Your Local Epidemiologist

10 Feb 2025

1/ 🚨 Big changes are coming. We’re entering a new era in America, and it’s messy out there. But I’m here to help you navigate the chaos with evidence-based, clear health information. If you’re tired of the noise, you’re in the right place. 👇

1/ If we need another sign the U.S. is going backward in health, here it is. Measles cases in the U.S. have now topped 4,500 this year, which is the highest annual case count since 1991. Cases are still climbing, so let's break down what’s happening and what comes next. 🧵

7/ What happens if we lose elimination status? In practice, we won’t notice the official change in status on the ground. What we will see is more outbreaks, more illnesses, and more hospitalizations for kids.

8/ What does this mean for you? If you’re up to date on your MMR vaccines, your risk is very low. In areas with ongoing transmission, infants as young as 6 months may be eligible for an early dose after talking with their pediatrician. Two routine doses are still needed later.

5/ Over 56,000 MMR vaccine doses were administered last month in PA, which is more than twice the usual monthly total. A CDC “disease detective” also arrived to help assess the outbreak and the impact of vaccination. This is good news given the dispute between the governor and RFK over the outbreak.

6/ All of this comes just weeks before the Pan American Health Organization decides whether the U.S. has lost its measles elimination status, which it has held since 2000. The review looks at whether measles has spread continuously for a year. Sustained transmission in Utah makes this likely.

3/PA remains the epicenter, with 1,338 cases across 44 counties. It’s the state’s biggest outbreak in decades, leading to 5 confirmed deaths & a possible 6th. (There are new measles death criteria by the state, so it’s under review.) Only 4 of the people who got sick in the state had been vaccinated

4/ Although Pennsylvania’s outbreak is still growing, the pace appears to be slowing. Several things are likely contributing, including stronger coordination between state health officials and the CDC, more vaccination, and the virus running out of susceptible people in some communities.

2/ As of October 25, the CDC had recorded 4,588 cases nationwide. That’s double the total number of cases (2,289) for all of 2025. About 96% of this year’s cases have been in people who are unvaccinated or whose vaccination status is unknown.

1/ Fall in the Northeast means colorful leaves, apple cider donuts, and… measles, flu, and fall allergies? This week in the Northeast Dose, we’re tracking measles, what’s circulating as respiratory season begins, and how communities are tackling health risks from vaping to sexual violence. 👇

11/ So how do you reach teens when flavors, marketing, and social pressure compete with health warnings? Connecticut’s new “It’s Tox-Ick” campaign uses dark humor and uncomfortable parallels between chemicals found in vaping products and everyday products we would never consider ingesting.

lung.orgVaping Conversation GuideYou can play a significant role in protecting your child from the dangers of vaping and nicotine dependence. Maintain an open line of communication with your kid, and use the tips and suggestions belo...

12/ Parents and caregivers play a role here too. Talking about vaping doesn’t have to become a lecture. The American Lung Association has a guide to help you start the conversation with your teen: www.lung.org/quit-smoking...

opdv.ny.govOffice for the Prevention of Domestic Violence

10/ Remember, if you see something, say something. And if you or someone you know needs support in New York, the state’s Domestic and Sexual Violence Hotline is available at 1-800-942-6906. You can also text 844-997-2121 or chat through opdv.ny.gov.

11/ Moving on to Connecticut, 1 in 2 CT high school students has tried vaping. 1 in 3 has vaped in the past month. Vaping may help some adults quit smoking, but it isn’t harmless. Nicotine can affect young people’s attention and learning, increase addiction risk, and worsen anxiety and depression.

8/ How big is the problem? Campus climate surveys consistently find that far more students experience sexual violence than ever report it, often because of shame, fear of retaliation, or not knowing where to go. Of the reports that do reach Title IX offices, only ~6% also went to police in 2024.

9/ Prevention can work. Bystander programs like Green Dot have reduced violence. In a randomized trial, a resistance program for first-year university women nearly halved the rate of sexual assault over the following year.

6/ Next, violence, including sexual violence, is not a "disease," but it is a public health problem. The recent sexual assault reports at Cornell and FIT are a stark reminder of this.

7/ Nearly 1 in 2 women and 1 in 8 men in NY report experiencing sexual violence in their lifetime. Many incidents are never reported, often because of fear, shame, or uncertainty about where to turn.

4/ Next, sneezing more than usual? Fall allergies could be to blame. Ragweed tends to fade after the first frost, but mold can linger through November as wet leaves break down. Turning on indoor heating can also stir up allergens. So itchy eyes, nose, or throat may point to allergies, not a virus.

5/ Speaking of viruses, flu activity is rising across the Northeast, a few weeks earlier than usual, while Covid levels are lower than in the West and South and are likely nearing their peak. Now’s a good time to get your fall vaccines and mask in crowded indoor areas.

2/ Measles continues to spread in Pennsylvania, with 1,286 cases reported as of October 19 and five confirmed deaths. The rise in cases appears to be slowing, and vaccination efforts have ramped up, with more than 56,000 MMR doses given in September alone.

3/ NY has reported over 162 cases, with the most near the PA border. The rest of the Northeast is quieter, and high vaccination rates help limit the risk of wider spread. If you’re in an affected area, ask your child’s pediatrician about early vaccination for infants.

1/ I'm back with your weekly infectious disease report. First, the viral forecast. Nationally, illness levels are still low but rising. The West Coast is the current hot spot for both flu and Covid, but their trajectories are moving in opposite directions: flu is climbing while Covid-19 is falling.

8/ So should you wait to get your flu shot? For most people, no. The goal is to build protection before flu activity peaks, and flu is already starting to rise. Waiting could leave you less protected during the weeks when you need it.

9/ Ok, so what does all of this mean for you? Now is a good time to get your recommended fall vaccines. As virus levels are increasing, consider masking in crowded indoor spaces and stay home if you're feeling sick. We’ll keep watching the data as the season unfolds.

6/ Yes, protection from the flu vaccine can fade over time. A recent review pooling data from more than 49 studies found that vaccine effectiveness declines over the season, especially in adults over 65. This is because our immune systems respond less strongly to vaccines as we age.

7/ But keep in mind, protection can decline without disappearing, and it doesn't decline evenly. In one study tracking vaccine effectiveness during the 2023–2024 season, protection in children changed very little over time. In adults over 65, it dropped more noticeably.

4/ As we can see here, seasonal viruses tend to take turns rather than surge together. One possible explanation is “viral interference,” where the immune response to one infection temporarily makes it harder for another virus to take hold. This results in population-level patterns of different peaks

5/ We've also had a few people ask if they should be worried about protection warning if they got the flu vaccine early this season. Since flu season has started early this year, meaning a lot of people have gotten vaccinated earlier than usual, I wanted to take a minute to answer.

2/ As we move east across the U.S., levels of both viruses decline. In the Northeast and Mid-Atlantic, Covid-19 is still the biggest contributor to viral illness, while flu is just beginning to creep up. Your local picture may look very different from the national one, so keep that in mind.

3/ RSV levels are extremely low but starting to stir. On the one hand, hospitalizations from RSV are still rare, though they’re starting to increase in the South. On the other hand, emergency department visits for RSV are increasing in almost every state.

1/ Last week, three children and a teacher were killed, and another child and teacher were seriously injured in a school shooting in Bend, Oregon. Among those killed was a 5-year-old, the youngest person killed in a school shooting since Education Week began tracking these incidents in 2018. 🧵

8/ 3️⃣ Finally, speak up when something feels wrong. Many attackers show warning signs or communicate their plans beforehand. Reporting concerning behavior can give others a chance to intervene. None of these steps can prevent every tragedy by themselves, but they can help reduce risk.

9/ As a parent, I wish keeping our kids safe were simpler. But gun violence isn’t inevitable, and we shouldn’t treat it that way.

6/ So what can we do? There are practical steps families can take to reduce the risk of gun violence, starting at home. 1️⃣ First, lock up firearms. Many children are killed with a family member’s gun. Store firearms locked and unloaded, with ammunition secured separately.

7/ 2️⃣ Second, ask about guns before playdates. It may feel awkward to ask another parent how firearms are stored, but it’s a reasonable safety question that could help protect your child.

4/ When a tragedy like this happens, people bring up mental illness as a cause. But it's incredibly important to highlight that mental illness is not the cause of most gun violence. In fact, people with mental illness are more likely to be victims of violence than perpetrators.

5/ This is also a uniquely American problem. Other wealthy countries experience mental illness, bullying and violence, too. But the U.S. has much greater access to guns. Our child and teen gun death rate is more than 9.5 times Canada’s, which has the second-highest rate among peer countries.

2/ As I’ve written before, gun violence is a public health issue: it’s predictable, which means it’s preventable. The U.S. has recorded 380 mass shootings (four or more people shot, not counting the shooter) so far this year. While that’s fewer than at the peak in 2021, but still more than one a day

3/ For the fifth consecutive year, guns are the leading cause of death for children and teens ages 1 to 17 in the U.S. As devastating and shocking as mass shootings are, most of the recorded gun deaths are actually homicides and suicides.

1/ While the headlines have faded, the Ebola outbreak in Central Africa hasn't. The outbreak of Bundibugyo Ebola in the Democratic Republic of Congo (DRC) continues to grow, and there’s been some concerning updates that have largely gotten lost in the news. Here’s the current situation.

10/ Health workers in the DRC are receiving Ervebo because some protection is better than none on the front line. Researchers are also preparing a trial to test it against Bundibugyo using “ring vaccination,” which means offering the vaccine to contacts of confirmed cases, then to their contacts.

11/ What does this mean for you? The risk to Americans remains very, very low. Ebola spreads through direct contact with a sick person’s bodily fluids, not through the air. But let this be a reminder that global surveillance and research to catch these threats early protect us all.

8/ The woman also developed symptoms Oct. 7 but wasn’t hospitalized until Oct. 11. so family members or healthcare workers could have been exposed before Ebola was suspected.

9/ Is there a vaccine for this? We do have an Ebola vaccine, Ervebo, though it was designed for a different strain (Zaire), and we don’t know whether it works against Bundibugyo. Early lab and animal research suggests possible cross-protection, but human data are needed to know how well it works.

6/ As for Nigeria, the country has confirmed an Ebola case in Abuja in a woman who arrived from Uganda. Uganda had previously reported Ebola cases but was declared free of the virus in late August. Authorities are currently tracing 44 contacts.

7/ This case is especially concerning because it's a significant geographic jump, and Uganda had been declared Ebola-free, so we don't know where she was exposed.

4/ Two other things stand out right now: 1️⃣ The death rate is clocking in at 48%. Bundibugyo has historically been less deadly than other Ebola species. This is a striking statistic, and it shows what happens when there are no proven treatments and health care is stretched thin.

5/ 2️⃣ Ebola reached Kenya and spread there, and today, it was reported to have reached Nigeria. Kenya has reported nine cases, all linked to one man returning from the DRC. As of now, there's no evidence of wider community transmission.

2/ The Democratic Republic of Congo (DRC) has reported more than 9,000 cases and 4,400 deaths since the outbreak was detected in May. The virus has now spread to an eighth province. At this pace, the outbreak could surpass the record-breaking Ebola epidemic in West Africa from 2014–2016.