauru Figure 1q Fiji | Fidji Figure 1r Solomon Islands | Îles Salomon Figure 1s Tuvalu | Tuvalu Figure 1t Vanuatu | Vanuatu Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) 5 W6 2025 (Feb 03-Feb 09) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1 2 3 W 31 2 02 4 W 32 2 02 4 0 10 5 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 100 200 300 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1 2 3 4 W 22 2 02 4 W 27 2 02 4 0 50 100 150 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 Figure 2a American Samoa | Samoa américaines Figure 2b N Mariana Isl. | Îles Mariannes du Nord Figure 2c Federated States of Micronesia Figure 2d Marshall Islands | Îles Marshall Figure 2f | Palau Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness Figure 2e Guam | Guam Country trends | Influenza like illness, SARI and Suspected COVID-19 ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 50 100 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 100 200 300 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 100 200 300 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 25 50 75 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 0 5 10 15 20 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 Figure 2g Tonga | Tonga Figure 2h Samoa | Samoa Figure 2i Cook Islands | Îles Cook Figure 2j Niue | Niue Legend SARI (Influenza-like illness that requires hospitalization) Suspected COVID-19 Influenza like illness Figure 2k Tokelau | Tokelau Figure 2l Wallis & Futuna | Wallis & Futuna Figure 2m New Caledonia | Nouvelle Calédonie Figure 2n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 50 100 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1000 2000 3000 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 0 10 20 30 40 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 25 50 75 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 150 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 09 2 02 4 0 50 100 150 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 200 400 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 Figure 2o Kiribati | Kiribati Figure 2p Nauru | Nauru Figure 2q Fiji | Fidji Figure 2r Solomon Islands | Îles Salomon Figure 2s Tuvalu | Tuvalu Figure 2t Vanuatu | Vanuatu Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness 5 W6 2025 (Feb 03-Feb 09) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 0 50 100 150 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 500 1000 1500 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 250 500 750 1000 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 50 100 150 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 0 250 500 750 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 Figure 3a American Samoa | Samoa américaines Figure 3b N Mariana Isl. | Îles Mariannes du Nord Figure 3c Federated States of Micronesia Figure 3d Marshall Islands | Îles Marshall Figure 3e Guam | Guam Figure 3f | Palau Legend Dengue-like Illness (DLI) Diarrhoea Country trends | Diarrhoea and DLI ** Please note that X and Y axesvary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 20 40 60 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 25 50 75 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 20 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 2 4 6 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 10 20 30 40 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 Figure 3g Tonga | Tonga Figure 3h Samoa | Samoa Figure 3i Cook Islands | Îles Cook Figure 3j Niue | Niue Legend Dengue-like Illness (DLI) Diarrhoea Figure 3k Tokelau | Tokelau Figure 3l Wallis & Futuna | Wallis & Futuna Figure 3m New Caledonia | Nouvelle Calédonie Figure 3n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 20 40 60 W 01 2 02 5 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 05 2 02 5 0 100 200 300 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1 2 3 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 0 5 10 15 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 0 5 10 15 20 25 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 0 25 50 75 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 50 100 150 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 Figure 3o Kiribati | Kiribati Figure 3p Nauru | Nauru Figure 3q Fiji | Fidji Figure 3r Solomon Islands | Îles Salomon Figure 3s Tuvalu | Tuvalu Figure 3t Vanuatu | Vanuatu Legend Dengue-like Illness (DLI) Diarrhoea 5 W6 2025 (Feb 03-Feb 09) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 250 500 750 1000 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 10 20 30 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 500 1000 1500 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 200 400 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 10 5 15 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 0 100 200 300 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 Case Definitions Syndrome Case Definition Alert Threshold Acute Fever and Rash (AFR) Fever plus rash(non-blistering) 1 case if there is a measles outbreak. Prolonged fever (PF) Fever for 3 days or more Twice the average number of cases seen in the previous 2 weeks Influenza-like illness (ILI) An acute respiratory infection with: measured fever of ≥ 38 C° and cough; with onset within the last 10 days. Twice the average number of cases seen in the previous 2 weeks Diarrhoea 3 or more loose or watery stools in 24 hours (non- bloody) Twice the average number of cases seen in the previous 2 weeks Suspected dengue Fever for at least 2 days, plus at least two of the following: i. Nausea or vomiting; ii. Muscle or joint pain; iii. Severe headache or pain behind the eyes; iv. Rash; v. Bleeding Twice the average number of cases seen in the previous 3 weeks Severe acute respiratory infection, requiring hospitalisation (SARI) Sudden onset of fever above 38°C, cough or sore throat, shortness of breath or difficulty breathing, and requiring hospitalization. Twice moving average in 2 weeks COVID - 19 Twice moving average in 2 weeks Alert thresholds Please note that the alert thresholds have been set in EWARS and you will receive instant email notification once you have surpassed the alert threshold. New Indicators ∙ ∙ COVID-19 one (1) case, this is as the case definition set to identify suspected COVID- 19 including Multi-system Inflammatory cases in children. In addition, use the EBS to report details. ∙ SARI The alert threshold for SARI is set at one (1) case to increase sensitivity for its investigation as a suspected COVID-19 case and hence require laboratory confirmation or exclusion. Once you do receive an alert, you need to follow the link to verify the alert – enter brief notes to say what the cases were, what has been done to the cases (investigation, treatment) or any other cases regarding the cases – age, gender, residence, hospitalized or not? The alerts are set to auto-discard after 2 days if no action has been taken. In addition, there are now forms available on EWARS for reporting Event Based Surveillance (EBS). Please use these to report any unusual disease patterns/symptoms, unexpected deaths, disease or deaths in animals or anything that is of concern For more help and support, please contact: SHAKILA, Naidu World Health Organization Division of Pacific Technical Support Suva, Fiji Email: shakilan@who.int Notes: The Pacific Syndromic Surveillance System (PSSS) was started in 2010. With the support of the Pacific Community, it collects sentinel surveillance data on 4 syndromes (including one optional), from 23 Pacific Island Countries and areas. The aim is to monitor trends and to trigger alerts to rapidly detect and respond to suspected outbreaks. In 2017, the system was moved to an online platform called EWARS. Data is entered online by country focal points and is then analysed using an online application. This bulletin has been published automatically from EWARS. Le système de surveillance de la syndromie du Pacifique (PSSS) a été lancé en 2010. Avec le soutien de la Communauté du Pacifique, il collecte des données de surveillance sentinelle sur 4 syndromes (dont un optionnel), provenant de 23 pays insulaires du Pacifique. L'objectif est de surveiller les tendances et de déclencher des alertes pour détecter et répondre rapidement aux épidémies présumées. En 2017, le système a été transféré vers une plate-forme en ligne appelée EWARS. Les données sont entrées en ligne par points focaux de pays et sont ensuite analysées à l'aide d'une application en ligne. Ce bulletin a été publié automatiquement à partir d'EWARS.

Pacific Syndromic Surveillance System Weekly Bulletin Système de Surveillance Syndromic dans le Pacifique Bulletin Hebdomadaire W7 2025 (Feb 10-Feb 16) WHO gratefully acknowledges the support of Ministries of Health and partners in the following Pacific Island Countries and areas for the contribution of data to this bulletin | L'OMS reconnaît avec reconnaissance le soutien des ministères de la santé et des partenaires dans les pays insulaires du Pacifique suivants pour la contribution des données à ce bulletin: W1 2025 to W7 2025 | S1 2025 à S7 2025 Pacific Island Countries | Pays insulaires du Pacifique W7 % n 134 61% 14 83% 111 Cumulative % n Indicator 150 1. Number of sentinel sites Nombre de sites sentinelles 61% 113 2. Number of PICs thatreported Nombre de PICs qui ont rapporté 80% 119 3. Number of sites thatreported Nombre de sites qui ont rapporté Key indicators & Highlights | Indicateurs clé & faits saillants 1 W7 2025 (Feb 10-Feb 16) 1 2 1 1 Country/Area No. sites No. reported % reported AFR PF Diarrhoea DLI ILI SARI COVID-19 ** AFR: Acute Fever and Rash; PF: Prolonged Fever; DLI:Diarrhoea-like Illness; ILI: Influenza-like Illness; SARI: Severe Acute Respiratory Infection New Table American Samoa 0 0 0% 0 0 0 0 0 0 0 Cook Islands 0 0 0% 0 0 0 0 0 0 0 Fiji 29 28 97% 1 0 926 640 276 5 1 French Polynesia 0 0 0% 0 0 0 0 0 0 0 Guam 2 2 100% 0 12 0 0 49 29 6 Kiribati 12 12 100% 0 13 165 0 222 3 0 Marshall Islands (the) 2 2 100% 0 3 10 0 20 0 0 Micronesia (Federated States of) 0 0 0% 0 0 0 0 0 0 0 Nauru 2 2 100% 0 0 19 0 1 0 0 New Caledonia 25 7 28% 0 0 27 0 10 0 0 New Zealand 0 0 0% 0 0 0 0 0 0 0 Niue 1 1 100% 0 0 1 0 0 0 18 Northern Mariana Islands (the) 9 9 100% 0 35 9 0 56 3 2 Palau 0 0 0% 0 0 0 0 0 0 0 Papua New Guinea 0 0 0% 0 0 0 0 0 0 0 Pitcairn Islands 1 1 100% 0 0 0 0 0 0 0 Samoa 11 9 82% 0 0 73 1 1621 46 0 Solomon Islands 23 21 91% 0 194 162 9 566 13 0 Tokelau 0 0 0% 0 0 0 0 0 0 0 Tonga 13 13 100% 0 2 10 47 11 3 0 Tuvalu 2 2 100% 0 0 9 0 4 0 0 Vanuatu 0 0 0% 0 0 0 0 0 0 0 Wallis & Futuna 2 2 100% 0 3 16 1 165 2 3 Total 134 111 83% 1 262 1427 698 3001 104 30 Figure 1a American Samoa | Samoa américaines Figure 1b N Mariana Isl. | Îles Mariannes du Nord Figure 1c Federated States of Micronesia Figure 1d Marshall Islands | Îles Marshall Figure 1e Guam | Guam Not reported Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1f | Palau Country trends | AFR and PF ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. **No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 10 20 30 40 50 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 10 20 30 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 20 25 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1 2 3 4 W 04 2 02 5 W 05 2 02 5 W 06 2 02 5 Figure 1g Tonga | Tonga Figure 1h Samoa | Samoa Figure 1i Cook Islands | Îles Cook Figure 1j Niue | Niue Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1k Tokelau | Tokelau Figure 1l Wallis & Futuna | Wallis & Futuna Figure 1m New Caledonia | Nouvelle Calédonie Figure 1n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 2 4 6 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 05 2 02 5 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 4 W 14 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 5 10 15 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 50 100 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 Figure 1o Kiribati | Kiribati Figure 1p Nauru | Nauru Figure 1q Fiji | Fidji Figure 1r Solomon Islands | Îles Salomon Figure 1s Tuvalu | Tuvalu Figure 1t Vanuatu | Vanuatu Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) 5 W7 2025 (Feb 10-Feb 16) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1 2 3 W 31 2 02 4 W 32 2 02 4 0 10 5 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 100 200 300 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1 2 3 4 W 22 2 02 4 W 27 2 02 4 0 50 100 150 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 Figure 2a American Samoa | Samoa américaines Figure 2b N Mariana Isl. | Îles Mariannes du Nord Figure 2c Federated States of Micronesia Figure 2d Marshall Islands | Îles Marshall Figure 2f | Palau Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness Figure 2e Guam | Guam Country trends | Influenza like illness, SARI and Suspected COVID-19 ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 50 100 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 100 200 300 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 100 200 300 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 25 50 75 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 0 5 10 15 20 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 Figure 2g Tonga | Tonga Figure 2h Samoa | Samoa Figure 2i Cook Islands | Îles Cook Figure 2j Niue | Niue Legend SARI (Influenza-like illness that requires hospitalization) Suspected COVID-19 Influenza like illness Figure 2k Tokelau | Tokelau Figure 2l Wallis & Futuna | Wallis & Futuna Figure 2m New Caledonia | Nouvelle Calédonie Figure 2n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 50 100 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1000 2000 3000 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 20 24 0 10 20 30 40 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 25 50 75 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 100 200 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 4 0 50 100 150 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 200 400 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 Figure 2o Kiribati | Kiribati Figure 2p Nauru | Nauru Figure 2q Fiji | Fidji Figure 2r Solomon Islands | Îles Salomon Figure 2s Tuvalu | Tuvalu Figure 2t Vanuatu | Vanuatu Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness 5 W7 2025 (Feb 10-Feb 16) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 0 50 100 150 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 500 1000 1500 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 250 500 750 1000 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 50 100 150 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 250 500 750 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 Figure 3a American Samoa | Samoa américaines Figure 3b N Mariana Isl. | Îles Mariannes du Nord Figure 3c Federated States of Micronesia Figure 3d Marshall Islands | Îles Marshall Figure 3e Guam | Guam Figure 3f | Palau Legend Dengue-like Illness (DLI) Diarrhoea Country trends | Diarrhoea and DLI ** Please note that X and Y axesvary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 20 40 60 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 25 50 75 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 20 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 2 4 6 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 10 20 30 40 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 Figure 3g Tonga | Tonga Figure 3h Samoa | Samoa Figure 3i Cook Islands | Îles Cook Figure 3j Niue | Niue Legend Dengue-like Illness (DLI) Diarrhoea Figure 3k Tokelau | Tokelau Figure 3l Wallis & Futuna | Wallis & Futuna Figure 3m New Caledonia | Nouvelle Calédonie Figure 3n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 20 40 60 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 100 200 300 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1 2 3 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 0 5 10 15 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 10 20 30 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 25 50 75 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 50 100 150 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 Figure 3o Kiribati | Kiribati Figure 3p Nauru | Nauru Figure 3q Fiji | Fidji Figure 3r Solomon Islands | Îles Salomon Figure 3s Tuvalu | Tuvalu Figure 3t Vanuatu | Vanuatu Legend Dengue-like Illness (DLI) Diarrhoea 5 W7 2025 (Feb 10-Feb 16) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 250 500 750 1000 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 10 20 30 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 500 1000 1500 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 200 400 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 10 5 15 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 100 200 300 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 Case Definitions Syndrome Case Definition Alert Threshold Acute Fever and Rash (AFR) Fever plus rash(non-blistering) 1 case if there is a measles outbreak. Prolonged fever (PF) Fever for 3 days or more Twice the average number of cases seen in the previous 2 weeks Influenza-like illness (ILI) An acute respiratory infection with: measured fever of ≥ 38 C° and cough; with onset within the last 10 days. Twice the average number of cases seen in the previous 2 weeks Diarrhoea 3 or more loose or watery stools in 24 hours (non- bloody) Twice the average number of cases seen in the previous 2 weeks Suspected dengue Fever for at least 2 days, plus at least two of the following: i. Nausea or vomiting; ii. Muscle or joint pain; iii. Severe headache or pain behind the eyes; iv. Rash; v. Bleeding Twice the average number of cases seen in the previous 3 weeks Severe acute respiratory infection, requiring hospitalisation (SARI) Sudden onset of fever above 38°C, cough or sore throat, shortness of breath or difficulty breathing, and requiring hospitalization. Twice moving average in 2 weeks COVID - 19 Twice moving average in 2 weeks Alert thresholds Please note that the alert thresholds have been set in EWARS and you will receive instant email notification once you have surpassed the alert threshold. New Indicators ∙ ∙ COVID-19 one (1) case, this is as the case definition set to identify suspected COVID- 19 including Multi-system Inflammatory cases in children. In addition, use the EBS to report details. ∙ SARI The alert threshold for SARI is set at one (1) case to increase sensitivity for its investigation as a suspected COVID-19 case and hence require laboratory confirmation or exclusion. Once you do receive an alert, you need to follow the link to verify the alert – enter brief notes to say what the cases were, what has been done to the cases (investigation, treatment) or any other cases regarding the cases – age, gender, residence, hospitalized or not? The alerts are set to auto-discard after 2 days if no action has been taken. In addition, there are now forms available on EWARS for reporting Event Based Surveillance (EBS). Please use these to report any unusual disease patterns/symptoms, unexpected deaths, disease or deaths in animals or anything that is of concern For more help and support, please contact: SHAKILA, Naidu World Health Organization Division of Pacific Technical Support Suva, Fiji Email: shakilan@who.int Notes: The Pacific Syndromic Surveillance System (PSSS) was started in 2010. With the support of the Pacific Community, it collects sentinel surveillance data on 4 syndromes (including one optional), from 23 Pacific Island Countries and areas. The aim is to monitor trends and to trigger alerts to rapidly detect and respond to suspected outbreaks. In 2017, the system was moved to an online platform called EWARS. Data is entered online by country focal points and is then analysed using an online application. This bulletin has been published automatically from EWARS. Le système de surveillance de la syndromie du Pacifique (PSSS) a été lancé en 2010. Avec le soutien de la Communauté du Pacifique, il collecte des données de surveillance sentinelle sur 4 syndromes (dont un optionnel), provenant de 23 pays insulaires du Pacifique. L'objectif est de surveiller les tendances et de déclencher des alertes pour détecter et répondre rapidement aux épidémies présumées. En 2017, le système a été transféré vers une plate-forme en ligne appelée EWARS. Les données sont entrées en ligne par points focaux de pays et sont ensuite analysées à l'aide d'une application en ligne. Ce bulletin a été publié automatiquement à partir d'EWARS.

Pacific Syndromic Surveillance System Weekly Bulletin Système de Surveillance Syndromic dans le Pacifique Bulletin Hebdomadaire W9 2025 (Feb 24-Mar 02) WHO gratefully acknowledges the support of Ministries of Health and partners in the following Pacific Island Countries and areas for the contribution of data to this bulletin | L'OMS reconnaît avec reconnaissance le soutien des ministères de la santé et des partenaires dans les pays insulaires du Pacifique suivants pour la contribution des données à ce bulletin: W1 2025 to W9 2025 | S1 2025 à S9 2025 Pacific Island Countries | Pays insulaires du Pacifique W9 % n 3 0% 2 100% 3 Cumulative % n Indicator 150 1. Number of sentinel sites Nombre de sites sentinelles 63% 130 2. Number of PICs thatreported Nombre de PICs qui ont rapporté 80% 121 3. Number of sites thatreported Nombre de sites qui ont rapporté Key indicators & Highlights | Indicateurs clé & faits saillants 1 W9 2025 (Feb 24-Mar 02) 1 2 1 1 Country/Area No. sites No. reported % reported AFR PF Diarrhoea DLI ILI SARI COVID-19 ** AFR: Acute Fever and Rash; PF: Prolonged Fever; DLI:Diarrhoea-like Illness; ILI: Influenza-like Illness; SARI: Severe Acute Respiratory Infection New Table American Samoa 0 0 0% 0 0 0 0 0 0 0 Cook Islands 0 0 0% 0 0 0 0 0 0 0 Fiji 0 0 0% 0 0 0 0 0 0 0 French Polynesia 0 0 0% 0 0 0 0 0 0 0 Guam 0 0 0% 0 0 0 0 0 0 0 Kiribati 0 0 0% 0 0 0 0 0 0 0 Marshall Islands (the) 0 0 0% 0 0 0 0 0 0 0 Micronesia (Federated States of) 0 0 0% 0 0 0 0 0 0 0 Nauru 2 2 100% 0 0 14 0 3 0 0 New Caledonia 0 0 0% 0 0 0 0 0 0 0 New Zealand 0 0 0% 0 0 0 0 0 0 0 Niue 0 0 0% 0 0 0 0 0 0 0 Northern Mariana Islands (the) 0 0 0% 0 0 0 0 0 0 0 Palau 0 0 0% 0 0 0 0 0 0 0 Papua New Guinea 0 0 0% 0 0 0 0 0 0 0 Pitcairn Islands 1 1 100% 0 0 0 0 0 0 0 Samoa 0 0 0% 0 0 0 0 0 0 0 Solomon Islands 0 0 0% 0 0 0 0 0 0 0 Tokelau 0 0 0% 0 0 0 0 0 0 0 Tonga 0 0 0% 0 0 0 0 0 0 0 Tuvalu 0 0 0% 0 0 0 0 0 0 0 Vanuatu 0 0 0% 0 0 0 0 0 0 0 Wallis & Futuna 0 0 0% 0 0 0 0 0 0 0 Total 3 3 100% 0 0 14 0 3 0 0 Figure 1a American Samoa | Samoa américaines Figure 1b N Mariana Isl. | Îles Mariannes du Nord Figure 1c Federated States of Micronesia Figure 1d Marshall Islands | Îles Marshall Figure 1e Guam | Guam Not reported Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1f | Palau Country trends | AFR and PF ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. **No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 10 20 30 40 50 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 10 20 30 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 20 25 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1 2 3 4 W 04 2 02 5 W 05 2 02 5 W 06 2 02 5 W 07 2 02 5 Figure 1g Tonga | Tonga Figure 1h Samoa | Samoa Figure 1i Cook Islands | Îles Cook Figure 1j Niue | Niue Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1k Tokelau | Tokelau Figure 1l Wallis & Futuna | Wallis & Futuna Figure 1m New Caledonia | Nouvelle Calédonie Figure 1n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 2 4 6 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 05 2 02 5 0 2 4 6 8 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 Wallis and Futuna, New Caledonia, French Polynesia 0 5 10 15 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 09 2 02 4 W 05 2 02 5 0 50 100 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 Figure 1o Kiribati | Kiribati Figure 1p Nauru | Nauru Figure 1q Fiji | Fidji Figure 1r Solomon Islands | Îles Salomon Figure 1s Tuvalu | Tuvalu Figure 1t Vanuatu | Vanuatu Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) 5 W9 2025 (Feb 24-Mar 02) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1 2 3 W 31 2 02 4 W 32 2 02 4 0 10 5 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 100 200 300 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1 2 3 4 W 22 2 02 4 W 27 2 02 4 0 50 100 150 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 14 2 02 4 W 01 2 02 5 W 05 2 02 5 Figure 2a American Samoa | Samoa américaines Figure 2b N Mariana Isl. | Îles Mariannes du Nord Figure 2c Federated States of Micronesia Figure 2d Marshall Islands | Îles Marshall Figure 2f | Palau Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness Figure 2e Guam | Guam Country trends | Influenza like illness, SARI and Suspected COVID-19 ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 50 100 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 100 200 300 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 100 200 300 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 25 50 75 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 0 5 10 15 20 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 Figure 2g Tonga | Tonga Figure 2h Samoa | Samoa Figure 2i Cook Islands | Îles Cook Figure 2j Niue | Niue Legend SARI (Influenza-like illness that requires hospitalization) Suspected COVID-19 Influenza like illness Figure 2k Tokelau | Tokelau Figure 2l Wallis & Futuna | Wallis & Futuna Figure 2m New Caledonia | Nouvelle Calédonie Figure 2n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 50 100 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1000 2000 3000 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 0 10 20 30 40 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 25 50 75 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 2 4 6 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 100 200 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 4 0 50 100 150 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 200 400 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 14 2 02 4 W 18 2 02 4 Figure 2o Kiribati | Kiribati Figure 2p Nauru | Nauru Figure 2q Fiji | Fidji Figure 2r Solomon Islands | Îles Salomon Figure 2s Tuvalu | Tuvalu Figure 2t Vanuatu | Vanuatu Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness 5 W9 2025 (Feb 24-Mar 02) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 0 50 100 150 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 500 1000 1500 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 250 500 750 1000 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 50 100 150 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 250 500 750 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 Figure 3a American Samoa | Samoa américaines Figure 3b N Mariana Isl. | Îles Mariannes du Nord Figure 3c Federated States of Micronesia Figure 3d Marshall Islands | Îles Marshall Figure 3e Guam | Guam Figure 3f | Palau Legend Dengue-like Illness (DLI) Diarrhoea Country trends | Diarrhoea and DLI ** Please note that X and Y axesvary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 20 40 60 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 25 50 75 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 20 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 2 4 6 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 20 40 60 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 Figure 3g Tonga | Tonga Figure 3h Samoa | Samoa Figure 3i Cook Islands | Îles Cook Figure 3j Niue | Niue Legend Dengue-like Illness (DLI) Diarrhoea Figure 3k Tokelau | Tokelau Figure 3l Wallis & Futuna | Wallis & Futuna Figure 3m New Caledonia | Nouvelle Calédonie Figure 3n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 50 100 150 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 0 100 200 300 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1 2 3 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 20 25 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 25 50 75 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 09 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 50 100 150 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 Figure 3o Kiribati | Kiribati Figure 3p Nauru | Nauru Figure 3q Fiji | Fidji Figure 3r Solomon Islands | Îles Salomon Figure 3s Tuvalu | Tuvalu Figure 3t Vanuatu | Vanuatu Legend Dengue-like Illness (DLI) Diarrhoea 5 W9 2025 (Feb 24-Mar 02) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 250 500 750 1000 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 10 20 30 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 500 1000 1500 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 200 400 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 10 5 15 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 100 200 300 W 09 2 02 4 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 Case Definitions Syndrome Case Definition Alert Threshold Acute Fever and Rash (AFR) Fever plus rash(non-blistering) 1 case if there is a measles outbreak. Prolonged fever (PF) Fever for 3 days or more Twice the average number of cases seen in the previous 2 weeks Influenza-like illness (ILI) An acute respiratory infection with: measured fever of ≥ 38 C° and cough; with onset within the last 10 days. Twice the average number of cases seen in the previous 2 weeks Diarrhoea 3 or more loose or watery stools in 24 hours (non- bloody) Twice the average number of cases seen in the previous 2 weeks Suspected dengue Fever for at least 2 days, plus at least two of the following: i. Nausea or vomiting; ii. Muscle or joint pain; iii. Severe headache or pain behind the eyes; iv. Rash; v. Bleeding Twice the average number of cases seen in the previous 3 weeks Severe acute respiratory infection, requiring hospitalisation (SARI) Sudden onset of fever above 38°C, cough or sore throat, shortness of breath or difficulty breathing, and requiring hospitalization. Twice moving average in 2 weeks COVID - 19 Twice moving average in 2 weeks Alert thresholds Please note that the alert thresholds have been set in EWARS and you will receive instant email notification once you have surpassed the alert threshold. New Indicators ∙ ∙ COVID-19 one (1) case, this is as the case definition set to identify suspected COVID- 19 including Multi-system Inflammatory cases in children. In addition, use the EBS to report details. ∙ SARI The alert threshold for SARI is set at one (1) case to increase sensitivity for its investigation as a suspected COVID-19 case and hence require laboratory confirmation or exclusion. Once you do receive an alert, you need to follow the link to verify the alert – enter brief notes to say what the cases were, what has been done to the cases (investigation, treatment) or any other cases regarding the cases – age, gender, residence, hospitalized or not? The alerts are set to auto-discard after 2 days if no action has been taken. In addition, there are now forms available on EWARS for reporting Event Based Surveillance (EBS). Please use these to report any unusual disease patterns/symptoms, unexpected deaths, disease or deaths in animals or anything that is of concern For more help and support, please contact: SHAKILA, Naidu World Health Organization Division of Pacific Technical Support Suva, Fiji Email: shakilan@who.int Notes: The Pacific Syndromic Surveillance System (PSSS) was started in 2010. With the support of the Pacific Community, it collects sentinel surveillance data on 4 syndromes (including one optional), from 23 Pacific Island Countries and areas. The aim is to monitor trends and to trigger alerts to rapidly detect and respond to suspected outbreaks. In 2017, the system was moved to an online platform called EWARS. Data is entered online by country focal points and is then analysed using an online application. This bulletin has been published automatically from EWARS. Le système de surveillance de la syndromie du Pacifique (PSSS) a été lancé en 2010. Avec le soutien de la Communauté du Pacifique, il collecte des données de surveillance sentinelle sur 4 syndromes (dont un optionnel), provenant de 23 pays insulaires du Pacifique. L'objectif est de surveiller les tendances et de déclencher des alertes pour détecter et répondre rapidement aux épidémies présumées. En 2017, le système a été transféré vers une plate-forme en ligne appelée EWARS. Les données sont entrées en ligne par points focaux de pays et sont ensuite analysées à l'aide d'une application en ligne. Ce bulletin a été publié automatiquement à partir d'EWARS.

Pacific Syndromic Surveillance System Weekly Bulletin Système de Surveillance Syndromic dans le Pacifique Bulletin Hebdomadaire W11 2025 (Mar 10-Mar 16) WHO gratefully acknowledges the support of Ministries of Health and partners in the following Pacific Island Countries and areas for the contribution of data to this bulletin | L'OMS reconnaît avec reconnaissance le soutien des ministères de la santé et des partenaires dans les pays insulaires du Pacifique suivants pour la contribution des données à ce bulletin: W1 2025 to W11 2025 | S1 2025 à S11 2025 Pacific Island Countries | Pays insulaires du Pacifique W11 % n 139 57% 13 82% 114 Cumulative % n Indicator 162 1. Number of sentinel sites Nombre de sites sentinelles 66% 182 2. Number of PICs thatreported Nombre de PICs qui ont rapporté 79% 128 3. Number of sites thatreported Nombre de sites qui ont rapporté Key indicators & Highlights | Indicateurs clé & faits saillants 1 W11 2025 (Mar 10-Mar 16) 1 2 1 1 Country/Area No. sites No. reported % reported AFR PF Diarrhoea DLI ILI SARI COVID-19 ** AFR: Acute Fever and Rash; PF: Prolonged Fever; DLI:Diarrhoea-like Illness; ILI: Influenza-like Illness; SARI: Severe Acute Respiratory Infection New Table American Samoa 0 0 0% 0 0 0 0 0 0 0 Cook Islands 14 13 93% 0 0 0 0 28 0 0 Fiji 29 27 93% 2 0 826 865 376 4 0 French Polynesia 0 0 0% 0 0 0 0 0 0 0 Guam 0 0 0% 0 0 0 0 0 0 0 Kiribati 0 0 0% 0 0 0 0 0 0 0 Marshall Islands (the) 2 2 100% 0 5 5 0 12 0 0 Micronesia (Federated States of) 0 0 0% 0 0 0 0 0 0 0 Nauru 1 2 200% 1 1 6 0 2 0 0 New Caledonia 25 6 24% 0 0 10 0 10 0 0 New Zealand 0 0 0% 0 0 0 0 0 0 0 Niue 0 0 0% 0 0 0 0 0 0 0 Northern Mariana Islands (the) 9 9 100% 0 15 8 0 40 2 1 Palau 7 7 100% 0 0 97 0 5 0 0 Papua New Guinea 0 0 0% 0 0 0 0 0 0 0 Pitcairn Islands 1 1 100% 0 0 0 0 0 0 0 Samoa 11 11 100% 1 0 95 0 1263 51 0 Solomon Islands 23 20 87% 0 178 174 8 514 15 0 Tokelau 0 0 0% 0 0 0 0 0 0 0 Tonga 13 12 92% 0 0 4 99 4 2 0 Tuvalu 2 2 100% 0 0 8 0 9 0 0 Vanuatu 0 0 0% 0 0 0 0 0 0 0 Wallis & Futuna 2 2 100% 8 2 18 2 309 5 0 Total 139 114 82% 12 201 1251 974 2572 79 1 Figure 1a American Samoa | Samoa américaines Figure 1b N Mariana Isl. | Îles Mariannes du Nord Figure 1c Federated States of Micronesia Figure 1d Marshall Islands | Îles Marshall Figure 1e Guam | Guam Not reported Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1f | Palau Country trends | AFR and PF ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. **No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 10 20 30 40 50 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 10 20 30 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 20 25 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 1 2 3 4 W 04 2 02 5 W 05 2 02 5 W 06 2 02 5 W 07 2 02 5 W 08 2 02 5 W 09 2 02 5 W 10 2 02 5 Figure 1g Tonga | Tonga Figure 1h Samoa | Samoa Figure 1i Cook Islands | Îles Cook Figure 1j Niue | Niue Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1k Tokelau | Tokelau Figure 1l Wallis & Futuna | Wallis & Futuna Figure 1m New Caledonia | Nouvelle Calédonie Figure 1n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 2 4 6 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 05 2 02 5 W 09 2 02 5 0 2 4 6 8 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 10 5 15 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 25 50 75 100 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 Figure 1o Kiribati | Kiribati Figure 1p Nauru | Nauru Figure 1q Fiji | Fidji Figure 1r Solomon Islands | Îles Salomon Figure 1s Tuvalu | Tuvalu Figure 1t Vanuatu | Vanuatu Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) 5 W11 2025 (Mar 10-Mar 16) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 1 2 3 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 2 4 6 8 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 100 200 300 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 1 2 3 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 50 100 150 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 4 Figure 2a American Samoa | Samoa américaines Figure 2b N Mariana Isl. | Îles Mariannes du Nord Figure 2c Federated States of Micronesia Figure 2d Marshall Islands | Îles Marshall Figure 2f | Palau Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness Figure 2e Guam | Guam Country trends | Influenza like illness, SARI and Suspected COVID-19 ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 50 100 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 100 200 300 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 100 200 300 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 25 50 75 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 0 5 10 15 20 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 Figure 2g Tonga | Tonga Figure 2h Samoa | Samoa Figure 2i Cook Islands | Îles Cook Figure 2j Niue | Niue Legend SARI (Influenza-like illness that requires hospitalization) Suspected COVID-19 Influenza like illness Figure 2k Tokelau | Tokelau Figure 2l Wallis & Futuna | Wallis & Futuna Figure 2m New Caledonia | Nouvelle Calédonie Figure 2n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 50 100 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 1000 2000 3000 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 0 10 20 30 40 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 25 50 75 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 18 2 02 4 W 22 2 02 4 0 1 2 3 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 100 200 300 400 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 50 100 150 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 200 400 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 14 2 02 4 W 18 2 02 4 Figure 2o Kiribati | Kiribati Figure 2p Nauru | Nauru Figure 2q Fiji | Fidji Figure 2r Solomon Islands | Îles Salomon Figure 2s Tuvalu | Tuvalu Figure 2t Vanuatu | Vanuatu Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness 5 W11 2025 (Mar 10-Mar 16) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 4 W 18 2 02 4 0 50 100 150 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 500 1000 1500 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 250 500 750 1000 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 50 100 150 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 250 500 750 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 4 Figure 3a American Samoa | Samoa américaines Figure 3b N Mariana Isl. | Îles Mariannes du Nord Figure 3c Federated States of Micronesia Figure 3d Marshall Islands | Îles Marshall Figure 3e Guam | Guam Figure 3f | Palau Legend Dengue-like Illness (DLI) Diarrhoea Country trends | Diarrhoea and DLI ** Please note that X and Y axesvary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 20 40 60 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 25 50 75 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 20 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 2 4 6 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 50 100 150 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 Figure 3g Tonga | Tonga Figure 3h Samoa | Samoa Figure 3i Cook Islands | Îles Cook Figure 3j Niue | Niue Legend Dengue-like Illness (DLI) Diarrhoea Figure 3k Tokelau | Tokelau Figure 3l Wallis & Futuna | Wallis & Futuna Figure 3m New Caledonia | Nouvelle Calédonie Figure 3n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 100 200 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 100 200 300 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 1 2 3 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1 2 3 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 25 50 75 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 50 100 150 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 Figure 3o Kiribati | Kiribati Figure 3p Nauru | Nauru Figure 3q Fiji | Fidji Figure 3r Solomon Islands | Îles Salomon Figure 3s Tuvalu | Tuvalu Figure 3t Vanuatu | Vanuatu Legend Dengue-like Illness (DLI) Diarrhoea 5 W11 2025 (Mar 10-Mar 16) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 250 500 750 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 10 20 30 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 500 1000 1500 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 200 400 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 5 10 15 20 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 100 200 300 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 Case Definitions Syndrome Case Definition Alert Threshold Acute Fever and Rash (AFR) Fever plus rash(non-blistering) 1 case if there is a measles outbreak. Prolonged fever (PF) Fever for 3 days or more Twice the average number of cases seen in the previous 2 weeks Influenza-like illness (ILI) An acute respiratory infection with: measured fever of ≥ 38 C° and cough; with onset within the last 10 days. Twice the average number of cases seen in the previous 2 weeks Diarrhoea 3 or more loose or watery stools in 24 hours (non- bloody) Twice the average number of cases seen in the previous 2 weeks Suspected dengue Fever for at least 2 days, plus at least two of the following: i. Nausea or vomiting; ii. Muscle or joint pain; iii. Severe headache or pain behind the eyes; iv. Rash; v. Bleeding Twice the average number of cases seen in the previous 3 weeks Severe acute respiratory infection, requiring hospitalisation (SARI) Sudden onset of fever above 38°C, cough or sore throat, shortness of breath or difficulty breathing, and requiring hospitalization. Twice moving average in 2 weeks COVID - 19 Twice moving average in 2 weeks Alert thresholds Please note that the alert thresholds have been set in EWARS and you will receive instant email notification once you have surpassed the alert threshold. New Indicators ∙ ∙ COVID-19 one (1) case, this is as the case definition set to identify suspected COVID- 19 including Multi-system Inflammatory cases in children. In addition, use the EBS to report details. ∙ SARI The alert threshold for SARI is set at one (1) case to increase sensitivity for its investigation as a suspected COVID-19 case and hence require laboratory confirmation or exclusion. Once you do receive an alert, you need to follow the link to verify the alert – enter brief notes to say what the cases were, what has been done to the cases (investigation, treatment) or any other cases regarding the cases – age, gender, residence, hospitalized or not? The alerts are set to auto-discard after 2 days if no action has been taken. In addition, there are now forms available on EWARS for reporting Event Based Surveillance (EBS). Please use these to report any unusual disease patterns/symptoms, unexpected deaths, disease or deaths in animals or anything that is of concern For more help and support, please contact: SHAKILA, Naidu World Health Organization Division of Pacific Technical Support Suva, Fiji Email: shakilan@who.int Notes: The Pacific Syndromic Surveillance System (PSSS) was started in 2010. With the support of the Pacific Community, it collects sentinel surveillance data on 4 syndromes (including one optional), from 23 Pacific Island Countries and areas. The aim is to monitor trends and to trigger alerts to rapidly detect and respond to suspected outbreaks. In 2017, the system was moved to an online platform called EWARS. Data is entered online by country focal points and is then analysed using an online application. This bulletin has been published automatically from EWARS. Le système de surveillance de la syndromie du Pacifique (PSSS) a été lancé en 2010. Avec le soutien de la Communauté du Pacifique, il collecte des données de surveillance sentinelle sur 4 syndromes (dont un optionnel), provenant de 23 pays insulaires du Pacifique. L'objectif est de surveiller les tendances et de déclencher des alertes pour détecter et répondre rapidement aux épidémies présumées. En 2017, le système a été transféré vers une plate-forme en ligne appelée EWARS. Les données sont entrées en ligne par points focaux de pays et sont ensuite analysées à l'aide d'une application en ligne. Ce bulletin a été publié automatiquement à partir d'EWARS.

Pacific Syndromic Surveillance System Weekly Bulletin Système de Surveillance Syndromic dans le Pacifique Bulletin Hebdomadaire W12 2025 (Mar 17-Mar 23) WHO gratefully acknowledges the support of Ministries of Health and partners in the following Pacific Island Countries and areas for the contribution of data to this bulletin | L'OMS reconnaît avec reconnaissance le soutien des ministères de la santé et des partenaires dans les pays insulaires du Pacifique suivants pour la contribution des données à ce bulletin: W1 2025 to W12 2025 | S1 2025 à S12 2025 Pacific Island Countries | Pays insulaires du Pacifique W12 % n 225 83% 19 82% 184 Cumulative % n Indicator 202 1. Number of sentinel sites Nombre de sites sentinelles 75% 310 2. Number of PICs thatreported Nombre de PICs qui ont rapporté 80% 162 3. Number of sites thatreported Nombre de sites qui ont rapporté Key indicators & Highlights | Indicateurs clé & faits saillants 1 W12 2025 (Mar 17-Mar 23) 1 2 1 1 Country/Area No. sites No. reported % reported AFR PF Diarrhoea DLI ILI SARI COVID-19 ** AFR: Acute Fever and Rash; PF: Prolonged Fever; DLI:Diarrhoea-like Illness; ILI: Influenza-like Illness; SARI: Severe Acute Respiratory Infection New Table American Samoa 0 0 0% 0 0 0 0 0 0 0 Cook Islands 14 13 93% 0 0 0 0 23 0 0 Fiji 29 28 97% 0 0 1327 884 381 5 1 French Polynesia 40 37 93% 0 0 90 61 223 0 5 Guam 2 2 100% 5 0 0 0 26 32 5 Kiribati 12 11 92% 0 4 153 0 79 0 0 Marshall Islands (the) 2 2 100% 0 8 4 0 21 0 0 Micronesia (Federated States of) 4 2 50% 0 0 30 0 96 3 0 Nauru 1 1 100% 0 0 4 0 2 0 0 New Caledonia 25 10 40% 0 0 16 0 31 0 0 New Zealand 0 0 0% 0 0 0 0 0 0 0 Niue 1 1 100% 0 0 0 0 0 0 0 Northern Mariana Islands (the) 9 9 100% 0 10 9 0 23 1 3 Palau 7 7 100% 0 0 101 0 6 0 0 Papua New Guinea 0 0 0% 0 0 0 0 0 0 0 Pitcairn Islands 1 1 100% 0 0 0 1 0 0 0 Samoa 11 11 100% 0 0 95 0 876 24 0 Solomon Islands 23 20 87% 0 168 117 5 399 13 1 Tokelau 0 0 0% 0 0 0 0 0 0 0 Tonga 13 12 92% 0 1 16 173 38 3 0 Tuvalu 2 2 100% 1 1 5 0 2 0 0 Vanuatu 27 13 48% 0 18 24 0 192 0 0 Wallis & Futuna 2 2 100% 0 0 13 0 308 1 1 Total 225 184 82% 6 210 2004 1124 2726 82 16 Figure 1a American Samoa | Samoa américaines Figure 1b N Mariana Isl. | Îles Mariannes du Nord Figure 1c Federated States of Micronesia Figure 1d Marshall Islands | Îles Marshall Figure 1e Guam | Guam Not reported Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1f | Palau Country trends | AFR and PF ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. **No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 10 20 30 40 50 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 10 20 30 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 20 25 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 1 2 3 4 W 04 2 02 5 W 05 2 02 5 W 06 2 02 5 W 07 2 02 5 W 08 2 02 5 W 09 2 02 5 W 10 2 02 5 Figure 1g Tonga | Tonga Figure 1h Samoa | Samoa Figure 1i Cook Islands | Îles Cook Figure 1j Niue | Niue Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1k Tokelau | Tokelau Figure 1l Wallis & Futuna | Wallis & Futuna Figure 1m New Caledonia | Nouvelle Calédonie Figure 1n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 2 4 6 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 05 2 02 5 W 09 2 02 5 0 2 4 6 8 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 10 5 15 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 25 50 75 100 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 Figure 1o Kiribati | Kiribati Figure 1p Nauru | Nauru Figure 1q Fiji | Fidji Figure 1r Solomon Islands | Îles Salomon Figure 1s Tuvalu | Tuvalu Figure 1t Vanuatu | Vanuatu Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) 5 W12 2025 (Mar 17-Mar 23) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 1 2 3 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 2 4 6 8 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 100 200 300 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 1 2 3 4 W 01 2 02 5 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 05 2 02 5 W 09 2 02 5 0 50 100 150 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 4 Figure 2a American Samoa | Samoa américaines Figure 2b N Mariana Isl. | Îles Mariannes du Nord Figure 2c Federated States of Micronesia Figure 2d Marshall Islands | Îles Marshall Figure 2f | Palau Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness Figure 2e Guam | Guam Country trends | Influenza like illness, SARI and Suspected COVID-19 ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 50 100 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 100 200 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 100 200 300 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 25 50 75 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 0 5 10 15 20 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 Figure 2g Tonga | Tonga Figure 2h Samoa | Samoa Figure 2i Cook Islands | Îles Cook Figure 2j Niue | Niue Legend SARI (Influenza-like illness that requires hospitalization) Suspected COVID-19 Influenza like illness Figure 2k Tokelau | Tokelau Figure 2l Wallis & Futuna | Wallis & Futuna Figure 2m New Caledonia | Nouvelle Calédonie Figure 2n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 50 100 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 1000 2000 3000 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 20 24 0 10 20 30 40 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 25 50 75 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1 2 3 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 100 200 300 400 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 25 50 75 100 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 250 500 750 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 4 W 18 2 02 4 Figure 2o Kiribati | Kiribati Figure 2p Nauru | Nauru Figure 2q Fiji | Fidji Figure 2r Solomon Islands | Îles Salomon Figure 2s Tuvalu | Tuvalu Figure 2t Vanuatu | Vanuatu Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness 5 W12 2025 (Mar 17-Mar 23) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 18 2 02 4 0 50 100 150 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 500 1000 1500 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 250 500 750 1000 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 50 100 150 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 250 500 750 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 Figure 3a American Samoa | Samoa américaines Figure 3b N Mariana Isl. | Îles Mariannes du Nord Figure 3c Federated States of Micronesia Figure 3d Marshall Islands | Îles Marshall Figure 3e Guam | Guam Figure 3f | Palau Legend Dengue-like Illness (DLI) Diarrhoea Country trends | Diarrhoea and DLI ** Please note that X and Y axesvary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 20 40 60 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 25 50 75 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 5 10 15 20 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 2 4 6 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 50 100 150 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 Figure 3g Tonga | Tonga Figure 3h Samoa | Samoa Figure 3i Cook Islands | Îles Cook Figure 3j Niue | Niue Legend Dengue-like Illness (DLI) Diarrhoea Figure 3k Tokelau | Tokelau Figure 3l Wallis & Futuna | Wallis & Futuna Figure 3m New Caledonia | Nouvelle Calédonie Figure 3n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 100 200 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 100 200 300 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 1 2 3 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1 2 3 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 25 50 75 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 50 100 150 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 Figure 3o Kiribati | Kiribati Figure 3p Nauru | Nauru Figure 3q Fiji | Fidji Figure 3r Solomon Islands | Îles Salomon Figure 3s Tuvalu | Tuvalu Figure 3t Vanuatu | Vanuatu Legend Dengue-like Illness (DLI) Diarrhoea 5 W12 2025 (Mar 17-Mar 23) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 250 500 750 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 10 20 30 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 500 1000 1500 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 200 400 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 5 10 15 20 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 100 200 300 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 Case Definitions Syndrome Case Definition Alert Threshold Acute Fever and Rash (AFR) Fever plus rash(non-blistering) 1 case if there is a measles outbreak. Prolonged fever (PF) Fever for 3 days or more Twice the average number of cases seen in the previous 2 weeks Influenza-like illness (ILI) An acute respiratory infection with: measured fever of ≥ 38 C° and cough; with onset within the last 10 days. Twice the average number of cases seen in the previous 2 weeks Diarrhoea 3 or more loose or watery stools in 24 hours (non- bloody) Twice the average number of cases seen in the previous 2 weeks Suspected dengue Fever for at least 2 days, plus at least two of the following: i. Nausea or vomiting; ii. Muscle or joint pain; iii. Severe headache or pain behind the eyes; iv. Rash; v. Bleeding Twice the average number of cases seen in the previous 3 weeks Severe acute respiratory infection, requiring hospitalisation (SARI) Sudden onset of fever above 38°C, cough or sore throat, shortness of breath or difficulty breathing, and requiring hospitalization. Twice moving average in 2 weeks COVID - 19 Twice moving average in 2 weeks Alert thresholds Please note that the alert thresholds have been set in EWARS and you will receive instant email notification once you have surpassed the alert threshold. New Indicators ∙ ∙ COVID-19 one (1) case, this is as the case definition set to identify suspected COVID- 19 including Multi-system Inflammatory cases in children. In addition, use the EBS to report details. ∙ SARI The alert threshold for SARI is set at one (1) case to increase sensitivity for its investigation as a suspected COVID-19 case and hence require laboratory confirmation or exclusion. Once you do receive an alert, you need to follow the link to verify the alert – enter brief notes to say what the cases were, what has been done to the cases (investigation, treatment) or any other cases regarding the cases – age, gender, residence, hospitalized or not? The alerts are set to auto-discard after 2 days if no action has been taken. In addition, there are now forms available on EWARS for reporting Event Based Surveillance (EBS). Please use these to report any unusual disease patterns/symptoms, unexpected deaths, disease or deaths in animals or anything that is of concern For more help and support, please contact: SHAKILA, Naidu World Health Organization Division of Pacific Technical Support Suva, Fiji Email: shakilan@who.int Notes: The Pacific Syndromic Surveillance System (PSSS) was started in 2010. With the support of the Pacific Community, it collects sentinel surveillance data on 4 syndromes (including one optional), from 23 Pacific Island Countries and areas. The aim is to monitor trends and to trigger alerts to rapidly detect and respond to suspected outbreaks. In 2017, the system was moved to an online platform called EWARS. Data is entered online by country focal points and is then analysed using an online application. This bulletin has been published automatically from EWARS. Le système de surveillance de la syndromie du Pacifique (PSSS) a été lancé en 2010. Avec le soutien de la Communauté du Pacifique, il collecte des données de surveillance sentinelle sur 4 syndromes (dont un optionnel), provenant de 23 pays insulaires du Pacifique. L'objectif est de surveiller les tendances et de déclencher des alertes pour détecter et répondre rapidement aux épidémies présumées. En 2017, le système a été transféré vers une plate-forme en ligne appelée EWARS. Les données sont entrées en ligne par points focaux de pays et sont ensuite analysées à l'aide d'une application en ligne. Ce bulletin a été publié automatiquement à partir d'EWARS.

Pacific Syndromic Surveillance System Weekly Bulletin Système de Surveillance Syndromic dans le Pacifique Bulletin Hebdomadaire W13 2025 (Mar 24-Mar 30) WHO gratefully acknowledges the support of Ministries of Health and partners in the following Pacific Island Countries and areas for the contribution of data to this bulletin | L'OMS reconnaît avec reconnaissance le soutien des ministères de la santé et des partenaires dans les pays insulaires du Pacifique suivants pour la contribution des données à ce bulletin: W1 2025 to W13 2025 | S1 2025 à S13 2025 Pacific Island Countries | Pays insulaires du Pacifique W13 % n 245 78% 18 74% 181 Cumulative % n Indicator 202 1. Number of sentinel sites Nombre de sites sentinelles 75% 310 2. Number of PICs thatreported Nombre de PICs qui ont rapporté 80% 162 3. Number of sites thatreported Nombre de sites qui ont rapporté Key indicators & Highlights | Indicateurs clé & faits saillants 1 W13 2025 (Mar 24-Mar 30) 1 2 1 1 Country/Area No. sites No. reported % reported AFR PF Diarrhoea DLI ILI SARI COVID-19 ** AFR: Acute Fever and Rash; PF: Prolonged Fever; DLI:Diarrhoea-like Illness; ILI: Influenza-like Illness; SARI: Severe Acute Respiratory Infection New Table American Samoa 0 0 0% 0 0 0 0 0 0 0 Cook Islands 0 0 0% 0 0 0 0 0 0 0 Fiji 29 27 93% 0 0 872 714 386 3 0 French Polynesia 40 35 88% 0 0 87 62 274 0 1 Guam 2 2 100% 3 0 0 1 32 36 9 Kiribati 12 12 100% 0 4 182 0 143 5 0 Marshall Islands (the) 2 2 100% 0 4 5 0 18 0 0 Micronesia (Federated States of) 4 2 50% 0 0 10 0 22 0 0 Nauru 33 1 3% 0 0 5 0 2 0 0 New Caledonia 25 10 40% 0 0 8 0 26 0 0 New Zealand 0 0 0% 0 0 0 0 0 0 0 Niue 1 1 100% 0 0 0 0 0 6 0 Northern Mariana Islands (the) 9 9 100% 0 17 8 0 30 0 4 Palau 7 7 100% 0 0 83 0 3 0 0 Papua New Guinea 0 0 0% 0 0 0 0 0 0 0 Pitcairn Islands 1 1 100% 0 0 0 0 0 0 0 Samoa 11 11 100% 0 0 99 0 1006 43 0 Solomon Islands 23 19 83% 0 203 149 6 434 9 0 Tokelau 3 1 33% 0 0 0 0 0 0 0 Tonga 13 13 100% 0 1 31 146 65 7 0 Tuvalu 0 0 0% 0 0 0 0 0 0 0 Vanuatu 28 26 93% 0 16 107 0 483 2 0 Wallis & Futuna 2 2 100% 3 4 17 0 287 2 0 Total 245 181 74% 6 249 1663 929 3211 113 14 Figure 1a American Samoa | Samoa américaines Figure 1b N Mariana Isl. | Îles Mariannes du Nord Figure 1c Federated States of Micronesia Figure 1d Marshall Islands | Îles Marshall Figure 1e Guam | Guam Not reported Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1f | Palau Country trends | AFR and PF ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. **No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 10 20 30 40 50 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 10 20 30 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 18 2 02 4 W 22 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 20 25 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1 2 3 4 W 04 2 02 5 W 05 2 02 5 W 06 2 02 5 W 07 2 02 5 W 08 2 02 5 W 09 2 02 5 W 10 2 02 5 Figure 1g Tonga | Tonga Figure 1h Samoa | Samoa Figure 1i Cook Islands | Îles Cook Figure 1j Niue | Niue Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1k Tokelau | Tokelau Figure 1l Wallis & Futuna | Wallis & Futuna Figure 1m New Caledonia | Nouvelle Calédonie Figure 1n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 2 4 6 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 2 4 6 8 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 10 5 15 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 100 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 Figure 1o Kiribati | Kiribati Figure 1p Nauru | Nauru Figure 1q Fiji | Fidji Figure 1r Solomon Islands | Îles Salomon Figure 1s Tuvalu | Tuvalu Figure 1t Vanuatu | Vanuatu Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) 5 W13 2025 (Mar 24-Mar 30) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1 2 3 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 2 4 6 8 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 100 200 300 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1 2 3 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 50 100 150 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 4 W 14 2 02 5 Figure 2a American Samoa | Samoa américaines Figure 2b N Mariana Isl. | Îles Mariannes du Nord Figure 2c Federated States of Micronesia Figure 2d Marshall Islands | Îles Marshall Figure 2f | Palau Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness Figure 2e Guam | Guam Country trends | Influenza like illness, SARI and Suspected COVID-19 ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 50 100 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 100 200 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 100 200 300 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 0 5 10 15 20 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 14 2 02 4 Figure 2g Tonga | Tonga Figure 2h Samoa | Samoa Figure 2i Cook Islands | Îles Cook Figure 2j Niue | Niue Legend SARI (Influenza-like illness that requires hospitalization) Suspected COVID-19 Influenza like illness Figure 2k Tokelau | Tokelau Figure 2l Wallis & Futuna | Wallis & Futuna Figure 2m New Caledonia | Nouvelle Calédonie Figure 2n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 50 100 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1000 2000 3000 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 0 10 20 30 40 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 25 50 75 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 18 2 02 4 W 22 2 02 4 W 09 2 02 5 W 14 2 02 5 0 1 2 3 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 100 200 300 400 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 14 2 02 5 0 25 50 75 100 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 250 500 750 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 14 2 02 4 W 18 2 02 4 Figure 2o Kiribati | Kiribati Figure 2p Nauru | Nauru Figure 2q Fiji | Fidji Figure 2r Solomon Islands | Îles Salomon Figure 2s Tuvalu | Tuvalu Figure 2t Vanuatu | Vanuatu Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness 5 W13 2025 (Mar 24-Mar 30) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 4 0 50 100 150 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 500 1000 1500 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 14 2 02 4 0 250 500 750 1000 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 50 100 150 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 250 500 750 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 14 2 02 4 Figure 3a American Samoa | Samoa américaines Figure 3b N Mariana Isl. | Îles Mariannes du Nord Figure 3c Federated States of Micronesia Figure 3d Marshall Islands | Îles Marshall Figure 3e Guam | Guam Figure 3f | Palau Legend Dengue-like Illness (DLI) Diarrhoea Country trends | Diarrhoea and DLI ** Please note that X and Y axesvary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 20 40 60 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 5 10 15 20 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 2 4 6 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 0 50 100 150 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 3g Tonga | Tonga Figure 3h Samoa | Samoa Figure 3i Cook Islands | Îles Cook Figure 3j Niue | Niue Legend Dengue-like Illness (DLI) Diarrhoea Figure 3k Tokelau | Tokelau Figure 3l Wallis & Futuna | Wallis & Futuna Figure 3m New Caledonia | Nouvelle Calédonie Figure 3n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 100 200 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 100 200 300 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 1 2 3 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1 2 3 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 50 100 150 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 3o Kiribati | Kiribati Figure 3p Nauru | Nauru Figure 3q Fiji | Fidji Figure 3r Solomon Islands | Îles Salomon Figure 3s Tuvalu | Tuvalu Figure 3t Vanuatu | Vanuatu Legend Dengue-like Illness (DLI) Diarrhoea 5 W13 2025 (Mar 24-Mar 30) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 250 500 750 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 10 20 30 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 500 1000 1500 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 200 400 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 5 10 15 20 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 100 200 300 W 14 2 02 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Case Definitions Syndrome Case Definition Alert Threshold Acute Fever and Rash (AFR) Fever plus rash(non-blistering) 1 case if there is a measles outbreak. Prolonged fever (PF) Fever for 3 days or more Twice the average number of cases seen in the previous 2 weeks Influenza-like illness (ILI) An acute respiratory infection with: measured fever of ≥ 38 C° and cough; with onset within the last 10 days. Twice the average number of cases seen in the previous 2 weeks Diarrhoea 3 or more loose or watery stools in 24 hours (non- bloody) Twice the average number of cases seen in the previous 2 weeks Suspected dengue Fever for at least 2 days, plus at least two of the following: i. Nausea or vomiting; ii. Muscle or joint pain; iii. Severe headache or pain behind the eyes; iv. Rash; v. Bleeding Twice the average number of cases seen in the previous 3 weeks Severe acute respiratory infection, requiring hospitalisation (SARI) Sudden onset of fever above 38°C, cough or sore throat, shortness of breath or difficulty breathing, and requiring hospitalization. Twice moving average in 2 weeks COVID - 19 Twice moving average in 2 weeks Alert thresholds Please note that the alert thresholds have been set in EWARS and you will receive instant email notification once you have surpassed the alert threshold. New Indicators ∙ ∙ COVID-19 one (1) case, this is as the case definition set to identify suspected COVID- 19 including Multi-system Inflammatory cases in children. In addition, use the EBS to report details. ∙ SARI The alert threshold for SARI is set at one (1) case to increase sensitivity for its investigation as a suspected COVID-19 case and hence require laboratory confirmation or exclusion. Once you do receive an alert, you need to follow the link to verify the alert – enter brief notes to say what the cases were, what has been done to the cases (investigation, treatment) or any other cases regarding the cases – age, gender, residence, hospitalized or not? The alerts are set to auto-discard after 2 days if no action has been taken. In addition, there are now forms available on EWARS for reporting Event Based Surveillance (EBS). Please use these to report any unusual disease patterns/symptoms, unexpected deaths, disease or deaths in animals or anything that is of concern For more help and support, please contact: SHAKILA, Naidu World Health Organization Division of Pacific Technical Support Suva, Fiji Email: shakilan@who.int Notes: The Pacific Syndromic Surveillance System (PSSS) was started in 2010. With the support of the Pacific Community, it collects sentinel surveillance data on 4 syndromes (including one optional), from 23 Pacific Island Countries and areas. The aim is to monitor trends and to trigger alerts to rapidly detect and respond to suspected outbreaks. In 2017, the system was moved to an online platform called EWARS. Data is entered online by country focal points and is then analysed using an online application. This bulletin has been published automatically from EWARS. Le système de surveillance de la syndromie du Pacifique (PSSS) a été lancé en 2010. Avec le soutien de la Communauté du Pacifique, il collecte des données de surveillance sentinelle sur 4 syndromes (dont un optionnel), provenant de 23 pays insulaires du Pacifique. L'objectif est de surveiller les tendances et de déclencher des alertes pour détecter et répondre rapidement aux épidémies présumées. En 2017, le système a été transféré vers une plate-forme en ligne appelée EWARS. Les données sont entrées en ligne par points focaux de pays et sont ensuite analysées à l'aide d'une application en ligne. Ce bulletin a été publié automatiquement à partir d'EWARS.

Pacific Syndromic Surveillance System Weekly Bulletin Système de Surveillance Syndromic dans le Pacifique Bulletin Hebdomadaire W14 2025 (Mar 31-Apr 06) WHO gratefully acknowledges the support of Ministries of Health and partners in the following Pacific Island Countries and areas for the contribution of data to this bulletin | L'OMS reconnaît avec reconnaissance le soutien des ministères de la santé et des partenaires dans les pays insulaires du Pacifique suivants pour la contribution des données à ce bulletin: W1 2025 to W14 2025 | S1 2025 à S14 2025 Pacific Island Countries | Pays insulaires du Pacifique W14 % n 182 74% 17 86% 156 Cumulative % n Indicator 202 1. Number of sentinel sites Nombre de sites sentinelles 75% 310 2. Number of PICs thatreported Nombre de PICs qui ont rapporté 80% 162 3. Number of sites thatreported Nombre de sites qui ont rapporté Key indicators & Highlights | Indicateurs clé & faits saillants 1 W14 2025 (Mar 31-Apr 06) 1 2 1 1 Country/Area No. sites No. reported % reported AFR PF Diarrhoea DLI ILI SARI COVID-19 ** AFR: Acute Fever and Rash; PF: Prolonged Fever; DLI:Diarrhoea-like Illness; ILI: Influenza-like Illness; SARI: Severe Acute Respiratory Infection New Table American Samoa 0 0 0% 0 0 0 0 0 0 0 Cook Islands 0 0 0% 0 0 0 0 17 0 0 Fiji 29 26 90% 0 0 937 792 672 5 0 French Polynesia 40 37 93% 0 0 55 48 222 0 6 Guam 2 2 100% 0 0 0 0 31 27 8 Kiribati 12 12 100% 0 4 129 0 90 3 0 Marshall Islands (the) 2 2 100% 0 1 4 0 12 0 0 Micronesia (Federated States of) 4 4 100% 0 0 47 2 59 0 0 Nauru 1 1 100% 0 0 5 0 1 0 0 New Caledonia 25 9 36% 0 0 24 1 62 0 0 New Zealand 0 0 0% 0 0 0 0 0 0 0 Niue 1 1 100% 0 0 0 0 1 0 0 Northern Mariana Islands (the) 9 9 100% 0 26 13 0 27 1 3 Palau 7 7 100% 0 0 59 0 23 0 0 Papua New Guinea 0 0 0% 0 0 0 0 0 0 0 Pitcairn Islands 1 1 100% 0 0 0 0 0 0 0 Samoa 11 11 100% 5 0 112 4 957 30 0 Solomon Islands 23 19 83% 0 180 112 9 258 4 0 Tokelau 0 0 0% 0 0 0 0 0 0 0 Tonga 13 13 100% 0 0 27 116 48 10 0 Tuvalu 0 0 0% 0 0 0 0 0 0 0 Vanuatu 0 0 0% 0 0 0 0 0 0 0 Wallis & Futuna 2 2 100% 0 4 20 1 245 3 0 Total 182 156 86% 5 215 1544 973 2725 83 17 Figure 1a American Samoa | Samoa américaines Figure 1b N Mariana Isl. | Îles Mariannes du Nord Figure 1c Federated States of Micronesia Figure 1d Marshall Islands | Îles Marshall Figure 1e Guam | Guam Not reported Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1f | Palau Country trends | AFR and PF ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. **No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 10 20 30 40 50 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 10 20 30 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 18 2 02 4 W 22 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 20 25 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1 2 3 4 W 04 2 02 5 W 05 2 02 5 W 06 2 02 5 W 07 2 02 5 W 08 2 02 5 W 09 2 02 5 W 10 2 02 5 Figure 1g Tonga | Tonga Figure 1h Samoa | Samoa Figure 1i Cook Islands | Îles Cook Figure 1j Niue | Niue Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1k Tokelau | Tokelau Figure 1l Wallis & Futuna | Wallis & Futuna Figure 1m New Caledonia | Nouvelle Calédonie Figure 1n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 2 4 6 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 2 4 6 8 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Wallis and Futuna, New Caledonia, French Polynesia 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 100 W 18 2 02 4 W 22 2 02 4 Figure 1o Kiribati | Kiribati Figure 1p Nauru | Nauru Figure 1q Fiji | Fidji Figure 1r Solomon Islands | Îles Salomon Figure 1s Tuvalu | Tuvalu Figure 1t Vanuatu | Vanuatu Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) 5 W14 2025 (Mar 31-Apr 06) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1 2 3 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 2 4 6 8 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 100 200 300 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1 2 3 4 W 01 2 02 5 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 05 2 02 5 W 09 2 02 5 0 50 100 150 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 2a American Samoa | Samoa américaines Figure 2b N Mariana Isl. | Îles Mariannes du Nord Figure 2c Federated States of Micronesia Figure 2d Marshall Islands | Îles Marshall Figure 2f | Palau Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness Figure 2e Guam | Guam Country trends | Influenza like illness, SARI and Suspected COVID-19 ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 50 100 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 100 200 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 100 200 300 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 18 2 02 4 W 22 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 0 10 20 30 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 2g Tonga | Tonga Figure 2h Samoa | Samoa Figure 2i Cook Islands | Îles Cook Figure 2j Niue | Niue Legend SARI (Influenza-like illness that requires hospitalization) Suspected COVID-19 Influenza like illness Figure 2k Tokelau | Tokelau Figure 2l Wallis & Futuna | Wallis & Futuna Figure 2m New Caledonia | Nouvelle Calédonie Figure 2n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 50 100 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1000 2000 3000 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 0 10 20 30 40 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 4 W 22 2 02 4 0 1 2 3 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 100 200 300 400 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 100 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 250 500 750 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 4 Figure 2o Kiribati | Kiribati Figure 2p Nauru | Nauru Figure 2q Fiji | Fidji Figure 2r Solomon Islands | Îles Salomon Figure 2s Tuvalu | Tuvalu Figure 2t Vanuatu | Vanuatu Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness 5 W14 2025 (Mar 31-Apr 06) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 4 0 50 100 150 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 500 1000 1500 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 250 500 750 1000 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 50 100 150 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 250 500 750 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 3a American Samoa | Samoa américaines Figure 3b N Mariana Isl. | Îles Mariannes du Nord Figure 3c Federated States of Micronesia Figure 3d Marshall Islands | Îles Marshall Figure 3e Guam | Guam Figure 3f | Palau Legend Dengue-like Illness (DLI) Diarrhoea Country trends | Diarrhoea and DLI ** Please note that X and Y axesvary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 20 40 60 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 5 10 15 20 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 2 4 6 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 50 100 150 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 3g Tonga | Tonga Figure 3h Samoa | Samoa Figure 3i Cook Islands | Îles Cook Figure 3j Niue | Niue Legend Dengue-like Illness (DLI) Diarrhoea Figure 3k Tokelau | Tokelau Figure 3l Wallis & Futuna | Wallis & Futuna Figure 3m New Caledonia | Nouvelle Calédonie Figure 3n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 100 200 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 4 0 100 200 300 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 1 2 3 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1 2 3 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 50 100 150 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 3o Kiribati | Kiribati Figure 3p Nauru | Nauru Figure 3q Fiji | Fidji Figure 3r Solomon Islands | Îles Salomon Figure 3s Tuvalu | Tuvalu Figure 3t Vanuatu | Vanuatu Legend Dengue-like Illness (DLI) Diarrhoea 5 W14 2025 (Mar 31-Apr 06) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 250 500 750 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 10 20 30 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 500 1000 1500 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 200 400 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 5 10 15 20 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 100 200 300 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Case Definitions Syndrome Case Definition Alert Threshold Acute Fever and Rash (AFR) Fever plus rash(non-blistering) 1 case if there is a measles outbreak. Prolonged fever (PF) Fever for 3 days or more Twice the average number of cases seen in the previous 2 weeks Influenza-like illness (ILI) An acute respiratory infection with: measured fever of ≥ 38 C° and cough; with onset within the last 10 days. Twice the average number of cases seen in the previous 2 weeks Diarrhoea 3 or more loose or watery stools in 24 hours (non- bloody) Twice the average number of cases seen in the previous 2 weeks Suspected dengue Fever for at least 2 days, plus at least two of the following: i. Nausea or vomiting; ii. Muscle or joint pain; iii. Severe headache or pain behind the eyes; iv. Rash; v. Bleeding Twice the average number of cases seen in the previous 3 weeks Severe acute respiratory infection, requiring hospitalisation (SARI) Sudden onset of fever above 38°C, cough or sore throat, shortness of breath or difficulty breathing, and requiring hospitalization. Twice moving average in 2 weeks COVID - 19 Twice moving average in 2 weeks Alert thresholds Please note that the alert thresholds have been set in EWARS and you will receive instant email notification once you have surpassed the alert threshold. New Indicators ∙ ∙ COVID-19 one (1) case, this is as the case definition set to identify suspected COVID- 19 including Multi-system Inflammatory cases in children. In addition, use the EBS to report details. ∙ SARI The alert threshold for SARI is set at one (1) case to increase sensitivity for its investigation as a suspected COVID-19 case and hence require laboratory confirmation or exclusion. Once you do receive an alert, you need to follow the link to verify the alert – enter brief notes to say what the cases were, what has been done to the cases (investigation, treatment) or any other cases regarding the cases – age, gender, residence, hospitalized or not? The alerts are set to auto-discard after 2 days if no action has been taken. In addition, there are now forms available on EWARS for reporting Event Based Surveillance (EBS). Please use these to report any unusual disease patterns/symptoms, unexpected deaths, disease or deaths in animals or anything that is of concern For more help and support, please contact: SHAKILA, Naidu World Health Organization Division of Pacific Technical Support Suva, Fiji Email: shakilan@who.int Notes: The Pacific Syndromic Surveillance System (PSSS) was started in 2010. With the support of the Pacific Community, it collects sentinel surveillance data on 4 syndromes (including one optional), from 23 Pacific Island Countries and areas. The aim is to monitor trends and to trigger alerts to rapidly detect and respond to suspected outbreaks. In 2017, the system was moved to an online platform called EWARS. Data is entered online by country focal points and is then analysed using an online application. This bulletin has been published automatically from EWARS. Le système de surveillance de la syndromie du Pacifique (PSSS) a été lancé en 2010. Avec le soutien de la Communauté du Pacifique, il collecte des données de surveillance sentinelle sur 4 syndromes (dont un optionnel), provenant de 23 pays insulaires du Pacifique. L'objectif est de surveiller les tendances et de déclencher des alertes pour détecter et répondre rapidement aux épidémies présumées. En 2017, le système a été transféré vers une plate-forme en ligne appelée EWARS. Les données sont entrées en ligne par points focaux de pays et sont ensuite analysées à l'aide d'une application en ligne. Ce bulletin a été publié automatiquement à partir d'EWARS.

Pacific Syndromic Surveillance System Weekly Bulletin Système de Surveillance Syndromic dans le Pacifique Bulletin Hebdomadaire W15 2025 (Apr 07-Apr 13) WHO gratefully acknowledges the support of Ministries of Health and partners in the following Pacific Island Countries and areas for the contribution of data to this bulletin | L'OMS reconnaît avec reconnaissance le soutien des ministères de la santé et des partenaires dans les pays insulaires du Pacifique suivants pour la contribution des données à ce bulletin: W1 2025 to W15 2025 | S1 2025 à S15 2025 Pacific Island Countries | Pays insulaires du Pacifique W15 % n 146 70% 16 82% 119 Cumulative % n Indicator 202 1. Number of sentinel sites Nombre de sites sentinelles 75% 310 2. Number of PICs thatreported Nombre de PICs qui ont rapporté 80% 162 3. Number of sites thatreported Nombre de sites qui ont rapporté Key indicators & Highlights | Indicateurs clé & faits saillants 1 W15 2025 (Apr 07-Apr 13) 1 2 1 1 Country/Area No. sites No. reported % reported AFR PF Diarrhoea DLI ILI SARI COVID-19 ** AFR: Acute Fever and Rash; PF: Prolonged Fever; DLI:Diarrhoea-like Illness; ILI: Influenza-like Illness; SARI: Severe Acute Respiratory Infection New Table American Samoa 0 0 0% 0 0 0 0 0 0 0 Cook Islands 0 0 0% 0 0 0 0 10 0 0 Fiji 29 27 93% 0 0 997 943 443 5 0 French Polynesia 0 0 0% 0 0 0 0 0 0 0 Guam 2 2 100% 0 0 0 0 47 23 3 Kiribati 12 12 100% 0 1 165 0 68 1 0 Marshall Islands (the) 2 2 100% 0 6 9 0 14 0 0 Micronesia (Federated States of) 4 4 100% 0 1 27 0 49 1 0 Nauru 1 1 100% 0 0 2 0 0 0 0 New Caledonia 25 6 24% 0 0 24 1 33 0 0 New Zealand 0 0 0% 0 0 0 0 0 0 0 Niue 1 1 100% 0 0 0 0 12 0 0 Northern Mariana Islands (the) 9 9 100% 0 21 12 0 35 1 3 Palau 7 7 100% 0 3 31 0 23 0 0 Papua New Guinea 0 0 0% 0 0 0 0 0 0 0 Pitcairn Islands 1 1 100% 0 0 0 0 0 0 0 Samoa 11 11 100% 7 0 72 2 951 29 0 Solomon Islands 23 17 74% 0 193 103 8 229 3 0 Tokelau 0 0 0% 0 0 0 0 0 0 0 Tonga 13 13 100% 0 0 26 136 46 10 0 Tuvalu 0 0 0% 0 0 0 0 0 0 0 Vanuatu 0 0 0% 0 0 0 0 0 0 0 Wallis & Futuna 6 6 100% 0 3 17 0 149 1 0 Total 146 119 82% 7 228 1485 1090 2109 74 6 Figure 1a American Samoa | Samoa américaines Figure 1b N Mariana Isl. | Îles Mariannes du Nord Figure 1c Federated States of Micronesia Figure 1d Marshall Islands | Îles Marshall Figure 1e Guam | Guam Not reported Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1f | Palau Country trends | AFR and PF ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. **No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 10 20 30 40 50 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 10 20 30 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 18 2 02 4 W 22 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 5 10 15 20 25 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1 2 3 4 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 1g Tonga | Tonga Figure 1h Samoa | Samoa Figure 1i Cook Islands | Îles Cook Figure 1j Niue | Niue Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1k Tokelau | Tokelau Figure 1l Wallis & Futuna | Wallis & Futuna Figure 1m New Caledonia | Nouvelle Calédonie Figure 1n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 2 4 6 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 2 4 6 8 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Wallis and Futuna, New Caledonia, French Polynesia 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 100 W 18 2 02 4 W 22 2 02 4 Figure 1o Kiribati | Kiribati Figure 1p Nauru | Nauru Figure 1q Fiji | Fidji Figure 1r Solomon Islands | Îles Salomon Figure 1s Tuvalu | Tuvalu Figure 1t Vanuatu | Vanuatu Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) 5 W15 2025 (Apr 07-Apr 13) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1 2 3 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 2 4 6 8 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 100 200 300 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1 2 3 4 W 01 2 02 5 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 05 2 02 5 W 09 2 02 5 0 50 100 150 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 2a American Samoa | Samoa américaines Figure 2b N Mariana Isl. | Îles Mariannes du Nord Figure 2c Federated States of Micronesia Figure 2d Marshall Islands | Îles Marshall Figure 2f | Palau Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness Figure 2e Guam | Guam Country trends | Influenza like illness, SARI and Suspected COVID-19 ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 50 100 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 100 200 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 100 200 300 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 18 2 02 4 W 22 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 10 20 30 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 2g Tonga | Tonga Figure 2h Samoa | Samoa Figure 2i Cook Islands | Îles Cook Figure 2j Niue | Niue Legend SARI (Influenza-like illness that requires hospitalization) Suspected COVID-19 Influenza like illness Figure 2k Tokelau | Tokelau Figure 2l Wallis & Futuna | Wallis & Futuna Figure 2m New Caledonia | Nouvelle Calédonie Figure 2n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 50 100 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1000 2000 3000 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 0 10 20 30 40 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 4 W 22 2 02 4 0 1 2 3 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 100 200 300 400 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 50 100 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 250 500 750 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 4 Figure 2o Kiribati | Kiribati Figure 2p Nauru | Nauru Figure 2q Fiji | Fidji Figure 2r Solomon Islands | Îles Salomon Figure 2s Tuvalu | Tuvalu Figure 2t Vanuatu | Vanuatu Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness 5 W15 2025 (Apr 07-Apr 13) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 4 0 50 100 150 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 500 1000 1500 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 250 500 750 1000 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 50 100 150 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 250 500 750 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 3a American Samoa | Samoa américaines Figure 3b N Mariana Isl. | Îles Mariannes du Nord Figure 3c Federated States of Micronesia Figure 3d Marshall Islands | Îles Marshall Figure 3e Guam | Guam Figure 3f | Palau Legend Dengue-like Illness (DLI) Diarrhoea Country trends | Diarrhoea and DLI ** Please note that X and Y axesvary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 20 40 60 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 5 10 15 20 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 2 4 6 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 50 100 150 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 3g Tonga | Tonga Figure 3h Samoa | Samoa Figure 3i Cook Islands | Îles Cook Figure 3j Niue | Niue Legend Dengue-like Illness (DLI) Diarrhoea Figure 3k Tokelau | Tokelau Figure 3l Wallis & Futuna | Wallis & Futuna Figure 3m New Caledonia | Nouvelle Calédonie Figure 3n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 100 200 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 4 0 100 200 300 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 1 2 3 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1 2 3 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 50 100 150 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 3o Kiribati | Kiribati Figure 3p Nauru | Nauru Figure 3q Fiji | Fidji Figure 3r Solomon Islands | Îles Salomon Figure 3s Tuvalu | Tuvalu Figure 3t Vanuatu | Vanuatu Legend Dengue-like Illness (DLI) Diarrhoea 5 W15 2025 (Apr 07-Apr 13) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 250 500 750 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 10 20 30 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 500 1000 1500 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 200 400 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 5 10 15 20 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 100 200 300 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Case Definitions Syndrome Case Definition Alert Threshold Acute Fever and Rash (AFR) Fever plus rash(non-blistering) 1 case if there is a measles outbreak. Prolonged fever (PF) Fever for 3 days or more Twice the average number of cases seen in the previous 2 weeks Influenza-like illness (ILI) An acute respiratory infection with: measured fever of ≥ 38 C° and cough; with onset within the last 10 days. Twice the average number of cases seen in the previous 2 weeks Diarrhoea 3 or more loose or watery stools in 24 hours (non- bloody) Twice the average number of cases seen in the previous 2 weeks Suspected dengue Fever for at least 2 days, plus at least two of the following: i. Nausea or vomiting; ii. Muscle or joint pain; iii. Severe headache or pain behind the eyes; iv. Rash; v. Bleeding Twice the average number of cases seen in the previous 3 weeks Severe acute respiratory infection, requiring hospitalisation (SARI) Sudden onset of fever above 38°C, cough or sore throat, shortness of breath or difficulty breathing, and requiring hospitalization. Twice moving average in 2 weeks COVID - 19 Twice moving average in 2 weeks Alert thresholds Please note that the alert thresholds have been set in EWARS and you will receive instant email notification once you have surpassed the alert threshold. New Indicators ∙ ∙ COVID-19 one (1) case, this is as the case definition set to identify suspected COVID- 19 including Multi-system Inflammatory cases in children. In addition, use the EBS to report details. ∙ SARI The alert threshold for SARI is set at one (1) case to increase sensitivity for its investigation as a suspected COVID-19 case and hence require laboratory confirmation or exclusion. Once you do receive an alert, you need to follow the link to verify the alert – enter brief notes to say what the cases were, what has been done to the cases (investigation, treatment) or any other cases regarding the cases – age, gender, residence, hospitalized or not? The alerts are set to auto-discard after 2 days if no action has been taken. In addition, there are now forms available on EWARS for reporting Event Based Surveillance (EBS). Please use these to report any unusual disease patterns/symptoms, unexpected deaths, disease or deaths in animals or anything that is of concern For more help and support, please contact: SHAKILA, Naidu World Health Organization Division of Pacific Technical Support Suva, Fiji Email: shakilan@who.int Notes: The Pacific Syndromic Surveillance System (PSSS) was started in 2010. With the support of the Pacific Community, it collects sentinel surveillance data on 4 syndromes (including one optional), from 23 Pacific Island Countries and areas. The aim is to monitor trends and to trigger alerts to rapidly detect and respond to suspected outbreaks. In 2017, the system was moved to an online platform called EWARS. Data is entered online by country focal points and is then analysed using an online application. This bulletin has been published automatically from EWARS. Le système de surveillance de la syndromie du Pacifique (PSSS) a été lancé en 2010. Avec le soutien de la Communauté du Pacifique, il collecte des données de surveillance sentinelle sur 4 syndromes (dont un optionnel), provenant de 23 pays insulaires du Pacifique. L'objectif est de surveiller les tendances et de déclencher des alertes pour détecter et répondre rapidement aux épidémies présumées. En 2017, le système a été transféré vers une plate-forme en ligne appelée EWARS. Les données sont entrées en ligne par points focaux de pays et sont ensuite analysées à l'aide d'une application en ligne. Ce bulletin a été publié automatiquement à partir d'EWARS.

Pacific Syndromic Surveillance System Weekly Bulletin Système de Surveillance Syndromic dans le Pacifique Bulletin Hebdomadaire W16 2025 (Apr 14-Apr 20) WHO gratefully acknowledges the support of Ministries of Health and partners in the following Pacific Island Countries and areas for the contribution of data to this bulletin | L'OMS reconnaît avec reconnaissance le soutien des ministères de la santé et des partenaires dans les pays insulaires du Pacifique suivants pour la contribution des données à ce bulletin: W1 2025 to W16 2025 | S1 2025 à S16 2025 Pacific Island Countries | Pays insulaires du Pacifique W16 % n 123 61% 14 79% 97 Cumulative % n Indicator 202 1. Number of sentinel sites Nombre de sites sentinelles 75% 310 2. Number of PICs thatreported Nombre de PICs qui ont rapporté 80% 162 3. Number of sites thatreported Nombre de sites qui ont rapporté Key indicators & Highlights | Indicateurs clé & faits saillants 1 W16 2025 (Apr 14-Apr 20) 1 2 1 1 Country/Area No. sites No. reported % reported AFR PF Diarrhoea DLI ILI SARI COVID-19 ** AFR: Acute Fever and Rash; PF: Prolonged Fever; DLI:Diarrhoea-like Illness; ILI: Influenza-like Illness; SARI: Severe Acute Respiratory Infection New Table American Samoa 0 0 0% 0 0 0 0 0 0 0 Cook Islands 0 0 0% 0 0 0 0 0 0 0 Fiji 29 23 79% 0 0 804 817 418 10 0 French Polynesia 0 0 0% 0 0 0 0 0 0 0 Guam 2 2 100% 0 0 0 0 29 33 2 Kiribati 12 12 100% 0 0 157 5 73 2 0 Marshall Islands (the) 2 2 100% 0 0 7 0 18 0 0 Micronesia (Federated States of) 4 3 75% 0 2 16 1 45 0 0 Nauru 1 1 100% 0 1 0 0 0 0 0 New Caledonia 25 8 32% 0 0 12 0 28 0 0 New Zealand 0 0 0% 0 0 0 0 0 0 0 Niue 1 1 100% 0 0 0 0 16 0 1 Northern Mariana Islands (the) 9 9 100% 0 17 4 0 25 2 3 Palau 7 7 100% 0 3 22 0 15 0 0 Papua New Guinea 0 0 0% 0 0 0 0 0 0 0 Pitcairn Islands 1 1 100% 0 0 0 0 0 0 0 Samoa 11 9 82% 5 3 79 14 550 18 0 Solomon Islands 0 0 0% 0 0 0 0 0 0 0 Tokelau 0 0 0% 0 0 0 0 0 0 0 Tonga 13 13 100% 0 1 25 106 94 11 0 Tuvalu 0 0 0% 0 0 0 0 0 0 0 Vanuatu 0 0 0% 0 0 0 0 0 0 0 Wallis & Futuna 6 6 100% 0 0 9 0 72 1 0 Total 123 97 79% 5 27 1135 943 1383 77 6 Figure 1a American Samoa | Samoa américaines Figure 1b N Mariana Isl. | Îles Mariannes du Nord Figure 1c Federated States of Micronesia Figure 1d Marshall Islands | Îles Marshall Figure 1e Guam | Guam Not reported Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1f | Palau Country trends | AFR and PF ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. **No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 10 20 30 40 50 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 10 20 30 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 5 10 15 20 25 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1 2 3 4 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 1g Tonga | Tonga Figure 1h Samoa | Samoa Figure 1i Cook Islands | Îles Cook Figure 1j Niue | Niue Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1k Tokelau | Tokelau Figure 1l Wallis & Futuna | Wallis & Futuna Figure 1m New Caledonia | Nouvelle Calédonie Figure 1n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 2 4 6 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 2 4 6 8 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 10 5 15 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 4 W 22 2 02 4 0 25 50 75 100 W 18 2 02 4 W 22 2 02 4 Figure 1o Kiribati | Kiribati Figure 1p Nauru | Nauru Figure 1q Fiji | Fidji Figure 1r Solomon Islands | Îles Salomon Figure 1s Tuvalu | Tuvalu Figure 1t Vanuatu | Vanuatu Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) 5 W16 2025 (Apr 14-Apr 20) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1 2 3 W 14 2 02 5 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 2 4 6 8 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 100 200 300 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1 2 3 4 W 01 2 02 5 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 05 2 02 5 W 09 2 02 5 0 50 100 150 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 18 2 02 4 W 14 2 02 5 Figure 2a American Samoa | Samoa américaines Figure 2b N Mariana Isl. | Îles Mariannes du Nord Figure 2c Federated States of Micronesia Figure 2d Marshall Islands | Îles Marshall Figure 2f | Palau Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness Figure 2e Guam | Guam Country trends | Influenza like illness, SARI and Suspected COVID-19 ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 50 100 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 100 200 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 100 200 300 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 18 2 02 4 W 22 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 0 10 20 30 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 2g Tonga | Tonga Figure 2h Samoa | Samoa Figure 2i Cook Islands | Îles Cook Figure 2j Niue | Niue Legend SARI (Influenza-like illness that requires hospitalization) Suspected COVID-19 Influenza like illness Figure 2k Tokelau | Tokelau Figure 2l Wallis & Futuna | Wallis & Futuna Figure 2m New Caledonia | Nouvelle Calédonie Figure 2n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 50 100 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1000 2000 3000 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 20 24 0 10 20 30 40 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1 2 3 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 100 200 300 400 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 100 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 250 500 750 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 4 Figure 2o Kiribati | Kiribati Figure 2p Nauru | Nauru Figure 2q Fiji | Fidji Figure 2r Solomon Islands | Îles Salomon Figure 2s Tuvalu | Tuvalu Figure 2t Vanuatu | Vanuatu Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness 5 W16 2025 (Apr 14-Apr 20) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 4 0 50 100 150 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 500 1000 1500 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 250 500 750 1000 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 50 100 150 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 250 500 750 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 3a American Samoa | Samoa américaines Figure 3b N Mariana Isl. | Îles Mariannes du Nord Figure 3c Federated States of Micronesia Figure 3d Marshall Islands | Îles Marshall Figure 3e Guam | Guam Figure 3f | Palau Legend Dengue-like Illness (DLI) Diarrhoea Country trends | Diarrhoea and DLI ** Please note that X and Y axesvary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 20 40 60 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 5 10 15 20 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 2 4 6 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 50 100 150 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 3g Tonga | Tonga Figure 3h Samoa | Samoa Figure 3i Cook Islands | Îles Cook Figure 3j Niue | Niue Legend Dengue-like Illness (DLI) Diarrhoea Figure 3k Tokelau | Tokelau Figure 3l Wallis & Futuna | Wallis & Futuna Figure 3m New Caledonia | Nouvelle Calédonie Figure 3n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 100 200 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 4 0 100 200 300 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 1 2 3 4 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 1 2 3 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 50 100 150 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 3o Kiribati | Kiribati Figure 3p Nauru | Nauru Figure 3q Fiji | Fidji Figure 3r Solomon Islands | Îles Salomon Figure 3s Tuvalu | Tuvalu Figure 3t Vanuatu | Vanuatu Legend Dengue-like Illness (DLI) Diarrhoea 5 W16 2025 (Apr 14-Apr 20) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 250 500 750 W 14 2 02 5 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 10 20 30 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 500 1000 1500 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 200 400 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 5 10 15 20 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 100 200 300 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Case Definitions Syndrome Case Definition Alert Threshold Acute Fever and Rash (AFR) Fever plus rash(non-blistering) 1 case if there is a measles outbreak. Prolonged fever (PF) Fever for 3 days or more Twice the average number of cases seen in the previous 2 weeks Influenza-like illness (ILI) An acute respiratory infection with: measured fever of ≥ 38 C° and cough; with onset within the last 10 days. Twice the average number of cases seen in the previous 2 weeks Diarrhoea 3 or more loose or watery stools in 24 hours (non- bloody) Twice the average number of cases seen in the previous 2 weeks Suspected dengue Fever for at least 2 days, plus at least two of the following: i. Nausea or vomiting; ii. Muscle or joint pain; iii. Severe headache or pain behind the eyes; iv. Rash; v. Bleeding Twice the average number of cases seen in the previous 3 weeks Severe acute respiratory infection, requiring hospitalisation (SARI) Sudden onset of fever above 38°C, cough or sore throat, shortness of breath or difficulty breathing, and requiring hospitalization. Twice moving average in 2 weeks COVID - 19 Twice moving average in 2 weeks Alert thresholds Please note that the alert thresholds have been set in EWARS and you will receive instant email notification once you have surpassed the alert threshold. New Indicators ∙ ∙ COVID-19 one (1) case, this is as the case definition set to identify suspected COVID- 19 including Multi-system Inflammatory cases in children. In addition, use the EBS to report details. ∙ SARI The alert threshold for SARI is set at one (1) case to increase sensitivity for its investigation as a suspected COVID-19 case and hence require laboratory confirmation or exclusion. Once you do receive an alert, you need to follow the link to verify the alert – enter brief notes to say what the cases were, what has been done to the cases (investigation, treatment) or any other cases regarding the cases – age, gender, residence, hospitalized or not? The alerts are set to auto-discard after 2 days if no action has been taken. In addition, there are now forms available on EWARS for reporting Event Based Surveillance (EBS). Please use these to report any unusual disease patterns/symptoms, unexpected deaths, disease or deaths in animals or anything that is of concern For more help and support, please contact: SHAKILA, Naidu World Health Organization Division of Pacific Technical Support Suva, Fiji Email: shakilan@who.int Notes: The Pacific Syndromic Surveillance System (PSSS) was started in 2010. With the support of the Pacific Community, it collects sentinel surveillance data on 4 syndromes (including one optional), from 23 Pacific Island Countries and areas. The aim is to monitor trends and to trigger alerts to rapidly detect and respond to suspected outbreaks. In 2017, the system was moved to an online platform called EWARS. Data is entered online by country focal points and is then analysed using an online application. This bulletin has been published automatically from EWARS. Le système de surveillance de la syndromie du Pacifique (PSSS) a été lancé en 2010. Avec le soutien de la Communauté du Pacifique, il collecte des données de surveillance sentinelle sur 4 syndromes (dont un optionnel), provenant de 23 pays insulaires du Pacifique. L'objectif est de surveiller les tendances et de déclencher des alertes pour détecter et répondre rapidement aux épidémies présumées. En 2017, le système a été transféré vers une plate-forme en ligne appelée EWARS. Les données sont entrées en ligne par points focaux de pays et sont ensuite analysées à l'aide d'une application en ligne. Ce bulletin a été publié automatiquement à partir d'EWARS.

Pacific Syndromic Surveillance System Weekly Bulletin Système de Surveillance Syndromic dans le Pacifique Bulletin Hebdomadaire W17 2025 (Apr 21-Apr 27) WHO gratefully acknowledges the support of Ministries of Health and partners in the following Pacific Island Countries and areas for the contribution of data to this bulletin | L'OMS reconnaît avec reconnaissance le soutien des ministères de la santé et des partenaires dans les pays insulaires du Pacifique suivants pour la contribution des données à ce bulletin: W1 2025 to W17 2025 | S1 2025 à S17 2025 Pacific Island Countries | Pays insulaires du Pacifique W17 % n 138 65% 15 81% 112 Cumulative % n Indicator 202 1. Number of sentinel sites Nombre de sites sentinelles 75% 310 2. Number of PICs thatreported Nombre de PICs qui ont rapporté 80% 162 3. Number of sites thatreported Nombre de sites qui ont rapporté Key indicators & Highlights | Indicateurs clé & faits saillants 1 W17 2025 (Apr 21-Apr 27) 1 2 1 1 Country/Area No. sites No. reported % reported AFR PF Diarrhoea DLI ILI SARI COVID-19 ** AFR: Acute Fever and Rash; PF: Prolonged Fever; DLI:Diarrhoea-like Illness; ILI: Influenza-like Illness; SARI: Severe Acute Respiratory Infection New Table American Samoa 0 0 0% 0 0 0 0 0 0 0 Cook Islands 14 13 93% 0 0 0 1 14 0 0 Fiji 29 25 86% 3 0 857 671 251 11 0 French Polynesia 0 0 0% 0 0 0 0 0 0 0 Guam 0 0 0% 0 0 0 0 0 0 0 Kiribati 12 12 100% 0 2 118 16 70 0 0 Marshall Islands (the) 2 2 100% 0 5 13 0 34 0 0 Micronesia (Federated States of) 4 3 75% 0 0 46 0 54 0 1 Nauru 1 1 100% 0 0 6 0 0 0 0 New Caledonia 25 8 32% 0 0 6 0 13 0 0 New Zealand 0 0 0% 0 0 0 0 0 0 0 Niue 1 1 100% 0 0 0 0 10 0 0 Northern Mariana Islands (the) 9 9 100% 0 18 15 0 25 0 1 Palau 7 7 100% 0 3 24 0 14 0 0 Papua New Guinea 0 0 0% 0 0 0 0 0 0 0 Pitcairn Islands 1 1 100% 0 0 0 0 0 0 0 Samoa 11 10 91% 2 0 81 22 663 12 0 Solomon Islands 0 0 0% 0 0 0 0 0 0 0 Tokelau 3 3 100% 0 0 10 0 1 0 0 Tonga 13 12 92% 1 1 30 75 229 10 0 Tuvalu 0 0 0% 0 0 0 0 0 0 0 Vanuatu 0 0 0% 0 0 0 0 0 0 0 Wallis & Futuna 6 5 83% 1 2 5 0 46 2 0 Total 138 112 81% 7 31 1211 785 1424 35 2 Figure 1a American Samoa | Samoa américaines Figure 1b N Mariana Isl. | Îles Mariannes du Nord Figure 1c Federated States of Micronesia Figure 1d Marshall Islands | Îles Marshall Figure 1e Guam | Guam Not reported Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1f | Palau Country trends | AFR and PF ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. **No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 10 20 30 40 50 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 10 20 30 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 5 10 15 20 25 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1 2 3 4 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 1g Tonga | Tonga Figure 1h Samoa | Samoa Figure 1i Cook Islands | Îles Cook Figure 1j Niue | Niue Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1k Tokelau | Tokelau Figure 1l Wallis & Futuna | Wallis & Futuna Figure 1m New Caledonia | Nouvelle Calédonie Figure 1n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 2 4 6 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 0 2 4 6 8 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Wallis and Futuna, New Caledonia, French Polynesia 0 10 5 15 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 4 W 22 2 02 4 0 25 50 75 100 W 17 2 02 4 W 18 2 02 4 W 19 2 02 4 W 20 2 02 4 W 21 2 02 4 W 22 2 02 4 W 23 2 02 4 Figure 1o Kiribati | Kiribati Figure 1p Nauru | Nauru Figure 1q Fiji | Fidji Figure 1r Solomon Islands | Îles Salomon Figure 1s Tuvalu | Tuvalu Figure 1t Vanuatu | Vanuatu Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) 5 W17 2025 (Apr 21-Apr 27) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 5 10 15 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1 2 3 W 14 2 02 5 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 2 4 6 8 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 100 200 300 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1 2 3 4 W 01 2 02 5 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 05 2 02 5 W 09 2 02 5 0 50 100 150 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 18 2 02 4 W 14 2 02 5 Figure 2a American Samoa | Samoa américaines Figure 2b N Mariana Isl. | Îles Mariannes du Nord Figure 2c Federated States of Micronesia Figure 2d Marshall Islands | Îles Marshall Figure 2f | Palau Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness Figure 2e Guam | Guam Country trends | Influenza like illness, SARI and Suspected COVID-19 ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 50 100 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 100 200 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 4 0 100 200 300 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 22 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 10 20 30 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 2g Tonga | Tonga Figure 2h Samoa | Samoa Figure 2i Cook Islands | Îles Cook Figure 2j Niue | Niue Legend SARI (Influenza-like illness that requires hospitalization) Suspected COVID-19 Influenza like illness Figure 2k Tokelau | Tokelau Figure 2l Wallis & Futuna | Wallis & Futuna Figure 2m New Caledonia | Nouvelle Calédonie Figure 2n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 100 200 300 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1000 2000 3000 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 0 10 20 30 40 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 22 2 02 4 0 1 2 3 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Wallis and Futuna, New Caledonia, French Polynesia 0 100 200 300 400 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 100 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 250 500 750 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 4 Figure 2o Kiribati | Kiribati Figure 2p Nauru | Nauru Figure 2q Fiji | Fidji Figure 2r Solomon Islands | Îles Salomon Figure 2s Tuvalu | Tuvalu Figure 2t Vanuatu | Vanuatu Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness 5 W17 2025 (Apr 21-Apr 27) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 4 0 50 100 150 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 4 0 250 500 750 1000 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 50 100 150 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 250 500 750 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 3a American Samoa | Samoa américaines Figure 3b N Mariana Isl. | Îles Mariannes du Nord Figure 3c Federated States of Micronesia Figure 3d Marshall Islands | Îles Marshall Figure 3e Guam | Guam Figure 3f | Palau Legend Dengue-like Illness (DLI) Diarrhoea Country trends | Diarrhoea and DLI ** Please note that X and Y axesvary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 20 40 60 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 5 10 15 20 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1 2 3 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 50 100 150 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 3g Tonga | Tonga Figure 3h Samoa | Samoa Figure 3i Cook Islands | Îles Cook Figure 3j Niue | Niue Legend Dengue-like Illness (DLI) Diarrhoea Figure 3k Tokelau | Tokelau Figure 3l Wallis & Futuna | Wallis & Futuna Figure 3m New Caledonia | Nouvelle Calédonie Figure 3n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 100 200 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 100 200 300 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 1 2 3 4 W 09 2 02 5 W 14 2 02 5 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 5 10 15 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 2 4 6 8 10 12 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 50 100 150 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 3o Kiribati | Kiribati Figure 3p Nauru | Nauru Figure 3q Fiji | Fidji Figure 3r Solomon Islands | Îles Salomon Figure 3s Tuvalu | Tuvalu Figure 3t Vanuatu | Vanuatu Legend Dengue-like Illness (DLI) Diarrhoea 5 W17 2025 (Apr 21-Apr 27) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 250 500 750 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 10 20 30 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 500 1000 1500 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 200 400 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 5 10 15 20 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 100 200 300 W 18 2 02 4 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Case Definitions Syndrome Case Definition Alert Threshold Acute Fever and Rash (AFR) Fever plus rash(non-blistering) 1 case if there is a measles outbreak. Prolonged fever (PF) Fever for 3 days or more Twice the average number of cases seen in the previous 2 weeks Influenza-like illness (ILI) An acute respiratory infection with: measured fever of ≥ 38 C° and cough; with onset within the last 10 days. Twice the average number of cases seen in the previous 2 weeks Diarrhoea 3 or more loose or watery stools in 24 hours (non- bloody) Twice the average number of cases seen in the previous 2 weeks Suspected dengue Fever for at least 2 days, plus at least two of the following: i. Nausea or vomiting; ii. Muscle or joint pain; iii. Severe headache or pain behind the eyes; iv. Rash; v. Bleeding Twice the average number of cases seen in the previous 3 weeks Severe acute respiratory infection, requiring hospitalisation (SARI) Sudden onset of fever above 38°C, cough or sore throat, shortness of breath or difficulty breathing, and requiring hospitalization. Twice moving average in 2 weeks COVID - 19 Twice moving average in 2 weeks Alert thresholds Please note that the alert thresholds have been set in EWARS and you will receive instant email notification once you have surpassed the alert threshold. New Indicators ∙ ∙ COVID-19 one (1) case, this is as the case definition set to identify suspected COVID- 19 including Multi-system Inflammatory cases in children. In addition, use the EBS to report details. ∙ SARI The alert threshold for SARI is set at one (1) case to increase sensitivity for its investigation as a suspected COVID-19 case and hence require laboratory confirmation or exclusion. Once you do receive an alert, you need to follow the link to verify the alert – enter brief notes to say what the cases were, what has been done to the cases (investigation, treatment) or any other cases regarding the cases – age, gender, residence, hospitalized or not? The alerts are set to auto-discard after 2 days if no action has been taken. In addition, there are now forms available on EWARS for reporting Event Based Surveillance (EBS). Please use these to report any unusual disease patterns/symptoms, unexpected deaths, disease or deaths in animals or anything that is of concern For more help and support, please contact: SHAKILA, Naidu World Health Organization Division of Pacific Technical Support Suva, Fiji Email: shakilan@who.int Notes: The Pacific Syndromic Surveillance System (PSSS) was started in 2010. With the support of the Pacific Community, it collects sentinel surveillance data on 4 syndromes (including one optional), from 23 Pacific Island Countries and areas. The aim is to monitor trends and to trigger alerts to rapidly detect and respond to suspected outbreaks. In 2017, the system was moved to an online platform called EWARS. Data is entered online by country focal points and is then analysed using an online application. This bulletin has been published automatically from EWARS. Le système de surveillance de la syndromie du Pacifique (PSSS) a été lancé en 2010. Avec le soutien de la Communauté du Pacifique, il collecte des données de surveillance sentinelle sur 4 syndromes (dont un optionnel), provenant de 23 pays insulaires du Pacifique. L'objectif est de surveiller les tendances et de déclencher des alertes pour détecter et répondre rapidement aux épidémies présumées. En 2017, le système a été transféré vers une plate-forme en ligne appelée EWARS. Les données sont entrées en ligne par points focaux de pays et sont ensuite analysées à l'aide d'une application en ligne. Ce bulletin a été publié automatiquement à partir d'EWARS.

Pacific Syndromic Surveillance System Weekly Bulletin Système de Surveillance Syndromic dans le Pacifique Bulletin Hebdomadaire W18 2025 (Apr 28-May 04) WHO gratefully acknowledges the support of Ministries of Health and partners in the following Pacific Island Countries and areas for the contribution of data to this bulletin | L'OMS reconnaît avec reconnaissance le soutien des ministères de la santé et des partenaires dans les pays insulaires du Pacifique suivants pour la contribution des données à ce bulletin: W1 2025 to W18 2025 | S1 2025 à S18 2025 Pacific Island Countries | Pays insulaires du Pacifique W18 % n 81 48% 11 75% 61 Cumulative % n Indicator 192 1. Number of sentinel sites Nombre de sites sentinelles 72% 313 2. Number of PICs thatreported Nombre de PICs qui ont rapporté 80% 153 3. Number of sites thatreported Nombre de sites qui ont rapporté Key indicators & Highlights | Indicateurs clé & faits saillants 1 W18 2025 (Apr 28-May 04) 1 2 1 1 Country/Area No. sites No. reported % reported AFR PF Diarrhoea DLI ILI SARI COVID-19 ** AFR: Acute Fever and Rash; PF: Prolonged Fever; DLI:Diarrhoea-like Illness; ILI: Influenza-like Illness; SARI: Severe Acute Respiratory Infection New Table American Samoa 0 0 0% 0 0 0 0 0 0 0 Cook Islands 0 0 0% 0 0 0 0 0 0 0 Fiji 0 0 0% 0 0 0 0 0 0 0 French Polynesia 0 0 0% 0 0 0 0 0 0 0 Guam 2 2 100% 0 0 0 0 30 23 4 Kiribati 0 0 0% 0 0 0 0 0 0 0 Marshall Islands (the) 2 2 100% 0 1 7 0 18 0 0 Micronesia (Federated States of) 4 4 100% 0 0 39 0 93 0 0 Nauru 1 1 100% 0 0 2 0 0 0 0 New Caledonia 25 7 28% 0 0 10 0 13 0 0 New Zealand 0 0 0% 0 0 0 0 0 0 0 Niue 0 0 0% 0 0 0 0 0 0 0 Northern Mariana Islands (the) 9 9 100% 0 17 16 0 26 1 4 Palau 7 7 100% 0 3 26 0 8 0 0 Papua New Guinea 0 0 0% 0 0 0 0 0 0 0 Pitcairn Islands 1 1 100% 0 0 0 0 0 0 0 Samoa 11 10 91% 0 2 112 33 570 14 0 Solomon Islands 0 0 0% 0 0 0 0 0 0 0 Tokelau 0 0 0% 0 0 0 0 0 0 0 Tonga 13 12 92% 0 2 40 141 89 7 2 Tuvalu 0 0 0% 0 0 0 0 0 0 0 Vanuatu 0 0 0% 0 0 0 0 0 0 0 Wallis & Futuna 6 6 100% 0 4 8 0 39 0 0 Total 81 61 75% 0 29 260 174 886 45 10 Figure 1a American Samoa | Samoa américaines Figure 1b N Mariana Isl. | Îles Mariannes du Nord Figure 1c Federated States of Micronesia Figure 1d Marshall Islands | Îles Marshall Figure 1e Guam | Guam Not reported Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1f | Palau Country trends | AFR and PF ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. **No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 10 20 30 40 50 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 10 20 30 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 5 10 15 20 25 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 1 2 3 4 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Figure 1g Tonga | Tonga Figure 1h Samoa | Samoa Figure 1i Cook Islands | Îles Cook Figure 1j Niue | Niue Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1k Tokelau | Tokelau Figure 1l Wallis & Futuna | Wallis & Futuna Figure 1m New Caledonia | Nouvelle Calédonie Figure 1n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 2 4 6 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 18 2 02 5 0 2 4 6 8 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Wallis and Futuna, New Caledonia, French Polynesia 0 10 5 15 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 22 2 02 4 W 18 2 02 5 0 25 50 75 100 W 18 2 02 4 W 19 2 02 4 W 20 2 02 4 W 21 2 02 4 W 22 2 02 4 W 23 2 02 4 Figure 1o Kiribati | Kiribati Figure 1p Nauru | Nauru Figure 1q Fiji | Fidji Figure 1r Solomon Islands | Îles Salomon Figure 1s Tuvalu | Tuvalu Figure 1t Vanuatu | Vanuatu Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) 5 W18 2025 (Apr 28-May 04) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 5 10 15 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1 2 3 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 2 4 6 8 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 100 200 300 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1 2 3 4 W 01 2 02 5 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 05 2 02 5 W 09 2 02 5 0 50 100 150 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 2a American Samoa | Samoa américaines Figure 2b N Mariana Isl. | Îles Mariannes du Nord Figure 2c Federated States of Micronesia Figure 2d Marshall Islands | Îles Marshall Figure 2f | Palau Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness Figure 2e Guam | Guam Country trends | Influenza like illness, SARI and Suspected COVID-19 ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 50 100 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 100 200 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 100 200 300 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 22 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 25 50 75 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 10 20 30 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Figure 2g Tonga | Tonga Figure 2h Samoa | Samoa Figure 2i Cook Islands | Îles Cook Figure 2j Niue | Niue Legend SARI (Influenza-like illness that requires hospitalization) Suspected COVID-19 Influenza like illness Figure 2k Tokelau | Tokelau Figure 2l Wallis & Futuna | Wallis & Futuna Figure 2m New Caledonia | Nouvelle Calédonie Figure 2n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 100 200 300 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 1000 2000 3000 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 0 10 20 30 40 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 22 2 02 4 0 1 2 3 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Wallis and Futuna, New Caledonia, French Polynesia 0 100 200 300 400 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 25 50 75 100 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 250 500 750 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 2o Kiribati | Kiribati Figure 2p Nauru | Nauru Figure 2q Fiji | Fidji Figure 2r Solomon Islands | Îles Salomon Figure 2s Tuvalu | Tuvalu Figure 2t Vanuatu | Vanuatu Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness 5 W18 2025 (Apr 28-May 04) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 50 100 150 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 250 500 750 1000 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 250 500 750 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 3a American Samoa | Samoa américaines Figure 3b N Mariana Isl. | Îles Mariannes du Nord Figure 3c Federated States of Micronesia Figure 3d Marshall Islands | Îles Marshall Figure 3e Guam | Guam Figure 3f | Palau Legend Dengue-like Illness (DLI) Diarrhoea Country trends | Diarrhoea and DLI ** Please note that X and Y axesvary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 20 40 60 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 25 50 75 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 5 10 15 20 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 1 2 3 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 50 100 150 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Figure 3g Tonga | Tonga Figure 3h Samoa | Samoa Figure 3i Cook Islands | Îles Cook Figure 3j Niue | Niue Legend Dengue-like Illness (DLI) Diarrhoea Figure 3k Tokelau | Tokelau Figure 3l Wallis & Futuna | Wallis & Futuna Figure 3m New Caledonia | Nouvelle Calédonie Figure 3n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 100 200 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 100 200 300 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 1 2 3 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 5 10 15 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 10 5 15 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 20 40 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 18 2 02 5 0 50 100 150 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 3o Kiribati | Kiribati Figure 3p Nauru | Nauru Figure 3q Fiji | Fidji Figure 3r Solomon Islands | Îles Salomon Figure 3s Tuvalu | Tuvalu Figure 3t Vanuatu | Vanuatu Legend Dengue-like Illness (DLI) Diarrhoea 5 W18 2025 (Apr 28-May 04) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 250 500 750 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 10 20 30 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 200 400 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 5 10 15 20 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 100 200 300 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Case Definitions Syndrome Case Definition Alert Threshold Acute Fever and Rash (AFR) Fever plus rash(non-blistering) 1 case if there is a measles outbreak. Prolonged fever (PF) Fever for 3 days or more Twice the average number of cases seen in the previous 2 weeks Influenza-like illness (ILI) An acute respiratory infection with: measured fever of ≥ 38 C° and cough; with onset within the last 10 days. Twice the average number of cases seen in the previous 2 weeks Diarrhoea 3 or more loose or watery stools in 24 hours (non- bloody) Twice the average number of cases seen in the previous 2 weeks Suspected dengue Fever for at least 2 days, plus at least two of the following: i. Nausea or vomiting; ii. Muscle or joint pain; iii. Severe headache or pain behind the eyes; iv. Rash; v. Bleeding Twice the average number of cases seen in the previous 3 weeks Severe acute respiratory infection, requiring hospitalisation (SARI) Sudden onset of fever above 38°C, cough or sore throat, shortness of breath or difficulty breathing, and requiring hospitalization. Twice moving average in 2 weeks COVID - 19 Twice moving average in 2 weeks Alert thresholds Please note that the alert thresholds have been set in EWARS and you will receive instant email notification once you have surpassed the alert threshold. New Indicators ∙ ∙ COVID-19 one (1) case, this is as the case definition set to identify suspected COVID- 19 including Multi-system Inflammatory cases in children. In addition, use the EBS to report details. ∙ SARI The alert threshold for SARI is set at one (1) case to increase sensitivity for its investigation as a suspected COVID-19 case and hence require laboratory confirmation or exclusion. Once you do receive an alert, you need to follow the link to verify the alert – enter brief notes to say what the cases were, what has been done to the cases (investigation, treatment) or any other cases regarding the cases – age, gender, residence, hospitalized or not? The alerts are set to auto-discard after 2 days if no action has been taken. In addition, there are now forms available on EWARS for reporting Event Based Surveillance (EBS). Please use these to report any unusual disease patterns/symptoms, unexpected deaths, disease or deaths in animals or anything that is of concern For more help and support, please contact: SHAKILA, Naidu World Health Organization Division of Pacific Technical Support Suva, Fiji Email: shakilan@who.int Notes: The Pacific Syndromic Surveillance System (PSSS) was started in 2010. With the support of the Pacific Community, it collects sentinel surveillance data on 4 syndromes (including one optional), from 23 Pacific Island Countries and areas. The aim is to monitor trends and to trigger alerts to rapidly detect and respond to suspected outbreaks. In 2017, the system was moved to an online platform called EWARS. Data is entered online by country focal points and is then analysed using an online application. This bulletin has been published automatically from EWARS. Le système de surveillance de la syndromie du Pacifique (PSSS) a été lancé en 2010. Avec le soutien de la Communauté du Pacifique, il collecte des données de surveillance sentinelle sur 4 syndromes (dont un optionnel), provenant de 23 pays insulaires du Pacifique. L'objectif est de surveiller les tendances et de déclencher des alertes pour détecter et répondre rapidement aux épidémies présumées. En 2017, le système a été transféré vers une plate-forme en ligne appelée EWARS. Les données sont entrées en ligne par points focaux de pays et sont ensuite analysées à l'aide d'une application en ligne. Ce bulletin a été publié automatiquement à partir d'EWARS.

Pacific Syndromic Surveillance System Weekly Bulletin Système de Surveillance Syndromic dans le Pacifique Bulletin Hebdomadaire W19 2025 (May 05-May 11) WHO gratefully acknowledges the support of Ministries of Health and partners in the following Pacific Island Countries and areas for the contribution of data to this bulletin | L'OMS reconnaît avec reconnaissance le soutien des ministères de la santé et des partenaires dans les pays insulaires du Pacifique suivants pour la contribution des données à ce bulletin: W1 2025 to W19 2025 | S1 2025 à S19 2025 Pacific Island Countries | Pays insulaires du Pacifique W19 % n 92 52% 12 78% 72 Cumulative % n Indicator 205 1. Number of sentinel sites Nombre de sites sentinelles 72% 331 2. Number of PICs thatreported Nombre de PICs qui ont rapporté 80% 164 3. Number of sites thatreported Nombre de sites qui ont rapporté Key indicators & Highlights | Indicateurs clé & faits saillants 1 W19 2025 (May 05-May 11) 1 2 1 1 Country/Area No. sites No. reported % reported AFR PF Diarrhoea DLI ILI SARI COVID-19 ** AFR: Acute Fever and Rash; PF: Prolonged Fever; DLI:Diarrhoea-like Illness; ILI: Influenza-like Illness; SARI: Severe Acute Respiratory Infection New Table American Samoa 0 0 0% 0 0 0 0 0 0 0 Cook Islands 0 0 0% 0 0 0 0 0 0 0 Fiji 0 0 0% 0 0 0 0 0 0 0 French Polynesia 0 0 0% 0 0 0 0 0 0 0 Guam 0 0 0% 0 0 0 0 0 0 0 Kiribati 12 12 100% 0 0 66 17 65 0 0 Marshall Islands (the) 2 2 100% 0 3 7 0 19 0 0 Micronesia (Federated States of) 4 3 75% 0 1 29 0 30 0 0 Nauru 1 1 100% 0 0 1 0 0 0 0 New Caledonia 25 6 24% 0 0 7 0 6 0 0 New Zealand 0 0 0% 0 0 0 0 0 0 0 Niue 1 1 100% 0 0 0 0 0 0 0 Northern Mariana Islands (the) 9 9 100% 0 13 13 0 28 3 6 Palau 7 7 100% 0 3 25 0 15 0 0 Papua New Guinea 0 0 0% 0 0 0 0 0 0 0 Pitcairn Islands 1 1 100% 0 0 0 0 0 0 0 Samoa 11 11 100% 2 0 131 36 742 18 0 Solomon Islands 0 0 0% 0 0 0 0 0 0 0 Tokelau 0 0 0% 0 0 0 0 0 0 0 Tonga 13 13 100% 0 0 29 121 92 5 0 Tuvalu 0 0 0% 0 0 0 0 0 0 0 Vanuatu 0 0 0% 0 0 0 0 0 0 0 Wallis & Futuna 6 6 100% 2 0 20 0 48 2 1 Total 92 72 78% 4 20 328 174 1045 28 7 Figure 1a American Samoa | Samoa américaines Figure 1b N Mariana Isl. | Îles Mariannes du Nord Figure 1c Federated States of Micronesia Figure 1d Marshall Islands | Îles Marshall Figure 1e Guam | Guam Not reported Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1f | Palau Country trends | AFR and PF ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. **No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 10 20 30 40 50 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 10 20 30 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 5 10 15 20 25 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 1 2 3 4 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Figure 1g Tonga | Tonga Figure 1h Samoa | Samoa Figure 1i Cook Islands | Îles Cook Figure 1j Niue | Niue Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1k Tokelau | Tokelau Figure 1l Wallis & Futuna | Wallis & Futuna Figure 1m New Caledonia | Nouvelle Calédonie Figure 1n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 2 4 6 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 18 2 02 5 0 2 4 6 8 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Wallis and Futuna, New Caledonia, French Polynesia 0 10 5 15 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 4 0 25 50 75 100 W 19 2 02 4 W 20 2 02 4 W 21 2 02 4 W 22 2 02 4 W 23 2 02 4 Figure 1o Kiribati | Kiribati Figure 1p Nauru | Nauru Figure 1q Fiji | Fidji Figure 1r Solomon Islands | Îles Salomon Figure 1s Tuvalu | Tuvalu Figure 1t Vanuatu | Vanuatu Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) 5 W19 2025 (May 05-May 11) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 5 10 15 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1 2 3 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 2 4 6 8 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 100 200 300 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1 2 3 4 W 01 2 02 5 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 05 2 02 5 W 09 2 02 5 0 50 100 150 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Figure 2a American Samoa | Samoa américaines Figure 2b N Mariana Isl. | Îles Mariannes du Nord Figure 2c Federated States of Micronesia Figure 2d Marshall Islands | Îles Marshall Figure 2f | Palau Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness Figure 2e Guam | Guam Country trends | Influenza like illness, SARI and Suspected COVID-19 ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 50 100 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 100 200 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 22 2 02 4 W 18 2 02 5 0 100 200 300 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 22 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 25 50 75 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 10 20 30 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Figure 2g Tonga | Tonga Figure 2h Samoa | Samoa Figure 2i Cook Islands | Îles Cook Figure 2j Niue | Niue Legend SARI (Influenza-like illness that requires hospitalization) Suspected COVID-19 Influenza like illness Figure 2k Tokelau | Tokelau Figure 2l Wallis & Futuna | Wallis & Futuna Figure 2m New Caledonia | Nouvelle Calédonie Figure 2n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 100 200 300 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 1000 2000 3000 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 0 10 20 30 40 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 25 50 75 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 22 2 02 4 0 1 2 3 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Wallis and Futuna, New Caledonia, French Polynesia 0 100 200 300 400 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 25 50 75 100 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 250 500 750 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 2o Kiribati | Kiribati Figure 2p Nauru | Nauru Figure 2q Fiji | Fidji Figure 2r Solomon Islands | Îles Salomon Figure 2s Tuvalu | Tuvalu Figure 2t Vanuatu | Vanuatu Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness 5 W19 2025 (May 05-May 11) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 50 100 150 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 250 500 750 1000 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 10 20 30 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 250 500 750 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Figure 3a American Samoa | Samoa américaines Figure 3b N Mariana Isl. | Îles Mariannes du Nord Figure 3c Federated States of Micronesia Figure 3d Marshall Islands | Îles Marshall Figure 3e Guam | Guam Figure 3f | Palau Legend Dengue-like Illness (DLI) Diarrhoea Country trends | Diarrhoea and DLI ** Please note that X and Y axesvary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 20 40 60 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 25 50 75 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 5 10 15 20 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 1 2 3 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 50 100 150 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Figure 3g Tonga | Tonga Figure 3h Samoa | Samoa Figure 3i Cook Islands | Îles Cook Figure 3j Niue | Niue Legend Dengue-like Illness (DLI) Diarrhoea Figure 3k Tokelau | Tokelau Figure 3l Wallis & Futuna | Wallis & Futuna Figure 3m New Caledonia | Nouvelle Calédonie Figure 3n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 100 200 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 100 200 300 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 1 2 3 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 5 10 15 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 2 4 6 8 10 12 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 20 40 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 50 100 150 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 3o Kiribati | Kiribati Figure 3p Nauru | Nauru Figure 3q Fiji | Fidji Figure 3r Solomon Islands | Îles Salomon Figure 3s Tuvalu | Tuvalu Figure 3t Vanuatu | Vanuatu Legend Dengue-like Illness (DLI) Diarrhoea 5 W19 2025 (May 05-May 11) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 250 500 750 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 10 20 30 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 200 400 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 5 10 15 20 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 100 200 300 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Case Definitions Syndrome Case Definition Alert Threshold Acute Fever and Rash (AFR) Fever plus rash(non-blistering) 1 case if there is a measles outbreak. Prolonged fever (PF) Fever for 3 days or more Twice the average number of cases seen in the previous 2 weeks Influenza-like illness (ILI) An acute respiratory infection with: measured fever of ≥ 38 C° and cough; with onset within the last 10 days. Twice the average number of cases seen in the previous 2 weeks Diarrhoea 3 or more loose or watery stools in 24 hours (non- bloody) Twice the average number of cases seen in the previous 2 weeks Suspected dengue Fever for at least 2 days, plus at least two of the following: i. Nausea or vomiting; ii. Muscle or joint pain; iii. Severe headache or pain behind the eyes; iv. Rash; v. Bleeding Twice the average number of cases seen in the previous 3 weeks Severe acute respiratory infection, requiring hospitalisation (SARI) Sudden onset of fever above 38°C, cough or sore throat, shortness of breath or difficulty breathing, and requiring hospitalization. Twice moving average in 2 weeks COVID - 19 Twice moving average in 2 weeks Alert thresholds Please note that the alert thresholds have been set in EWARS and you will receive instant email notification once you have surpassed the alert threshold. New Indicators ∙ ∙ COVID-19 one (1) case, this is as the case definition set to identify suspected COVID- 19 including Multi-system Inflammatory cases in children. In addition, use the EBS to report details. ∙ SARI The alert threshold for SARI is set at one (1) case to increase sensitivity for its investigation as a suspected COVID-19 case and hence require laboratory confirmation or exclusion. Once you do receive an alert, you need to follow the link to verify the alert – enter brief notes to say what the cases were, what has been done to the cases (investigation, treatment) or any other cases regarding the cases – age, gender, residence, hospitalized or not? The alerts are set to auto-discard after 2 days if no action has been taken. In addition, there are now forms available on EWARS for reporting Event Based Surveillance (EBS). Please use these to report any unusual disease patterns/symptoms, unexpected deaths, disease or deaths in animals or anything that is of concern For more help and support, please contact: SHAKILA, Naidu World Health Organization Division of Pacific Technical Support Suva, Fiji Email: shakilan@who.int Notes: The Pacific Syndromic Surveillance System (PSSS) was started in 2010. With the support of the Pacific Community, it collects sentinel surveillance data on 4 syndromes (including one optional), from 23 Pacific Island Countries and areas. The aim is to monitor trends and to trigger alerts to rapidly detect and respond to suspected outbreaks. In 2017, the system was moved to an online platform called EWARS. Data is entered online by country focal points and is then analysed using an online application. This bulletin has been published automatically from EWARS. Le système de surveillance de la syndromie du Pacifique (PSSS) a été lancé en 2010. Avec le soutien de la Communauté du Pacifique, il collecte des données de surveillance sentinelle sur 4 syndromes (dont un optionnel), provenant de 23 pays insulaires du Pacifique. L'objectif est de surveiller les tendances et de déclencher des alertes pour détecter et répondre rapidement aux épidémies présumées. En 2017, le système a été transféré vers une plate-forme en ligne appelée EWARS. Les données sont entrées en ligne par points focaux de pays et sont ensuite analysées à l'aide d'une application en ligne. Ce bulletin a été publié automatiquement à partir d'EWARS.

Pacific Syndromic Surveillance System Weekly Bulletin Système de Surveillance Syndromic dans le Pacifique Bulletin Hebdomadaire W20 2025 (May 12-May 18) WHO gratefully acknowledges the support of Ministries of Health and partners in the following Pacific Island Countries and areas for the contribution of data to this bulletin | L'OMS reconnaît avec reconnaissance le soutien des ministères de la santé et des partenaires dans les pays insulaires du Pacifique suivants pour la contribution des données à ce bulletin: W1 2025 to W20 2025 | S1 2025 à S20 2025 Pacific Island Countries | Pays insulaires du Pacifique W20 % n 121 52% 12 78% 94 Cumulative % n Indicator 204 1. Number of sentinel sites Nombre de sites sentinelles 72% 346 2. Number of PICs thatreported Nombre de PICs qui ont rapporté 80% 164 3. Number of sites thatreported Nombre de sites qui ont rapporté Key indicators & Highlights | Indicateurs clé & faits saillants 1 W20 2025 (May 12-May 18) 1 2 1 1 Country/Area No. sites No. reported % reported AFR PF Diarrhoea DLI ILI SARI COVID-19 ** AFR: Acute Fever and Rash; PF: Prolonged Fever; DLI:Diarrhoea-like Illness; ILI: Influenza-like Illness; SARI: Severe Acute Respiratory Infection New Table American Samoa 0 0 0% 0 0 0 0 0 0 0 Cook Islands 14 13 93% 0 0 0 4 27 0 0 Fiji 0 0 0% 0 0 0 0 0 0 0 French Polynesia 0 0 0% 0 0 0 0 0 0 0 Guam 0 0 0% 0 0 0 0 0 0 0 Kiribati 12 8 67% 0 0 57 49 20 0 0 Marshall Islands (the) 2 2 100% 0 3 7 0 20 0 0 Micronesia (Federated States of) 0 0 0% 0 0 0 0 0 0 0 Nauru 1 1 100% 0 0 6 0 13 0 0 New Caledonia 25 7 28% 0 0 10 0 12 0 0 New Zealand 0 0 0% 0 0 0 0 0 0 0 Niue 1 1 100% 0 0 0 0 0 0 0 Northern Mariana Islands (the) 10 10 100% 0 18 24 0 25 1 7 Palau 0 0 0% 0 0 0 0 0 0 0 Papua New Guinea 0 0 0% 0 0 0 0 0 0 0 Pitcairn Islands 0 0 0% 0 0 0 0 0 0 0 Samoa 11 10 91% 3 0 109 45 628 20 0 Solomon Islands 23 20 87% 0 108 156 7 406 10 0 Tokelau 3 3 100% 0 0 2 0 2 0 0 Tonga 13 13 100% 0 0 28 132 78 7 0 Tuvalu 0 0 0% 0 0 0 0 0 0 0 Vanuatu 0 0 0% 0 0 0 0 0 0 0 Wallis & Futuna 6 6 100% 1 1 15 1 79 1 0 Total 121 94 78% 4 130 414 238 1310 39 7 Figure 1a American Samoa | Samoa américaines Figure 1b N Mariana Isl. | Îles Mariannes du Nord Figure 1c Federated States of Micronesia Figure 1d Marshall Islands | Îles Marshall Figure 1e Guam | Guam Not reported Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1f | Palau Country trends | AFR and PF ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. **No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 10 20 30 40 50 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 10 20 30 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 5 10 15 20 25 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 1 2 3 4 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Figure 1g Tonga | Tonga Figure 1h Samoa | Samoa Figure 1i Cook Islands | Îles Cook Figure 1j Niue | Niue Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1k Tokelau | Tokelau Figure 1l Wallis & Futuna | Wallis & Futuna Figure 1m New Caledonia | Nouvelle Calédonie Figure 1n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 2 4 6 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 18 2 02 5 0 2 4 6 8 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Wallis and Futuna, New Caledonia, French Polynesia 0 5 10 15 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 25 50 75 100 W 20 2 02 4 W 21 2 02 4 W 22 2 02 4 W 23 2 02 4 Figure 1o Kiribati | Kiribati Figure 1p Nauru | Nauru Figure 1q Fiji | Fidji Figure 1r Solomon Islands | Îles Salomon Figure 1s Tuvalu | Tuvalu Figure 1t Vanuatu | Vanuatu Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) 5 W20 2025 (May 12-May 18) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 5 10 15 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1 2 3 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 2 4 6 8 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 100 200 300 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 0 1 2 3 4 W 01 2 02 5 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 05 2 02 5 W 09 2 02 5 0 50 100 150 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Figure 2a American Samoa | Samoa américaines Figure 2b N Mariana Isl. | Îles Mariannes du Nord Figure 2c Federated States of Micronesia Figure 2d Marshall Islands | Îles Marshall Figure 2f | Palau Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness Figure 2e Guam | Guam Country trends | Influenza like illness, SARI and Suspected COVID-19 ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 50 100 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 100 200 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 22 2 02 4 W 18 2 02 5 0 100 200 300 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 25 50 75 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 10 20 30 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Figure 2g Tonga | Tonga Figure 2h Samoa | Samoa Figure 2i Cook Islands | Îles Cook Figure 2j Niue | Niue Legend SARI (Influenza-like illness that requires hospitalization) Suspected COVID-19 Influenza like illness Figure 2k Tokelau | Tokelau Figure 2l Wallis & Futuna | Wallis & Futuna Figure 2m New Caledonia | Nouvelle Calédonie Figure 2n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 100 200 300 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 1000 2000 3000 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 20 24 0 10 20 30 40 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 25 50 75 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1 2 3 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Wallis and Futuna, New Caledonia, French Polynesia 0 100 200 300 400 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 25 50 75 100 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 250 500 750 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 2o Kiribati | Kiribati Figure 2p Nauru | Nauru Figure 2q Fiji | Fidji Figure 2r Solomon Islands | Îles Salomon Figure 2s Tuvalu | Tuvalu Figure 2t Vanuatu | Vanuatu Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness 5 W20 2025 (May 12-May 18) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 50 100 150 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 250 500 750 1000 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 2 4 6 8 10 12 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 250 500 750 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Figure 3a American Samoa | Samoa américaines Figure 3b N Mariana Isl. | Îles Mariannes du Nord Figure 3c Federated States of Micronesia Figure 3d Marshall Islands | Îles Marshall Figure 3e Guam | Guam Figure 3f | Palau Legend Dengue-like Illness (DLI) Diarrhoea Country trends | Diarrhoea and DLI ** Please note that X and Y axesvary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 20 40 60 W 01 2 02 5 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 25 50 75 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 5 10 15 20 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 1 2 3 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 50 100 150 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Figure 3g Tonga | Tonga Figure 3h Samoa | Samoa Figure 3i Cook Islands | Îles Cook Figure 3j Niue | Niue Legend Dengue-like Illness (DLI) Diarrhoea Figure 3k Tokelau | Tokelau Figure 3l Wallis & Futuna | Wallis & Futuna Figure 3m New Caledonia | Nouvelle Calédonie Figure 3n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 100 200 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 100 200 300 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 2 4 6 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 5 10 15 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 10 5 15 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 10 20 30 40 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 50 100 150 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 3o Kiribati | Kiribati Figure 3p Nauru | Nauru Figure 3q Fiji | Fidji Figure 3r Solomon Islands | Îles Salomon Figure 3s Tuvalu | Tuvalu Figure 3t Vanuatu | Vanuatu Legend Dengue-like Illness (DLI) Diarrhoea 5 W20 2025 (May 12-May 18) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 250 500 750 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 10 20 30 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 200 400 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 5 10 15 20 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 0 100 200 300 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Case Definitions Syndrome Case Definition Alert Threshold Acute Fever and Rash (AFR) Fever plus rash(non-blistering) 1 case if there is a measles outbreak. Prolonged fever (PF) Fever for 3 days or more Twice the average number of cases seen in the previous 2 weeks Influenza-like illness (ILI) An acute respiratory infection with: measured fever of ≥ 38 C° and cough; with onset within the last 10 days. Twice the average number of cases seen in the previous 2 weeks Diarrhoea 3 or more loose or watery stools in 24 hours (non- bloody) Twice the average number of cases seen in the previous 2 weeks Suspected dengue Fever for at least 2 days, plus at least two of the following: i. Nausea or vomiting; ii. Muscle or joint pain; iii. Severe headache or pain behind the eyes; iv. Rash; v. Bleeding Twice the average number of cases seen in the previous 3 weeks Severe acute respiratory infection, requiring hospitalisation (SARI) Sudden onset of fever above 38°C, cough or sore throat, shortness of breath or difficulty breathing, and requiring hospitalization. Twice moving average in 2 weeks COVID - 19 Twice moving average in 2 weeks Alert thresholds Please note that the alert thresholds have been set in EWARS and you will receive instant email notification once you have surpassed the alert threshold. New Indicators ∙ ∙ COVID-19 one (1) case, this is as the case definition set to identify suspected COVID- 19 including Multi-system Inflammatory cases in children. In addition, use the EBS to report details. ∙ SARI The alert threshold for SARI is set at one (1) case to increase sensitivity for its investigation as a suspected COVID-19 case and hence require laboratory confirmation or exclusion. Once you do receive an alert, you need to follow the link to verify the alert – enter brief notes to say what the cases were, what has been done to the cases (investigation, treatment) or any other cases regarding the cases – age, gender, residence, hospitalized or not? The alerts are set to auto-discard after 2 days if no action has been taken. In addition, there are now forms available on EWARS for reporting Event Based Surveillance (EBS). Please use these to report any unusual disease patterns/symptoms, unexpected deaths, disease or deaths in animals or anything that is of concern For more help and support, please contact: SHAKILA, Naidu World Health Organization Division of Pacific Technical Support Suva, Fiji Email: shakilan@who.int Notes: The Pacific Syndromic Surveillance System (PSSS) was started in 2010. With the support of the Pacific Community, it collects sentinel surveillance data on 4 syndromes (including one optional), from 23 Pacific Island Countries and areas. The aim is to monitor trends and to trigger alerts to rapidly detect and respond to suspected outbreaks. In 2017, the system was moved to an online platform called EWARS. Data is entered online by country focal points and is then analysed using an online application. This bulletin has been published automatically from EWARS. Le système de surveillance de la syndromie du Pacifique (PSSS) a été lancé en 2010. Avec le soutien de la Communauté du Pacifique, il collecte des données de surveillance sentinelle sur 4 syndromes (dont un optionnel), provenant de 23 pays insulaires du Pacifique. L'objectif est de surveiller les tendances et de déclencher des alertes pour détecter et répondre rapidement aux épidémies présumées. En 2017, le système a été transféré vers une plate-forme en ligne appelée EWARS. Les données sont entrées en ligne par points focaux de pays et sont ensuite analysées à l'aide d'une application en ligne. Ce bulletin a été publié automatiquement à partir d'EWARS.

Pacific Syndromic Surveillance System Weekly Bulletin Système de Surveillance Syndromic dans le Pacifique Bulletin Hebdomadaire W21 2025 (May 19-May 25) WHO gratefully acknowledges the support of Ministries of Health and partners in the following Pacific Island Countries and areas for the contribution of data to this bulletin | L'OMS reconnaît avec reconnaissance le soutien des ministères de la santé et des partenaires dans les pays insulaires du Pacifique suivants pour la contribution des données à ce bulletin: W1 2025 to W21 2025 | S1 2025 à S21 2025 Pacific Island Countries | Pays insulaires du Pacifique W21 % n 120 61% 14 89% 107 Cumulative % n Indicator 196 1. Number of sentinel sites Nombre de sites sentinelles 73% 367 2. Number of PICs thatreported Nombre de PICs qui ont rapporté 81% 158 3. Number of sites thatreported Nombre de sites qui ont rapporté Key indicators & Highlights | Indicateurs clé & faits saillants 1 W21 2025 (May 19-May 25) 1 2 1 1 Country/Area No. sites No. reported % reported AFR PF Diarrhoea DLI ILI SARI COVID-19 ** AFR: Acute Fever and Rash; PF: Prolonged Fever; DLI:Diarrhoea-like Illness; ILI: Influenza-like Illness; SARI: Severe Acute Respiratory Infection New Table American Samoa 0 0 0% 0 0 0 0 0 0 0 Cook Islands 14 13 93% 0 0 0 3 20 0 0 Fiji 29 24 83% 0 0 776 573 437 2 0 French Polynesia 0 0 0% 0 0 0 0 0 0 0 Guam 0 0 0% 0 0 0 0 0 0 0 Kiribati 12 9 75% 0 1 65 0 50 0 0 Marshall Islands (the) 2 2 100% 0 5 7 0 16 0 0 Micronesia (Federated States of) 4 4 100% 0 0 35 1 73 0 0 Nauru 1 1 100% 0 0 0 0 3 0 0 New Caledonia 0 0 0% 0 0 0 0 0 0 0 New Zealand 0 0 0% 0 0 0 0 0 0 0 Niue 1 1 100% 0 0 0 0 0 0 0 Northern Mariana Islands (the) 10 10 100% 0 22 13 0 28 0 5 Palau 7 7 100% 0 1 13 0 21 0 0 Papua New Guinea 0 0 0% 0 0 0 0 0 0 0 Pitcairn Islands 1 1 100% 0 0 0 0 0 0 0 Samoa 11 9 82% 1 0 98 76 587 9 0 Solomon Islands 23 21 91% 0 104 182 5 407 9 0 Tokelau 3 3 100% 0 0 1 0 0 0 0 Tonga 0 0 0% 0 0 0 0 0 0 0 Tuvalu 2 2 100% 0 1 6 0 1 0 0 Vanuatu 0 0 0% 0 0 0 0 0 0 0 Wallis & Futuna 0 0 0% 0 0 0 0 0 0 0 Total 120 107 89% 1 134 1196 658 1643 20 5 Figure 1a American Samoa | Samoa américaines Figure 1b N Mariana Isl. | Îles Mariannes du Nord Figure 1c Federated States of Micronesia Figure 1d Marshall Islands | Îles Marshall Figure 1e Guam | Guam Not reported Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1f | Palau Country trends | AFR and PF ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. **No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 10 20 30 40 50 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 10 20 30 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 5 10 15 20 25 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 1 2 3 4 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Figure 1g Tonga | Tonga Figure 1h Samoa | Samoa Figure 1i Cook Islands | Îles Cook Figure 1j Niue | Niue Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1k Tokelau | Tokelau Figure 1l Wallis & Futuna | Wallis & Futuna Figure 1m New Caledonia | Nouvelle Calédonie Figure 1n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 2 4 6 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 18 2 02 5 0 2 4 6 8 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Wallis and Futuna, New Caledonia, French Polynesia 0 10 5 15 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 4 0 25 50 75 W 22 2 02 4 W 23 2 02 4 Figure 1o Kiribati | Kiribati Figure 1p Nauru | Nauru Figure 1q Fiji | Fidji Figure 1r Solomon Islands | Îles Salomon Figure 1s Tuvalu | Tuvalu Figure 1t Vanuatu | Vanuatu Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) 5 W21 2025 (May 19-May 25) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 5 10 15 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 1 2 3 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 2 4 6 8 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 100 200 300 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 0 1 2 3 4 W 01 2 02 5 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 50 100 150 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Figure 2a American Samoa | Samoa américaines Figure 2b N Mariana Isl. | Îles Mariannes du Nord Figure 2c Federated States of Micronesia Figure 2d Marshall Islands | Îles Marshall Figure 2f | Palau Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness Figure 2e Guam | Guam Country trends | Influenza like illness, SARI and Suspected COVID-19 ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 25 50 75 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 100 200 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 22 2 02 4 W 18 2 02 5 0 100 200 300 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 25 50 75 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 10 20 30 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Figure 2g Tonga | Tonga Figure 2h Samoa | Samoa Figure 2i Cook Islands | Îles Cook Figure 2j Niue | Niue Legend SARI (Influenza-like illness that requires hospitalization) Suspected COVID-19 Influenza like illness Figure 2k Tokelau | Tokelau Figure 2l Wallis & Futuna | Wallis & Futuna Figure 2m New Caledonia | Nouvelle Calédonie Figure 2n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 100 200 300 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 1000 2000 3000 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 0 10 20 30 40 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 25 50 75 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 22 2 02 4 0 1 2 3 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Wallis and Futuna, New Caledonia, French Polynesia 0 100 200 300 400 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 25 50 75 100 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 250 500 750 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 2o Kiribati | Kiribati Figure 2p Nauru | Nauru Figure 2q Fiji | Fidji Figure 2r Solomon Islands | Îles Salomon Figure 2s Tuvalu | Tuvalu Figure 2t Vanuatu | Vanuatu Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness 5 W21 2025 (May 19-May 25) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 50 100 150 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 250 500 750 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 250 500 750 1000 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 2 4 6 8 10 12 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 250 500 750 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Figure 3a American Samoa | Samoa américaines Figure 3b N Mariana Isl. | Îles Mariannes du Nord Figure 3c Federated States of Micronesia Figure 3d Marshall Islands | Îles Marshall Figure 3e Guam | Guam Figure 3f | Palau Legend Dengue-like Illness (DLI) Diarrhoea Country trends | Diarrhoea and DLI ** Please note that X and Y axesvary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 20 40 60 W 01 2 02 5 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 25 50 75 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 5 10 15 20 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 1 2 3 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 50 100 150 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Figure 3g Tonga | Tonga Figure 3h Samoa | Samoa Figure 3i Cook Islands | Îles Cook Figure 3j Niue | Niue Legend Dengue-like Illness (DLI) Diarrhoea Figure 3k Tokelau | Tokelau Figure 3l Wallis & Futuna | Wallis & Futuna Figure 3m New Caledonia | Nouvelle Calédonie Figure 3n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 100 200 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 100 200 300 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 2 4 6 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 5 10 15 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 2 4 6 8 10 12 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 10 20 30 40 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 18 2 02 5 0 50 100 150 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 3o Kiribati | Kiribati Figure 3p Nauru | Nauru Figure 3q Fiji | Fidji Figure 3r Solomon Islands | Îles Salomon Figure 3s Tuvalu | Tuvalu Figure 3t Vanuatu | Vanuatu Legend Dengue-like Illness (DLI) Diarrhoea 5 W21 2025 (May 19-May 25) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 250 500 750 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 10 20 30 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 200 400 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 5 10 15 20 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 100 200 300 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Case Definitions Syndrome Case Definition Alert Threshold Acute Fever and Rash (AFR) Fever plus rash(non-blistering) 1 case if there is a measles outbreak. Prolonged fever (PF) Fever for 3 days or more Twice the average number of cases seen in the previous 2 weeks Influenza-like illness (ILI) An acute respiratory infection with: measured fever of ≥ 38 C° and cough; with onset within the last 10 days. Twice the average number of cases seen in the previous 2 weeks Diarrhoea 3 or more loose or watery stools in 24 hours (non- bloody) Twice the average number of cases seen in the previous 2 weeks Suspected dengue Fever for at least 2 days, plus at least two of the following: i. Nausea or vomiting; ii. Muscle or joint pain; iii. Severe headache or pain behind the eyes; iv. Rash; v. Bleeding Twice the average number of cases seen in the previous 3 weeks Severe acute respiratory infection, requiring hospitalisation (SARI) Sudden onset of fever above 38°C, cough or sore throat, shortness of breath or difficulty breathing, and requiring hospitalization. Twice moving average in 2 weeks COVID - 19 Twice moving average in 2 weeks Alert thresholds Please note that the alert thresholds have been set in EWARS and you will receive instant email notification once you have surpassed the alert threshold. New Indicators ∙ ∙ COVID-19 one (1) case, this is as the case definition set to identify suspected COVID- 19 including Multi-system Inflammatory cases in children. In addition, use the EBS to report details. ∙ SARI The alert threshold for SARI is set at one (1) case to increase sensitivity for its investigation as a suspected COVID-19 case and hence require laboratory confirmation or exclusion. Once you do receive an alert, you need to follow the link to verify the alert – enter brief notes to say what the cases were, what has been done to the cases (investigation, treatment) or any other cases regarding the cases – age, gender, residence, hospitalized or not? The alerts are set to auto-discard after 2 days if no action has been taken. In addition, there are now forms available on EWARS for reporting Event Based Surveillance (EBS). Please use these to report any unusual disease patterns/symptoms, unexpected deaths, disease or deaths in animals or anything that is of concern For more help and support, please contact: SHAKILA, Naidu World Health Organization Division of Pacific Technical Support Suva, Fiji Email: shakilan@who.int Notes: The Pacific Syndromic Surveillance System (PSSS) was started in 2010. With the support of the Pacific Community, it collects sentinel surveillance data on 4 syndromes (including one optional), from 23 Pacific Island Countries and areas. The aim is to monitor trends and to trigger alerts to rapidly detect and respond to suspected outbreaks. In 2017, the system was moved to an online platform called EWARS. Data is entered online by country focal points and is then analysed using an online application. This bulletin has been published automatically from EWARS. Le système de surveillance de la syndromie du Pacifique (PSSS) a été lancé en 2010. Avec le soutien de la Communauté du Pacifique, il collecte des données de surveillance sentinelle sur 4 syndromes (dont un optionnel), provenant de 23 pays insulaires du Pacifique. L'objectif est de surveiller les tendances et de déclencher des alertes pour détecter et répondre rapidement aux épidémies présumées. En 2017, le système a été transféré vers une plate-forme en ligne appelée EWARS. Les données sont entrées en ligne par points focaux de pays et sont ensuite analysées à l'aide d'une application en ligne. Ce bulletin a été publié automatiquement à partir d'EWARS.

Pacific Syndromic Surveillance System Weekly Bulletin Système de Surveillance Syndromic dans le Pacifique Bulletin Hebdomadaire W22 2025 (May 26-Jun 01) WHO gratefully acknowledges the support of Ministries of Health and partners in the following Pacific Island Countries and areas for the contribution of data to this bulletin | L'OMS reconnaît avec reconnaissance le soutien des ministères de la santé et des partenaires dans les pays insulaires du Pacifique suivants pour la contribution des données à ce bulletin: W1 2025 to W22 2025 | S1 2025 à S22 2025 Pacific Island Countries | Pays insulaires du Pacifique W22 % n 160 65% 15 80% 128 Cumulative % n Indicator 196 1. Number of sentinel sites Nombre de sites sentinelles 73% 386 2. Number of PICs thatreported Nombre de PICs qui ont rapporté 81% 159 3. Number of sites thatreported Nombre de sites qui ont rapporté Key indicators & Highlights | Indicateurs clé & faits saillants 1 W22 2025 (May 26-Jun 01) 1 2 1 1 Country/Area No. sites No. reported % reported AFR PF Diarrhoea DLI ILI SARI COVID-19 ** AFR: Acute Fever and Rash; PF: Prolonged Fever; DLI:Diarrhoea-like Illness; ILI: Influenza-like Illness; SARI: Severe Acute Respiratory Infection New Table American Samoa 0 0 0% 0 0 0 0 0 0 0 Cook Islands 14 13 93% 0 0 0 5 23 0 0 Fiji 29 26 90% 0 0 800 321 441 2 0 French Polynesia 0 0 0% 0 0 0 0 0 0 0 Guam 0 0 0% 0 0 0 0 0 0 0 Kiribati 12 11 92% 0 1 77 12 137 0 0 Marshall Islands (the) 2 2 100% 0 2 2 0 10 0 0 Micronesia (Federated States of) 4 2 50% 0 0 35 0 73 0 0 Nauru 1 1 100% 0 0 0 0 1 0 0 New Caledonia 25 7 28% 0 0 6 0 40 0 0 New Zealand 0 0 0% 0 0 0 0 0 0 0 Niue 0 0 0% 0 0 0 0 0 0 0 Northern Mariana Islands (the) 10 10 100% 0 20 9 0 27 0 9 Palau 7 7 100% 0 0 11 0 2 0 0 Papua New Guinea 0 0 0% 0 0 0 0 0 0 0 Pitcairn Islands 1 1 100% 0 0 0 0 0 0 0 Samoa 11 9 82% 0 0 97 31 687 27 0 Solomon Islands 23 19 83% 0 88 225 4 278 5 0 Tokelau 0 0 0% 0 0 0 0 0 0 0 Tonga 13 12 92% 0 1 23 70 34 5 0 Tuvalu 2 2 100% 0 0 8 0 5 0 0 Vanuatu 0 0 0% 0 0 0 0 0 0 0 Wallis & Futuna 6 6 100% 0 0 12 0 82 1 0 Total 160 128 80% 0 112 1305 443 1840 40 9 Figure 1a American Samoa | Samoa américaines Figure 1b N Mariana Isl. | Îles Mariannes du Nord Figure 1c Federated States of Micronesia Figure 1d Marshall Islands | Îles Marshall Figure 1e Guam | Guam Not reported Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1f | Palau Country trends | AFR and PF ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. **No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 10 20 30 40 50 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 10 20 30 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 5 10 15 20 25 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 1 2 3 4 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Figure 1g Tonga | Tonga Figure 1h Samoa | Samoa Figure 1i Cook Islands | Îles Cook Figure 1j Niue | Niue Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) Figure 1k Tokelau | Tokelau Figure 1l Wallis & Futuna | Wallis & Futuna Figure 1m New Caledonia | Nouvelle Calédonie Figure 1n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 2 4 6 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 18 2 02 5 W 22 2 02 5 0 2 4 6 8 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Wallis and Futuna, New Caledonia, French Polynesia 0 10 5 15 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 4 0 20 40 60 80 W 22 2 02 4 W 23 2 02 4 Figure 1o Kiribati | Kiribati Figure 1p Nauru | Nauru Figure 1q Fiji | Fidji Figure 1r Solomon Islands | Îles Salomon Figure 1s Tuvalu | Tuvalu Figure 1t Vanuatu | Vanuatu Legend Acute Fever and Rash (AFR) Prolonged Fever (PF) 5 W22 2025 (May 26-Jun 01) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 5 10 15 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 1 2 3 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 2 4 6 8 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 100 200 300 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 22 2 02 5 0 1 2 3 W 01 2 02 5 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 50 100 150 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Figure 2a American Samoa | Samoa américaines Figure 2b N Mariana Isl. | Îles Mariannes du Nord Figure 2c Federated States of Micronesia Figure 2d Marshall Islands | Îles Marshall Figure 2f | Palau Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness Figure 2e Guam | Guam Country trends | Influenza like illness, SARI and Suspected COVID-19 ** Please note that X and Y axes vary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 25 50 75 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 100 200 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 22 2 02 4 W 18 2 02 5 W 22 2 02 5 0 100 200 300 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 22 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 25 50 75 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 10 20 30 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 Figure 2g Tonga | Tonga Figure 2h Samoa | Samoa Figure 2i Cook Islands | Îles Cook Figure 2j Niue | Niue Legend SARI (Influenza-like illness that requires hospitalization) Suspected COVID-19 Influenza like illness Figure 2k Tokelau | Tokelau Figure 2l Wallis & Futuna | Wallis & Futuna Figure 2m New Caledonia | Nouvelle Calédonie Figure 2n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 100 200 300 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 1000 2000 3000 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 0 10 20 30 40 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 25 50 75 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 1 2 3 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Wallis and Futuna, New Caledonia, French Polynesia 0 100 200 300 400 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 25 50 75 100 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 250 500 750 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 2o Kiribati | Kiribati Figure 2p Nauru | Nauru Figure 2q Fiji | Fidji Figure 2r Solomon Islands | Îles Salomon Figure 2s Tuvalu | Tuvalu Figure 2t Vanuatu | Vanuatu Legend SARI (Influenza-like illness that requires hospitalization) COVID-19 Influenza-like illness 5 W22 2025 (May 26-Jun 01) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 50 100 150 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 250 500 750 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 250 500 750 1000 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 2 4 6 8 10 12 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 250 500 750 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Figure 3a American Samoa | Samoa américaines Figure 3b N Mariana Isl. | Îles Mariannes du Nord Figure 3c Federated States of Micronesia Figure 3d Marshall Islands | Îles Marshall Figure 3e Guam | Guam Figure 3f | Palau Legend Dengue-like Illness (DLI) Diarrhoea Country trends | Diarrhoea and DLI ** Please note that X and Y axesvary by country depending on data availability and magnitude of data. Please pay attention to the scale of the X and Y axis prior to data interpretation and comparison. ** No line indicates data not reported. American Samoa, CNMI, FSM, RMI, Guam, Palau 0 20 40 60 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 25 50 75 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 5 10 15 20 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 1 2 3 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 0 50 100 150 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 Figure 3g Tonga | Tonga Figure 3h Samoa | Samoa Figure 3i Cook Islands | Îles Cook Figure 3j Niue | Niue Legend Dengue-like Illness (DLI) Diarrhoea Figure 3k Tokelau | Tokelau Figure 3l Wallis & Futuna | Wallis & Futuna Figure 3m New Caledonia | Nouvelle Calédonie Figure 3n French Polynesia | Polynésie française Tonga, Samoa, Cooks Island, Niue, Tokelau 0 100 200 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 100 200 300 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 2 4 6 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 5 10 15 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 0 10 5 15 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Wallis and Futuna, New Caledonia, French Polynesia 0 50 100 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 10 20 30 40 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 50 100 150 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 Figure 3o Kiribati | Kiribati Figure 3p Nauru | Nauru Figure 3q Fiji | Fidji Figure 3r Solomon Islands | Îles Salomon Figure 3s Tuvalu | Tuvalu Figure 3t Vanuatu | Vanuatu Legend Dengue-like Illness (DLI) Diarrhoea 5 W22 2025 (May 26-Jun 01) Kiribati, Nauru, Fiji, Solomon Islands, Tuvalu, Vanuatu 0 250 500 750 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 10 20 30 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 0 500 1000 1500 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 200 400 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 5 10 15 20 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 W 22 2 02 5 0 100 200 300 W 22 2 02 4 W 27 2 02 4 W 31 2 02 4 W 35 2 02 4 W 40 2 02 4 W 44 2 02 4 W 48 2 02 4 W 01 2 02 5 W 05 2 02 5 W 09 2 02 5 W 14 2 02 5 W 18 2 02 5 Case Definitions Syndrome Case Definition Alert Threshold Acute Fever and Rash (AFR) Fever plus rash(non-blistering) 1 case if there is a measles outbreak. Prolonged fever (PF) Fever for 3 days or more Twice the average number of cases seen in the previous 2 weeks Influenza-like illness (ILI) An acute respiratory infection with: measured fever of ≥ 38 C° and cough; with onset within the last 10 days. Twice the average number of cases seen in the previous 2 weeks Diarrhoea 3 or more loose or watery stools in 24 hours (non- bloody) Twice the average number of cases seen in the previous 2 weeks Suspected dengue Fever for at least 2 days, plus at least two of the following: i. Nausea or vomiting; ii. Muscle or joint pain; iii. Severe headache or pain behind the eyes; iv. Rash; v. Bleeding Twice the average number of cases seen in the previous 3 weeks Severe acute respiratory infection, requiring hospitalisation (SARI) Sudden onset of fever above 38°C, cough or sore throat, shortness of breath or difficulty breathing, and requiring hospitalization. Twice moving average in 2 weeks COVID - 19 Twice moving average in 2 weeks Alert thresholds Please note that the alert thresholds have been set in EWARS and you will receive instant email notification once you have surpassed the alert threshold. New Indicators ∙ ∙ COVID-19 one (1) case, this is as the case definition set to identify suspected COVID- 19 including Multi-system Inflammatory cases in children. In addition, use the EBS to report details. ∙ SARI The alert threshold for SARI is set at one (1) case to increase sensitivity for its investigation as a suspected COVID-19 case and hence require laboratory confirmation or exclusion. Once you do receive an alert, you need to follow the link to verify the alert – enter brief notes to say what the cases were, what has been done to the cases (investigation, treatment) or any other cases regarding the cases – age, gender, residence, hospitalized or not? The alerts are set to auto-discard after 2 days if no action has been taken. In addition, there are now forms available on EWARS for reporting Event Based Surveillance (EBS). Please use these to report any unusual disease patterns/symptoms, unexpected deaths, disease or deaths in animals or anything that is of concern For more help and support, please contact: SHAKILA, Naidu World Health Organization Division of Pacific Technical Support Suva, Fiji Email: shakilan@who.int Notes: The Pacific Syndromic Surveillance System (PSSS) was started in 2010. With the support of the Pacific Community, it collects sentinel surveillance data on 4 syndromes (including one optional), from 23 Pacific Island Countries and areas. The aim is to monitor trends and to trigger alerts to rapidly detect and respond to suspected outbreaks. In 2017, the system was moved to an online platform called EWARS. Data is entered online by country focal points and is then analysed using an online application. This bulletin has been published automatically from EWARS. Le système de surveillance de la syndromie du Pacifique (PSSS) a été lancé en 2010. Avec le soutien de la Communauté du Pacifique, il collecte des données de surveillance sentinelle sur 4 syndromes (dont un optionnel), provenant de 23 pays insulaires du Pacifique. L'objectif est de surveiller les tendances et de déclencher des alertes pour détecter et répondre rapidement aux épidémies présumées. En 2017, le système a été transféré vers une plate-forme en ligne appelée EWARS. Les données sont entrées en ligne par points focaux de pays et sont ensuite analysées à l'aide d'une application en ligne. Ce bulletin a été publié automatiquement à partir d'EWARS.