Gallalee S, Cranford HM, Drummond A
… +3 more, Ekpo LL, Ellis BR, Ellis EM
MMWR Morb Mortal Wkly Rep
· 2026 Jul · PMID 42391093
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Legionellosis is a bacterial disease caused by inhalation or aspiration of Legionella bacteria; Legionnaires disease is a type of legionellosis characterized by illness with pneumonia. During November 2024, the U.S. Virg...Legionellosis is a bacterial disease caused by inhalation or aspiration of Legionella bacteria; Legionnaires disease is a type of legionellosis characterized by illness with pneumonia. During November 2024, the U.S. Virgin Islands (USVI) Department of Health (VIDOH) was notified of two confirmed Legionnaires disease cases among travelers to two different hotels on St. Croix Island. VIDOH investigated to determine exposure sources and prevent additional cases. Two additional legionellosis cases were identified. The four patients with cases were aged 53-73 years; two patients were hospitalized and none died. At hotel A, L. pneumophila was detected in three of 21 (14%) environmental samples. VIDOH required hotel A to close one guest room, remediate, and retest. At hotel B, L. pneumophila was detected in 22 of 40 (55%) samples. VIDOH required hotel B to cease hotel operations until remediation and retesting were completed. L. pneumophila was isolated from shower samples at both hotels, in the cistern and cold water system at hotel A, and in cold and hot water systems at hotel B. The two USVI outbreaks underscore the importance of reporting legionellosis among returned travelers to facilitate local public health investigations and prevent additional cases. In addition, in tropical climates, cold water systems operate at temperatures favorable for Legionella growth (77°F-113°F [25°C-45°C]), highlighting the importance of effective water management programs and water system disinfection to prevent disease spread.
Alpha-gal syndrome (AGS) is an emerging, noninfectious tickborne disease characterized by an allergic reaction to galactose-α-1,3-galactose (alpha-gal), an oligosaccharide found in red (mammalian) meat and other mammalia...Alpha-gal syndrome (AGS) is an emerging, noninfectious tickborne disease characterized by an allergic reaction to galactose-α-1,3-galactose (alpha-gal), an oligosaccharide found in red (mammalian) meat and other mammalian products such as dairy and gelatin. As of 2022, AGS was estimated to affect up to 450,000 persons in the United States (1). Anaphylactic AGS reactions can be fatal, and AGS allergic reactions encompass a range of symptoms including urticaria, angioedema, wheezing, and gastrointestinal distress. AGS is primarily managed through an avoidance diet. The U.S. geographic distribution of AGS is closely associated with the range of the lone star tick (Amblyomma americanum); bites from this tick introduce alpha-gal through its saliva, which can trigger the allergy. Diagnosis of AGS requires both the presence of clinically compatible symptoms and the detection of serologic immunoglobulin E (IgE) antibodies against alpha-gal. Persons can have alpha-gal-specific IgE antibodies without clinical symptoms. The proportion of persons in the United States who are seropositive for alpha-gal IgE is unknown. To better understand the distribution and seroprevalence of alpha-gal IgE among U.S. adults, 3,000 serum samples collected during November 2024-April 2025 from blood donors living in 10 states were tested for the presence of alpha-gal IgE antibodies. States previously reported to have high numbers of suspected AGS cases were found to have correspondingly high seroprevalences. Among the 10 states, the highest estimated seroprevalences among persons aged ≥16 years were detected in Arkansas (31.2%) and Missouri (26.0%). These findings can guide the development of surveillance systems for AGS and help identify regions at increased risk.
Singichetti B, Cammack AL, Rekieta P
… +7 more, Schumacher A, van Santen KL, Kaczkowski W, Radhakrishnan L, Anderson KN, Ballesteros MF, Lee R
MMWR Morb Mortal Wkly Rep
· 2026 Jun · PMID 42348443
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Suicide is a substantial public health problem. In 2024, approximately 49,000 persons died by suicide in the United States, and an estimated 2.9 million persons aged ≥12 years reported having attempted suicide. Emergency...Suicide is a substantial public health problem. In 2024, approximately 49,000 persons died by suicide in the United States, and an estimated 2.9 million persons aged ≥12 years reported having attempted suicide. Emergency department (ED) visits for suspected suicide attempts among adolescents increased during 2020-2021, then decreased in 2022; reports based on more recent data, including ED visits for suicide attempts among older age groups, are lacking. National Syndromic Surveillance Program data were examined overall and by sex and age group to identify changes in ED visits for suspected suicide attempts. During 2021-2025, numbers of ED visits for suspected suicide attempts and proportions of those visits among all ED visits for any reason (visit proportions) were highest among adolescents aged 12-17 years compared with other age groups and were higher among females than among males. Compared with 2021, overall visit proportions in 2025 declined 7.0%, with the largest decreases occurring among adolescents aged 12-17 years (20.8% decline) and females (10.7% decline). Visit proportions increased among adults in age groups ≥26 years (range = 1.4%-15.2%). These findings highlight the need for suicide prevention in all groups, particularly in those with high or increasing proportions of suicide attempts. Timely monitoring of suicide-related data and a comprehensive approach that both prevents suicidal behavior by addressing multiple risk and protective factors and also supports those who have attempted suicide are critical for saving lives.
Richard DM, Routledge I, Koeller S
… +6 more, Ghinai I, Hsu CH, Chatham-Stephens K, Bruce BB, Kahn R, Holmdahl I
MMWR Morb Mortal Wkly Rep
· 2026 Jun · PMID 42275278
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On May 15, 2026, the ministries of health in the Democratic Republic of the Congo and Uganda declared outbreaks of Bundibugyo virus disease (BVD), a type of Ebola disease. In response to reports of high numbers of suspec...On May 15, 2026, the ministries of health in the Democratic Republic of the Congo and Uganda declared outbreaks of Bundibugyo virus disease (BVD), a type of Ebola disease. In response to reports of high numbers of suspected cases and deaths in the affected countries, CDC assessed the risk posed by the BVD outbreak to the U.S. population during the next 3 months. This analysis used a standardized risk assessment approach that included epidemiologic data from the ongoing outbreak and historical data from previous Ebola outbreaks; the overall risk was determined by taking into account independent assessments of the likelihood of infection and the impact of infection. The assessment found that the overall risk to the U.S. population posed by the current BVD outbreak during the next 3 months is low, based on the extremely low likelihood of transmission, despite the high impact that potential infection could have and the resources that would be required to respond to the outbreak. Limitations to this assessment included uncertainties around the epidemiology of BVD as well as the current and future scope and geographic spread of the outbreak. CDC continues to monitor factors that could change this risk assessment.
Mooring EQ, Koval WT, Routledge I
… +5 more, Holmdahl I, Hudson K, España G, Kahn R, Bruce BB
MMWR Morb Mortal Wkly Rep
· 2026 Jun · PMID 42275271
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On May 15, 2026, the Ministries of Health in the Democratic Republic of the Congo and Uganda declared outbreaks of Bundibugyo virus disease (BVD), a type of Ebola disease. In response to reports of high numbers of suspec...On May 15, 2026, the Ministries of Health in the Democratic Republic of the Congo and Uganda declared outbreaks of Bundibugyo virus disease (BVD), a type of Ebola disease. In response to reports of high numbers of suspected cases and deaths in these outbreaks, CDC simulated scenario projections to understand possible future morbidity and mortality. A branching process model with the capacity to model transmission-reducing nonpharmaceutical interventions was calibrated to three putative cumulative death counts and projected for four possible intervention scenarios ranging from poor (20%) to extremely high (95%) levels of isolation and treatment of symptomatic persons. The analysis suggested a plausible spillover event (i.e., the transmission of a virus from its natural animal reservoir to humans) in mid to late February 2026. With poor isolation levels of patients with BVD (20%) and no other interventions, the likelihood of an outbreak that exceeds 20,000 cases within 3 months is 65%. If, however a high proportion of patients were to enter isolation (70%), only a one in 20 chance is projected for an outbreak with ≥10,000 cases within 3 months. These results underscore the importance of strong public health interventions, because the current outbreak is already the largest known BVD outbreak and has the potential to quickly become one of the largest Ebola disease outbreaks ever recorded.
Morse M, Zartarian M, Savage B
… +14 more, O'Connor P, Nicholas D, Jones H, Gil C, Wroblewski D, Chmura S, Biswas N, Bocketti C, Willard G, Blumerman S, Hattenrath T, Gowie D, Mingle L, Lauper U
MMWR Morb Mortal Wkly Rep
· 2026 Jun · PMID 42275248
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In mid-October 2024, the New York State Department of Health (NYSDOH) was notified of two cases of Legionnaires disease in persons who stayed at the same short-term vacation rental property and had both used the rental p...In mid-October 2024, the New York State Department of Health (NYSDOH) was notified of two cases of Legionnaires disease in persons who stayed at the same short-term vacation rental property and had both used the rental property's hot tub. The diagnoses were confirmed by urine antigen tests, and NYSDOH successfully isolated Legionella pneumophila serogroup 1 from the sputum of one patient. Local health department staff members collected three samples from three sinks and two samples from two showers to assess the rental property's potable water system, which was supplied by a private well. Three samples were also collected from the rental property's hot tub. Whole genome sequencing of isolates from the hot tub samples and the sputum specimen were closely related, suggesting that the hot tub was the likely source of exposure. Hot tubs create aerosols and typically maintain water temperatures of approximately 100°F-104°F (38°C-40°C). This temperature is within the most favorable range for Legionella growth and also accelerates the decay of disinfectants. Guidance from NYSDOH and CDC regarding proper operation, disinfection, and remediation of hot tubs was provided to the rental property owner. NYSDOH recommended that the owner close the hot tub until proper remediation was performed and postremediation samples without detection of any Legionella bacteria were collected by NYSDOH staff members. The rental property owner did not initially comply with NYSDOH recommendations, and a public nuisance law was used to ensure that proper measures were taken to disinfect the hot tub before use by future guests. Activities to raise awareness among short-term rental and vacation rental property owners regarding the risks associated with an improperly managed hot tub are needed to decrease the likelihood that rental property hot tubs are in a condition that is conducive to Legionella growth and reduce the risk for Legionnaires disease associated with vacation rental stays. Travelers staying in vacation rental properties should be aware that use of hot tubs might pose a risk for Legionnaires disease and exercise caution when using hot tubs, particularly those travelers with underlying medical conditions.
Thomas SA, Gosdin LK, Terplan M
… +2 more, Kim SY, Deputy NP
MMWR Morb Mortal Wkly Rep
· 2026 Jun · PMID 42275246
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Alcohol consumption during pregnancy can cause adverse birth outcomes and fetal alcohol spectrum disorders. One U.S. study identified a slight increasing trend in alcohol consumption during pregnancy from 2011 to 2018. D...Alcohol consumption during pregnancy can cause adverse birth outcomes and fetal alcohol spectrum disorders. One U.S. study identified a slight increasing trend in alcohol consumption during pregnancy from 2011 to 2018. During 2018-2020, 13.5% of pregnant women reported current drinking; more recent estimates are unavailable. CDC analyzed 2021-2024 Behavioral Risk Factor Surveillance System data to estimate prevalence of self-reported current drinking (one or more alcoholic drinks during the past 30 days), binge drinking (four or more alcoholic drinks on at least one occasion during the past 30 days), and heavy drinking (eight or more alcoholic drinks within 1 week during the past 30 days) among U.S. pregnant women aged 18-49 years. Multivariable regression was used to estimate adjusted prevalence ratios and identify correlates of alcohol consumption during pregnancy. Among U.S. pregnant women, 15.2% reported current drinking, 4.9% reported binge drinking, and 2.2% reported heavy drinking during the past 30 days. Higher prevalences of alcohol consumption were observed among pregnant women who were not married and those with frequent mental distress. Alcohol consumption during pregnancy remains a public health concern. Both clinical and community interventions might help reduce alcohol consumption during pregnancy and its associated adverse health outcomes.
During 2025, the United States recorded the highest number of measles cases since measles elimination was declared in 2000. On March 21, 2025, Lubbock Public Health (LPH) in Texas received a report of a child care attend...During 2025, the United States recorded the highest number of measles cases since measles elimination was declared in 2000. On March 21, 2025, Lubbock Public Health (LPH) in Texas received a report of a child care attendee aged 3 years, with fever, rash, cough, coryza, conjunctivitis, otitis media, and diarrhea who received a positive test result for measles by real-time reverse transcription-polymerase chain reaction (RT-PCR). Six additional children who attended the same child care facility and the grandfather of one of the children were confirmed by RT-PCR testing to have measles. None of the patients was reported to have traveled. LPH contacted the pediatric patients' caregivers to conduct case investigations and provided recommendations to the child care facility for home isolation, vaccination, and testing. LPH also communicated with caregivers, other child care facilities in the area, and the public to raise awareness. The child care facility implemented measures to minimize transmission, including separating children who were not yet eligible for the measles, mumps, and rubella vaccine; minimizing the use of shared spaces; and monitoring signs and symptoms. Collaboration between public health and community partners such as child care facilities can facilitate a rapid response and control of infectious disease outbreaks.
Wang D, Rogers CC, Lutz CS
… +20 more, Sajewski ET, Almas S, Clemmons NS, Gressick KA, Hernandez C, Holbrooks Z, Kidd MT, Martínez DL, McClaran K, Mendoza E, Milton JS, Northcott KD, Raines K, Rai S, Wells K, Sugerman DE, Crisp C, Shetty V, Filardo TD, Shuford JA
MMWR Morb Mortal Wkly Rep
· 2026 May · PMID 42207686
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Measles is a highly infectious respiratory virus with the potential to cause severe illness resulting in hospitalization or death. On January 29, 2025, the Texas Department of State Health Services Public Health Region 1...Measles is a highly infectious respiratory virus with the potential to cause severe illness resulting in hospitalization or death. On January 29, 2025, the Texas Department of State Health Services Public Health Region 1 was notified by the South Plains Public Health District of a case of measles in an unvaccinated school-aged child. During January 20-March 18, 2025, a total of 325 confirmed measles cases were reported; 60 (18.5%) patients were hospitalized. Available medical records for 54 hospitalized patients were reviewed; 49 (90.7%) were aged <18 years, and 48 (88.9%) had no underlying medical conditions. All 54 were unvaccinated or had unknown vaccination status. Hospitalized patients were admitted for a median of 2 days (range = 0-20 days) and many experienced complications, including pneumonia (39; 72.2%), dehydration (25; 46.3%), hepatitis (one; 1.9%), and febrile seizures (one; 1.9%). Thirty-eight (70.4%) hospitalized patients required supplemental oxygen, four (7.4%) were admitted to an intensive care unit, two (3.7%) required intubation and mechanical ventilation, and one (1.9%) died. Although most persons with confirmed measles were not hospitalized, approximately one in five required hospitalization, consistent with previously reported rates. Vaccination remains a critical tool for the prevention of measles infection and severe disease.
MMWR Morb Mortal Wkly Rep
· 2026 May · PMID 42207678
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The genus Amanita contains approximately 600 species of mushrooms, including some that produce amatoxins, which can lead to liver failure and death when ingested. Poisonous mushrooms often resemble and are difficult to d...The genus Amanita contains approximately 600 species of mushrooms, including some that produce amatoxins, which can lead to liver failure and death when ingested. Poisonous mushrooms often resemble and are difficult to distinguish visually from nonpoisonous, edible mushrooms. After above-average late November 2025 rainfall in California, regional mycologists observed numerous Amanita mushroom blooms in regional parks and area wildlands. On November 18, 2025, specialists at the San Francisco division of the California Poison Control System (CPCS) suspected amatoxin-containing mushroom poisoning in two patients who gastrointestinal symptoms and hepatotoxicity after eating foraged wild mushrooms. Over the next 17 weeks (November 18, 2025-March 17, 2026), 39 cases of suspected amatoxin mushroom poisoning in patients who had eaten foraged wild mushrooms were reported to CPCS. These 39 cases were characterized by a pattern of delayed onset of gastrointestinal symptoms and hepatotoxicity; 32 (82%) patients recovered, three (8%) required liver transplants, and four (10%) died. CPCS and the California Department of Public Health Toxicological Outbreak Program coordinated a response that included a statewide health advisory and educational materials translated into multiple languages for the public; collectively, the affected patients spoke at least six languages other than English. This is the largest reported outbreak of mushroom-associated hepatotoxic poisoning in California history and the largest in the United States in several decades. This was also the first outbreak of this size in which some persons ate Amanita ocreata, another poisonous Amanita species. The morbidity and potential lethality associated with amatoxin-containing mushroom ingestion is a serious public health concern. Educational materials, including for non-English-speaking communities, during the late fall to mid-spring when fruiting of amatoxin-containing mushrooms occurs, might reduce the number of poisonings.
Holman DM, Boring MA, Julian AK
… +3 more, Moser RP, Peterson KT, Perna FM
MMWR Morb Mortal Wkly Rep
· 2026 May · PMID 42166354
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Sunburn is an important risk factor for skin cancer. Understanding sunburn prevalence and the contexts in which sunburn commonly occurs might help guide the development and implementation of sun safety interventions. Dat...Sunburn is an important risk factor for skin cancer. Understanding sunburn prevalence and the contexts in which sunburn commonly occurs might help guide the development and implementation of sun safety interventions. Data from the 2024 National Health Interview Survey sample adult questionnaire were analyzed to describe the prevalence of one or more and four or more sunburns among U.S. adults during the previous 12 months and the percentages of U.S. adults who experienced their most recent sunburn while they were working at their job; intentionally tanning; exercising; spending time in, on, or near water; using sunscreen; or drinking alcohol. Overall, an estimated 88.1 million (35.1%) U.S. adults had at least one sunburn during the previous 12 months, and 18.8 million (7.5%) had four or more sunburns. Among adults who experienced sunburn during the previous year, spending time in, on, or near the water was the most frequently reported context of their most recent sunburn (60.6%); followed by exercising (24.7%); drinking alcohol (17.6%); intentionally tanning (15.9%); and working at their job (12.9%). Approximately one half (55.1%) of respondents reported that their most recent sunburn occurred despite using sunscreen. These findings can help guide research and activities to adapt, tailor, and expand evidence-based interventions to improve use of sun protection, prevent sunburn, and reduce skin cancer risk.
MMWR Morb Mortal Wkly Rep
· 2026 May · PMID 42166353
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The emergence of antibiotic-resistant organisms is a substantial public health concern because these organisms can cause severe, difficult-to-treat infections and spread easily in congregate settings. In January 2025, an...The emergence of antibiotic-resistant organisms is a substantial public health concern because these organisms can cause severe, difficult-to-treat infections and spread easily in congregate settings. In January 2025, an outbreak of carbapenemase-producing Enterobacterales (CPE) infection and colonization was identified in a long-term care facility (LTCF) in Ontario, Canada, after a resident's urine culture grew Escherichia coli carrying the Klebsiella pneumoniae carbapenemase (KPC) gene. An investigation by the local public health agency in Windsor, Ontario, revealed that the source of infection was likely another patient with KPC-producing K. pneumoniae infection who had been admitted to the LTCF 1 year earlier without appropriate infection prevention and control precautions. The epidemiologic link between the two patients triggered unitwide screening. Three additional asymptomatic carriers who had not previously received CPE testing were identified during point-prevalence screening. All five affected residents were older adults with multiple comorbidities (including patients with frequent antibiotic use or an indwelling device such as a urinary catheter) who lived in the same unit and shared multiple potential exposure sources that likely contributed to the spread. Potential sources included overlapping staff member assignments, use of a common-area bathroom, and shared dining facilities. Whole genome sequencing confirmed the outbreak. Public health responses included rapid implementation of contact precautions, staff member cohorting, enhanced environmental cleaning, ensuring compliance with enhanced infection prevention and control practices, and risk communication with facility staff members, which halted further spread; evidence does not support the use of antimicrobials or other methods to decolonize asymptomatic CPE carriers. The outbreak highlighted the need for risk-based admission screening of LTCF residents, consistent infection-prevention practices, and antibiotic stewardship. Strengthening these practices can help prevent prolonged undetected transmission and reduce the incidence of CPE infection in congregate care settings.
Rolfes MA, Bauck L, Lipton BA
… +12 more, Margrey SF, Campagna RA, Harker E, Basler CA, Dewart CM, Ellington SR, Holzbauer SM, Ireland MJ, Kuo JW, Szablewski CM, Durand LO, Reed C
MMWR Morb Mortal Wkly Rep
· 2026 May · PMID 42133554
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Many U.S. households keep backyard bird flocks for their personal food supply or as garden partners. Backyard flocks in the United States have occasionally been infected with avian influenza A viruses, putting flock owne...Many U.S. households keep backyard bird flocks for their personal food supply or as garden partners. Backyard flocks in the United States have occasionally been infected with avian influenza A viruses, putting flock owners at risk for exposure. During July-December 2025, CDC, in collaboration with state health and agricultural partners, conducted an online survey to learn more about backyard flock owners and their knowledge, attitudes, and practices related to avian influenza. Among 638 respondents who completed the survey, 92% were White (and not Hispanic or Latino), and approximately one half had a graduate or professional degree; a majority kept small, predominantly chicken flocks; and many reported that wild birds could access their flock or the flock's food or water, which increases the flock's risk for avian influenza exposure. Although a majority of respondents had heard of avian influenza, approximately one third were unaware of the signs and symptoms of infection in their birds or humans. If they needed to interact with ill or dead birds, a majority of owners knew the recommended precautions to take and indicated willingness to use most, though not all, recommended personal protective equipment. These findings highlight important topics for risk messaging and educational resources so that backyard flock owners are better informed and better able to protect their flocks, themselves, and their families from avian influenza.