Tag: measles

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.

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Dr. Aletha

The United States Is No Longer Measles-Free

Did you know the U.S. may lose its measles-free status due to a significant outbreak affecting over 2,400 people? Dr. Ralph Abraham, the new CDC deputy, downplays this issue, attributing it to unvaccinated communities. Experts express concern over rising cases and stress the importance of vaccines amid loosening requirements.

This information is current as of the date of original publication or update but may have changed by the time you read this. Do not use this information for diagnosis or treatment purposes. Before making health decisions, discuss with a qualified healthcare professional.

I’m sharing this article originally published on KFF Health News. I have added hyperlinks for additional context. I have also added additional information for context, these are indicated in italics

As US Is Poised To Lose Measles-Free Status, RFK Jr.’s New CDC Deputy Downplays Its Significance

By Amy Maxmen January 21, 2026

After a year of ongoing measles outbreaks that have sickened more than 2,400 people, the United States is poised to lose its status as a measles-free country.

However, the newly appointed principal deputy director at the Centers for Disease Control and Prevention, Dr. Ralph Abraham, said he was unbothered by the prospect at a briefing for journalists this week.

Before entering public office, Abraham practiced medicine and veterinary medicine for decades. He represented Louisiana in Congress from 2014 to 2020 and was appointed surgeon general of Louisiana last year.

“It’s just the cost of doing business with our borders being somewhat porous for global and international travel,” Dr. Abraham said. “We have these communities that choose to be unvaccinated. That’s their personal freedom.”

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

Infection from Abroad vs. Domestic

Infections from other countries, however, accounted for only about 10% of measles cases detected since Jan. 20, 2025, the official start of the deadly measles outbreak in West Texas, which spread to other states and Mexico. The rest were acquired domestically.

This marks a change since the U.S. eliminated measles in 2000. Measles occasionally popped up in the U.S. from people infected abroad, but the cases rarely sparked outbreaks, because of extremely high rates of vaccination. Two doses of the measles, mumps, and rubella vaccine strongly prevent infection and halt the virus’s spread.

Measles DNA detectives

To maintain its measles elimination status, the U.S. must prove that the virus has not circulated continuously in the nation for a year, between Jan. 20, 2025, and Jan. 20, 2026. To answer the question, scientists are examining whether the major outbreaks in South Carolina, Utah, Arizona, and Texas were linked.

Health officials confirmed that the main measles virus strain in each of these outbreaks is D8-9171. But because this strain also occurs in Canada and Mexico, CDC scientists are now analyzing the entire genomes of measles viruses — about 16,000 genetic letters long — to see whether those in the United States are more closely related to one another than to those in other countries.

The CDC expects to complete its studies within a couple of months and make the data public. Then the Pan American Health Organization, which oversees the Americas in partnership with the World Health Organization, will decide whether the U.S. will lose its measles elimination status. And that would mean that costly, potentially deadly, and preventable measles outbreaks could become common again.

(However, the United States has withdrawn from the World Health Organization.)

Reponse from Infection Experts

“When you hear somebody like Abraham say ‘the cost of doing business,’ how can you be more callous,” said pediatrician and vaccine specialist Paul Offit, in an online discussion hosted by the health blog Inside Medicine on Jan. 20, 2026.

Dr. Offit is the Director of the Vaccine Education Center and an attending physician in the Division of Infectious Diseases at Children’s Hospital of Philadelphia, as well as a Professor of Pediatrics at the University of Pennsylvania School of Medicine.

“Three people died of measles last year in this country,” Dr. Offit added. “We eliminated this virus in the year 2000 — eliminated it. Eliminated circulation of the most contagious human infection. That was something to be proud of.”

Jennifer Nuzzo, director of the Pandemic Center at Brown University, disparaged the Trump administration’s focus on finding genetic technicalities that may spare the country’s measles-free status. “This is the wrong thing to pay attention to. Our attention has to be on stopping the outbreaks,” she said.

“If we keep our status, it should be because we have stopped the spread of measles,” she said. “It’s like they’re trying to be graded on a curve.”

Jennifer Nuzzo is a nationally and globally recognized leader on global health security, public health preparedness and response, and health systems resilience.

HHS and CDC Vaccine Policy Shifts

Dr. Abraham said vaccination remains the most effective way to prevent measles but that parents must have the freedom to decide whether to vaccinate their children. Several states have loosened school vaccine requirements since 2020, and vaccine rates have dropped. A record rate of kindergartners, representing about 138,000 children, obtained vaccine exemptions for the 2024-25 school year.

CDC recommended measles vaccination for children

Information on vaccines has been muddied by Health and Human Services Secretary Robert F. Kennedy Jr., who previously founded an anti-vaccine organization. He has undermined vaccines throughout his tenure. On national television, he has repeated scientifically debunked rumors that vaccines may cause autism, brain swelling, and death.

The Trump administration impeded the CDC’s ability to assist West Texas during the first critical weeks of its outbreak and slowed the release of federal emergency funds, according to KFF Health News investigations.

However, the agency stepped up its activity last year, providing local health departments with measles vaccines, communication materials, and testing. Dr. Abraham said HHS would give South Carolina $1.5 million to respond to its outbreak, which began nearly four months ago and had reached 646 cases as of Jan. 20.

If the CDC’s genomic analyses show that last year’s outbreaks resulted from separate introductions from abroad, political appointees will probably credit Kennedy for saving the country’s status, said Demetre Daskalakis, a former director of the CDC’s national immunization center, who resigned in protest of Kennedy’s actions in August.

And if studies suggest the outbreaks are linked, Daskalakis predicted, the administration will cast doubt on the findings and downplay the reversal of the country’s status: “They’ll say, who cares.”

Indeed, at the briefing, Dr. Abraham told a reporter from Stat that a reversal in the nation’s status would not be significant: “Losing elimination status does not mean that the measles would be widespread.”

Data shows otherwise. Case counts last year were the highest since 1991, before the government enacted vaccine policies to ensure that all children could be protected with measles immunization.

Lauren Sausser contributed reporting.

Amy Maxmen, KFF Health News public health local editor and correspondent, covers efforts to prevent disease and improve well-being outside of the medical system, and the obstacles that stand in the way. Before joining KFF Health News in 2024, she was a senior reporter at Nature covering health inequities, global health, infectious diseases, and genomics. She earned a Ph.D. from Harvard University in evolutionary biology.

This story also ran on Healthbeat. It can be republished for free.

Oklahoma Voice shared this story.

Measles, Mumps, Rubella Vaccination Recommendation Summary

Images in this Post

The cover illustration is a 3D graphic representation of a spherical-shaped, measles virus particle, that was studded with glycoprotein tubercles. Those tubercular studs colorized maroon, are known as H-proteins (hemagglutinin), while those colorized gray, represented what are referred to as F-proteins (fusion).

The F-protein is responsible for fusion of the virus and host cell membranes, viral penetration, and hemolysis. The H-protein is responsible for the binding of virions to cells. Both types of proteinaceous studs are embedded in the particle envelope’s lipid bilayer.

Illustrator: Alissa Eckert, Content provider:CDC/ Allison M. Maiuri, MPH, CHES, 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.

Use this search box for related posts on this blog or other topics of interest to you.

Dr. Aletha