r/ContagionCuriosity

Michigan is reporting its first human case of Eastern equine encephalitis, also known as EEE, in five years, with the recent diagnosis of someone who lives in Roscommon County.

That diagnosis might also be the first human case in the U.S. this year.

"EEE is one of the most dangerous mosquito-borne diseases in the U.S., with a 30% fatality rate among people who become ill," said Dr. Natasha Bagdasarian, the state's chief medical executive. An EEE outbreak in Michigan during 2019 resulted in 10 human cases, including six fatalities, along with 46 animal cases.

Eastern equine encephalitis is among the mosquito-borne viruses that can cause illness in both animals and, less frequently, in humans. The Michigan Department of Health and Human Services, which reported the human case on Wednesday, said it had not confirmed any animal-related cases so far this year. There were cases confirmed in domestic horses in Michigan during 2023, 2024 and 2025.

As of mid-August, the Centers for Disease Control had not recorded any human cases for 2026. An average of 11 human cases is reported to the agency each year. "Due to delays in reporting, state, territorial, and local health departments may have more up-to-date information," the CDD added.

Roscommon County is in Northern Lower Michigan.

Michigan officials said state and local health departments are working with the Michigan Department of Agriculture and Rural Development and the Michigan Department of Natural Resources to monitor for signs of EEE in humans, mosquitoes, domestic animals, and wildlife. The stepped-up efforts in Roscommon County include additional mosquito trapping and testing beyond the routine weekly mosquito population checks already scheduled for the season.

Mosquito population checks in Michigan so far this year have found signs of West Nile virus and Jamestown Canyon virus. State officials said they have also found birds and a squirrel that tested positive for West Nile virus this year in Michigan. [...]

If you want to know how bad a future tick season will be, it may be more useful to count the number of acorns on the ground than the number of deer in the forest.

That’s one of several surprising findings to emerge from more than 30 years of tracking ticks, mice, deer, and weather in a Lyme disease hot spot. The findings, published this week in PNAS, challenge long-held ideas about what drives Lyme disease risk.

For the study, researchers from the Cary Institute of Ecosystem Studies and Bard College analyzed decades of data from a forested area in New York’s Hudson Valley. The long span of the study enabled researchers to track trends over time.

“Studies of this depth and length are incredibly rare,” says study coauthor and co-director of the Cary Institute of Ecosystem Studies, Shannon LaDeau, PhD, in an institute news release. “This research has followed an ecological community—including oak trees, mammals, and microorganisms—examining how interactions like predation, parasitism, and competition shape the system over time.”

“The evolution of understanding summarized in this paper is something you simply cannot get without such a long-term and system-focused study,” she added.

4 findings that upend risk assumptions

#1. More deer don’t mean more dangerous ticks

It’s long been assumed that more deer equal more ticks, because when deer are abundant, more female ticks are able to feed and lay eggs on them. That would lead to more larval ticks the following summer, the theory goes—and, in turn, more nymphal ticks two years later. Nymphal-stage ticks are responsible for most human infections in North America.

But after observing more than a sixfold variation in deer abundance over the course of the study, the researchers found no relationship between the number of deer and the density of nymphs. [...]

#2. Mice matter, but so do squirrels and skunks and opossums…

White-footed mice are very good at passing the bacterium that causes Lyme disease (Borrelia burgdorferi) to larval ticks, so researchers expected that mouse-abundant years would lead to more infected nymphal ticks.

But in the study, the number of mice didn’t predict the proportion of nymphal ticks infected with B burgdorferi. Instead, the rate of infection appeared to depend on how larval ticks were distributed across the entire community of small mammals who serve as hosts for the bacteria.

In years when mice are abundant, other hosts, like skunks and squirrels, might be more abundant, too. But those other hosts aren’t very good at spreading B burgdorferi to ticks. So the higher their numbers, the lower the rate of Lyme bacteria in nymphal ticks.

Mice did, however, strongly predict the number of nymphal ticks. A strong mouse year was associated with approximately 40% more nymphs the following year.

#3. Acorns play an outsized role

Mice feed on acorns that fall from large red oaks. When a large number of oak trees drop their acorns at the same time, it creates an endless buffet for mice. All those hearty meals help boost the mouse population the following year and, in turn, the number of nymphal ticks the year after that. [...]

#4. Warmer weather doesn’t simply mean more ticks

Previous laboratory studies have shown that extreme heat and cold can kill black-legged ticks, which suggests that severe seasonal temperatures may help determine tick abundance. But ticks outsmart frigid winters and steamy spring days by burrowing into the soil, write the researchers. The current findings suggest that neither extremely cold winter days nor extremely warm spring days predicted nymphal tick density.

But in the warmest years, mice had roughly 45% fewer nymphal ticks than in colder years. “ [...]

Between 2016 and 2018, more than 2,000 people fell ill with yellow fever in Brazil, and nearly 750 of them died. It was the country’s first urban outbreak of the disease in decades.

Now, scientists have proposed a possible explanation of how the deadly epidemic unfolded. In a study published August 14 in the journal Science Advances, they make the case that an extreme, once-in-a-century drought may have helped the disease proliferate.

Based on computer simulations, the scientists suspect that the drought changed the behavior of forest-dwelling howler monkeys, marmosets and mosquitoes, which are all vectors of the virus that causes yellow fever. With little water available in the forest, these nonhuman primates and insects likely increasingly headed toward urban areas in search of the vital liquid. Additionally, the mosquitoes may have started biting more to avoid drying out. Together, these behavioral changes probably contributed to the spread of yellow fever among humans, according to the researchers.

The paper “makes a really strong case” for this scenario, Noah Rose, an ecologist at the University of California, San Diego who was not involved with the research, tells Science’s Ailie McWhinnie. “It’s a cool and somewhat surprising result.”

Scientists know that excess rainfall can increase the risk of mosquito-borne disease transmission by creating stagnant pools of water that serve as ideal breeding grounds for the blood-sucking bugs. However, in addition to very wet conditions, the new study hints that extremely dry conditions may also influence the spread of disease—an important consideration in the face of human-caused climate change, which is contributing to more frequent and more severe droughts.

“We’re going to be seeing more scenarios where it gets drought-y enough for long enough that it’s going to promote [similar types of] coincidences,” Sadie Ryan, a medical geographer at the University of Florida who was not involved with the research, tells Science News’ Erin Garcia de Jesús.

[...]

Real-world evidence seems to support the researchers’ conclusions. Brazil’s recent urban outbreak was driven primarily by forest-dwelling Haemagogus mosquitoes, not A. aegypti, which is unusual. “And anecdotally, there were a lot more primate carcasses in and around the city than normal,” hinting that the animals were emerging from the forest, lead study author Jamie Caldwell, a disease ecologist at Princeton University, tells Science.

However, drought was likely only one of the outbreak’s contributing factors, David Soeiro, an epidemiologist at the Federal University of Minas Gerais who was not involved in the study, tells the outlet. In addition to low vaccination coverage because yellow fever had been managed well in the country, he also points to warming temperatures that likely boosted mosquito reproduction, as well as increased human encroachment into the forest due to deforestation.

Even so, the study authors say their findings could have important real-world implications. Since drought is a relatively slow-moving process, it gives public health officials plenty of time to take action.

“It can build over months or even years,” Caldwell tells Durrie Bouscaren for NPR’s “All Things Considered.” “And so that actually gives us a lot of lead time to get vaccines, for instance, and distribute them to the population where it’s needed.”

The number of confirmed Ebola cases in ​the Democratic Republic of Congo now exceeds 5,000, government data showed late on Tuesday, as health ​officials ‌warn that response efforts are ⁠failing to contain the deadly disease.

Congo’s 17th Ebola epidemic ‌turned into the biggest in the country’s history ⁠in terms of number of cases in late July and over the weekend ​the death toll hit 2,378, ‌the public health institute said, surpassing the previous worst outbreak in 2018-2020.

The institute has so far ‌logged 5,021 cases, according to its latest situation report, making ​it the second-worst outbreak globally, behind only the 2014 to 2016 epidemic in West Africa in both ​infections and deaths.

The ongoing outbreak is ​caused by the Bundibugyo species ​of Ebola, which has no approved vaccines or treatments.

It has ​gained momentum since it was declared on May 15, as weak health infrastructure, community resistance, instability and protests by response workers hinder efforts ⁠to identify and respond to cases.

Sweden’s Public Health Agency said Wednesday it had recorded 21 cases of measles connected to a folk music festival in the country’s north.

The agency said the cases were reported in several regions but all connected to the music festival Urkult, which was held in the north of Sweden in late July and early August.

A majority of those affected were under the age of 18 and most of the cases involved people who had not been vaccinated.

“Outbreaks of measles are rare. Vaccination against measles is included in the national childhood vaccination programme, and vaccination coverage is around 95 percent,” the health agency said in a statement.

It added that regional health authorities were carrying out contact tracing in order to limit the spread.

Measles causes fever, respiratory symptoms and skin rashes.

In some cases, it can also lead to more severe complications, including pneumonia and brain inflammation, which can lead to serious long-term impacts and death.

Untraced outbreaks of the “explosive diarrhea” illness cyclosporiasis are still on the rise, even as the Trump administration says nationwide spread has been “contained.”

The largest outbreak - which began in Michigan in May and has been tied to contaminated iceberg lettuce from a Taylor Farms facility in Mexico - has slowed over the past month, according to data from state health officials.

However smaller outbreaks, caused by unknown food sources, are still growing in number since they were first reported in July, according to the U.S. Food and Drug Administration last week.

It’s not clear where these outbreaks are because the FDA has yet to attach states to the data. But the agency says it is investigating potential causes and products that could be linked.

While FDA investigations into the outbreaks are underway, top Trump health officials have said that the U.S. food supply remains safe and that fresh produce is safe to eat. Health Secretary Robert F. Kennedy, Jr. told reporters last month that the situation is “under control.”

[...]

People in 40 states have fallen ill with cyclosporiasis this year after being exposed to the microscopic parasite cyclospora. More new cases were reported this week in Hawaii, Wisconsin and Nebraska.

There are currently close to 25,000 cases in the U.S., according to the Centers for Disease Control and Prevention.

Michigan - the epicenter of a major outbreak - has seen nearly 14,000 of those cases, as well as the only two deaths from infections so far.

Three smaller outbreaks total in the dozens or hundreds of cases, the FDA data shows. The largest increased by 60 cases this month, totaling 172 people who have fallen ill.

https://archive.is/llAXX

A person has died and hundreds have fallen ill with salmonella food posioning in an outbreak that UK experts believe is linked to eating food made with imported eggs.

The UK Health Security Agency has launched an investigation into the 207 cases it has seen in the past year, with most recorded in recent weeks.

More than a third of those affected - some babies and others as old as 90 - have needed hospital care, with two developing serious blood poisoning. Most people get better without treatment, however.

While salmonella cases can happen any time, this outbreak involves a specific, identical strain.

[...]

It is more unusual to see an outbreak like this linked to one specific strain of the bacterium affecting many people at one time.

The UKHSA says "extensive" epidemiological and food chain investigations are ongoing to identify the source but that egg consumption remains the strongest to date.

People appear to have fallen ill after eating out rather than after consuming food prepared at home.

Some of the food businesses linked to 24 of the cases use imported eggs.

"At this time there is no identified link to UK-produced eggs or poultry," says the UKHSA.

Any extra precautions or preventative measures will be implemented if needed, it says. The risk to the general public is low.

Jacquelyn McCormick, Head of Incidents at the Food Standards Agency, said eggs which are thoroughly cooked and handled hygienically should not present a food safety risk.

She advised: "Infants, young children, pregnant people and older adults should only eat runny or raw eggs if they have a British Lion mark or are produced under the Laid in Britain egg assurance scheme."

People handling eggs, eggshells or egg packaging should wash their hands thoroughly with soap and water, she added.

Catering outlets have a food hygiene rating, so looking at these when deciding where to eat, recommends Dr Kathleen O'Reilly from the London School of Hygiene and Tropical Medicine.

More kindergarten students (4.2%) were exempted from at least one vaccination during the 2025-26 school year than in the previous year (3.6%), the Centers for Disease Control and Prevention (CDC) said yesterday.

The increase in vaccine exemptions could mean more infectious disease outbreaks.

“We should be worried, because we’re already seeing the consequences of declines in vaccination. All you have to do is look at measles,” Jeanne Marrazzo, MD, MPH, CEO of the Infectious Diseases Society of America (IDSA), told CIDRAP News. “The less we see people taking up vaccinations, the more we’re going to see these cases accumulate.”

During the 2025-26 school year, an estimated 280,000 children started kindergarten without proof that they completed the measles, mumps, and rubella (MMR) vaccine series. In total, 92.4% of kindergarteners received it—below the proportion needed to prevent measles from spreading in the community.

“More than a quarter of a million children started kindergarten last year without protection from the MMR vaccine,” Andrew D. Racine, MD, PhD, president of the American Academy of Pediatrics (AAP), said yesterday in a statement. “For some diseases like measles, even a small decrease in vaccination rates can lead to more outbreaks of disease because community immunity requires over 95% of susceptible individuals to be immunized.”

A similar percentage of kindergarteners as that receiving the MMR vaccine received the diphtheria, tetanus, and acellular pertussis (DTaP) vaccine (92%). “When it comes to vaccination rates, however, anything less than achieving an A+ grade is not good enough,” Racine said. 

Forty-one states and Washington, DC, experienced a spike in exemptions, and 24 states saw more than 5% of their kindergarten students exempted. The steady creep of vaccine exemptions could lead to more outbreaks. [...]

In a packed intensive care ward in Dhaka, three-year-old Abdul lay paralysed, his tiny body contorted by a rabies infection that had reached his brain.

His mother, Sheuli Akter, 38, sat at his side massaging his legs in the hope that this might loosen his muscles, but it was having no effect. Even his hands and feet were seized up by cramps.

Abdul had been in the hospital for a month but doctors said he was unlikely to live much longer. The infection, they said, had progressed to degenerative encephalitis; the virus had got to his brain.

Abdul was shaking, gripped by fever. His breathing was rapid and panicked, punctuated occasionally by groans of pain.

On his chin was the telltale scar of a dog bite, the source of the infection.

“He was playing outside with the other children,” said Sheuli. “The dog, which was one of those always waiting around outside, suddenly attacked him. They said it went for him because he was the smallest.”

Rabies is a constant threat in the crowded and unsanitary slums of Bangladesh’s capital, and the Infectious Diseases Hospital has experienced a surge in deaths from the disease over the last three years.

After decades of progress, stories like Abdul’s are becoming more common again as the number of rabies cases and deaths rises in hotspots like Bangladesh, India, and in parts of Africa.

In almost all cases, the rising cases coincide with large populations of stray dogs. In some affected countries like Morocco and Sri Lanka, these and other stray animals have even become tourist attractions.

So what is to be done, and why is rabies on the rise? [...]

Some 99 per cent of human cases are acquired from the bite of an infected dog, and global health metrics show that countries with high numbers of free-roaming, unvaccinated strays suffer the overwhelming majority of deaths.

India, for example, is believed to be home to some 60 million street dogs and accounts for more than a third of all global human rabies deaths.

By contrast, countries that have enforced mandatory vaccination orders and other public health measures, and taken steps to control their stray dog populations, have effectively eliminated the disease.

Take the United States, for example.

One of the most famous scenes in all of 20th century literature was the fictional lawyer Atticus Finch shooting dead a rabid dog that had wandered into town.

The scene, from ‘To Kill a Mockingbird’, is a key moment in the hero’s character arc but it is also a reflection of the much greater threat rabies once posed to Americans.

In the 1930s, when the book is set, the rabies virus was still endemic in American dog populations, leading to thousands of cases in domestic animals and dozens in humans every year.

But by the time the book was published in 1960, rabies was largely under control, and by the end of that decade less than 500 cases of rabies in dogs and only three in humans were reported, according to data from the US Centres for Disease Control and Prevention (CDC).

Academics attribute this sharp fall in rabies cases largely to post-Second World War public health drives.

In the 40s and 50s many US states began introducing compulsory rabies vaccination for dogs. At the same time, many local authorities also began introducing rules requiring dogs to be kept on leads.

Targeted culls and the country’s extensive network of dog shelters also played a key role in controlling the stray dog population. [...]

So what has stopped other countries from repeating this success?

“It’s all about mass dog vaccination,” said Felix Lankester, Director of Rabies Free Africa and a Professor at Washington State University.

“Those countries that have put in place mass vaccination – coordinated, systematic mass dog vaccination – have been successful, and the countries that haven’t shown any progress are, in my experience, those with no coordinated programme,” he told The Telegraph.

“If you look across much of Africa, most countries are really doing very little. And similarly in Asia, it has to be a coordinated nationwide strategy to vaccinate dogs. Otherwise, there’ll be pockets of endemicity remaining, which will then cause problems.”

The reason a simple cull of strays is not enough is that the virus bounces back when the stray population recovers – unless they have been vaccinated.

The pandemic may also have played in the current rebound as it disrupted vaccination campaigns.

“There are a lot of questions about whether the pandemic impacted vaccination,” said Prof Lankester. “Certainly, around the time of the pandemic, vaccination where we work in East Africa was impacted because we couldn’t get our teams out.”

Cuts to global health funding have also hurt budgets for countries with big rabies problems, he added.

Even a brief disruption to vaccination programmes can be calamitous, as the disease can rapidly re-establish itself in a canine population.

[...]

https://archive.is/oGSDY

The White House is working to strengthen safeguards against biological attacks after staffing cuts early in the second Trump administration depleted expertise in a field where officials increasingly fear artificial intelligence could make it easier to create deadly pathogens.

By the end of President Joe Biden’s term, the White House had built a team of as many as 30 people focused on biological security, according to three former government officials who worked on the issue — two for Biden and Trump, and one just for Biden — and spoke on the condition of anonymity to avoid professional retaliation.

This specialized staff was charged with coordinating the web of federal agencies that deal with biohazards and provided scientific guidance to top officials.

That team rapidly dwindled after Trump returned to office amid cuts and reorganizations, said the three former officials, as well as a fourth former official, who also worked for both administrations. At times, nobody at the White House was dedicated solely to biosecurity, according to three of the former officials.

The losses have come as the administration has delayed replacing key Biden-era directives. It revoked a 2023 executive order on AI calling for stronger biological safeguards and cast doubt on a policy issued the following year designed to require companies to screen buyers seeking genetic components that could be used to create biological agents — widely seen by experts as a basic pillar of the nation’s defenses.

Trump directed officials to produce a revised version by August 2025. More than a year later, it has yet to appear, even as AI companies say their most advanced models are gaining increasingly sophisticated biological capabilities alongside the hacking skills that have alarmed officials this year.

They have kneecapped themselves in their ability to create any policy that would have staying power,” said one of the former experts, who recently worked directly on outbreak response policy. “That’s the risk, they’re not playing the long game. The whole purpose of having the technocrats there is to advise political leaders on the nuanced tradeoffs of taking one path or another.”

In the absence of a large team, the White House has relied on a small revolving cast of employees. They have included a junior fellow without a security clearance; a part-timer from the research organization Rand; a pair of CIA staffers with little expertise in the field; and an Air Force doctor who had been a consultant to the White House medical office, according to the three experts.

A White House official said the administration was working to strengthen the Biden-era policy, calling it inadequate and technically limited despite the staff devoted to developing it and did not address questions about the staffing changes.

“The Administration’s commitment to addressing AI and biological safety risks is clear and ongoing,” the official said in an email. “The White House has been developing policy for over a year, including in our AI Action Plan last summer.”

The Trump administration has acknowledged the biological security risks AI poses while touting the potential for the technology to help keep the nation safe. Trump told foreign leaders gathered at the United Nations last year that he wanted to prevent biological weapons disasters and said AI was a tool to help.

At the Pentagon, a former health official who led Operation Warp Speed — the effort during the first Trump administration to rapidly produce a vaccine for the coronavirus — is involved in efforts to use AI to speed the development of new defenses against future pandemics and to deter biowarfare. Part of the work involves analyzing billions of tweaks to antibodies to assess how to respond to new forms of the coronavirus.

But that work is taking place in a government that analysts and the former experts say has been drained of expertise amid broader cuts to federal public health and science funding. [...]

Keep reading: Link

Just FYI — go to the links to see the explanatory video — I am not personally involved with this website, just sharing this — but I can testify that CDC did make this change:

https://pmc19.com/

August 17, 2026 - Report

"Alert: This week, the CDC has modified how they link numeric wastewater data to descriptive levels (e.g., Low) in ways that generally describe transmission as one category lower than their previous system (e.g., Low is now "Very Low"). We have made a brief video explainer. Note that all PMC data use the pre-August 14 system, unless otherwise noted. 

Bluewashing: How the CDC Makes COVID Levels Appear Artificially Low (An Ethics Crisis)

The US has 15 states/territories with COVlD outbreaks, characterized by one or multiple counties at high to very high levels. The largest waves are in California, Texas, Alaska, Hawai’i, and Guam. Washington, Nevada, Mississippi, Alabama, Kentucky, and Florida are experiencing regional outbreaks. Finally, there are isolated hot spots in north central Utah (Summit/Wasatch), north central Illinois (Boone/DeKalb), central North Carolina (Cabarrus), and northwest Connecticut (Litchfield). 

There are major reporting irregularities in Texas. Of the 19 sites online this week, 3 (16%) reported with high/very high levels. Of the 20 Texas sites offline this week that have reported data for last week, 18 (90%) report high/very high levels, with 16 (80%) reporting very high levels. The reason why high and very high sites are disproportionately offline this week is unknown. This creates a major discrepancy between the PMC and CDC maps. If carrying forward last week’s data for the offline sites, the CDC would place Texas in their “high” category, with 21 of 39 sites at high/very high levels (54%), and just below the threshhold for “very high” (17/39, 44%). Houston was previously a leader in wastewater monitoring with 8 sites but has not reported any data the past two updates."

The nationwide cyclospora outbreak is very likely a result of sewage contamination in the food supply, according to scientific researchers and public health officials.

The parasite's spread can become a self-perpetuating cycle. Cyclospora is found only in humans, where it replicates in the intestinal tract, causing severe diarrhea. The organism reproduces by releasing oocysts, which are excreted in those human feces. In the U.S., feces usually end up in sewage systems.

In many states, sewage water is treated — though not always in ways that remove or kill the oocysts — and then released into waterways and can be used to irrigate crops. The oocysts mature in the environment with warm temperatures in about a week. Then a human comes along and eats the irrigated food or drinks the water and gets sick, releasing more oocysts into sewage systems.

I am a public health water microbiologist who collects sewage water and tests it for evidence of harmful pathogens, such as cyclospora. The first time I studied cyclospora was in the first outbreak ever documented in the U.S., a small, 45-case outbreak in Florida in 1995.

The cause was initially suspected to be strawberries grown in California, but later it was determined it was more likely due to imported contaminated raspberries from Guatemala. That country's raspberries were also associated with much larger outbreaks in 1996 and 1997. At the time, little was known about this single-celled protozoan pathogen.

More than 30 years later, the largest outbreak ever recorded in the U.S. has sickened more than 22,000 people, and contributed to the deaths of two in Michigan, where I live and work. Using treated sewage to irrigate crops is common in many places, especially where groundwater and surface water are in short supply.

22 states allow treated sewage water to irrigate food crops

An additional 14 states allow treated sewage water to be used to irrigate crops, but only those not used for food. And the remaining 15 states are split among those that have guidelines – which are not as strict as regulations – or no policies at all about using treated sewage for irrigation.

See Reclaimed Water Use Regulations in the U.S.: Evaluating Changes and Regional Patterns in Patchwork State Policies from 2004–2023

There are two reasons researchers like me collect sewage and monitor what's in it.

The first is to evaluate levels of disease in a community. Measuring viruses such as SARS-CoV-2 in untreated sewage helped paint a picture of the spread of COVID-19 and the emergence of variants as the pandemic continued.

The second reason is to determine whether and how sewage treatment removes, inactivates or kills pathogens.

It is not easy to measure cyclospora oocysts in sewage, contaminated water or food. Even modern laboratory methods have trouble reliably detecting low levels of oocysts, which can still cause disease.

Cyclospora oocysts have been found in sewage around the world. A range of studies across the world shows that they can be detected in up to 25% of sewage samples – but not all studies report how high or low the concentrations of the oocysts were. So it can be hard to say exactly how widespread it is.

A person who is infected with cyclospora excretes somewhere between 100 and 10,000 oocysts per gram of feces for as long as 60 days. Based on what is known about other fecal pathogen excretions from patients, related to the concentrations of those pathogens in sewage, I estimate that there could be anywhere from 1 to 100 oocysts per liter in sewage. [..]

What happens during sewage treatment?

There isn't clear data on how well standard sewage treatment processes reduce the numbers of cyclospora oocysts. But there is information on two other similar protozoa that also cause significant diarrhea in humans: Cryptosporidium produces an oocyst about half the size of cyclospora, and giardia produces a cyst that is similar in size to cyclospora.

From 2001 to 2003, my laboratory studied the occurrence of those protozoa at six sewage treatment plants – one each in Arizona and California and four in Florida. All had been approved by their respective state regulators for nonpotable reuse, including irrigation of landscapes and, in some cases, crops.

In that study, we found these protozoa in all the untreated sewage we tested, indicating there is some portion of the population that is infected and excreting their cysts or oocysts.

The five treatment plants whose processes included disinfection with chlorine were able to get rid of a high percentage – but not all – of the protozoa in their discharged wastewater. Some cysts and oocysts remained intact, with the potential to cause disease, even in water that had gone through the entire treatment process, as it is known that wastewater chlorination does not kill these protozoa.

From that data, it seems reasonable to assume that at least some small proportion of cyclospora oocysts also survive sewage treatment processes and are released back into the environment, where they can survive for months.

What about reuse?

Across the U.S., 200 billion gallons of treated sewage wastewater are used for irrigation of agricultural lands each year.

Some of that wastewater undergoes additional filtration and disinfection for reuse before being spread directly on landscapes or crops. The volumes, however, are not readily known. And other treated sewage, which undergoes only standard secondary treatment, is discharged into rivers, streams and reservoirs that could provide irrigation water.

But few states regulate efforts to remove or monitor protozoa such as cyclospora in treated sewage. Filtration can remove protozoa but must be designed and operated correctly. Chlorination is not effective, but ultraviolet light does inactivate cryptosporidium and eimeria, a chicken protozoan highly related to and used as a surrogate in studies testing methods of killing cyclospora by the food safety industry. [...]

Author: Joan Rose is a Professor of Water Research and the Director of the Water Alliance at Michigan State University

https://archive.is/PV6Ut

At least 93 patients have tested positive for cholera at a single hospital in Myanmar’s biggest city, officials said, as an outbreak that began last week spread across the region.

They are among more than 180 people in the city, Yangon, who have been hospitalized with diarrhea, a common symptom of the disease, Dr. Nanda Win, the head of the Yangon Region Public Health and Medical Services Department, said Friday. One 92-year-old man had died, he said.

The outbreak is the latest strain on Myanmar’s faltering medical system, which has been neglected under a junta rule that has prioritized weapons over health budgets.

Dr. Nanda Win said cases were concentrated in downtown Yangon, many of them in Chinatown, and identified contaminated water and takeaway street food as possible sources. Officials are still tracking where patients live and have traveled to determine how widely the disease has spread.

The authorities were preparing supplies at 83 other hospitals across the Yangon region and were working to ensure that the water supply was safe, he said.

Cholera outbreaks are not unusual in Myanmar, but experts say they are rare in the Yangon region and attribute the latest outbreak to poor sanitation.

Dr. Tin Tun, a doctor and former district chairman in Yangon, said food outlets had not been properly inspected, water for cleaning was insufficient and drainage systems were no longer being properly maintained.

While Yangon General Hospital was prepared to treat cholera patients, he said, facilities elsewhere might not be. “If it spreads to other towns and villages where health care services are weak, I am worried that the death rate could be higher,” Dr. Tin Tun said.

There have also been reports of cholera outside of the Yangon region.

“We have also seen cases among people returning from Yangon,” said Aung Myo, an ambulance worker in Kyaikkhami, Mon State. [...]

It happened last September, when I was enjoying my usual hike around a farm in Maryland. It used to be that these walks had a Disney feel, and while Mr. Bluebird wasn’t on my shoulder, I might see a few. I might also come across a fawn, or a collection of electric blue butterflies hovering over the creek. I occasionally saw a fox, sitting alone on a hill. Sometimes I’d see bald eagles, and rarely a statuesque blue heron. But lately I’d been preoccupied with coyotes and bears. I had been finding little carcasses so I knew the coyotes were active. They had been caught on camera late at night, red-eyed, prowling around the sheep field. Bears had destroyed a neighbor’s beehive, and while I had been assured that they were more scared of me than I was of them, I didn’t believe that for a minute. I carried an air horn to scare the bears and coyotes, just in case.

I was worried about the wrong predators. Mine were nearly invisible.

I couldn’t see them, even though they were waiting for me. I didn’t feel them, even while they injected me with a molecule that would rewrite my body’s immune code. I wouldn’t understand this, what they had done to me, until months later.

Later that day, when I undressed to shower, I noticed about 40 small insect bites across my abdomen and ankles. The bites didn’t itch, not at first, which was strange. I assumed they were chiggers, because the bites were grouped together in lines and little clumps, just like the internet chiggers I googled. I didn’t know it then, but I had walked into a tick bomb—a nest of hundreds of lone star tick larvae, seed ticks, each about the size of a poppy seed.

The ticks hide in massive clusters on vegetation and wait for a body to happen by, providing the blood meal essential for their survival. That day, when I brushed by, they were hidden in the undulating tall grass, and they did exactly what they were programmed to do: feed. I never did see their tiny black bodies on me.

The following day, a ferocious, weekslong itching began. Six months later, I began having gastrointestinal symptoms. I won’t describe them, but use your imagination. This lasted about two days, during which time I was too sick to leave the house. The symptoms vanished only to come back sporadically, always lasting two days, always miserable. This went on for six weeks while I puzzled over what could be causing these intermittent gastric flares. At first, I thought it was something I ate—maybe I was gluten intolerant. I eliminated gluten but the symptoms remained. Could I have developed irritable bowel syndrome, or IBS? It seemed unlikely at my age. I tried the FODMAP diet anyway, a highly restrictive diet that serves to both torture patients and diagnose IBS. Still, the two-day gastric episodes kept coming. Being a retired physician, the outliers were front of mind. Cancer, diverticulosis, Crohn’s or celiac disease? Probably not. Finally, I began to wonder if I might have developed a dairy sensitivity. I didn’t wonder for long. One night, I ate a giant bowl of chocolate chip ice cream, made healthy with the addition of blueberries. The next morning, I felt awful. The ice cream had been decadent, crammed with chocolate chips. I didn’t know it at the time, but it was to be my last.

Then a stroke of luck: I read an epidemiology newsletter about ticks. Ticks have been getting a lot of bad press recently, all richly deserved. Deer ticks can cause Lyme disease and several lesser-known but no less harmful illnesses. You don’t want any of these, but caught early, they are mostly responsive to antibiotics. Less well known, although highly publicized recently, is alpha-gal syndrome. Alpha-gal syndrome is an allergy to mammalian foods and byproducts. Unlike most food allergies that trigger nearly immediate symptoms, the allergic symptoms of alpha-gal syndrome are delayed by hours, making it tricky to diagnose, according to research. An alpha-gal reaction can be gastrointestinal, allergic or both. If you were to merge the symptoms of a severe allergic reaction with a stomach bug, awakening you at 3 a.m., this is the alpha-gal experience. Finally, I had an answer. I was experiencing delayed GI symptoms after eating dairy products.

I was sure I had alpha-gal syndrome.

My internist was less convinced—didn’t I think lactose intolerance was more likely? I reminded him I was already lactose intolerant so it must be something else. He agreed to order the test. While I awaited the results, I decided to have a steak for dinner. Dumb, right? But the steak clinched the diagnosis. I was violently ill the next morning and remained so for the following two days. When the test came back four days later, it confirmed what I already knew: I had alpha-gal syndrome. I had the juvenile pleasure of imagining telling my internist, “I told you so.” Because I wanted him to continue answering my emails, I stayed silent. When I called my family with the news, my sister and sister-in-law were both solicitous. My brother’s sympathies were pithier: “I always knew you were an alpha gal”. [...]

I was relieved to have a diagnosis. After a few weeks, I started feeling better and decided to venture out to a restaurant. It was our anniversary, and after looking at menus (is there anything I can eat?) my husband and I went to a neighborhood French bistro. We walked into the narrow space filled with a dozen tables and were led past the chef, who was decked out in a toque hat and a stained white apron, surrounded by vintage copper pots. He looked like the chef from Beauty and the Beast, flushed and cheerful. It was a warm, early summer night, and the server led us out to a small patio, verdant with vines growing on brick walls and small ornamental trees in corner planters. It was intimate, with maybe eight tables. I breathed in the seductive smell of the food, as plates were dropped off at tables. The server handed us menus, which quickly turned into a Tale of Two Menus. My husband’s menu was lusty and rich, drenched in butter. My menu was spartan, boring and kind of heartbreaking. Then came the part I’ve grown to hate, negotiating with the server over what I can eat. I explained alpha-gal to her, which saved me from feeling like a fussy restaurant Karen. I settled on the salmon, then we removed every part of the dish that made it, in my imagination at least, sublime.

My husband ordered lobster in puff pastry as an appetizer. It arrived smelling wonderfully, dressed in a little pastry purse, crimped at the top and overflowing with seafood. Melted butter oozed out the moment he bit into it. I watched as he ate every last bite while I picked at my salad. I was getting distinct Prince and the Pauper vibes. After dinner, the server, knowing it was our anniversary, brought out a crème brulee, compliments of the chef. I sat, envious, as my husband cracked past the caramelized, sugary crust and into the rich crème.

Dining out has become an exercise in anxiety and thwarted desire. Yet, after a few months, I made my peace with alpha-gal. I miss cheese and yogurt and ice cream. But I can survive without them. I still want to grab a bite of steak from my husband’s plate, but I’d been looking for an excuse to stop eating meat. For some fortunate alpha-gal patients, if they can avoid more tick bites, their symptoms may decline over time. Conversely, get another tick bite, and your sentence is extended.

It’s not really about food. You eat a meal and it’s done. Nature, though, lingers. The farm, the woods, the sheep in their field, the horses dozing in the sun, the fox resting on the hill are sustaining, essential.

The ticks stole wonder and freedom, replacing them with foreboding.

At first, I thought I’d have to give up my farm walks, but why let a tick scare me away from what I love? I’m not entirely sure how to protect myself—I was doing all the right things the day I was bitten; my socks were pulled over my pants, and my clothes were sprayed with permethrin. The tick won that skirmish. It might win another.

But I will return.

Author: Anne Sagalyn, M.D., is a retired physician who practiced in the Washington, D.C., area for 35 years. Her work has appeared in Annals of Internal Medicine and Equus.

GAITHERSBURG, Md. — A 10-year-old girl was attacked by a beaver while canoeing at Seneca Creek State Park in Montgomery County, Maryland, on Thursday, marking the third reported beaver attack in the state in less than a month.

According to the Maryland Department of Natural Resources, the attack happened around 3:30 p.m. while the girl was participating in a summer camp canoeing trip on a creek. Camp counselors were able to get the beaver off the girl before it escaped into the water.

The girl was taken to a hospital with three wounds to her upper leg.

“They do have rather large, rather sharp teeth,” said Aaron Hall, Beaver Corps program director with the Beaver Institute. “While they don't attack humans very often, when they do it can be serious.”

Park officials have temporarily closed part of Seneca Creek State Park while they search for the beaver involved in the attack.

Hall said beavers typically try to avoid people and will usually flee when approached.

“They do a tail slap, which is their warning signal to us and to predators, and then they swim away and try to flee,” Hall said.

The latest incident follows two separate beaver attacks at Cunningham Falls State Park in Frederick County earlier this month.

In those cases, a 13-year-old who was swimming and a 19-year-old who was fishing were attacked. Both beavers were captured, euthanized and tested positive for rabies.

Hall said beavers generally do not spread rabies among themselves. Instead, he said, the infected animals may have contracted the virus from other rabid wildlife, such as raccoons or foxes.

“Beavers are not transmitting rabies between each other,” Hall said.

He added that wildlife officials should focus on monitoring rabies activity among raccoon populations. [...]

Despite the recent attacks, Maryland officials said there is no evidence of an active rabies outbreak in Montgomery or Frederick counties.

Seneca Creek State Park and Cunningham Falls State Park are more than 36 miles apart, and officials said the incidents are not considered related.

Federal regulators have begun an inspection of Taylor Farms' central Mexico processing plant, which has been linked to a multistate outbreak of cyclosporiasis.

The Food and Drug Administration is conducting an inspection and collecting samples at Taylor Farms de Mexico of Guanajuato, Mexico, the agency said on Aug. 13. The inspection comes almost a month after the Salinas, California-headquartered Taylor Farms said on July 17 that it was removing iceberg lettuce sourced from Central Mexico from the marketplace. [...]

Donald Prater, the FDA’s acting deputy commissioner for food, told The Washington Post that agricultural water is often the cause of cyclospora contamination. The FDA is “looking carefully at the available data to be able to understand what could have happened,” he said. [...]

Since officials have not identified a source for all of the cases, Dr. Dana G. Mordue, associate professor of pathology, microbiology and immunology at New York Medical College, suggests caution, especially for people at risk of more serious illness, such as older adults and children.

"I would be reluctant to say that it is safe to go back to eating the fruits and vegetables," she told USA TODAY. "In fact, we don't even know for sure what fruits and vegetables are causing the disease."

Frank Yiannas, who served more than three years as deputy commissioner for food policy and response at the FDA before leaving in early 2022, wrote in a Food Safety News July 13 editorial that regulators should create a National Foodborne Outbreak Investigation Board, akin to the National Transportation Safety Board, which investigates accidents such as plane crashes and train derailments. Such a board would "strengthen coordination, improve transparency, and accelerate the identification of lessons learned following major foodborne outbreaks," he wrote.

"Just like hurricane tracking, projections, and building standards have improved over time, so too should capabilities in regard to Cyclospora surveillance, detection and prevention," Yiannas wrote

Such a board could have "a Go Team in the air within hours, because everybody involved understands that a scene degrades," wrote food safety expert and personal injury lawyer Bill Marler in Food Safety News on Aug. 13.

The FDA inspection announcement "does not say when that inspection began or whether anyone is there now," Marler wrote. "Whatever an inspection turns up now, it is turning it up in a plant that has been shut for nearly a month."

The Trump administration delayed a rule last year that could have sped up the effort to pinpoint the source of the contamination. Critics charge that food safety oversight has eroded overall.

Interesting analysis & charts of various factors behind the WHO's concerns.

• Ebola cases in the first 100 days
• 'Hidden' transmission - deaths in the community
• Attacks on aid workers in the Democratic Republic of the Congo
• Mass movement in the DRC
• CFRs of recent Ebola virus outbreaks

Another recent discussion here on this prediction, and the latest WHO Disease Outbreak News release (14 Aug)