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the (299), and (123), cases (118), outbreak (75), clinical (61), foi (56), #confirmed (54), with (52), have (50), this (50), 2026 (49), july (49), for (46), reported (45), read (44), has (44), year (42), more (41), been (40), week (39), you (36), states (35), from (35), state (34), cdc (34), measles (33), cyclosporiasis (33), national (32), are (31), may (30), that (29), issue (28), edition (26), new (24), alert (23), last (22), michigan (22), min (22), since (21), not (21), when (21), total (21), health (20), ohio (19), county (18), across (17), case (17), each (17), than (17), cluster (17), briefing (16), two (16), send (16), 000 (16), season (16), day (16), june (16), news (15), data (15), recall (15), vaccine (15), there (15), disease (14), first (14), something (14), get (14), same (14), reporting (14), date (14), virus (14), 2025 (14), west (14), all (13), utah (13), south (13), welcome (13), urgent (13), breaks (13), interest (13), under (13), taylor (13), farms (13), flu (12), 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jul 8 2026 7 min read foi clinical issue 22 jul 1 2026 8 min read foi clinical issue 21 jun 23 2026 5 min read foi clinical issue 20 may 19 2026 3 min read advisory bundibugyo ebolavirus outbreak and hantavirus update may 7 2026 6 min read advisory andes hantavirus mv hondius cruise ship outbreak apr 9 2026 9 min read more on rsv activity apr 1 2026 5 min read foi clinical issue 8 mar 25 2026 7 min read foi clinical issue 7 mar 18 2026 7 min read foi clinical issue 6 mar 11 2026 6 min read foi clinical issue 5 feb 16 2026 4 min read seasonal vaccine effectiveness what the data shows feb 14 2026 1 min read alert extensively drug resistant salmonella linked to moringa powder capsules jan 19 2026 2 min read what to expect caitlin rivers foi clinical issue 28 welcome to the twenty eighth edition of foi clinical each week we ll send you a briefing on outbreak news when something urgent breaks you ll get an alert the same day in this issue measles cyclosporiasis and other foodborne illnesses covid 19 west nile virus powassan in northern states dengue in southern states ebola in the democratic republic of congo national interest measles measles continues to exceed recent records with 2 566 confirmed cases so far this year exceeding last year s total of 2 289 states with currently active clusters include pennsylvania 55 reported to the national notifiable disease surveillance system last week ohio 20 and maryland 8 the last two years have been marked by large and protracted outbreaks that eventually been controlled through intensive response efforts this pattern will likely continue until vaccine coverage rises to the roughly 95 required for herd immunity that scenario seems unlikely in the near term earlier this month president trump signed an executive order recommending that the mmr vaccine be split into three separate products each to be given at a different visit no such products are available in the united states and there are no concrete plans to bring any to market nonetheless the executive order and related measures will likely undermine vaccine confidence and contribute to the years long pattern of falling coverage the executive order also proposed limiting immunization recommendations to a smaller set than is currently recommended by cdc however professional medical societies recommend maintaining the current vaccination schedule and it is state and local jurisdictions not the federal government that determine school entry requirements according to data recently released by cdc 92 4 of kindergartners have received two doses against measles mumps and rubella this figure is down from a 2019 2020 high of 95 2 in some states such as idaho coverage has fallen dramatically dropping from 90 to 75 in the last decade falling coverage is largely attributable to an increase in non medical exemptions which many state legislatures have moved to loosen in recent years source cdc cyclosporiasis and other foodborne illnesses although a month has passed since taylor farms recalled shredded and iceberg lettuce the number of cyclosporiasis cases continues to rise according to cdc data 15 716 cases have been reported since may 1 an additional 11 841 suspected cases are under investigation a typical year sees 3 000 to 4 000 cases reported making this year by far the largest year on record nearly every state has reported cases over the last two months the geographic spread points to additional exposure sources however to date no additional sources have been identified and investigations are ongoing by state and local health departments according to the food and drug administration at least six clusters of unknown source have been reported since early july including one with over 200 associated cases the unusual number of clusters may be in part due to improved ascertainment widespread awareness about the iceberg linked outbreak may have increased testing that in turn revealed outbreaks that would have otherwise gone undetected read more gage moreno foi clinical issue 27 welcome to the twenty seventh edition of foi clinical each week we ll send you a briefing on outbreak news when something urgent breaks you ll get an alert the same day in this edition moderna mflusiva approved cyclosporiasis salmonella jalapeños measles west nile virus vibrio vulnificus louisiana legionnaires ohio nursing home ebola national interest moderna mflusiva first mrna flu vaccine approved the fda approved moderna s mflusiva mrna 1010 the world s first licensed mrna based seasonal influenza vaccine approval is split by age ages 50 64 traditional full approval based on clinical efficacy data from the fluent phase 3 trial 40 000 participants ages 65 accelerated approval with a required post licensure confirmatory trial spanning two flu seasons fda concern the trial used standard dose comparator not high dose adjuvanted vaccines recommended for that age group phase 3 efficacy the trial found a 27 relative reduction in confirmed influenza illness versus standard dose flu vaccine 48 reduction in healthcare utilization ed visits hospitalizations reactogenicity was consistent with other mrna vaccines with reported symptoms including transient fatigue myalgia arthralgia there were no new safety signals moderna expects doses available within weeks in time for the 2026 2027 flu season the mrna platform compresses vaccine manufacturing from 6 months to 2 3 months which addresses the strain mismatch problem that undermines annual vaccine effectiveness when antigenic drift occurs between strain selection and distribution the accelerated approval pathway for 65 means this age group can begin receiving mflusiva immediately with confirmatory efficacy data required post market cyclosporiasis michigan fading ohio still climbing the outbreak trajectory is diverging by state michigan s mdhhs lifted its precautionary salad advisory august 6 calling the outbreak fading michigan is now reporting 12 485 cases and 279 hospitalizations as of august 6 reported cases in ohio continue to climb 4 900 statewide as of august 4 with a second consecutive week of significant increases missouri is also heavily affected with more than 1 000 cases reported nationwide approximately 24 300 cases have been reported 13 895 confirmed 10 455 probable or under investigation across 45 states a subset of 6 358 cases in 15 states is formally linked to the taylor farms de méxico taco bell iceberg lettuce cluster the taylor farms recall remains in effect 27 states no product sample has tested positive epidemiological and traceback evidence remains the basis for the recall read more gage moreno foi clinical issue 26 welcome to the twenty sixth edition of foi clinical each week we ll send you a briefing on outbreak news when something urgent breaks you ll get an alert the same day in this edition cyclosporiasis measles west nile virus vibrio vulnificus florida dengue florida virginia tularemia long island legionnaires new york city closed ebola national interest cyclosporiasis on august 3 the michigan department of health and human services announced that two michigan residents both of whom had serious underlying medical conditions died in connection with cyclosporiasis and dehydration these are the first confirmed deaths from cyclosporiasis ever recorded in the united states in this outbreak or any previous one the department said it would not release further details about the two cases illnesses have now been reported in 45 states and the cdc has called this the largest cyclosporiasis outbreak on record in the united states a typical year sees 3 000 4 000 cases reported to the national notifiable disease surveillance system national surveillance data through the week ending july 25 show the heaviest burden in michigan 4 843 cases ohio 2 905 new york city 554 kansas 448 and florida 264 case counts reported by state and federal agencies as of early august jurisdiction cases hospitalized reported as of michigan 11 234 193 august 3 2 deaths ohio 4 013 july 31 kansas 289 12 july 22 nine state cluster under cdc investigation 1 947 98 july 27 national suspected total 18 200 423 july 29 cases reported to cdc by state health departments year to date 11 877 week ending july 25 the taylor farms de méxico recall of iceberg lettuce distributed to 27 states issued july 17 remains the only recall currently in effect no food source has been confirmed by laboratory testing an investigation into a nine state cluster which accounts for 1 947 cases and 98 hospitalizations is ongoing measles the cdc s july 30 update put the national total at 2 371 confirmed cases across 45 jurisdictions that tally exceeds the total for all of 2025 2 289 and represents the highest annual count since 1991 recent state activity pennsylvania 202 cases and the largest active outbreak in the country lancaster county accounts for roughly 92 cases 28 people have been hospitalized statewide virginia 177 cases unchanged for a second week buckingham and cumberland counties remain under active outbreak status delaware 5 cases linked to an outbreak declared on july 22 all are adult men in kent county four of them unvaccinated the pan american health organization has postponed its review of u s measles elimination status until november 2026 the united states will likely lose the elimination status it achieved in 2000 canada which is also experiencing extensive outbreaks lost its status last year west nile virus first death outside arizona national cases climb national surveillance recorded 143 confirmed human cases across 23 states as of august 4 up from 113 the week before the count is running roughly five to nine times higher than is typical for this point in the season read more gage moreno foi clinical issue 25 welcome to the twenty fifth edition of foi clinical each week we ll send you a briefing on outbreak news when something urgent breaks you ll get an alert the same day in this edition cyclosporiasis measles salmonella shell eggs west nile virus covid 19 leprosy florida legionnaires new york city vibrio vulnificus ebola cyclosporiasis nine state cluster outbreak deepens the taylor farms de méxico iceberg lettuce cluster has expanded from five to nine states indiana kentucky michigan ohio west virginia plus illinois kansas oklahoma and pennsylvania added july 22 according to cdc the cluster now stands at 1 947 confirmed cases and 98 hospitalizations with zero deaths as a reminder cdc reporting is delayed compared to state level reporting across all domestic investigations 4 173 lab confirmed cases in 41 states have been reported since may 1 state burdens as of july 27 28 jurisdiction cases hospitalized as of michigan 9 253 160 july 27 mdhhs ohio nw ohio 2 689 july 27 kansas 461 12 july 29 kdhe national lab confirmed cdc 4 173 141 july 22 nndss ytd 7 907 week 28 july 18 national surveillance recorded 2 275 cases during the most recent reporting week the highest weekly count in the past year and the first time that ceiling has been broken weekly counts have more than doubled in each of the last four weeks rising from 180 358 874 2 275 kansas has moved into the top five states nationally at 461 cases year to date reflecting continued cluster expansion johnson county accounts for 143 of the state s total recall status the taylor farms de méxico voluntary recall remains in effect across 28 states covering iceberg lettuce sourced from mexico and distributed june 29 july 16 no confirmatory positive product sample exists fda maintains six active cluster investigations only taylor farms has a named recall clinical reminders standard stool o p does not detect cyclospora request modified acid fast staining or cyclospora specific pcr explicitly tmp smx ds bid 7 10 days full clinical guidance in the foi han alert measles 35 year record cdc updated to 2 318 confirmed cases on july 23 now in 45 jurisdictions surpassing the 2025 full year total 2 289 and marking the highest annual count since 1991 read more gage moreno foi clinical issue 24 student discount training in medicine or public health foi clinical is available at 50 off for students and trainees just send a note to email protected if you think your program or library should have institutional access we d love to hear from you welcome to the twenty fourth edition of foi clinical each week we ll send you a briefing on outbreak news when something urgent breaks you ll get an alert the same day in this edition cyclosporiasis measles west nile virus covid 19 legionnaires new york city grand canyon mystery illness new world screwworm ebola marburg uganda national interest cyclosporiasis the taylor farms de méxico recall is the most significant food safety development of the 2026 outbreak season on july 17 cdc and fda traced the multistate midwest cluster spanning michigan ohio west virginia kentucky and indiana to shredded iceberg lettuce supplied by taylor farms de méxico a grower in central mexico fda reports that 90 of interviewed cases in the five state cluster reported eating iceberg lettuce taylor farms issued a voluntary recall on july 17 covering products distributed june 29 july 16 across 27 states including marketside iceberg salad and shredded lettuce sold at walmart as well as products distributed through taco bell jack in the box and sysco on july 18 a taylor farms lettuce sample not included in the recalled products tested positive on july 19 fda reversed course and announced the result was a false positive fda laboratory experts concluded the finding does not represent true amplification no microbiologically confirmed positive product sample exists the recall remains in effect fda and cdc state that epidemiological and traceback evidence overwhelmingly supports iceberg lettuce as the vehicle the five state cluster now has 1 644 cases and 94 hospitalizations per cdc reporting from individual states is substantially higher the five state cluster is distinct from a new york city cluster 403 cases which has no confirmed link to taylor farms and likely involves a separate produce source consistent with nyc s historical pattern of cyclospora outbreaks linked to raspberries and cilantro from separate importers state burdens as of july 20 21 state health department sources jurisdiction cases hospitalized as of michigan 7 171 102 july 22 mdhhs ohio nw ohio 2 029 2 149 july 21 ohio statewide 1 316 96 july 17 odh mi oh combined 8 000 july 21 new york city 403 july 10 dohmh separate cluster national confirmed cdc 1 645 141 july 13 14 national total incl under review 11 500 july 21 the most recent reporting week in nndss shows 874 cases with year to date totals at 3 713 2 5x prior year the last five weeks have seen increases from 64 73 180 358 874 thus there is no current evidence of slowing per nndss data colorado 153 ytd cases are predominantly travel associated and not linked to the taylor farms cluster cdc expects cases to continue rising through the end of august clinical reminders standard stool o p...