Current Risks of Outbreaks and Alerts

Are Your Kids at Risk from These Infectious Disease Outbreaks?

The Centers for Disease Control and Prevention (CDC), together with local and state health departments, does a great job notifying people of current risks of outbreaks and alerts. They notify people who are at risk for infectious disease outbreaks and work to get them contained as quickly as possible.

You can do your part by being aware of the latest outbreaks, working to avoid them, and being alert for symptoms if you or your child does get caught up in an outbreak.

In the Spotlight - Zika Virus Outbreaks

A baby in Brazil with microcephaly that was likely caused by the Zika virus.
A baby in Brazil with microcephaly that was likely caused by the Zika virus. Photo by Mario Tama/Getty Images

We have been talking about the Zika virus for a few years now as an emerging infection that had been spreading to islands in the Western Pacific from endemic areas in Africa and Asia. Of course, Zika is getting a lot more attention now that it has become widespread in South America, Central America, Mexico and the Caribbean.

Association with microcephaly has also likely raised the alarm about Zika infections.

What do you need to know about Zika?

Are you traveling to an area with​ local transmission? If so, or you aren't sure, review the CDC travel information page.

Remember, if you are pregnant, the CDC recommends that you "consider postponing travel to any area where Zika virus transmission is ongoing." If you aren't pregnant or considering getting pregnant, then you should take steps to avoid mosquito bites.

2015-16 Flu Season

Flu Activity Map
Flu activity continues to increase across the United States. Photo courtesy of the CDC

Flu activity has winded down for 2015-2016.

More specifically:

  • There have been 77 pediatrics flu deaths including two new deaths, following 148 pediatric flu deaths last flu season.
  • Following an initial flu vaccine delay,146 million doses of flu vaccine have already been distributed and it is estimated that we may have up to 179 million doses available this flu season.
  • This year's flu vaccine works well, as the CDC reports that "laboratory analysis of influenza viruses to date suggests the majority of viruses circulating worldwide in the past few months are similar to 2015–16 vaccine viruses."

Measles Outbreaks

Measles Outbreaks 2015
This has been another big year for measles outbreaks in the United States. courtesy of the CDC

Because of its high level of contagiousness, measles is the indicator disease for weaknesses of an immunization program. With gaps in immunization coverage, measles is often the first vaccine-preventable disease one sees, indicating that a theoretical problem, low immunization coverage, has been converted into a real problem of disease, disability, and deaths.

- Walter Orenstein, MD

Following a big year for measles in 2014 (at least 648 cases of measles in the United States) and 2015 (189 cases), 2016 has gotten off to a slow start:

  • 43 people in 11 states (Arizona, California, Florida, Georgia, Hawaii, Illinois, Indiana, Massachusetts, Minnesota, Tennessee, and Texas).
  • An ongoing outbreak in Arizona that are linked to a private detention center, with at least 23 cases.
  • An outbreak near Memphis, that was up to seven people, almost all unvaccinated, in ​three unrelated outbreaks.

The measles vaccine has been available since 1971. A routine booster dose was added to the routine childhood immunization schedule in 1990.

As the measles outbreaks wind down, we will have to start to look at how much it cost to contain the record number of outbreaks we have had this year, keeping in mind that it cost "$2.7 million to $5.3 million" to contain far fewer cases in 2011.

West Nile Virus Outbreaks

Mosquito spraying is often done is areas where West Nile is found.
Mosquito spraying is often done is areas where West Nile is found. Photo by Justin Sullivan/Getty Images

West Nile virus season typically begins in spring and peaks in late summer or early fall. Since 1999, there have been at least 39,557 cases of West Nile virus disease and 1,668 deaths in the United States.

In 2015:

  • 48 states reported West Nile infections in people, birds, or mosquitoes.
  • at least 2,060 people have been reported to have gotten West Nile virus disease, including 1,360 with neuroinvasive disease, and 119 deaths.
  • since 2005, the number of cases has ranged from 712 (43 deaths) to 5,674 (286 deaths).

There is no vaccine to prevent West Nile virus infections and no treatment once you get sick, which makes taking preventative measures to avoid mosquito bites important, especially if West Nile has been found in your area.

Pertussis Outbreaks

Welcome to California
California is experiencing a statewide epidemic of pertussis, which has already led to two infant deaths. Photo by Getty Images

Like measles, pertussis, or whooping cough, is another vaccine-preventable disease that has been increasing in recent years.

In 2012, there were 48,277 cases of pertussis in the United States, the most since 1951, when we had 68,687 cases. Unfortunately, with the rise in cases, we are also seeing the tragic consequences of this disease - 20 deaths in 2012, mostly infants under age 3 months.

Pertussis cases remained steady, but high, in 2013 and 2014, at just over 28,600 cases in the United States.

In California, pertussis has reached epidemic levels in the entire state. The California Department of Public Health reported at least 11,114 cases in 2014 - the highest numbers of pertussis cases in the state in 70 years.

And as expected with the rise in cases, there were three pertussis-related deaths in California - all infants who had contracted pertussis when they were less than 8 weeks old. Two of the infants became sick in 2013, but the third, a 5-week-old baby, got infected in 2014.

Another baby, only 25 days old died in early 2015, but will be counted as the second death of 2014 since that is when the illness started.

About 383 patients, mostly infants who are less than 4 months old, were hospitalized in California last year, including 80 who required intensive care. And according to the California Department of Public Health, about 82 percent of the cases in infants were born to mothers who did not receive a dose of Tdap during their third trimester of pregnancy.

About 10 percent of pertussis cases in California report not having any pertussis-containing vaccine.

And unfortunately, 2015 has been another big year for pertussis.

The pertussis epidemic is in addition to the outbreaks of measles in the state, which included a large outbreak in Orange County, California.

Other recent outbreaks of pertussis include:

  • San Diego, California - 1,629 cases
  • Napa County, California - pertussis incidence rate of 95 per 100,000 vs 26 in the rest of the state
  • Sonoma County, California - pertussis incidence rate of 141 per 100,000 vs 26 in the rest of the state
  • Traverse City, Michigan - a large outbreak that lead to the closure of Grand Traverse Academy and which has now affected 22 schools in the area.
  • Staunton, Illinois
  • Mobile County, Alabama
  • Logan County, Ohio
  • Spearfish, South Dakota
  • Pickens County, South Carolina
  • Lewis and Clark County, Montana
  • Kennebunk, Maine
  • Weber County, Utah
  • Weld County, Colorado
  • Suffolk County, New York
  • Kent County, Delaware - a large outbreak in an Amish community

The first pertussis vaccines were developed in the 1930s and became more widely used in the 1940s when it was combined into the whole-cell DTP vaccine. This was replaced with the acellular DTaP vaccine in 1997, with the Tdap vaccine being added to the vaccine schedule in 2006. 

MERS Outbreaks

Middle East Respiratory Syndrome Coronavirus (MERS-CoV) finally made its way to the United States in 2014:

  • a traveler in Florida who had just returned from Saudi Arabia
  • a traveler in Indiana who had just returned from Saudi Arabia

Fortunately, the CDC states that "the MERS situation in the U.S. represents a very low risk to the general public in this country."

Except for some travel-associated cases, MERS had only been found in the Arabian Peninsula, including Saudi Arabia, United Arab Emirates (UAE), Qatar, Oman, Jordan, Kuwait, Yemen, and Lebanon, etc.

There was also an outbreak of MERS in South Korea since May 2015 though that spread to 186 people, including 36 who died. Over 2,300 people in South Korea were in quarantine and more than 1,000 schools were closed in an attempt to stop the outbreak.

There was a "quickly growing MERS-CoV outbreak" in Jordan and in Riyadh, Saudi Arabia, just before 2 to 3 million Muslims were travel to Mecca, Saudi Arabia for the Hajj.

Worldwide, there have been 1,728 cases of MERS since 2012 and 624 deaths.

West Africa Ebola Outbreak

A scientist working at the CDC mobile Ebola lab in Liberia.
A new mobile Ebola lab the CDC recently set up is a big step up from previous equipment being used to fight the Ebola epidemic in West Africa. Photo by John Moore/Getty Images

An ongoing outbreak of Ebola in West Africa has many people worried, especially as Ebola is often described as 'one the world's most virulent diseases.'

While Ebola has been around since 1976, the current outbreak is the first in West Africa and the largest in history, with 28,616 cases and 11,310 deaths. This includes 881 health-care workers who have become infected with Ebola, 513 of whom have died.

The outbreak may have been started by a 2-year-old who died on December 6 in southeastern Guinea.

You can not get Ebola from contaminated water or food or through the air. It is only transmitted by direct contact with the blood or bodily fluids of an infected symptomatic person or through exposure to objects (such as needles) that have been contaminated with infected secretions.

The first two Americans who first contracted Ebola were healthcare workers who were living in Monrovia, Liberia.

Unfortunately, there is no treatment or cure for Ebola virus infections, which are often deadly. Very limited supplies of an experimental treatment have been available for some patients, though. Of course, that hasn't kept many 'alternative' health sites from pushing bogus homeopathic cures for Ebola virus infections.

On July 31, 2015, an experimental Ebola vaccine developed in Guinea was shown to have a 100 percent effectiveness rate on adults. Trials on teens and children are upcoming. 

Among the latest updates are that:

  • The US dedicated additional resources to help address the Ebola epidemic in West Africa in July 2014. A new Ebola czar, Ron Klain, was appointed to oversee the United State's response to Ebola. And new infection control protocols have been issued for hospitals.
  • A patient in Dallas who had recently returned from West Africa has tested positive for Ebola. Fortunately, local and state health departments and the CDC will work to stop the further spread of Ebola when cases like this arise. Only ten people in Dallas had enough direct contact with the patient to be at risk for getting Ebola and they are being closely monitored for Ebola symptoms. An additional 50 lower risk contacts are also being followed on a daily basis to see if they develop a fever. Tragically, the man has died.
  • An NBC cameraman who may have contracted Ebola in Liberia while washing a contaminated car is being treated in Omaha, Nebraska. The rest of the news team (who were considered at low risk for infection and are symptom-free), including Dr. Nancy Snyderman, is now under mandatory quarantine because they broke an agreement to isolate themselves from others. He is now Ebola virus free though and has been released from the hospital.
  • A healthcare worker at Texas Presbyterian Hospital in Dallas (Nina Pham) tested positive for Ebola. The nurse helped provide care for the first Ebola patient after he was diagnosed with Ebola and so had extensive direct contact with him and the infection likely represents some kind of breach in safety protocols, which have since been updated. The new patient was already self-monitoring for Ebola symptoms and is in isolation. She only had one additional contact while she had symptoms. Fortunately, she is doing well and has been transferred to an NIH center in Maryland for specialized treatment. Her condition was recently upgraded to good and she is now Ebola-free and she has been discharged from the hospital.
  • second healthcare worker at Texas Presbyterian Hospital in Dallas (Amber Vinson) has tested positive for Ebola and will be transferred to a specialty hospital in Atlanta. She had traveled on a flight from Cleveland to Dallas on Frontier Airlines the night before developing symptoms, which have lead the CDC to "begin interviewing passengers about the flight, answering their questions, and following up." Since you are not contagious before you have Ebola symptoms (and she did not on the flight) and other passengers likely would not have any direct contact with any of her bodily fluids, the people in Cleveland and passengers on this flight or any subsequent flights should not be at any real risk for developing Ebola. Three of her contacts are being investigated in addition to passengers on the planes. She is also now Ebola virus free and has been discharged from the hospital.
  • Overabundance of caution and fear, a few schools in Texas and Ohio have closed for cleaning because of possible contact with people who may have been in contact with someone with Ebola
  • A doctor returning from Guinea, where he had been treating Ebola patients with Doctors Without Borders, has been diagnosed with Ebola in New York City. Dr. Craig Spencer is in isolation at Bellevue Hospital Center after developing a low-grade fever. His fiance and two friends are also in isolation, although they have no symptoms. No one else in New York City is thought to be at risk. He is now Ebola-free and has been released from the hospital.
  • A nurse in Maine, Kaci Kickox, successfully fought a 21-day mandatory quarantine imposed on her because she had returned from working with Ebola patients in Sierra Leone, even though these quarantines are not recommended by health experts.
  • The Ebola monitoring period for all of the people in Dallas came to an end with much less attention than all of the Ebola hype that led to school closings in the area.
  • A doctor from Sierra Leone, Dr. Martin Salia, who is critically ill was transferred to a Biocontainment Unit at Nebraska Medical Center for further treatment. Unfortunately, he died.
  • An American health care worker with Ebola and 10 contacts have returned to the United States from Sierra Leone. A few weeks later, one has been upgraded from serious to fair condition.
  • Liberia was declared Ebola free on May 9, going 42 days without a case.
  • Three new cases of Ebola were identified in Liberia in late June.
  • There have again been no new cases of Ebola in Liberia.
  • A Scottish nurse has relapsed 9 months after recovering from Ebola, raising fears that the Ebola virus can hide in immuno-privileged pockets of the body, including the semen and the fluid of the eye.
  • As of February 19, 2016, enhanced entry screening has been discontinued for travelers coming to the United States from Guinea. The United States is no longer conducting enhanced entry screening for Ebola.

Keep in mind that the CDC has always stated that 'Ebola poses little risk to the U.S. general population.'

All outbreak countries are currently at zero cases, although there have been cases that are thought to be related to viral persistence in Ebola survivors.

Salmonella Outbreaks

Recalled Sprouted Chia Seed Powder linked to Salmonella outbreak
Recalled Sprouted Chia Seed Powder from Health Matters America Inc. has been linked to a multistate Salmonella outbreak. Photo courtesy of the FDA

Reports of Salmonella outbreaks are not uncommon.

Recent outbreaks of Salmonella include:

  • An ongoing outbreak with at least 11 people in nine states who have gotten sick with Salmonella that has been linked to recalled pistachios from Wonderful Pistachios of Lost Hills, California.
  • An ongoing outbreak with at least 13 people in four states who have gotten sick with Salmonella that are likely linked to alfalfa sprouts produced by Sweetwater Farms of Inman, Kansas.
  • At least 33 people in 23 states who have gotten sick with Salmonella are likely linked to RAW Meal Organic Shake & Meal products made by Garden of Life, LLC.
  • At least 13 people in 13 states who got sick with Salmonella after eating contaminated nut butter spreads from JEM Raw Chocolate, LLC. (2015).

In previous years, Salmonella outbreaks have been linked to chicken, cucumbers, ground beef, small turtles, peanut butter, mangoes, cantaloupe, dry dog good, ground turkey, papayas, alfalfa sprouts, water frogs, and live chicks and ducklings, etc.

E. coli Outbreaks

Escherichia coli is a bacteria that has been associated with several recent outbreaks of food poisoning, including:

  • At least 11 people in two states in an outbreak that was linked to alfalfa sprouts from Jack & The Green Sprouts of River Falls, Wisconsin. (2016)
  • At least 19 people in seven states in an outbreak that was linked to rotisserie chicken salad made and sold in Costco. (2015)
  • At least 55 people in 11 states in an outbreak that was likely linked to a common meal item or ingredient served at Chipotle Mexican Grill restaurants. (2015)
  • At least 19 people in six states who have become infected with the outbreak strain of Shiga toxin-producing Escherichia coli O121 (STEC O121), probably after eating raw clover sprouts produced by Evergreen Fresh Sprouts, LLC of Idaho. (2014)
  • An outbreak in Massachusetts, Michigan, Missouri, and Ohio that had gotten at least 12 people sick, including six hospitalizations, and which was likely linked to outbreak strains of Shiga toxin-producing Escherichia coli O157:H7 (STEC O157:H7) on contaminated ground beef produced by Wolverine Packing Company, which have since been recalled. (2014)This outbreak appears to be over. (2014)

In previous years, E. coli outbreaks have been linked to ready-to-eat salad, organic spinach, raw clover sprouts, romaine lettuce, ground beef, and pre-packaged cookie dough, etc.

Other Outbreaks

Get Your Flu Shot Now
A yearly flu vaccine can help your family avoid the flu. Photo by Spencer Platt/Getty Images

Other recent and ongoing outbreaks include:

  • An outbreak of mumps in Illinois, affecting the University of Illinois' Urbana-Champaign campus (134 cases) and two high schools in Normal, Illinois.
  • A multistate outbreak of Listeriosis that is linked to eating soft cheeses from Karoun Dairies that has gotten 24 people sick, including 22 people who have been hospitalized, and one that died.
  • A case of rubella in a student at TCU in Fort Worth, Texas.
  • An outbreak of Legionnaires' disease in the South Bronx of New York City has gotten at least 108 people sick, including 10 deaths.
  • There have been several cases of human plague in children and adults in the western U.S. this year, including a child from California who had been camping at Yosemite National Park and a teenager in Colorado who died.
  • An outbreak of Listeriosis that was linked to Blue Bell ice cream brand products made at an Oklahoma production facility has gotten 10 people sick, including three deaths.
  • At least eight students at the University of Texas at Austin have mumps.
  • An outbreak of Listeriosis that has been linked to commercially produced, prepackaged caramel apples which have gotten 32 people sick in 11 states and leading to six deaths.
  • An outbreak of mono that has gotten over 30 people sick  in Osage County, Oklahoma and led to the shutdown of the ​Woodland Public School District.
  • At least five cases of Listeria, including two deaths, that are likely related to mung bean sprouts produced by Wholesome Soy Products, Inc.
  • At least 10 cases of tularemia (rabbit fever) cases in four Denver counties. Although tularemia is a potentially life-threatening bacterial infection, it can be treated with antibiotics.
  • Three cases of E. coli at a Montessori school in Clackamas County, Oregon, near where a 4-year-old recently died with the same strain of bacteria.
  • Outbreaks of mumps in Ohio (482 cases in or associated with Franklin, Delaware, and Madison counties), New York (Fordham University), and Idaho.
  • Cyclosporiasis outbreak in 19 states, with many of the cases in Texas possibly linked to fresh cilantro from Puebla, Mexico.
  • Outbreaks of Vibriosis caused by the Vibrio vulnificus bacteria, which can cause people to get sick after getting exposed by eating contaminated oysters or having an open wound in warm seawater. Called the 'flesh-eating bacteria' in media reports, it has already hospitalized 32 people in Florida and 10 people have died.
  • Serogroup B meningococcal disease outbreaks at UC, Santa Barbara, and Princeton University.

Other emerging infections that are causing outbreaks include Zika fever, dengue fever, and Chikungunya.

Avoiding Outbreaks That Can Get Kids Sick

How do you avoid these and other outbreaks?

Simply being aware of the outbreaks is a good first step, but you should also make sure that your kids:

  • Wash their hands properly.
  • Are up-to-date on all of their vaccines. Of course that won't help them with an infection like MERS or Salmonella, but it can help you avoid measles, mumps, and hepatitis A, etc.
  • Review the latest health alerts before traveling.
  • Use insect repellants to avoid insect bites.
  • Do regular tick checks when camping and hiking.
  • Wash fruits and vegetables before eating them.
  • Avoid high risk foods, such as raw milk, undercooked beef or chicken, and raw eggs, etc.

And just as importantly, be sure to tell your pediatrician if your child is exposed to any of these outbreaks and develops symptoms. Whether it is measles, mumps, or MERS, it will likely be harder to diagnose your child if you leave out any key information that could have put him at higher risk for one of these infections.

Continue Reading