Measles, Cyclospora-When Should You Be Concerned?

In this post I review the CURRENT outbreaks of preventable illnesses in the United States. I also discuss the significance of significant unlying conditions.

Have you wondered how they know the current cyclospora outbreak in the United States may have started with lettuce at a Taco Bell restaurant?

This article from KFF Health News explains how. Nurses from the local public health department call infected people and ask them about their eating habits.

Can you remember what you ate two weeks ago, the brand name on the package, and where it came from? What restaurant did you go to two weeks ago? If you didn’t order on an app or save your receipt, you might not remember.

Fortunately for the sake of disease tracing, some people do.

Nurses Chase Cyclospora, Aided by Interviews, Fast-Food Receipts — And the Messy Details

By Kate Wells, Aug 4, 2026

A woman holding a phone to her left ear sits in front of a laptop and looks at the screen.
Linda Kim, a nurse with the Washtenaw County Health Department in Michigan, has been helping to investigate the county’s 900-plus cases of cyclosporiasis since mid-June. Public health investigations of foodborne illnesses are complex, and that’s especially the case with cyclosporiasis, because symptoms can take as long as two weeks to appear after someone’s eaten contaminated food. (Kate Wells/KFF Health News)

Listen at this link.

More than 900 people in Washtenaw County, Michigan, have been sickened with cyclosporiasis since mid-June. Linda Kim, a public health nurse, has called more than 100 of them. Almost everyone has said the same thing: It’s excruciating, and one of the worst illnesses they’ve experienced.

But on a Wednesday in July, she called one man who said he wouldn’t mind having it again, actually.

“You’re enjoying the weight loss?” Kim said, laughing as she took notes in a small conference room at the Washtenaw County Health Department building, just outside Ann Arbor. “Well, I’m glad to hear that. At least you got something good out of it!”

Normally, Kim’s supposed to be working downstairs in the clinic, where families wait in gray plastic chairs in the lobby for free or low-cost immunizations. But she hasn’t been there in months.

First, a Measles Outbreak

In March, Kim was transferred to a different department to help deal with a measles outbreak that sickened seven people in the county, five of them children. It was an all-hands-on-deck situation; everyone worked overtime. The state issued an advisory urging families in Washtenaw and surrounding counties to get babies 6 months or older vaccinated ahead of schedule, if possible.

The contact-tracing calls for measles could be contentious, Kim said. People were suspicious, asking her how she knew they had tested positive, or why they should give her any information.

“People were like, ‘Oh, you’re just trying to restrict my life,’ or ‘You’re just trying to get information out of me and get me in trouble,’” she said. “It’s like, no, we’re actually not doing that at all.”

As she tried to explain to them, tracing the spread of the highly contagious virus and publicizing possible exposure sites was an effort to “keep it contained, so it doesn’t become something huge.”

Measles is highly contagious and spreads through the air when an infected person coughs or sneezes.
Then, Cyclospora “Exploded”

The county’s measles outbreak ended in late May. Then in June, reports of cyclosporiasis cases started pouring in — more than 11,000 so far in Michigan, including two deaths. Both people who died had “significant underlying health conditions that may have been impacted by cyclosporiasis and dehydration,” the state health department said on its website Aug. 3.

Health officials aren’t providing more details, department spokesperson Lynn Sutfin said in an email, but are stressing that cyclosporiasis generally isn’t life-threatening and that deaths from it are uncommon in the U.S.

Kim said the cyclosporiasis surveillance has been very different from her experience with the measles outbreak.

Now, people seem eager to divulge even the most graphic details, such as “pooping their beds, and, like, putting down towels and it’s not enough.”

Linda Kim, public health nurse

Since she’s a nurse, such confessions don’t faze her, she said. Still, staffers have hundreds of these calls to make, so they try to keep each conversation under an hour.

“Crunchy or Soft?”

But foodborne illness investigations are complex. Especially for this parasite, cyclospora. Symptoms can take as long as two weeks to appear after people have eaten contaminated food. And no one remembers what they ate two weeks ago, public health staffers said.

The interview process can be extremely detailed. Kim and her colleagues ask people to pull up their restaurant receipts, scroll through purchases on their grocery store apps, even try to recall details such as the exact brand of bagged salad mix they bought, or the type of taco they got at Taco Bell.

“Is that the crunchy one or the soft one?” Kim asked on a recent call, typing on a laptop decorated with cat and vaccine-themed stickers.

Kim has been working with the health department for two years, a period defined by federal funding cuts.

Federal Funding Cuts Hurt

Laina Stebbins, a spokesperson for the Michigan Department of Health and Human Services, said the Trump administration’s sweeping cuts to public health grants eliminated a contract between the state health department and 44 of the state’s 45 local departments that funded 123 full-time employees.

Those cuts also affected the state’s disease surveillance labs, “reducing funding for equipment maintenance contracts, data modernization, and the ability to innovate laboratory processes during emerging disease response,” Stebbins said.

Some of that funding was restored after Michigan won a temporary restraining order against the Trump administration. But Washtenaw’s health department still had to scale back some disease surveillance and outbreak response work. Currently, employees who leave or retire aren’t replaced, except for those on the nursing team, which is hiring but still understaffed.

The county’s Health Equity Council, which aims to reduce health disparities, including in mental health, was shuttered suddenly in early 2025. Nearly a year later, it resumed its work, with funding at least through this September.

An image of a building where the sign on its wall reads, "State of Michigan Department of Health & Human Services."
Staff at the Washtenaw County Health Department in Ypsilanti, Michigan, have been working to trace the sources of the recent cyclospora outbreaks by conducting detailed, often lengthy interviews with hundreds of people. (Kate Wells/KFF Health News)
Slow Response from Federal Public Health

An employee from the Centers for Disease Control and Prevention had been stationed at the department. During the funding chaos, the worker was fired, then rehired, then furloughed.

The federal response to cyclosporiasis has felt frustratingly slow, according to Christina Zilke, a nursing supervisor at the Washtenaw health department.

“It took them forever to say that this was lettuce, and fast-food restaurants were taking it off the shelves before the CDC ever said what it was,” she said.

During a July 14 press call, the deputy director of the CDC’s Division of Foodborne, Waterborne, and Environmental Diseases, Gwen Biggerstaff, said it’s not unusual for it to take a long time to identify a specific source for cyclosporiasis — if it’s identified at all. That’s partly due to the lag time between exposure and the appearance of symptoms, and the complexity of tracing this particular parasite.

Meanwhile, Zilke’s been stocking the coffee station and bringing in pizza, trying to keep up staff morale. It’s not a reward, she said. “It’s more like: ‘Here’s some food for survival. Here’s a break so you don’t quit.’”

Kim, for her part, remains enthusiastic about the job but said it’s been a surreal introduction to a public health career — first measles, now cyclospora.

“If nationally they don’t know what’s going on, how are we locally expected to know what’s going on?” she said. “And also just frustrating to be, like, ‘Wow, I don’t think even our government knows how important public health is.’”

But there’s no time to dwell. She has to move on to the next call, as soon as she can wrap up this one. She gives each person her work number, so people can call or text with any follow-up questions.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

This article first appeared on KFF Health News and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Underlying Health Conditions Explained

One term used in this story you’ve heard before –“people with significant underlying health conditions.” During COVID, these people were known to be at increased risk of severe disease, complications, and death. That’s true of many acute illnesses, not just COVID, cyclospora, or other infections.

What exactly is a significant underlying health condition? Simply put, any medical condition that involves a critical body organ or system-heart, lungs, kidneys, brain. An official definition of “significant underlying health conditions” is

 long-term or chronic medical issues that last for more than one year, require ongoing medical care, and can increase the risk of severe complications from infections like COVID-19. Examples are

  Heart Conditions: Heart failure, coronary artery disease, and cardiomyopathies.

  Chronic Lung Diseases: COPD, moderate-to-severe asthma, and pulmonary fibrosis.

  Diabetes: Type 1 and Type 2 diabetes, particularly with complications.

  Obesity: Having a high body mass index (BMI) that strains organ function.

  Chronic Kidney and Liver Disease: Stage-based kidney disease or chronic liver failure/cirrhosis.

  Immunocompromised States: Active cancer treatments, organ transplants, or HIV.

The “one-year” means they are expected to last at least that long, not that we wait a year before considering them significant. Most of the ones listed become lifelong concerns.

Other significant medical conditions include age-the very young or old, pregnancy, neurological dysfunction, homelessness, and substance abuse.

These are also referred to as Chronic Diseases. However, some chronic diseases do not necessarily increase one’s risk of serious illness.

How do you know if you have one of these conditions? Usually, they are diagnosed when symptoms prompt someone to seek medical attention and undergo an appropriate exam and testing. But sometimes people walk around for years ignoring “minor” symptoms until they become major. By this time, heart, lung, or kidney disease can be in advanced stages, as can cancer.

But that doesn’t mean people without serious underlying conditions are not at risk of getting seriously ill or dying from COVID, measles, cyclospora, influenza, pneumonia, or any other unexpected disease or injury. We all need to be vigilant to protect our health.

Next Steps

If you have a serious chronic disease, how do you protect yourself from acute illnesses that might become severe or life-threatening?

What else do you need to know, and where will you get this information?

If you don’t have a chronic disease now, what do you do to prevent one? Do you wonder what more you could do?

Your physician can help you. Consider asking about screening for the chronic diseases mentioned above.

Review your family medical history. If a close relative has a chronic disease, you may be at increased risk.

Review your use of tobacco, alcohol, and other substances.

Last but not least, we all need to monitor our daily activities-what we eat, how much we sit, how much we move, and our sleep. These are all vitally important to good health, but often ignored.

Exploring the HEART of Health

Thanks to KFF Health News and NPR for this report. The cover photo is by Photo by SpotOn POS on Pexels.com.

You’ve made it through a long post with much information to digest. Take it one step at a time. One can get fatigued with too many good intentions.

I appreciate your time reading this post and invite you to follow this blog and me on social media.

I share information and inspiration to help you transform challenges into opportunities for learning and growth.

Add your name to the subscribe box to be notified of new posts by email. Click the link to read the post and browse other content. It’s that simple. No spam.

I enjoy seeing who is new to Watercress Words. When you subscribe, I will visit your blog or website. Thanks and see you next time.

Dr. Aletha

Tick-Borne Diseases: Smart Tips for Prevention

This post will help you understand and avoid health risks from ticks. Ticks pose a growing risk for diseases in the U.S., particularly in warmer climates. Lyme disease and Alpha-gal syndrome are among the most common illnesses caused by ticks. Preventative measures include using repellents, wearing protective clothing, and timely tick removal to minimize disease transmission.

As a practicing family physician, I occasionally saw patients concerned about a tick bite. Most of the time, they had already removed the tick but were concerned about the possibility of an infection. I was usually able to reassure them that the tick had not been attached long enough to transmit a disease. If they had symptoms or were not sure how long the tick had been on their body, I would prescribe an antibiotic to cover the most likely infection.

Humans can catch infectious diseases in multiple ways. The pathogens that make us sick can enter our bodies through water, food, the air, and even direct contact with other people or their bodily fluids like blood.

Another source is contact with animals, including ones we may not see. The vast majority of these, the vector-borne diseases, are caused by ticks, mosquitoes, fleas, flies, and lice.

Ticks are small arachnids in the mite family that feed on the blood of mammals and birds. Ticks can transmit bacteria, viruses, and parasites that can cause illness in humans and animals

The most common tick-borne diseases in the U.S. include Lyme disease, anaplasmosis, babesiosis, and Rocky Mountain Spotted Fever. Symptoms typically include flu-like fever, chills, and fatigue, but can also involve unique indicators like a “bullseye” rash (Lyme disease). Most bacterial infections are successfully treated with antibiotics, making early diagnosis crucial. [1, 2, 3, 4]

This 2007 photograph depicts the pathognomonic erythematous rash in the pattern of a bull’s-eye, referred to as erythema migrans. The rash manifested at the site of a tick bite, on this Maryland woman’s posterior upper arm, signifying a case of Lyme disease, caused by the bacterium Borrelia burgdorferi, and transmitted to humans, by the bite of infected blacklegged ticks.CDC/ James Gathany, public domain

Ticks can also cause non-infectious diseases. Tick paralysis is caused by a toxin in the tick’s saliva. Symptoms include weakness or even paralysis that gradually moves up the body.

Another example is the alpha-gal syndrome, AGS, discussed in this article. People with AGS can have an allergic reaction after eating red meat or being exposed to products containing alpha-gal.

Tick bites are surging in the US this year. Here’s what to know.

by Amelia Twyman, Oklahoma Voice
July 6, 2026

WASHINGTON — The prime time for ticks is here in the United States, and after an especially active start to the season, experts are urging the public to stay alert and take preventive measures. 

Monthly emergency department visits for tick bites in April spiked to their highest level since 2017 and continued to remain high throughout May and June, according to the Centers for Disease Control and Prevention’s tick bite tracker.

Though it’s hard to predict what the rest of the season will look like, given that tick activity depends on a number of different factors, there has definitely been a recent geographic expansion of the area ticks inhabit, said Pilar Fernandez, a disease ecologist and assistant professor at Washington State University. 

The tiny blood-suckers, which tend to thrive in warmer climates, are spreading to places that used to be too cold for their existence, she said during a July 1 SciLine media briefing, as temperatures rise in the United States and around the world.

With more ticks comes a greater risk of individuals developing tick-borne diseases such as Lyme disease, Alpha-gal syndrome and anaplasmosis. That’s why researchers are encouraging people to know their facts and learn how to protect themselves from bites as they venture outdoors. 

What’s going on this year?

According to the CDC, an estimated 31 million people are bitten by ticks each year, with most encounters taking place between April and October. But in 2026, ER visits began rising as early as March. 

Weekly ER trips for tick bites are also up in every U.S. region except for South Central as of June 28, the online tick tracker shows. 

Global warming is certainly one reason behind this recent surge in tick activity, though Fernandez said the whole picture is much more complicated.

Because ticks can live for up to two to three years, it’s difficult to understand the delayed seasonal effects of increased temperatures or precipitation on their population, she said.

Other factors including local environmental conditions and how much time people spend outside can have an impact on annual tick encounters, she added. 

Every spring and summer, she said, people ask her if it’s going to be a “big year” for ticks, which is “a really hard question to answer, because it’s not equal across all locations.” 

Most tick cases are recorded in the Northeast and Midwest, but different species of ticks are found in every region of the country. And as the population expands into areas where people are unaware of how to protect themselves and unaccustomed to checking for bites, the threat of contracting a tick-borne infection grows, Fernandez said. 

Tick-borne diseases

Ticks carry pathogens that they then pass on to humans by biting into their skin and feeding on their blood. An untreated tick bite can lead to the development of one of nearly 20 different human diseases in the U.S., the most common of which is Lyme disease — about 476,000 patients are treated annually, according to the CDC. 

Another tick-borne infection that has been on the rise is Alpha-gal syndrome, which causes people to experience a serious allergic reaction after they eat red meat or other animal products that contain the sugar molecule alpha-gal. It is most commonly associated with the lone star species of tick distributed throughout the Northeastern, Southern and Midwestern United States. 

Haemaphysalis longicornis  ticks, commonly known as the longhorned tick. The smaller of the two ticks on the left, was a nymph. The larger tick was an adult female. Males are rare.
 CDC, James Gathany, public domain

Initial symptoms of tick-borne illnesses are unspecific and often the same as those that come with regular sickness, such as a fever, headache, muscle aches and joint pain, according to Alvaro Toledo, an associate professor in the Department of Entomology at Rutgers who also spoke at the July 1 media briefing. 

“Physicians need to be vigilant and aware if they receive a patient with symptoms that are compatible with a tick-borne disease,” he said.

What if you find a tick?

If one discovers a tick on the skin, Toledo said the proper response is to first quickly remove the tick with tweezers by pinching and pulling it up in a vertical motion, then disinfecting the area and monitoring for signs of sickness. 

People should not, on the other hand, deal with a tick by burning it off or applying petroleum jelly to the bite, said University of Wisconsin-Madison Assistant Professor Adela Oliva Chavez, a tick researcher, at the briefing. 

“Those are myths,” she warned. 

Ticks typically do not transmit infection until after they have been attached to the skin for 24 hours, which is why the CDC recommends people aim to remove the pests as soon as possible within the first day.   

However, experts say the most effective way to prevent tickborne disease in humans is by limiting exposure to ticks in the first place.  

Toledo said people should use chemical sprays such as permethrin on their clothing and classic bug repellents on their skin to keep ticks away. It’s also a good idea to wear long, light-colored clothing when spending time in forests and other highly vegetated areas where ticks are abundant. 

But, he added as a reminder to the public, there is “no zero-risk zone anywhere when you go out … even in your backyard, risk is not zero.” 

Individuals can further reduce their chance of acquiring a tick bite by checking their pets just as often themselves, according to Oliva Chavez. Dogs and cats can easily bring ticks into the house from outside, and if they aren’t yet attached to the animal’s flesh, they can make their way onto humans, she said. 

Oklahoma Voice is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Oklahoma Voice maintains editorial independence. Contact Editor Janelle Stecklein for questions: info@oklahomavoice.com. Article reprinted here under Creative Commons license.

Cover Image

from the Public Health Image Library, CDC

“Keeping your furry pets healthy includes keeping them clean, as well. Together, this family was in the process of washing their Labrador retriever outside in the fresh air. With help from two neighbor girls, the mother, young daughter, and son, were all soaping down the dog’s coat, while the father was steadying the pet using a leash and his hand.

By washing down his coat, chances for the animal to bring contaminants indoors, is highly reduced. After returning from the outdoors, pets can bring allergens, disease vectors such as ticks and fleas, and pathogens from other animals indoors, thereby exposing the entire family to these dangers. One should remember to wash his/her hands after finishing this activity.”

CDC/ Dawn Arlotta, public domain

Exploring the HEART of Health

I appreciate your time reading this post and invite you to follow this blog and me on social media.

I share information and inspiration to help you transform challenges into opportunities for learning and growth.

Add your name to the subscribe box to be notified of new posts by email. Click the link to read the post and browse other content. It’s that simple. No spam.

I enjoy seeing who is new to Watercress Words. When you subscribe, I will visit your blog or website. Thanks and see you next time.

Dr. Aletha