In my case, I have setup like
AWS ELB >> ECS(nginx) >> ECS(php-fpm).
I had configured the wrong AWS security group for ECS(php-fpm) service, so Nginx wasn't able to reach out to php-fpm task container. That's why i was getting errors in nginx task log
499 0 - elb-healthchecker/2.0
Health check was configured as to check php-fpm service and confirm it's up and give back a response.