Greece - Mink and minkworkers tested positive for Covid-19 - 17 out 91 farms tested positive - At least 120 human cases with mink virusvariant - OIE

[Gert van der Hoek]

Alarm in Kastoria - Positive 10 employees on mink farms

Ten positive cases of coronavirus in workers on mink farms in Western Macedonia showed rapid tests.

According to information from kozan.gr, in the context of rapid tests on workers on mink farms in Western Macedonia, the following emerged:

• In 21 rapid tests on farm workers in Grevena, all samples were negative.
• In 91 rapid tests on farm workers in Kastoria, 10 positive samples were diagnosed.
• In 22 rapid tests on farm workers in Florina, all samples were negative.

According to information, samples of mink have already been taken, however the results have not been released yet.


Positive in the Koronai mink breeder in the municipality of Voio

It is noted that, as ERT reported earlier, a furry animal breeder was found positive in the corona virus in the area of the municipality of Voio.
A team from the Veterinary Service has gone to the animal farm to investigate the incident. Some dead animals were found on the farm, while others have symptoms. The team will examine the animals to determine the causes.

In the meantime, rapid tests, as decided, will be carried out on all mink breeders, by order of EODY, as announced by the Veterinary Services of the Region of W. Macedonia. The tests take place today in Kastoria and tomorrow in Kozani.

The coronavirus-positive breeder has been quarantined for days, as he underwent a test following symptoms he had in the previous days.

[Gert van der Hoek]

Kozani: Mink disease came to Greece - All samples on the farm are positive

Positive breeders in Greece as well.

Nov 13 , 2020


According to the results of the laboratory tests and the eight samples received yesterday by the veterinary team from a farm where the owner was also positive for the virus, in the area of Voio, all the fur-bearing animals are mink-positive.


Both the dead and the living mink had all the indications that they had been infected with the virus - respiratory symptoms, nasal discharge, anorexia and depression. According to ERT, there is a danger for the other animals on the farm, as the distances to their breeding area are close to each other.

Coronavirus positive and mink breeders

In addition to the owner of the farm in the area of Kozani, positive in the corona virus were also found workers in mink farms in the area, where about 500,000 furry animals are raised. For this reason, yesterday mobile units of EODY carried out a rapid test in farms in Kastoria, where 10 positive employees in the coronavirus were found in a total of 91 tests.

The 21 samples in Grevena were negative, as well as the 22 in Florina.

The design for the farm with the positive mink

As reported today to kozan.gr, the Director of Veterinary P.E. Kozani Theofilos Kantzoglou "Based on the specific results, it is proven that the virus is present in the specific breeding unit.Regarding the next steps, we are waiting for central instructions to be sent to us, but the most probable scenario is that all the mings in the unit will be killed, in total around 2500. I appeal to all breeders of such units. To enter the units the absolutely necessary personnel for the care of the animals, which must observe all the necessary bio-safety measures, to use clothes exclusively for the unit, which they will wear and deposit at the entrance of the unit, always using a mask & protective goggles if possible with disposable overalls, gloves, disinfectants and the car with which the specific personnel arrives at the unit not to enter the premises and to be parked at a safe distance (eg 50 meters away) ?.

[Gert van der Hoek]

Kozani: 2,500 mink that tested positive for the coronavirus are killed

Starting on Saturday, the 2,500 mink infected with the coronavirus on a farm in Kaloneri in the municipality of Voi Kozani will be killed , according to the vice-president of the Fur Breeders Association, Athanasios Langas.

According to Mr. Langas, their killing is expected to be completed in two days, while the animals will be buried at a depth of more than four meters in an area designated by the competent authorities. Referring to the farm in Kaloneri, Kozani, he stressed that it was created in 2014 . In Western Macedonia, there are about 84 fur farms and the mink is estimated at about one million.

[Gert van der Hoek]

Coronavirus found in Greek mink farms

The new coronavirus has been found in mink at two farms in northern Greece, an agriculture ministry official said on Friday.

The strain found in the mink had not mutated from that found in humans, the official said.

The breeder at one of the farms, in the northerly Kozani region, also tested positive for the virus, and tests were being conducted on workers. A cull of the 2,500 mink at that farm was due to begin shortly.

[Gert van der Hoek]

Two positive workers on a mink farm in Kastoria


Two workers in a fur farming unit (mink) tested positive for coronavirus


in Kastoria, after rapid tests in which they were submitted by an EODY team. This is the same unit where two other positive workers were identified last week. Specifically, in a total of 77 tests carried out today by EODY in fur-bearing farms in Kastoria -in employees and their owners- the tests of two employees in a unit that raises 10,000 mink mangoes were positive, with the annual production being estimated at 30 -40 000 animals.

the mink, however, as assured, speaking to ANA-MPA, the president of the Association of Kastoria Furriers, Apostle Tsouka and Vice President of the Panhellenic Association of fur animal Athanasios pygmy, "there they show symptoms and their clinical picture is excellent, at least so far ".

After today's tests in Kastoria and Florina, in the fur farms, it is the turn of Kozani tomorrow, where similar farms operate in the area of Voio and the prefecture of Grevena. A well-informed source in the Ministry of Rural Development and Food, reiterated today in the APE-MPE that the policy pursued by the Ministry of Agriculture, Rural Development is fully in line with EU requirements regarding the management of the issue that has arisen with fur farms of animals (mink).

[Gert van der Hoek]

Kastoria: No mutation of Covid-19 virus occurs in mink

26.11.2020


The examination of the genome carried out by the scientific staff of the National Center for Research and Technological Development (CERTH) does not reveal a mutation of the coronavirus virus in fur animals (mink), as confirmed by the Minister of Rural Development and Agriculture. Βορίδης.

, in the 60 tests carried out today by an EODY team, a positive employee was identified in Covid-19, who is employed in a unit that is already under close monitoring from the first at the time the virus broke out on a farm.

the results of the sampling carried out today by an EODY team on the owners and employees of the four dryers operating in the area showed positivity in Covid-19 of four people, a total of 97.


The mink on a farm in Thessaloniki remain negative in Covid-19

[Gert van der Hoek]

Koronovios - Thessaloniki: Three workers on a mink farm are positive for the virus

The three people who tested positive for covid-19 are working in the breeding of fur animals (mink) in Grevena , after the rapid tests carried out today by the EODY team of owners and employees of farms in the wider area of Voio.

As the vice-president of the Panhellenic Fur Animal Breeding Association, Athanasios Langas, stated to APE-MPE, in a total of 55 rapid tests, all three were positive. " The next step", he noted, "which is already in the process of implementation by EODY, is the submission to a molecular test of all 15 employees of the aforementioned farm in Grevena ".

Meanwhile, according to secure information from the Ministry of Rural Development and Food, new genomes from humans and animals have already been sent to the National Center for Research and Technological Development (CERTH) to re-test for a covid-19 virus mutation . "It is a process that is done systematically, in order to monitor the issue closely," ministry sources told APE-MPE, noting that inspections are being carried out on fur farms to ensure public health.

It is reminded that the new rapid tests that took place yesterday in Kastoria confirmed the result of the previous week for zero spread of the coronavirus in the farms of the area. In the 60 tests carried out yesterday by an EODY team, a covid-19-positive worker was found , who works in a unit that is already under close surveillance from the first moment the virus appeared on a farm.

The results of the sampling that was also done yesterday to the owners and employees of the four dryers operating in Kastoria, showed positivity in covid-19 of four people, a total of 97. These are people who work on a farm that is under surveillance.

At the same time, the fur-bearing animals (mink or mink), which are bred in a unit that operates within the boundaries of the municipality of Pylaia-Chortiatis, remain negative in covid-19 . The veterinary services of PKM will continue to closely monitor the progress of the health of the mink in the aforementioned unit and the inspections will be carried out on a weekly basis.

[Gert van der Hoek]

Infection with SARS-CoV-2, Greece

Information received on 19/12/2020 from Mrs Chrysoula Dile, Head, Animal Health Directorate, Ministry of Rural Development and Food, ATHENS, Greece

Summary Report type Follow-up report No. 1 Date of start of the event 04/12/2020 Date of confirmation of the event 08/12/2020 Report date 19/12/2020 Date submitted to OIE 19/12/2020 Reason for notification Emerging disease Morbidity 2 (scale 0 to 5) Mortality 1 (scale 0 to 5) Zoonotic impact To date, the Y453F mutation in the spike (S) protein of the virus, referred to as mink-related-variant, has been detected in 5 sequenced SARS-CoV-2 genomes from human cases directly related to mink (farm workers/owners). Presence of the Y453F mutation has been also confirmed in virus genomes from one farm so far. None of the other mutations described on the Rapid Risk Assessment of the 12th November 2020 from EU agencies (ECDC, EFSA, EMA) has been found up to now neither in humans nor animals. Sequencing of virus genomes from human and mink samples is ongoing Causal agent SARS-CoV-2 Related reports Immediate notification (15/12/2020) Follow-up report No. 1 (19/12/2020)

New outbreaks (2)

Outbreak 1 (KOZANI_9) Regional Unit of Kozani, Local Community of Peponia, Municipality of Voio, Dytiki Makedonia Date of start of the outbreak 11/12/2020 Outbreak status Continuing (or date resolved not provided) Epidemiological unit Farm Affected animals Species Susceptible Cases Deaths Killed and disposed of Slaughtered Mustelidae 3300 3300 400 0 0 Affected population The animals are bred in a commercial farm for their fur. Suspicion was raised in the framework of surveillance activities following notification about increased mink mortality. Samples (oropharyngeal swabs) were collected from ten dead animals and tested positive with RT- PCR. Infected mink showed respiratory symptoms and reduced feed intake.

Outbreak 2 (GREVENA_4) Regional Unit of Grevena, Local Community of Kivotos, Municipality of Grevena, Dytiki Makedonia Date of start of the outbreak 13/12/2020 Outbreak status Continuing (or date resolved not provided) Epidemiological unit Farm Affected animals Species Susceptible Cases Deaths Killed and disposed of Slaughtered Mustelidae 3000 0 0 0 Affected population The animals are bred in a commercial farm for their fur. Suspicion was raised in the framework of surveillance activities following notification about a confirmed human case (farm worker) for COVID-19. Samples (oropharyngeal swabs) were collected from twenty animals and were tested positive with RT- PCR. Mink showed no clinical symptoms and feed intake was not reduced. No mortality was observed.

Summary of outbreaks Total outbreaks: 2 Total animals affected Species Susceptible Cases Deaths Killed and disposed of Slaughtered Mustelidae 6300 3300 ** 400 0 0 Outbreak statistics Species Apparent morbidity rate Apparent mortality rate Apparent case fatality rate Proportion susceptible animals lost* Mustelidae ** 6.35% ** 6.35% *Removed from the susceptible population through death, destruction and/or slaughter **Not calculated because of missing information

Epidemiology Source of the outbreak(s) or origin of infection Unknown or inconclusive Farm staff from all infected farms tested positive for COVID-19 Epidemiological comments In total, 17 out of 91 mink farms have been tested positive for SARS-CoV-2 since the first outbreak was confirmed on 13/11/2020. Stamping out and official disposal of carcasses were only applied to the first confirmed farm. At that point, it was decided to stop culling animals. The whole country is practically considered a single zone. Movement restrictions (complete standstill for live animals) and strict biosecurity measures, including the mandatory use of personal protective equipment (PPE), have been imposed not only to the infected mink farms, but also to all fur farms in Greece. Reporting of increased mink morbidity and mortality to the veterinary authorities is obligatory at national level. When human vaccines become available, everyone who comes in close contact with mink (farm workers, owners, veterinarians) shall be included in the highest priority group to receive vaccination. In the framework of the one-health approach, veterinary and health authorities have been closely collaborating both at local and central level. Active repeated weekly surveillance (rapid tests and RT-PCR) is conducted by health authorities in all mink farm workers/owners. Results are notified directly to veterinary authorities which investigate every farm that is epidemiologically linked to a confirmed human case. In addition, veterinary authorities investigate every notification for increased animal morbidity and mortality. Oropharyngeal swabs are collected from the animals and tested with RT-PCR. Sequencing of virus genomes from human and mink samples is conducted.

Control measures Measures applied Movement control inside the country Surveillance outside containment and/or protection zone Surveillance within containment and/or protection zone Traceability Quarantine Zoning Vaccination permitted (if a vaccine exists) No treatment of affected animals Measures to be applied No other measures

Diagnostic test results Laboratory name and type Species Test Test date Result Centre for Research and Technology Hellas (CERTH) (National laboratory) Mustelidae real-time PCR 18/12/2020 Positive Centre for Research and Technology Hellas (CERTH) (National laboratory) Mustelidae virus sequencing 16/12/2020 Positive

Future Reporting The event is continuing. Weekly follow-up reports will be submitted.

Map of outbreak locations

[Shiloh]

Source: https://greece.greekreporter.com/202...rthern-greece/

Covid-19 Mutant Strain from Mink Found in Northern Greece
By Philip Chrysopoulos -
Jan 12, 2021

A Covid-19 mutant strain that infected mink during the second wave of the pandemic in November has also spread to humans in Western Macedonia, scientists say.

According to scientists from the Biomedical Research Foundation of the Academy of Athens (IIBEAA), the mutated strain is responsible for the largest spread of the pandemic in Northern Greece.

Mutant strains of the SARS-CoV-2 coronavirus were detected in 120 random tests of infected residents of Kozani, Grevena and Kastoria.

These are the same variants of the coronavirus that infected the mink in the area during the second wave of the pandemic and killed thousands of animals...

[Gert van der Hoek]

Infection with SARS-CoV-2, Greece

Information received on 12/01/2021 from Mrs Chrysoula Dile, Head, Animal Health Directorate, Ministry of Rural Development and Food, ATHENS, Greece

Summary Report type Follow-up report No. 2 Date of start of the event 04/12/2020 Date of confirmation of the event 08/12/2020 Report date 12/01/2021 Date submitted to OIE 12/01/2021 Reason for notification Emerging disease Morbidity 2 (scale 0 to 5) Mortality 1 (scale 0 to 5) Zoonotic impact To date, the Y453F mutation in the spike (S) protein of the virus, referred to as mink-related-variant, has been detected in sequenced SARS-CoV-2 genomes from 6 human cases directly related to mink (farm workers/owners). Presence of the Y453F mutation has been also confirmed in virus genomes from 3 farms so far. None of the other mutations described on the Rapid Risk Assessment of the 12th November 2020 from EU agencies (ECDC, EFSA, EMA) has been found up to now neither in humans nor animals. Sequencing of virus genomes from human and mink samples is ongoing Causal agent SARS-CoV-2 Related reports Immediate notification (15/12/2020) Follow-up report No. 1 (19/12/2020) Follow-up report No. 2 (12/01/2021)

New outbreaks (4)

Outbreak 1 (KOZANI_10) Regional Unit of Kozani, Local Community of Melidoni, Municipality of Voio, Dytiki Makedonia Date of start of the outbreak 24/12/2020 Outbreak status Continuing (or date resolved not provided) Epidemiological unit Farm Affected animals Species Susceptible Cases Deaths Killed and disposed of Slaughtered Mustelidae 3500 3500 200 0 0 Affected population The animals are bred in a commercial farm for their fur. Suspicion was raised in the framework of surveillance activities following notification about a) increased mink mortality b) a confirmed human case (farm owner) for COVID-19. Samples (oropharyngeal swabs) were collected from 3 dead and 7 symptomatic animals and tested positive with RT- PCR. Infected mink showed respiratory symptoms and reduced feed intake was observed.

Outbreak 2 (KOZANI_11) Regional Unit of Kozani, Local Community of Galatini, Municipality of Voio, Dytiki Makedonia Date of start of the outbreak 31/12/2020 Outbreak status Continuing (or date resolved not provided) Epidemiological unit Farm Affected animals Species Susceptible Cases Deaths Killed and disposed of Slaughtered Mustelidae 14000 0 0 0 0 Affected population The animals are bred in a commercial farm for their fur. Suspicion was raised in the framework of surveillance activities following notification about a confirmed human case (farm worker) for COVID-19. Samples (oropharyngeal swabs) were collected from twenty animals and all 4 pooled samples were tested positive with RT- PCR. Mink showed no clinical symptoms and feed intake was not reduced. No mortality was observed.

Outbreak 3 (KASTORIA_5) Regional Unit of Kastoria, Local Community of Ano Pteria, Municipality of Kastoria, Dytiki Makedonia Date of start of the outbreak 31/12/2020 Outbreak status Continuing (or date resolved not provided) Epidemiological unit Farm Affected animals Species Susceptible Cases Deaths Killed and disposed of Slaughtered Mustelidae 3200 0 0 0 0 Affected population The animals are bred in a commercial farm for their fur. Suspicion was raised in the framework of surveillance activities following notification about a confirmed human case (farm worker) for COVID-19. Samples (oropharyngeal swabs) were collected from twenty animals and 1 out of 4 pooled samples was tested positive with RT- PCR. Mink showed no clinical symptoms and feed intake was not reduced. No mortality was observed.

Outbreak 4 (KASTORIA_6) Regional Unit of Kastoria, Local Community of Kalochori, Municipality of Kastoria, Dytiki Makedonia Date of start of the outbreak 31/12/2020 Outbreak status Continuing (or date resolved not provided) Epidemiological unit Farm Affected animals Species Susceptible Cases Deaths Killed and disposed of Slaughtered Mustelidae 3000 0 0 0 0 Affected population The animals are bred in a commercial farm for their fur. Suspicion was raised in the framework of surveillance activities following notification about a confirmed human case (farm owner) for COVID-19. Samples (oropharyngeal swabs) were collected from twenty animals and 1 out of 4 pooled samples was tested positive with RT- PCR. Mink showed no clinical symptoms and feed intake was not reduced. No mortality was observed.

Summary of outbreaks Total outbreaks: 4 Total animals affected Species Susceptible Cases Deaths Killed and disposed of Slaughtered Mustelidae 23700 3500 200 0 0 Outbreak statistics Species Apparent morbidity rate Apparent mortality rate Apparent case fatality rate Proportion susceptible animals lost* Mustelidae 14.77% 0.84% 5.71% 0.84% *Removed from the susceptible population through death, destruction and/or slaughter

Epidemiology Source of the outbreak(s) or origin of infection Unknown or inconclusive Epidemiological comments In total, 21 out of 91 mink farms have been tested positive for SARS-CoV-2 since the first outbreak was confirmed on 13/11/2020. At the same time, at least one human case has been detected in all 21 infected farms. Stamping out and official disposal of carcasses were only applied to the first confirmed farm. At that point, it was decided to stop culling animals. The whole country is practically considered a single zone. Movement restrictions (complete standstill for live animals) and strict biosecurity measures, including the mandatory use of personal protective equipment (PPE), have been imposed not only to the infected mink farms, but also to all fur farms in Greece. Reporting of increased mink morbidity and mortality to the veterinary authorities is obligatory at national level. When human vaccines become available, everyone who comes in close contact with mink (farm workers, owners, veterinarians) shall be included in the highest priority group to receive vaccination. In the framework of the one-health approach, veterinary and health authorities have been closely collaborating both at local and central level. Active repeated weekly surveillance (rapid tests and RT-PCR) is conducted by health authorities in all mink farm workers/owners. Results are notified directly to veterinary authorities which investigate every farm that is epidemiologically linked to a confirmed human case. In addition, veterinary authorities investigate every notification for increased animal morbidity and mortality. Oropharyngeal swabs are collected from the animals and tested with RT-PCR. Sequencing of virus genomes from human and mink samples is conducted.

Control measures Measures applied Movement control inside the country Surveillance outside containment and/or protection zone Surveillance within containment and/or protection zone Traceability Quarantine Zoning Vaccination permitted (if a vaccine exists) No treatment of affected animals Measures to be applied No other measures

Diagnostic test results Laboratory name and type Species Test Test date Result Centre for Research and Technology Hellas (CERTH) (National laboratory) Mustelidae real-time PCR 08/12/2020 Positive Centre for Research and Technology Hellas (CERTH) (National laboratory) Mustelidae real-time PCR 08/01/2021 Positive Centre for Research and Technology Hellas (CERTH) (National laboratory) Mustelidae virus sequencing 12/01/2021 Positive

Future Reporting The event is continuing. Weekly follow-up reports will be submitted.

Map of outbreak locations

[Gert van der Hoek]

Infection with SARS-CoV-2, Greece

Information received on 08/02/2021 from Mrs Chrysoula Dile, Head, Animal Health Directorate, Ministry of Rural Development and Food, ATHENS, Greece

Summary Report type Follow-up report No. 3 Date of start of the event 04/12/2020 Date of confirmation of the event 08/12/2020 Report date 06/02/2021 Date submitted to OIE 08/02/2021 Reason for notification Emerging disease Morbidity 2 (scale 0 to 5) Mortality 1 (scale 0 to 5) Zoonotic impact To date, the Y453F mutation in the spike (S) protein of the virus, referred to as mink-related-variant, has been detected in sequenced SARS-CoV-2 genomes from 6 human cases directly related to mink (farm workers/owners), but it has not been detected in samples from the general population. Presence of the Y453F mutation has been also confirmed in virus genomes from 4 farms so far. None of the other mutations described on the Rapid Risk Assessment of the 12th November 2020 from EU agencies (ECDC, EFSA, EMA) has been found up to now neither in humans nor animals. Sequencing of virus genomes from human and mink samples is ongoing Causal agent SARS-CoV-2 Related reports Immediate notification (15/12/2020) Follow-up report No. 1 (19/12/2020) Follow-up report No. 2 (12/01/2021) Follow-up report No. 3 (06/02/2021)

New outbreaks (1)

Outbreak 1 (KASTORIA_7) Regional Unit of Kastoria, Local Community of Chiliodendro, Municipality of Kastoria, Dytiki Makedonia Date of start of the outbreak 26/01/2021 Outbreak status Continuing (or date resolved not provided) Epidemiological unit Farm Affected animals Species Susceptible Cases Deaths Killed and disposed of Slaughtered Mustelidae 716 716 55 0 0 Affected population The animals are bred in a commercial farm for their fur. On 1/2/2021 veterinary authorities were notified by the farm owner about increased mortality and clinical symptoms. According to the owner, reduced feed intake was first observed on 26/1/2021, while respiratory symptoms and increased mortality were first detected on 29/1/2021. On 3/2/2021, samples (oropharyngeal swabs) were collected from 3 dead and 7 symptomatic animals and all of them were tested positive with RT- PCR.

Summary of outbreaks Total outbreaks: 1 Total animals affected Species Susceptible Cases Deaths Killed and disposed of Slaughtered Mustelidae 716 716 55 0 0 Outbreak statistics Species Apparent morbidity rate Apparent mortality rate Apparent case fatality rate Proportion susceptible animals lost* Mustelidae 100.00% 7.68% 7.68% 7.68% *Removed from the susceptible population through death, destruction and/or slaughter

Epidemiology Source of the outbreak(s) or origin of infection Unknown or inconclusive Epidemiological comments In total, 22 out of 91 mink farms have been tested positive for SARS-CoV-2 since the first outbreak was confirmed on 13/11/2020. Epidemiological data and comparative analysis among human and mink isolated SARS-CoV-2 genomes indicate that minks were infected, in most of the cases, by humans. Stamping out and official disposal of carcasses were only applied to the first confirmed farm. At that point, it was decided to stop culling animals. The whole country is practically considered a single zone. Movement restrictions (complete standstill for live animals) and strict biosecurity measures, including the mandatory use of personal protective equipment (PPE), have been imposed not only to the infected mink farms, but also to all fur farms in Greece. Reporting of increased mink morbidity and mortality to the veterinary authorities is obligatory at national level. Vaccination of high-risk population directly related to farms (farm workers, owners, veterinarians) has already commenced and is in progress. In the framework of the one-health approach, veterinary and health authorities have been closely collaborating both at local and central level. Active repeated weekly surveillance (rapid tests and RT-PCR) is conducted by health authorities in all mink farm workers/owners. Results are notified directly to veterinary authorities which investigate every farm that is epidemiologically linked to a confirmed human case. In addition, veterinary authorities investigate every notification for increased animal morbidity and mortality. Oropharyngeal swabs are collected from the animals and tested with RT-PCR. Sequencing of virus genomes from human and mink samples is conducted.

Control measures Measures applied Movement control inside the country Surveillance outside containment and/or protection zone Surveillance within containment and/or protection zone Traceability Quarantine Zoning Vaccination permitted (if a vaccine exists) No treatment of affected animals Measures to be applied No other measures

Diagnostic test results Laboratory name and type Species Test Test date Result Centre for Research and Technology Hellas (CERTH) (National laboratory) Mustelidae real-time PCR 08/12/2020 Positive Centre for Research and Technology Hellas (CERTH) (National laboratory) Mustelidae real-time PCR 05/02/2021 Positive Centre for Research and Technology Hellas (CERTH) (National laboratory) Mustelidae virus sequencing 08/02/2021 Positive

Future Reporting The event is continuing. Weekly follow-up reports will be submitted.

Map of outbreak locations