Tag: chronic disease

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

Can Kennedy’s HHS Restructuring End Chronic Disease?

In this post I look at Secretary of Health Robert Kennedy Jr’s plans to cut 10,000 jobs and close five regional offices in the Department of Health and Human Services (HHS) to tackle the “chronic disease epidemic”. The restructuring intends to reduce HHS’s budget by $1.8 billion while facing significant criticism from Democrats about the potential public health impact.

Secretary of Health Robert Kennedy Jr. and President Trump have established a goal of eliminating the “chronic disease epidemic.” To do so, the Secretary has ordered a massive reduction in the budget and workforce of HHS, the Department of Health and Human Services.

What is Chronic Disease?

Chronic diseases are defined broadly as conditions that last 1 year or more and require ongoing medical attention or limit activities of daily living or both.

Centers for Disease Control and Prevention

What is an Epidemic?

In the 21st century, epidemics of infectious diseases have threatened humans. Severe acute respiratory syndrome (SARS), avian influenza, and HIV/AIDS have supported the reality of this threat. 

Measles is highly contagious and spreads through the air when an infected person coughs or sneezes.

Late in the 20th century, epidemic was applied to noninfectious diseases, such as cancer epidemics or epidemics of obesity. Using epidemic for noninfectious causes refers to a disease that affects many people, with a recent and substantial increase in cases.

For nonmedical events, journalists use the term epidemic for anything that adversely affects large numbers of persons or objects and propagates like a disease, such as crack cocaine, computer viruses, or severe weather.

Reference: Martin P, Martin-Granel E. 2,500-year Evolution of the Term Epidemic. Emerging Infectious Diseases. 2006;12(6):976-980. doi:10.3201/eid1206.051263.

Here is the Secretary’s plan for HHS to address the “epidemic” he believes exists.

U.S. Department of Health and Human Services to slash 10,000 jobs, close 5 regional offices

By Jennifer Shutt, States Newsroom, March 27, 2025 | 12:26 pm ET

WASHINGTON — The Trump administration announced a sweeping plan Thursday to restructure the Department of Health and Human Services by cutting an additional 10,000 workers and closing down half of its 10 regional offices.

The overhaul will affect many of the agencies that make up HHS, including the Food and Drug Administration, Centers for Disease Control and Prevention, National Institutes of Health, and the Centers for Medicare and Medicaid Services.

HHS overall will be downsized from a full-time workforce of 82,000 to 62,000, including those who took early retirement or a buyout offer.

HHS Secretary Robert F. Kennedy, Jr. released a written statement along with the announcement, saying the changes would benefit Americans.

“We aren’t just reducing bureaucratic sprawl.

We are realigning the organization with its core mission and our new priorities in reversing the chronic disease epidemic,” Kennedy said. “This Department will do more — a lot more — at a lower cost to the taxpayer.”  

The U.S. Senate voted to confirm Kennedy as the nation’s top public health official in mid-February.

James H. Shannon Building (Building One), NIH campus, Bethesda, MD
James H. Shannon Building (Building One), NIH campus, Bethesda, MD

Congressional reaction

Democrats immediately reacted with deep concern.

Senate Appropriations Committee ranking member Patty Murray, D-Wash., said that she was “stunned at the lack of thought about what they are doing to the American public and their health.”

Murray said the committee, which controls about one-third of all federal spending, “absolutely” has an oversight role to play in tracking HHS actions.

Wisconsin Sen. Tammy Baldwin, the top Democrat on the Appropriations subcommittee that funds HHS, said she believes HHS has overstepped its authority and expects the panel will look into its actions.

“These individuals who are going to be terminated under this plan play vital roles in the health of Wisconsinites and people nationally,” Baldwin said. “And I believe that they do not have the authority, the Trump administration does not have the authority to do this wholesale reorganization without working with Congress.”

Maryland Democratic Sen. Angela Alsobrooks, whose constituents in suburban Washington likely hold many of the jobs in question, wrote in a statement the HHS’ restructuring plans are “dangerous and deadly.”

“I warned America that confirming RFK Jr. would be a mistake,” Alsobrooks wrote. “His blatant distrust of science and disregard for research and advancement makes him completely unqualified.”

Cuts across department

The announcement says reorganizing HHS will cut its $1.7 trillion annual budget by about $1.8 billion, in part, by lowering overall staff levels.

Staffing cuts will be spread out over HHS and several of the agencies it oversees. The restructuring plans to eliminate

  • 3,500 full-time workers at the FDA,
  • 2,400 employees at the CDC,
  • 1,200 staff at the NIH and
  • 300 workers at the Centers for Medicare and Medicaid Services.
President Donald Trump visited NIH on March 3, 2020 and toured the National Institute of Allergy and Infectious Diseases’ Vaccine Research Center (VRC) to learn about research on a vaccine for the novel coronavirus SARS-CoV-2. public domain photo from flickr

“The consolidation and cuts are designed not only to save money, but to make the organization more efficient and more responsive to Americans’ needs, and to implement the Make America Healthy Again goal of ending the chronic disease epidemic,” according to a fact sheet.

Senate Health, Education, Labor and Pensions, or HELP, Committee Chairman Bill Cassidy, R-La., wrote in a statement that he looks “forward to hearing how this reorganization furthers these goals.”

“I am interested in HHS working better, such as lifesaving drug approval more rapidly, and Medicare service improved,” Cassidy wrote.

Regional offices, divisions affected

HHS did not immediately respond to a request from States Newsroom about which five of its 10 regional offices would shutter or when those closures would take effect.

Its website shows the offices are located in Boston; New York City; Philadelphia; Atlanta; Chicago; Dallas; Kansas City, Missouri; Denver; San Francisco; and Seattle.

HHS plans to reduce its divisions from 28 to 15 while also establishing the Administration for a Healthy America, or AHA.

That new entity will combine the Office of the Assistant Secretary for Health, Health Resources and Services Administration, Substance Abuse and Mental Health Services Administration, Agency for Toxic Substances and Disease Registry and National Institute for Occupational Safety and Health.

That change will “improve coordination of health resources for low-income Americans and will focus on areas including, Primary Care, Maternal and Child Health, Mental Health, Environmental Health, HIV/AIDS, and Workforce development.

Transferring SAMHSA to AHA will increase operational efficiency and assure programs are carried out because it will break down artificial divisions between similar programs,” according to the announcement.

HHS will roll the Administration for Strategic Preparedness and Response into the CDC.

The department plans to create a new assistant secretary for enforcement, who will be responsible for work within the Departmental Appeals Board, Office of Medicare Hearings and Appeals and Office for Civil Rights.

House speaker says HHS is ‘bloated’

U.S. House Speaker Mike Johnson, R-La., posted on social media that he fully backed the changes in store for HHS.

​​”HHS is one of the most bureaucratic and bloated government agencies,” Johnson wrote. “@SecKennedy is bringing new, much-needed ideas to the department by returning HHS to its core mission while maintaining the critical programs it provides Americans.”

Advocates shared Democrats’ concern about the staff cutbacks.

Stella Dantas, president of the American College of Obstetricians and Gynecologists, released a statement saying the organization was “alarmed by the sudden termination of thousands of dedicated HHS employees, whose absence compounds the loss of thousands of fellow employees who have already been forced to leave U.S. health agencies.”

“Thanks to collaboration with HHS, ACOG has been able to contribute to advances in the provision of maternal health care, broadened coverage of critical preventive care, increased adoption of vaccines, raised awareness of fetal alcohol syndrome, strengthened STI prevention efforts, and more,” Dantas wrote. “This attack on public health—and HHS’ ability to advance it—will hurt people across the United States every single day.”

Originally Published on News From The States

All States Newsroom content is free to republish, as per our policy. 

https://www.newsfromthestates.com/article/us-department-health-and-human-services-slash-10000-jobs-close-5-regional-offices

Is there an “epidemic of chronic disease”?

When I practiced medicine, I and other professionals treated “chronic disease” daily. The number of people who live with a specific chronic disease varies, but the number and percentage of the population who have a chronic disease doesn’t seem to change much.

While we will always work to eliminate chronic disease, that will likely be impossible, at least soon. But improved treatments and lifestyle changes do help people with chronic diseases live longer, and healthier.

Key prevention points from the CDC

  • Most chronic diseases are caused by a short list of risk factors: tobacco use, poor nutrition, physical inactivity, and excessive alcohol use.
    • By avoiding these risks and getting good preventive care, you can improve your chance of staying well, feeling good, and living longer.
examples of ways to reduce the risk of a chronic disease, breast cancer.
Cover Image

The cover image is from the CDC website. It represents hypertension, high blood pressure, one of the most prevalent chronic medical conditions.

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