Organised by the ESCMID Emerging Infections Subcommittee and Amsterdam University Medical Center

Epi Alert

About Epi Alert

Summary: 21 July 2026

A prolonged diphtheria outbreak in Nigeria has caused 65,759 suspected cases and 2,229 deaths since 2022, exacerbated by low vaccination coverage. In Europe, four Frankfurt Airport workers contracted malaria, likely from an imported mosquito, highlighting the rare phenomenon of "airport malaria." Asia reports 7 confirmed Chandipura virus cases in children in Gujarat, India, resulting in 3 deaths, alongside widespread measles outbreaks in Bangladesh, which have caused 114,164 suspected cases and 771 deaths. Meanwhile, cholera continues to affect Africa, with Cameroon and Chad reporting outbreaks contributing to over 63,000 cases across 19 African Union states this year. In North America, the United States is managing a significant measles resurgence, with 2,260 confirmed cases across 44 jurisdictions, predominantly linked to outbreaks.

Highlights

Diphtheria — Africa
An ongoing outbreak in Nigeria has resulted in 65,759 suspected cases and 2,229 deaths between 2022 and July 2026. A new suspected cluster was reported in Niger State in July 2026. The outbreak occurs against a backdrop of low vaccination coverage, with only 62% of Nigerian children receiving the recommended three doses of the DTP vaccine.

Malaria — Europe
Four workers at Frankfurt Airport have contracted malaria, likely transmitted by an imported Anopheles mosquito arriving via aircraft. "Sirport malaria" events are rare in Germany and can result in delayed diagnoses. The last similar case occurred at the same airport in 2023, and local health authorities are currently investigating the infections.

Chandipura virus disease — Asia
Seven confirmed cases of Chandipura virus infection have been reported in children in Gujarat, resulting in three deaths, with four patients requiring ventilatory support. Chandipura virus is an arbovirus of the family Rhabdoviridae, the same family as rabies virus, and can cause rapidly progressive acute encephalitis. It is transmitted primarily by sandflies, with no documented human-to-human transmission.

Cholera — Africa
Cameroon reported 121 total cases and 8 deaths, with Vibrio cholerae O1 Ogawa identified. In Chad, an outbreak of the same strain has spread causing 120 total cases and 4 deaths. The Central African Republic has declared its first cholera outbreak in 9 years, reaching 436 suspected cases with case fatality rate exceeding the WHO alert threshold. Continent-wide, 19 African Union Member States have reported 63,095 total cases and 1,229 deaths this year.

Ebola virus disease
The Democratic Republic of the Congo, Uganda, France
Africa
Ebola virus disease
The Democratic Republic of the Congo, Uganda, France
Africa

Outbreak continues to spread with 2181 confirmed cases and 864 deaths

Source: BEACON - 18 Jul 2026
COVID-19
Taiwan, Chinese Taipei
Asia
COVID-19
Taiwan, Chinese Taipei
Asia

Increasing transmission (NB.1.8.1 variant)

Source: BEACON - 15 Jul 2026
Dengue
Bangladesh
Asia
Dengue
Bangladesh
Asia

2726 hospitalizations and 9 deaths this month.

Source: BEACON - 13 Jul 2026
Diphtheria
Nigeria
Africa
Diphtheria
Nigeria
Africa

Ongoing outbreak with 65,759 suspected cases and 2,229 deaths.

Source: BEACON - 19 Jul 2026
Measles
Bangladesh
Asia
Measles
Bangladesh
Asia

Outbreak reaches 114,164 suspected cases and 771 deaths

Source: BEACON - 16 Jul 2026
Measles
The Democratic Republic of the Congo
Africa
Measles
The Democratic Republic of the Congo
Africa

Nearly 100,000 cases amid multiple humanitarian emergencies.

Source: BEACON - 17 Jul 2026
Measles
United States
North America
Measles
United States
North America

2,260 confirmed cases across 44 jurisdictions

Source: BEACON - 18 Jul 2026
Poliomyelitis
Afghanistan
Asia
Poliomyelitis
Afghanistan
Asia

11 confirmed WPV 1 cases

Source: BEACON - 15 Jul 2026
Crimean-Congo hemorrhagic fever
Spain
Europe
Crimean-Congo hemorrhagic fever
Spain
Europe

Second locally acquired case (fatal)

Source: BEACON - 18 Jul 2026
Malaria
Germany
Europe
Malaria
Germany
Europe

Airport malaria in 4 airport workers

Source: H-Radar - 19 Jul 2026
Cyclosporiasis
United States
North America
Cyclosporiasis
United States
North America

Increase in cases (2,500 in Michigan, > 500 cases in NY)

Source: Outbreak News Today - 13 Jul 2026
Legionnaires disease
United States
North America
Legionnaires disease
United States
North America

Ongoing investigation with 71 cases and 1 death

Source: Outbreak News Today - 18 Jul 2026
Vibriosis
United States
North America
Vibriosis
United States
North America

10 cases and 1 fatality across seven counties.

Source: Outbreak News Today - 18 Jul 2026
Chandipura virus disease
India
Asia
Chandipura virus disease
India
Asia

7 confirmed pediatric cases, including 3 deaths.

Source: BEACON - 16 Jul 2026
Scrub typhus
Nepal
Asia
Scrub typhus
Nepal
Asia

893 cases during the last fiscal year

Source: H-Radar - 17 Jul 2026
Anthrax
Uganda
Africa
Anthrax
Uganda
Africa

Gastrointestinal outbreak with 5 deaths and 9 critical cases.

Source: BEACON - 15 Jul 2026
Cholera
Cameroon, Chad
Africa
Cholera
Cameroon, Chad
Africa

121 cases in Cameroon and 120 in Chad.

Source: Outbreak News Today - 13 Jul 2026
Cholera
Central African Republic
Africa
Cholera
Central African Republic
Africa

First outbreak in 9 years with 436 suspected cases.

Source: BEACON - 18 Jul 2026

About

The ESCMID-AUMC Epi Alert, a strategic collaboration between the ESCMID Emerging Infections Subcommittee and the Center of Tropical Medicine and Travel Medicine of Amsterdam University Medical Center (AUMC) that integrates expertise and resources to advance emerging infectious diseases surveillance and intelligence sharing. This collaboration integrates ESCMID's extensive international network and emerging infections expertise with AUMC's proven surveillance capabilities, led by Dr. Abraham Goorhuis and the AUMC team and other collaborators form European Institutions. 

The Epi Alert aims to be a weekly publication. The briefings are curated by infectious disease specialists prioritising data from trusted sources (such as Beacon, H-Radar, Outbreaknews, WHO, ECDC, CDC) based on potential impact, geographic region and urgency/relevancy to clinical practice. It aims to provide concise summaries for busy healthcare professionals with direct links for further investigation and transparency. 

This integrated collaboration represents a significant milestone in ESCMID's commitment to emerging infections preparedness, strengthening our collective capacity to detect, analyse, and respond to infectious disease threats through international cooperation.

Disclaimer: The information in this epi-alert is a weekly summary of the information that is available on the internet, mainly the websites of Beacon, H-Radar, Outbreaknews, WHO, ECDC, CDC, and others. For this summary, we consider issues that are most relevant to the ESCMID members involved in clinical patient care. Therefore, this report is not comprehensive, but we strive to include all major global issues in this report on a weekly basis.