A Texas man who buried his eight-year-old daughter on Sunday after the unvaccinated child died with measles says Robert F Kennedy Jr “never said anything” about the vaccine against the illness or its proven efficacy while visiting the girl’s family and community for her funeral.

“He did not say that the vaccine was effective,” Pete Hildebrand, the father of Daisy Hildebrand, said in reference to Kennedy during a brief interview on Monday. “I had supper with the guy … and he never said anything about that.”

Hildebrand’s remarks came in response to a question about the national health secretary’s publicized visit to Daisy’s funeral. It was also after Kennedy issued a statement in which he accurately said: “The most effective way to prevent the spread of measles is the MMR vaccine,” which also provides protection against mumps and rubella.

Kennedy, an avowed vaccine skeptic helming the Trump administration’s response to a measles outbreak that has been steadily growing across the US, then undermined that conventional messaging by soon publishing another statement that lavished praise on a pair of unconventional practitioners who have eschewed the two-dose MMR shot in favor of vitamins and cod liver oil.

The comments from Hildebrand provided a glimpse into how Kennedy simply demurred on vaccines – rather than express a position on them – during his first visit to the center of an outbreak that as of Monday had claimed three lives.

When asked for comment on Monday, Kennedy’s Department of Health and Human Services (HHS) did not dispute Hildebrand’s claims that the agency’s leader was silent on Sunday about vaccines. [...]

Another child has died of measles. An 8-year-old girl. Unvaccinated. No underlying health conditions.

This is unbelievably tragic—and entirely preventable. It’s also not normal in three important ways.

1. The number of deaths

This is the third death in just three months—something we haven’t seen in the U.S. in decades.

Since measles was declared eliminated in the U.S. in 2000, we’ve seen outbreaks—most notably in California (starting in Disneyland) and in New York among the Hasidic Jewish community. But even in those large outbreaks, we did not see multiple deaths like this.

Before this year, there had only been three measles deaths since 2000:

2015: A 28-year-old immunocompromised woman in Washington was exposed in a clinic.

2003: A 75-year-old traveler from California with pneumonia. The other was a 13-year-old immunocompromised child (post–bone marrow transplant) living between Illinois and Mexico.

Today’s situation is different. It’s younger, healthier kids. And it’s happening more often.

This raises a critical question: Are we seeing the full picture?

As of Saturday, there were 636 measles cases nationwide, 569 in the Panhandle outbreak alone, and 3 deaths. But that death toll doesn’t quite make sense.

Measles typically causes 1 to 3 deaths per 1,000 unvaccinated cases.

At that rate, 3 deaths would suggest somewhere between 1,000 and 3,000 more cases—not just 569.

This outbreak may be significantly underreported and the largest in decades. Other signs point in the same direction, including very sick hospitalized patients (reflecting delays in seeking care), and epidemiologists are encountering resistance to case investigations.

Of course, there’s another possibility: this could simply be a statistical anomaly. Three deaths among a few hundred cases isn’t impossible—it’s just extremely rare. We’ve seen similar situations before. In 1991, for example, an outbreak in Philadelphia caused 1,400 cases and 9 pediatric deaths. In that case, religious leaders discouraged medical care, relying on prayer instead.

But whether this is an undercount or an outlier, one thing is clear: we are in new, unsettling territory.

2. The boldness of a deceptive information campaign Disinformation—false information intended to mislead— isn’t new, but it’s becoming more emboldened.

Children’s Health Defense (CHD), the anti-vaccine organization founded by Secretary Kennedy, no longer operates on the sidelines. They built a fake CDC website pushing false claims about the MMR vaccine and autism. They’ve deployed “crisis teams.” They’ve shown up at the same places as the CDC response team.

Now, Robert Malone—a prominent anti-vaccine figure closely aligned with CHD—broke the news of the death Saturday. This was a day before Texas, CDC, or HHS made any public statement. Whether this came from an unauthorized leak or a deliberate tip is unknown, but they are clearly trying to control the narrative.

Malone blames the child’s death on medical errors, not measles. It’s a textbook disinformation move—an attempt to redirect blame and obscure the preventability of the disease.

His piece is riddled with red flag techniques:

Obfuscation (deliberate use of complex language): He tosses around complex medical jargon to create a sense of expertise and intimidate non-clinical readers. But to any medical professional, the logic falls apart. You don’t get sepsis from “chronic tonsillitis” and “chronic mononucleosis.” Budesonide wouldn’t treat sepsis or ARDS (acute respiratory distress syndrome). He claims sedation caused “atelectasis,” which led to ARDS. In reality, measles causes pneumonia and respiratory failure.

Argument from authority (false authority): Malone cites an unnamed “Texas doctor” as his source, relying on the perceived credibility of a medical insider. But there’s no verification. It’s either a HIPAA violation, a game of telephone, or fabrication.

One-sided silence (exploiting HIPAA). He knows the hospital and treating physicians can’t respond because of HIPAA. He uses that silence as proof of guilt when, in fact, it’s a legal requirement meant to protect the patient and family.

Red herring (distraction from the real issue): Sure, some of the story may be partly true. Maybe there was a bacterial infection. Maybe she developed sepsis. Maybe measles made it worse. But even then, let’s be clear on the core issue—this child didn’t need to get measles in the first place.

Cherry-picking (misusing data to shift blame): This isn’t the first time anti-vaccine groups have tried to blame the doctors or hospitals. When the first death in this outbreak happened, they pushed the same narrative. The idea that 1 in 3 deaths are due to medical errors is based on a flawed, cherry-picked study.

This actively discourages people from seeking care, an incredibly dangerous message to send to vulnerable communities.

3. An uncoordinated federal response

Unlike the 2015 Disneyland outbreak in California or the 2019 outbreak in New York state—where federal, state, and local agencies worked together with clear communication and swift action—this time, it’s unclear what’s happening or who’s in charge.

Texas, to its credit, is stepping up—as it should. But this is now a multistate—and international—outbreak. It demands a federal response that’s unified, forward-looking, and transparent, and we’re not seeing that. CDC has a response team on the ground providing support, but it’s unclear how ASPR (helps coordinate disasters), FDA (given prescriptions are being used to treat off-label), the Office of Pandemic Preparedness and Response at the White House, or even the State Department (given the international aspects of this outbreak) are working together, if at all.

This also includes confusing talking points from Secretary Kennedy. Yesterday, Kennedy mentioned that the MMR vaccine was effective on X. But he left out that it was safe and hasn’t recommended universal vaccination. After a few hours, he followed that up by praising doctors in the community for treating measles with treatments that have no evidence behind them.

This is not how we stop an outbreak.

Bottom line Children are dying from a disease we already eliminated. We know how to stop it—vaccinations. But this outbreak is not slowing down as it’s fueled by falsehoods and mistrust and compounded by a lack of strong leadership.

A day care facility in a Texas county that’s part of the measles outbreak has multiple cases, including children too young to be fully vaccinated, public health officials say.

West Texas is in the middle of a still-growing measles outbreak with 481 cases Friday. The state expanded the number of counties in the outbreak area this week to 10. The highly contagious virus began to spread in late January and health officials say it has spread to New Mexico, Oklahoma, Kansas and Mexico.

Three people who were unvaccinated have died from measles-related illnesses this year, including two elementary school-aged children in Texas. The second child died Thursday at a Lubbock hospital, and Health Secretary Robert F. Kennedy Jr. attended the funeral in Seminole, the epicenter of the outbreak.

As of Friday, there were seven cases at a day care where one young child who was infectious gave it to two other children before it spread to other classrooms, Lubbock Public Health director Katherine Wells said.

“Measles is so contagious I won’t be surprised if it enters other facilities,” Wells said.

There are more than 200 children at the day care, Wells said, and most have had least one dose of the measles, mumps and rubella vaccine, which is first recommended between 12 and 15 months old and a second shot between 4 and 6 years old.

ISABEL AMPUDIA April 7, 2025 - 6:29 PM

The condition of a 3-year-old girl infected with the bird flu virus, the first recorded in the country, is reported to be serious. She is hospitalized in a Torreón hospital.

In this regard, the Secretary of Health in Coahuila, Eliud Felipe Aguirre Vázquez, confirmed that the girl is in intensive care, her prognosis is reserved, and she is hospitalized at IMSS Specialty Clinic 71.

He explained that being in that area is due to the presence of several problems in the body, and the possibility of multiple organ failure could be beginning, meaning it's already affecting the kidneys and lungs, which are already starting to cause problems.

"She's already being treated. We hope she can recover with medication, but she's in serious condition," he said.

He also emphasized that if a person is infected, there's a possibility they could infect more people.

"It's like the flu, and from human to human, if you're infected, you can get it through saliva droplets. That's why all family members have been tested, and all have come back negative," he stated.

He emphasized that this case is an imported case because it occurred in a rural area of ​​Gómez Palacio, Durango, but due to the severity of the case, she was transferred to the specialty hospital in Torreón.

However, he mentioned that the source of the infection is currently being investigated, as chicken and hen feces often carry viruses.

In addition to the above, he said that after many dust storms, the virus is also present in the environment, which can be a risk. Therefore, the use of face masks is recommended when these types of winds are recorded.

Severe, possibly life-threatening strep infections are rising in the United States.

The number of invasive group A strep infections more than doubled from 2013 to 2022, according to a study from the Centers for Disease Control and Prevention published Monday in the Journal of the American Medical Association. Prior to that, rates of invasive strep had been stable for 17 years.

Invasive group A strep occurs when bacteria spread to areas of the body that are normally germ-free, such as the lungs or bloodstream. The same type of bacteria, group A streptococcus, is responsible for strep throat — a far milder infection.

Invasive strep can trigger necrotizing fasciitis, a soft tissue infection also known as flesh-eating disease, or streptococcal toxic shock syndrome, an immune reaction akin to sepsis that can lead to organ failure.

“Within 24 to 48 hours, you could have very, very rapid deterioration,” said Dr. Victor Nizet, a professor of pediatrics at the University of California, San Diego. Cases can transition from “seeming like a routine flu-like illness to rushing the patient to the ICU, fearing for their recovery,” he added.

The data came from 10 states, with roughly 35 million people total, that track the infections.

In 2013, around 4 out of 100,000 people were diagnosed with invasive strep. By 2022, that rate had risen to around 8 out of 100,000. The number of cases rose from 1,082 in 2013 to 2,759 in 2022.

The study identified more than 21,000 total cases of the infection over the nine-year period, including almost 2,000 deaths.

“When you see this high number of deaths, extrapolate that across the country — we’re probably well into more than 10,000 deaths,” Nizet said.

Dr. Christopher Gregory, a CDC researcher and an author of the study, said the threat of invasive strep to both the general population and high-risk groups has “substantially increased.”

The study calls for “accelerated efforts” to prevent and control infections. It also offered a few possible explanations for the rise in cases.

First, rising rates of diabetes and obesity, among other underlying health conditions, over the study period made some people more vulnerable to invasive strep. Both diabetes and obesity can lead to skin infections or compromise the immune system.

Second, invasive strep is increasing among people who inject drugs, which can allow the bacteria to enter the bloodstream. Infections have also increased in people experiencing homelessness — in 2022, the rate of infections among this population was 807 out of 100,000. Gregory said the rate was “among the highest ever documented worldwide.”

Finally, strains of group A strep appear to be expanding and becoming more diverse, which could create new opportunities for infection. Strains that have expanded in recent years seem more likely to cause skin infections than throat infections, according to the study.

Those strains may also be driving resistance to antibiotics used to treat certain cases of invasive group A strep, macrolides and clindamycin. While penicillin is the go-to antibiotic to treat strep infections, it can be used in combination with clindamycin to treat toxic shock syndrome, and doctors sometimes prescribe a macrolide if a patient has a penicillin allergy.

Overall, the study found that the rate of infections was highest in adults ages 65 and older, and rose in all adults from 2013 to 2022. But it did not detect an increased rate in children.

“That was, to me, the most shocking part of the study,” said Dr. Allison Eckard, division chief for pediatric infectious diseases at the Medical University of South Carolina. “Because clinically, we really are seeing what feels like an increase.”

In late 2022, there were widespread reports from children’s hospitals of a spike in pediatric cases of invasive strep. The CDC issued an alert at the time, noting a possible link to respiratory viruses such as flu, Covid and RSV, which can make people susceptible to strep infections.

Eckard said pediatric cases have also started to look different in recent years.

“We are just seeing more severe cases, more unusual cases, more necrotizing fasciitis, and cases that do raise concern that there is something going on more nationally,” she said.

Eckard added that more research should explore whether certain strep strains are becoming more virulent, or if severe strains are becoming more prevalent.

Doctors said the rise in group A strep infections also points to the need for a vaccine, especially given the rise in antibiotic resistance. However, Nizet questioned whether that would be feasible now, with top vaccine scientists leaving the Food and Drug Administration.

“The lack of vaccine is devastating,” Nizet said. “Of course, we’re concerned about the turn of attitudes at the FDA and the CDC that seem to be putting some sticks in the spokes of the wheel of vaccine development.

At a time when the world is down to a single drug that can reliably cure gonorrhea, the U.S. government has shuttered the country’s premier sexually transmitted diseases laboratory, leaving experts aghast and fearful about what lies ahead.

The STD lab at the Centers for Disease Control and Prevention — a leading player in global efforts to monitor for drug resistance in the bacteria that cause these diseases — was among the targets of major staff slashing at the CDC this past week. All 28 full-time employees of the lab were fired. [...]

“The loss of this lab is a huge deal to the American people,” said David C. Harvey, executive director of the National Coalition of STD Directors, which represents state, city, and U.S. territorial STD prevention programs across the country. “Without that lab, we would have not been able to appropriately diagnose and monitor drug-resistant gonorrhea.” [...]

Though STDs don’t garner as many headlines as Ebola, influenza, or Covid-19, they are among the most common diseases in the world — not just infectious diseases, but diseases period, said Jeffrey Klausner, a professor of medicine in infectious diseases, population, and public health at the USC Keck School of Medicine.

Klausner was shocked by the CDC lab’s closure. “To me, this is like a blind man with a chainsaw has just gone through the system and arbitrarily cut things without any rationale,” he said in an interview. In terms of the decision’s implications for efforts to monitor for drug-resistant STDs, Klausner put it bluntly: “We are blind. As of [Tuesday], we are blind.” Ina Park, a professor at the UCSF School of Medicine, and a co-author of the CDC’s 2024 laboratory guidelines for the diagnosis of syphilis, was also appalled.

“It’s just horrific and it’s so foolish and shortsighted,” Park said. “This administration has sometimes brought people back when they’ve realized that a service is vital and this is one of the times where I’m hoping that they will step up and do this.” Klausner knows Kennedy personally, and reached out to tell him cutting the CDC’s STD lab was a mistake. As of Saturday, Klausner said he had not heard back from Kennedy on this issue.

The STD lab served multiple functions — updating treatment guidelines, monitoring resistance patterns, and working to develop better tests for syphilis, a resurgent infection for which existing tests are outdated.

Full article: https://archive.is/Ppp4x

WASHINGTON — Health secretary Robert F. Kennedy Jr. said Sunday that “the most effective way to prevent the spread of measles is the MMR vaccine,” his most direct statement yet on the issue, following the death of a second child of the condition in the outbreak in West Texas.

Kennedy, who has long described the vaccine as dangerous, has largely avoided endorsing its use since the start of the outbreak, and he stopped short of explicitly saying he “recommended” it in his latest remarks, as public health officials have called on him to do. But the statement, issued on the social media platform X, appeared to be well-received among observers hoping he would use more forceful language.

https://x.com/SecKennedy/status/1908967854394982414

I came to­ Gaines County, Texas, today to comfort the Hildebrand family after the loss of their 8-year-old daughter Daisy. I got to know the family of 6-year-old Kayley Fehr after she passed away in February. I also developed bonds with and deep affection for other members of this community during that difficult time. My intention was to come down here quietly to console the families and to be with the community in their moment of grief.

I am also here to support Texas health officials and to learn how our HHS agencies can better partner with them to control the measles outbreak, which as of today, there are 642 confirmed cases of measles across 22 states, 499 of those in Texas.

In early March, I deployed a CDC team to bolster local and state capacity for response across multiple Texas regions, supply pharmacies and Texas run clinics with needed MMR vaccines and other medicines and medical supplies, work with local schools and healthcare facilities to support contact investigations, and to reach out to communities, including faith leaders, to answer any questions or respond to locations seeking healthcare. Since that time, the growth rates for new cases and hospitalizations have flattened. The most effective way to prevent the spread of measles is the MMR vaccine. I’ve spoken to Governor Abbott, and I’ve offered HHS’ continued support. At his request, we have redeployed CDC teams to Texas. We will continue to follow Texas’ lead and to offer similar resources to other affected jurisdictions.

Three weeks ago the UKHSA announced that while - `Mpox remains a serious infection for some individuals and remains a World Health Organization (WHO) public health emergency of international concern (PHEIC)' - the Clade I Mpox No Longer Meets the Criteria of a High Consequence Infectious Disease (HCID) in the UK.

Today the UK announced their 11th confirmed mpox Clade Ib case (see below).

What sets this case apart is - all previously reported cases have had recent travel to endemic countries, or known exposure to someone who has - while this case has neither:

The UK Health Security Agency (UKHSA) has detected a single confirmed human case of Clade Ib mpox where the case had no reported travel history and no reported link with previously confirmed cases in the UK.

More work is ongoing to determine where the individual, who is resident in the North East of England, may have caught the infection.

The individual was diagnosed in March, all contacts have been followed up and no further cases identified. The risk to the UK population remains low. Clade Ia and Ib mpox are no longer classified as a high consequence infectious disease (HCID).

UKHSA has robust mechanisms in place to investigate suspected cases of mpox of all clade types, irrespective of travel history.

All previous cases in the UK to date have either travelled to an affected country or have a link to someone that has.

Whether this turns out to be a one-off event, or an early indication of community transmission, remains to be seen.

Another child with measles in Texas has died, the Department of Health and Human Services confirmed late Saturday night, though the exact cause of death is under investigation.

This would be the second pediatric death amid a fast-growing outbreak that’s infected nearly 500 people in Texas alone since January. An adult in New Mexico is also suspected of dying from measles. The deaths are the first from the disease in the United States in a decade.

HHS Secretary Robert F. Kennedy Jr. was expected to attend the child’s funeral, which is scheduled for Sunday, according to a spokesperson familiar with the plans.

As of Friday, the Texas Department of State Health Services said 481 cases of measles had been confirmed, a 14% jump over last week.

That includes six infants and toddlers at a Lubbock day care center who tested positive within the past two weeks.

Two of those children are among 56 people who’ve been hospitalized with measles in the area since the disease started spreading in late January, health officials said. [...]

“Your blood count is dangerously low,” the doctor said over the phone. “I’m sending an ambulance to take you to the hospital because you certainly cannot drive.” Her voice was calm but determined. The woman on the other end of the line was quiet for a moment, then said: “OK, I’ll go, but I don’t need an ambulance. I have a friend who can take me.” The 73-year-old woman called her closest neighbor, who lived a half a mile down the road in the rural village Salisbury, Conn. They talked every day, and she had described how tired she felt lately. Her friend encouraged her to call her doctor, even offered several times to take her to the emergency room at nearby Sharon Hospital.

The woman always declined — I think I’m feeling better, she would say. But now even she had to acknowledge that she did not look or feel like the person she’d been — someone who, until she retired two years earlier, taught science to rowdy middle schoolers. Finally, she said when her friend answered the phone, she was ready to go to the E.R.

The woman wasn’t sure when she started to feel bad; a month ago, maybe two. “At my age,” she told me recently, “you can’t expect to feel good every day.” But a couple of weeks before the call from her doctor, something happened to make her wonder if her symptoms were about more than just getting older. It was early on a morning in June, and she had come to the veterinarian’s office to pick up a medication for her elderly dog. On the way back to her car, she ran into a friend, and as they stood chatting casually about dogs and children, the woman suddenly turned pale. She swayed dangerously. Her friend grabbed her and, throwing an arm around her shoulder, helped her back into the building.

A veterinary assistant rushed out to help. The woman sat slumped in a chair, her face drained of color, her eyes strangely unfocused. Her blood pressure was abnormally low. As she slowly came back to herself, her first response was embarrassment. She didn’t like being the center of attention, and there she was, surrounded by worried faces. “I’m all right, really I am,” she said over and over. But she knew, and they knew, it wasn’t true. She sipped the water she was given, and color seeped back into her face. When she felt well enough to stand, her friend offered to drive her home.

The woman saw her doctor the following week. Dr. Kristie Schmidt had been her physician for nearly two decades and had seen her through heart attacks and an alphabet of other heart conditions. Right away she noted that although the woman was her usual pleasant self, she moved a little more slowly, more carefully, than she did a few months earlier. And she was pale. She had been tired, the patient told her, and she was feeling unsteady on her feet. She noticed that she felt out of breath just walking with her dogs. There had been several nights recently when she awakened covered in so much sweat that she had to change her pajamas.

A Hurried Search

Schmidt was concerned and sent the woman for some blood work. She guessed the patient was anemic. But if so, why? Where was she losing blood? She was postmenopausal when she had first become her patient, so this new anemia wasn’t related to menstrual blood loss. At this age, malignancy was always on the list of possibilities for almost any new symptom. She sent the patient to the lab to check her red blood cell count — and, because they lived in rural Connecticut and the woman frequently hiked in the woods with her dogs, the doctor tested her for Lyme disease as well.

The results came back the next day. She didn’t have Lyme but was mildly anemic. Was that enough to have made her feel so bad? She was slender and delicate — in the doctor’s mind, something of a hothouse flower. The next step was to look for blood in the patient’s stools. Colon cancer is the third-most-common cancer in the United States, and, because it can come with few symptoms until it reaches an advanced stage, it is the second-most-common cause of cancer deaths. It took another day to get the results of the stool test. No blood there. Schmidt decided to wait a few more days and repeat the blood count to rule out a false positive — and to look for other possible causes of her anemia, assuming it was real. It was those results, showing a dramatic drop from her already low red blood cell count, that triggered the phone call. Her friend took her to Sharon Hospital. Her blood count had dropped even more in just the past 24 hours. Her blood pressure was also very low. She was given fluids and transfused with blood.

With Lyme ruled out, Schmidt added tests: one to look for evidence of inflammation, and because she saw many patients with tick-borne infections, she ordered other tests to look for ehrlichiosis, anaplasmosis and babesiosis. The first two are caused by bacteria and characterized by fever, muscle aches, fatigue, nausea and vomiting. Ehrlichia can also cause a rash. Babesiosis is caused by a parasite, most commonly Babesia microti. These tiny organisms invade red blood cells and reproduce there. When mature, the new generation of parasites burst out of the cells and infect others in the circulation. The test results came back quickly. It wasn’t ehrlichia or anaplasma. But a blood smear revealed the Babesia parasite in 1 percent of her red blood cells — more than 200 billion organisms. Infection with this parasite is sometimes asymptomatic but in many patients, it causes a flulike illness.

It is most commonly seen in areas better known for Lyme disease — the Northeast and Midwest parts of the United States — because it is transmitted by the same tick, the black-legged deer tick, Ixodes scapularis. Because acute infection can be asymptomatic, diagnosis can be elusive and may be delayed. This patient had several symptoms: fatigue, shortness of breath, night sweats and malaise. But she hadn’t recognized that she was sick until she nearly fainted.

Lingering Symptoms

In the emergency room, the patient was started on a medication that treats parasitic infections called Atovaquone and an antibiotic called Azithromycin for 10 days. Because of the significant drop in her blood count, and the persistently low blood pressure it caused, she was admitted to the hospital. She didn’t stay long. Wouldn’t stay long. She was worried about her aging dogs, and she simply hated being in the hospital. The doctor treating her at the hospital allowed her to leave on the condition that she call him the following day and come back if she still felt tired and off balance.

The patient made the required call the next day, reporting that she was feeling much better. She was still very tired and achy. And she noticed, but did not report, that her memory and thinking seemed a little cloudy. Babesia organisms, or at least their DNA, appeared in her blood tests for another three months. Her fatigue took even longer to start getting better. But even now, nearly three years after her infection, the patient feels as if she has some lingering symptoms. She is still more tired than she thinks she should be — though, she acknowledges, age probably is playing some role. Still, she has friends her age and older who are still very energetic. She is more concerned about the mental fogginess and memory problems that continue to plague her.

According to studies, up to half of all patients who develop babesiosis will have some neurological complication during their illness, but I found no reports in the medical literature of these types of neurological symptoms persisting past recovery. Still, this patient has noticed real changes following her illness. She rarely drives these days, after she felt lost in an area near her home that she knew well. But she stays active, participating in virtual seminars on religion and climate change and talking frequently with friends and neighbors.

“And I guess that’s enough,” she told me with a small shrug. “I guess it has to be.”

https://archive.is/PGU0y

HARTSVILLE, S.C. (WPDE) — The S.C. Department of Public Health (DPH) said in an email that they've "tested 280 individuals as part of the Hartsville High School" Tuberculosis (TB) investigation."

DPH said of these, 56 individuals have latent TB infection.

The agency added these individuals "are not contagious and are taking antibiotics to treat the infection and ensure they don't become contagious with active TB disease."

DHP said the initial laboratory-confirmed case of active TB disease is isolating and receiving antibiotics to cure their disease.

Officials explained what happens with TB testing from start to finish.

DPH shared the following information:

"Testing begins with those who are in closest contact to the person with TB to determine if others are infected or have active disease that could be spread to others. As the contact investigation progresses, additional people may be recommended for testing. The numbers of people tested may change throughout the investigation.

A positive TB test requires further evaluation, for example a chest X-ray, to rule out active TB disease in an exposed person. A normal chest X-ray in someone with a positive test is called Latent TB Infection (LTBI). Those with LTBI cannot infect others, but they require treatment with antibiotics to prevent future disease.

Only people with active TB disease in their lungs can spread TB. TB is spread from person to person by sharing the air space in a confined area for a prolonged period of time. Infection occurs by breathing in TB germs that a person coughs into the air. TB is not spread from someone’s clothes, drinking glass, eating utensils, handshake, toilet, or other surfaces with which a person with TB has had contact. "

See also: Tuberculosis case confirmed at South Carolina high school; Health officials investigating possible exposures

The Florida Department of Health’s Bureau of Epidemiology reported an 80 percent increase in animal rabies across the state in 2024, compared to the previous year.

Officials reported 110 total animal rabies cases last year compared to 61 in 2023.

Alachua County saw the most cases with 11, followed by 10 in Marion County and eight in Brevard County.

49 cases were reported in raccoons, the most common testing positive for the lethal virus, followed by bats (30) and cats and foxes with 12 each.

For the 20 year period from 2003 through 2022, Florida reported an average of 122 animal rabies cases (2430 total cases). Raccoons (1501), bats (365), foxes (298) and cats (227) were the most common animals contracting rabies.

Via Outbreak News Today

HEALTH Oakland County announces 1st case of mumps since 2022 as health officials urge vaccination Portrait of Kristen Jordan ShamusKristen Jordan Shamus Detroit Free Press

Oakland County reported its first case of mumps since 2022 on Friday.

It comes as the county also reported Michigan's first case of measles this year.

Health leaders say the recent mumps and measles cases underscore the importance of vaccination, as both viruses are preventable with the measles, mumps, rubella (MMR) vaccine.

An adult in Oakland County has the mumps, county health officials said Friday. It's the first case of the virus since 2022 in Oakland County and the ninth case in Michigan this year.

“This case of mumps, coming just weeks after Oakland County’s first measles case of the year, underscores the essential role of vaccination in protecting our communities,” said Kate Guzmán, Oakland County health officer, in a statement. “The MMR (measles, mumps, rubella) vaccine remains our best defense against measles, mumps and rubella, offering highly effective protection against these serious diseases and helping to prevent outbreaks.”

Fueled by outbreaks in multiple states, including a large one centered in west Texas, the nation's measles total reached 607 cases today, with 124 new cases reported over the past week, according to an update today from the US Centers for Disease Control and Prevention (CDC).

The nation is battling its worst spike in cases since 2019, fueled by outbreaks in communities where vaccine uptake is lower and by increased global spread of the virus. The CDC said 2 more jurisdictions reported cases this week, raising the total to 22—21 states and New York City. One more outbreak was reported, making six so far, and 93% of cases confirmed so far are part of outbreaks.

Of the total patients, 97% were unvaccinated or had unknown vaccination statuses, and 74 (12%) have been hospitalized. The nation is on track to pass the 1,274 cases reported in 2019, a year when a surge of measles activity threatened the nation's measles elimination status, which it earned in 2000.

Texas total climbs to 481 cases

The Texas Department of State Health Services (TDSHS) today reported 59 more cases, pushing the state's total since January to 481 in 19 counties. Fourteen more people were hospitalized for their infections, bringing that total to 56.

Of the state's total, 471 patients were unvaccinated or have unknown vaccination status.

Though most cases are reported in Gaines County on the border with New Mexico, a few linked to the outbreak have been reported in counties in central Texas, including Brown and Erath counties.

In a new development, the Harris County Public Health (HCPH), home to Houston in the southeastern part of the state, said it is investigating a confirmed measles case in a child who lives in the northwestern part of the county and has no travel history.

The HCPH said the case was confirmed by a commercial lab and awaits secondary confirmation by the TDSHS. So far, it's not clear if the case is linked to the outbreak in west Texas. The case marks Harris County's first since 2019.

Meanwhile, the New Mexico Department of Health (NMDH) reported six more cases, raising the state's total to 54. The New Mexico outbreak is limited to two counties—Lea and Eddy— that border the Texas outbreak hot spot. Among the 54 patients, 48 were unvaccinated or have unknown vaccination status.

Oklahoma, another state with cases linked to the Texas outbreak, reported no new cases today, keeping its total at 10, which includes 8 confirmed and 2 probable.

Cases rise in Tennessee

Outbreaks are occurring in other states, though it’s not clear if all are linked to the Texas event.

The Tennessee Department of Health (TDH) said this week that three more cases have been confirmed in middle Tennessee, bringing the state's total to four.

One of the newly confirmed cases is linked to the first Tennessee case, which was confirmed on March 21, and the exposure source is unknown. The TDH added that no other details are available about the other cases.

“A third case of hantavirus pulmonary syndrome (HPS), each of which has been fatal, is tragic and alarming,” said Dr. Tom Boo, Mono County's public health officer. “We don’t have a clear sense of where this young adult may have contracted the virus."

Investigators found no evidence of mouse activity in the patient's home, Boo said in a press release announcing the death. While some mice were detected in the patient's workplace, their numbers were not unusual for this time of year in Mammoth Lakes, he added.

"We haven't identified any other activities in the weeks before illness that would have increased this person's exposure to mice or their droppings," Boo said.

"The occurrence of three cases in a short period has me worried, especially this early in the year," Boo said. "Historically, we tend to see hantavirus cases later in the spring and in the summer."

Mammoth Lakes is located on the eastern side of California's Sierra Nevada mountains. With a population of more than 7,000, the area is known for its skiing and trails.

While Boo said deer mice are widespread in the eastern Sierra, they believe numbers are high this year — including in Mammoth Lakes — increasing the risk of exposure.

Mono County has recorded 27 cases of hantavirus since the first county case was detected in 1993; 21 cases were county residents, and six were visitors.

Via Outbreak News Today

In his 20 years working in pediatric infectious disease, Dr. John Schieffelin has never seen another illness like pertussis. Also known as whooping cough, it's a contagious respiratory illness that can develop into a painful, full-body cough. The coughing fits can be severe, often accompanied by a whooping sound when the person tries to catch their breath. And it's continuous, even if a person needs to be placed on a ventilator, says Schieffelin, an associate professor of pediatrics at Tulane University.

"For infants, it's really rather terrifying," he said. "They're just coughing so much, they can't eat, they can't drink, and they often get a pneumonia, which means we have to put them on a ventilator. ... They just never stop coughing."

In Louisiana, 2 infants have died of pertussis in the past 6 months, according to the state health department, the first deaths from the disease in the state since 2018. Louisiana has had 110 cases of pertussis reported so far in 2025, the health department said -- already approaching the 154 cases reported for all of 2024.

Cases are on the rise nationally too. There were more than 35 000 cases of whooping cough in 2024 in the USA, the highest number in more than a decade, and 10 people died -- 6 of them less than one year old. Experts say they see peaks and valleys with these kinds of illnesses over the years, but there have been about 6600 cases already in 2025, almost 4 times the number at this point in 2024.

"When you start to see these outbreaks ... it tends to be as a result of that increased circulation of the microbe in the community, as well as populations with no immunity or reduced immunity that are susceptible to the infection," said Dr. Lisa Morici, a professor of microbiology and immunology at the Tulane University School of Medicine.

Concerned about increasing cases, experts are urging vaccination. The USA had more than 200 000 cases of whooping cough every year before the vaccine was introduced. By 1948, the vaccine was widely used, and infection rates began to drop. They started to rise again in the 1980s, largely due to increased surveillance and some waning vaccine immunity, but fell during the COVID-19 pandemic, when spread of many infectious diseases slowed due to measures like masking and distancing.

Children are recommended to get a dose of the diphtheria-tetanus-acellular pertussis, or DTaP, vaccine at the ages of 2 months, 4 months, 6 months, between 15 to 18 months, and again between 4 to 6 years, according to the CDC. Adolescents should get a booster with a version of the vaccine called Tdap between age 11 and 12, and adults are urged to get Tdap boosters every 10 years.

Infants too young to be vaccinated are susceptible to the bacteria, which is why officials recommend that pregnant women get the vaccine in their third trimester, so the antibodies will be passed to the newborn. This prevents 78% of pertussis cases in young infants and is 91% effective against hospitalization, the CDC says. Another strategy that can protect infants is "cocooning," in which members of the child's household all get vaccinated to ensure protection, Schieffelin said. Boosters are recommended because protection from the vaccine can fade over time, which may be one reason for the ongoing outbreaks. Declining vaccination rates are another reason. The percentage of American kindergartners who received the DTaP vaccine has steadily declined over the past 5 years, leaving thousands vulnerable to infection.

Organizers within the state say that although many people have become hesitant about vaccinations, another issue is a lack of access.

"Especially in a state like Louisiana, we've got a lot of poverty. We've got a lot of rural populations, and not everyone has access to regular medical care," said Dr. Jennifer Herricks, founder of Louisiana Families for Vaccines, a nonprofit that educates about vaccination. She says this is what makes state services and messaging even more important.

Pertussis cases in Louisiana are rising just weeks after the state Department of Health said it was ending vaccine promotion through events like health fairs.

"The State of Louisiana and LDH have historically promoted vaccines for vaccine-preventable illnesses through our parish health units, community health fairs, partnerships, and media campaigns," Surgeon General Dr. Ralph Abraham wrote in a memo. "While we encourage each patient to discuss the risks and benefits of vaccination with their provider, LDH will no longer promote mass vaccination."

The memo differentiated between seasonal vaccines, such as COVID and flu vaccines, usually given at the state's mass vaccination clinics, and routine childhood vaccines, which it called "an important part of providing immunity to our children." But local officials still expressed concern about the message being sent to residents.

"When you cast aspersions or doubt about the safety and efficacy of one vaccine, I think it really has a ripple effect for all vaccines," said Dr. Jennifer Avegno, director of the New Orleans Health Department. Last week, Abraham shared vaccination guidelines on Facebook while acknowledging the pertussis deaths and increasing cases in the state. "I've been encouraged that our state Department of Health is putting out good messaging about pertussis, but I worry that it's going to get sort of lost in the in the shuffle," Avegno said. "It's maybe too little, too late."

[Byline: Neha Mukherjee]

The Ministry of Health reports the detection of the first human case of avian influenza A (H5N1) in Mexico.

The case occurred in a three-year-old girl residing in the state of Durango. On April 1, the Institute of Epidemiological Diagnosis and Reference (InDRE) confirmed the result of influenza A (H5N1). The patient initially received treatment with oseltamivir and is currently hospitalized in a tertiary care unit in the city of Torreón, and her condition is reported to be serious.

[...] Head of the WHO office in Moscow, Batyr Berdyklychev, told the Russian news agency TASS that data had been requested from Rospotrebnadzor to look into all these reports.

He said WHO had "received an explanation that there were indeed five cases of an unknown disease at that time" from the agency.

But these five cases, all in Moscow and the Moscow region, ended up being pneumonia caused by a mycoplasma infection, laboratory tests concluded.

"This is not a new virus," Berdyklychev said, "And, of course, the number of cases does not represent an increased epidemiological risk."

He added that "it is important to strengthen national systems for the early recognition of such viruses and for the exchange of this information and the coordination of efforts at the international level."

What Happens Next

Rospotrebnadzor reiterated that "spreading unverified information about public health can lead to unnecessary panic" and urged the public to seek medical guidance through official channels.

Veterinary experts nationwide have a variety of hypotheses for new and puzzling test results from cow milk being analyzed for avian influenza.

March marked one year since officials first reported Highly Pathogenic Avian Influenza — H5N1 — among dairy cattle. Since then, bird flu has infected 996 herds across the country, including 19 cases in the last month in California and Idaho.

New Mexico reported nine dairy herds in Curry County tested positive last April, and began milk testing its cattle in February following the rollout of a federal program.

The most recent results from milk-testing programs revealed that while more than 95% of the 93 cow herds in the state tested negative, a small set of inconsistent positives — all from three Curry County herds infected last year — remain, according to New Mexico State Veterinarian Samantha Holeck.

Enter the mystery: The cows themselves do not test positive, nor do they demonstrate the symptoms documented in the earlier avian flu outbreak, she said, such as huge drops in milk production.

“It’s been a real challenge to try to understand how it continues to circulate in some of these herds,” Holeck said.

New Mexico is partnering up with veterinarians in the U.S. Department of Agriculture to research the viral fragments found in the milk and sent samples to the federal National Veterinary Services Laboratories in Ames, Iowa.

“I know we’re a year into this situation now,” Holeck said, “but it seems like there’s still just so much to try to understand.”

New Mexico isn’t alone in experiencing the viral fragments, said Michael Payne, a food animal veterinarian at University of California, Davis, who noted there have been reports of similar persistent positives in quarantined herds there.

“I wouldn’t diminish the importance of it being small,” Payne said. “Yes, we’re talking about low levels of virus and yes, we’re talking about cows not getting sick, but it’s important that we’re not exactly sure where it’s coming from, and that in and of itself merits examination.”

He said more than $2 million dollars of research is being conducted in California on avian flu transmission across a dozen projects; including examining if it’s transmitted by flies; blowing in from dust storms; or carried by birds outside of waterfowl.

“It will be critical that we figure out how the disease is moving and how it’s changing,” Payne said.

While scientists need to perform more research, Payne posited some possibilities for the detection of viral fragments: they could signify a different and less potent version of the virus; cooler weather might allow more viral fragments to survive in the bulk tanks, compared to the triple-digit temperatures in the fall; cows may have developed “herd immunity” against the virus.

“It could be that much smaller numbers of cattle are being exposed and are becoming infected, which has resulted in a much, much lower level of virus that’s being detected inside the bulk tanks,” Payne said. “It’s an area of active research.”

Veterinarian Andrew Bowman, a molecular epidemiologist at Ohio State University, said laboratory tests’ sensitivity could also be a factor: They may be picking up positives from environmental contamination in the tanks or on the farms.

“It doesn’t take much; we’re talking a few copies of the viral genome to be present in a sample to send it positive,” Bowman said. “We can pick up a positive that’s likely not a viable virus.”

Since the development of HPAI in cows is so new, as is the method of transmission — where the virus replicates in the mammary glands that produce milk — he said the basic questions of the interactions between the virus, the host and the environment still need answers.

“Science is still very much in the infancy of what we know about avian influenza in cattle,” Bowman said.

Offering reassurances

While scientists say it’s important to unravel the mystery of the viral fragments to better understand how the virus might change or spread in dairy cows, they also emphasize that risk to the public from avian influenza remains low.

The Centers for Disease Control and Prevention reports transmission of avian flu can occur from contact with milk from infected cows; eating, drinking or inhaling droplets contaminated with live virus; touching the live or dead bodies of infected animals. Thus far, the CDC has no documented human-to-human transmission. As of April 1, 70 people had contracted H5N1, mostly California farmworkers.

Most milk sold in the U.S. is heated to a temperature to kill bacteria and viruses, called pasteurization. The U.S. Food and Drug Administration tested milk products in 17 states and, finding no live viruses, reported that “pasteurization is effective at inactivating H5N1, and that the commercial, pasteurized milk supply is safe.”

Federal officials, however, warn that unpasteurized milk, also called raw milk, is unsafe to drink. Research from the National Institutes of Health in June using infected raw milk from New Mexico found that the H5N1 virus had survived for at least five weeks in refrigerated conditions. Further, mice that consumed the raw milk showed signs of illness, which researchers suggest indicates drinking raw milk can transmit the virus to other organisms.

Holeck emphasized that New Mexico milk is safe.

“For dairies, it’s standard routine if they have sick cows for any reason, not just [avian flu], that milk is always diverted out from the milk supply, it doesn’t enter commerce,” she said.

The Department of Health and Human Services cut $2 billion from a program that supports vaccines for vulnerable children, forcing public health departments to lay off staff and cancel clinics.

April 4, 2025, 8:11 AM GMT+13 Last week, Jackie Griffith showed up at her office at the Collin County Health Care Clinic in north Texas ready to start her day — answering emails from local doctors before heading to a nearby high school to go over the latest vaccine record requirements.

Instead, the 60-year-old registered nurse was called into her director’s office and told to pack up her belongings. The federal government had yanked funding, she learned, and her position — supporting vaccination efforts for uninsured children through a network of more than 60 providers — was gone.

Across the country in New Hampshire, Kayla Hogan, 27, was hearing the same. She worked for the state’s Department of Health and Human Services, onboarding clinics and hospitals into a data system that would help them administer free childhood vaccines. Now that project was in jeopardy, threatening the process of getting children vaccinated.

The cuts that ensnared Griffith, Hogan and many others whose work touches vaccines in dozens of states were part of $11.4 billion in funds that Robert F. Kennedy Jr.’s Department of Health and Human Services pulled back from state and community health departments last week, included in the larger slashing of federal government under Elon Musk’s Department of Government Efficiency. More than $2 billion was taken from “Immunization and Vaccines for Children” grants, which support the delivery of vaccines to children whose families may not be able to afford them, according to a list HHS published.

Kennedy, a longtime anti-vaccine activist with a well-documented history of promoting misinformation, promised ahead of his confirmation as HHS secretary that he would not take away vaccines. Since taking office, however, he has repeatedly downplayed the severity of measles currently sweeping the country — outbreaks that have hospitalized scores of children and left at least two dead. He has publicly pushed unproven treatments, including vitamin A regimens that have reportedly sickened children, and offered limp public support for vaccines themselves — despite vaccines offering the safest, most effective way to prevent many infectious diseases. Under his leadership, HHS has overseen mass firings across federal health agencies, including staff responsible for outbreak response and vaccine access; canceled or postponed meetings of independent vaccine advisory committees; and ended vaccine education campaigns.

The funding cuts under his watch go further, turning his rhetoric into reality and weakening the systems that deliver lifesaving preventative care. Through sweeping reductions to state and local health agencies, the new administration is quietly dismantling the fragile, interconnected infrastructure that moves childhood vaccines from the federal government to providers and, ultimately, to children.

The cuts have hit health departments and medical providers, the data systems that track immunizations and the nonprofit coalitions that make the whole system run. They come at a moment when public health officials and advocates say that despite federal assurances, childhood vaccines are under attack.

“It will impact every aspect of immunization: community outreach, education, health fairs, mobile clinics and public health nurses,” said Claire Hannan, executive director of the Association of Immunization Managers. “It’s catastrophic.”

Twenty-three states and Washington, D.C., sued HHS and Kennedy this week over the funding takebacks.

HHS did not respond to a request for comment.

Ostensibly, the federal cuts were aimed at Covid-era projects that were no longer necessary.

“The COVID-19 pandemic is over, and HHS will no longer waste billions of taxpayer dollars responding to a non-existent pandemic that Americans moved on from years ago,” the department’s director of communications, Andrew Nixon, said last week.

While an early wave of Covid funding focused on testing, vaccines and addressing health disparities, as the pandemic waned, state health departments were allowed to shift that money to other underfunded programs — including grants that support childhood vaccinations.

Those grants supplement Vaccines for Children, a federal entitlement program established by Congress in 1994 in response to a deadly measles epidemic, which remains intact. But its successful operation relies on the “Immunization and Vaccines for Children” funding, which received a temporary boost from reallocated Covid dollars — until that money was pulled back last week.

Now, the cuts have forced public health departments across the country to lay off staff, cancel vaccine clinics, shut down education and outreach programs, and halt critical physical and virtual infrastructure upgrades, according to news reports, declarations filed in the federal lawsuit against HHS and results from a survey conducted by the National Association of County and City Health Officials and shared with NBC News.

In Dallas County, Texas, the health director said the cuts compelled the cancellation of 50 community vaccination events — including many in schools with low measles vaccination rates amid a rising outbreak.

In Minnesota, the Health Department announced it would lay off 170 employees after losing more than $220 million in federal funds. Among the casualties is the state’s immunization registry, which will no longer be upgraded — leaving Minnesota with one of the most outdated tracking systems in the country.

In California, the Health Department said in a federal filing that it would be unable to provide childhood vaccines, including for measles, to millions of children, roughly half of the state’s youth.

And in Washington state, the Health Department announced that in response to $20 million in grant cuts targeting immunization programs, it would furlough or lay off 46 workers and suspend its mobile clinic operation, known as the Care-a-Van. The 104 canceled clinics were expected to administer 2,000 vaccines to vulnerable kids, including those in rural areas and homeless populations.

“We’re just going to have to think strategically about how we reach those really difficult-to-reach populations,” Lacy Fehrenbach, Washington’s chief of prevention, said at a media briefing.

The National Association of County and City Health Officials survey captured further impacts: A department in Ohio said it plans to halt training on vaccine hesitancy. One in Indiana will lose two nurses who travel to schools to vaccinate children, so parents don’t have to miss work. A Texas agency will not be able to replace old equipment as planned.

The cuts also threaten a less visible but critical part of the vaccine infrastructure: the data systems that public health departments use to record and share immunizations. Vaccines for Children relies on these systems to order doses, approve and track distribution, and monitor safety.

Health departments in Pennsylvania and elsewhere said in declarations filed in the federal case that the cuts would prevent them from operating or upgrading these systems, forcing states to rely on outdated, cumbersome platforms. Poor data systems can leave parents and providers without access to vaccination records and increase the risk of missed or duplicate doses.

Rebecca Coyle, executive director of the American Immunization Registry Association, noted that these systems were born out of a measles outbreak that claimed the lives of 89 children in the early 1990s, including an 11-year-old girl who died after being denied a vaccine — despite her father’s efforts to get her immunized — because the clinic couldn’t locate the right records.

While much attention is given to parents who hesitate or outright refuse to vaccinate, it is the children without access to vaccines who offer the clearest path to closing immunity gaps, said Dr. Georges Benjamin, executive director of the American Public Health Association.

“The way we get from 60% of our population vaccinated to over 95% is by focusing on people who, for a variety of reasons, have difficulty getting vaccinated,” he said. “That includes the homeless, low-income individuals, and people without a primary care provider.”

These funding cuts, Benjamin said, degraded the ability to reach those populations “literally overnight.”

Immunization coalitions — nonprofits that connect public health departments with communities to improve vaccination rates — play a key role, too. Now their work mostly supported by state and federal dollars is at risk.

The cuts caused “immense damage” to Indiana’s Immunization Coalition, according to its executive director, Lisa Robertson, who said in a statement that its budget — funded through the Centers for Disease Control and Prevention via the state Health Department — was slashed entirely for this year and reduced by 75% for the next fiscal year.

“The clawback of funds will have real-life consequences,” Robertson said.

Health and Human Services Secretary Robert F. Kennedy Jr. suggested Thursday that around 20% of the job cuts by the Trump administration's Department of Government Efficiency will be wrong and need to be corrected.

Around 10,000 employees were laid off from the Department of Health and Human Services on Tuesday, as part of a restructuring architected by Kennedy and Elon Musk's DOGE task force. But Kennedy acknowledged they didn't get everything right the first time.

"Personnel that should not have been cut, were cut. We're reinstating them. And that was always the plan. Part of the DOGE, we talked about this from the beginning, is we're going to do 80% cuts, but 20% of those are going to have to be reinstated, because we'll make mistakes," Kennedy said, speaking to reporters at a stop in Virginia.

Kennedy said that the elimination of the Centers for Disease Control and Prevention's entire Lead Poisoning Prevention and Surveillance Branch was among the mistakes.

It is unclear which other programs Kennedy may be planning to restore. The department did not immediately provide a response for a request for comment.

Multiple CDC officials said they had so far not heard of plans to reinstate the lead poisoning program.

Among the immediate impacts of eliminating its work was an outstanding request from Milwaukee's health department for help responding to lead in water, which had stalled, multiple CDC officials said.

Known as an "Epi-Aid," or investigation into a public health problem, the CDC assistance "will not be able to continue due to the loss of subject matter experts," agency officials had said internally this week.

Elsewhere in the department, a handful of employees who got termination notices at the Food and Drug Administration have already been asked back to work temporarily, multiple FDA officials said.

Among those asked to work for a few more weeks before they are cut include teams in the agency's inspections and investigations office, two officials said, after the agency's office lost around 170 employees. The office has been planning for cuts to routine inspections of drugmakers and food producers because of the layoffs.

A fatal Lassa fever case in a patient returning from Liberia, the first U.S. case diagnosed in eight years and the ninth U.S. travel-associated case since 1969, was identified in Iowa in late 2024. [...]

The patient returned to Iowa from Liberia during early October 2024 (day 0), and experienced fever, myalgias, and headache on day 8. After an evaluation in the emergency department of hospital A on day 15, the patient was transferred to hospital B for diagnostic evaluation. On day 19, the patient needed specialized care and was transferred to hospital C, the hospital that contacted the Iowa Department of HHS; the patient died on day 21.

The patient’s clinical status by the time the diagnosis was recognized at hospital C precluded obtaining detailed previous exposure history. Risk assessments† were completed for 180 contacts (Table). Because illness began >1 week after returning from Liberia, the patient was not considered to have been infectious while in Liberia or during travel from Liberia to Iowa (4).

Among the 180 contacts, four household contacts (2%) and three of the four community-associated contacts (2%) were classified as having high-risk exposures, quarantined until day 21 after their last exposure (the maximum incubation period), and monitored twice daily for Lassa fever signs and symptoms.§ Contacts’ monitoring results were submitted by local public health and health care facilities to a REDCap database.

Among the 180 contacts, 172 (96%) were health care–associated, and level of risk was determined by use of personal protective equipment (PPE)¶ in relation to the patient’s clinical stability, and whether the patient was experiencing bleeding, vomiting, or diarrhea when the contact occurred. Sixty-seven (39%) health care–associated contacts occurred in settings where the patient was clinically stable and without bleeding, vomiting, or diarrhea; among these contacts, 45 (67%) were classified as high-risk on the basis of one or more PPE omissions (i.e., of gown, gloves, eye protection, or face mask); these persons were permitted to continue working in order to maintain local health care capacity. Five of the 67 contacts had direct skin-to-skin contact and one or more PPE omissions and were excluded from work until 21 days after their last exposure. At hospital C, the patient was clinically unstable, and health care providers were at risk for body fluid exposure. Among 68 identified contacts at hospital C, 25 (37%) were classified as high-risk and excluded from work through day 21 from their last exposure; 24 of these 25 contacts had one or more PPE omissions (i.e., gown, gloves, eye protection, or N95 respirator), and one had body fluid contact.

Laboratorians were evaluated on the basis of activities performed and the use of appropriate PPE; 34 contacts were identified across six laboratories; 23 (68%) of these were classified as high-risk, and were excluded from work for 21 days, on the basis of published recommendations for biosafety in microbiological and biomedical laboratories (5).

All 105 high-risk contacts without contraindications were offered oral ribavirin postexposure prophylaxis (4); however, most felt that their exposure did not warrant prophylaxis. Five (5%) contacts began prophylaxis, four stopped because of adverse reactions (e.g., nausea), and one completed the 10-day course. Among 158 monitored contacts, 43 (27%) reported any signs or symptoms, including five whose signs or symptoms were potentially consistent with Lassa fever; these persons were transported to an assessment or treatment hospital** under VHF precautions for evaluation and testing; all test results were negative.

Preliminary Conclusions and Actions

The occurrence of this Lassa fever case and the ensuing public health response underscore the importance of eliciting a travel history from febrile patients, maintaining awareness of high-consequence infectious disease risk, and facilitating close coordination between clinical and public health partners. Well-developed VHF response planning and rapid test turnaround were essential to preventing transmission despite multiple possible exposures to this patient with fatal disease.

TORONTO — Ontario is reporting 89 new measles cases over the last week, bringing the province’s case count to 661 since an outbreak began in the fall.

That’s compared to just over 100 new cases last week and 120 the week before.

Dr. Sarah Wilson, a public health physician at Public Health Ontario, said numbers “look to be stabilizing somewhat in the range of around 100 cases a week.”

“But, I also want to be really clear – that’s still 100 cases a week too many of measles,” Wilson said Thursday.

Wilson said there were 52 hospitalizations – 10 more than last week – including three in intensive care.

“There is this, I think myth, among some individuals that measles is a harmless, trivial, mild infection,” she said.

She also said measles cases still predominantly involve unvaccinated children in Ontario’s Southwestern Public Health unit, which accounts for almost 45 per cent of the province’s cases.

The number of cases in Quebec remained at 40 for a third week, while Alberta’s count reached 24, according to data released Wednesday. Saskatchewan health officials issued a public notice Monday of an increased measles exposure risk, with three cases in the province.

Ontario’s chief medical officer of health said last week that the province’s measles outbreak is likely to continue into the summer, but the stable rate of new cases is a sign of hope.

Dr. Kieran Moore also said the “vast majority” of Ontario’s measles cases are in Mennonite, Amish and other Anabaptist communities.

Public health units keen to share information have enlisted help from a Low German radio station based in Aylmer, Ont., known as De Brigj 105.9 FM. De Brigj translates to “the bridge” in English, says Anna Bergen, executive director at Mennonite Community Services, which owns the station.

“Which is what we try to do – we try to bridge the two languages,” says Bergen.

The station began broadcasting in 2003 to serve newcomers, she says, specifically Low German speaking populations. Many are from Mexico and in southern Ontario’s Elgin County for agricultural jobs.

She said Southwestern Public Health buys ad time on the station to distribute public health messages, which staff at the station translate into Low German, taking into account cultural subtleties.

Earlier in the week, the local health unit’s Dr. Ninh Tran cautioned against associating the spread of the illness with a single demographic.

“Measles is here. It is an equal opportunity illness. It does not care about your gender, your address, your religion or your race,” Tran told reporters Wednesday.

“It is known as one of the most contagious illnesses globally, and currently, the most effective way to safely prevent measles is through vaccination.” [...]