Cyclospora widens across 31 states

Cyclospora widens across 31 states

This week’s digest leads with the multistate Cyclospora outbreak, where state and media-compiled counts are moving faster than CDC’s public surveillance page. It also covers Ebola growth in DRC, Nara formula botulism, measles, food allergen recalls, travel notices, MMWR items, Philadelphia clinical alerts, and New World screwworm monitoring.

A multistate Cyclospora surge leads the domestic alerts in the July 3-10 public health window. State and media-compiled counts put the outbreak at about 2,912 cases across 31 states, while CDC-confirmed counts lag behind at 843 cases under investigation and 86 hospitalizations, with no deaths reported. 1
For US households, the actions split by risk type. Cyclospora calls for symptom awareness and caution around fresh produce because no single source has been confirmed; the Nara Organics formula, ALDI kimbap, Bakr cookie dough, Zapp's/Dirty chips, and Clover Hill Dairy alerts call for product checks; Ebola remains the main international watch item for travelers, clinicians, and organizations moving staff through affected areas.

This week at a glance

AlertWhat changedWho should actWhat to do now
CyclosporiasisState and media-compiled data put the outbreak near 2,912 cases in 31 states, while CDC has confirmed 843 cases and is investigating 1,500+ reports. 1Families, clinicians, food-service operatorsTreat persistent watery diarrhea as a reason to seek care and ask about Cyclospora testing; do not treat Taco Bell ingredient removals as a formal FDA or FSIS recall. 2
Ebola in DRC and UgandaDRC reached 1,792 confirmed Bundibugyo Ebola cases and 625 deaths as of July 8; Uganda remained at 20 confirmed cases and 2 deaths, with its last confirmed case on June 21. 3Travelers, clinicians, aid organizationsCheck CDC Ebola updates before travel and keep screening pathways current for compatible symptoms after travel from affected areas. 3
Nara Organics infant formulaFDA confirmed a fourth infant botulism case on July 6; all four infants were hospitalized, and no deaths were reported. 4Parents and caregivers using infant formulaDo not use Nara Organics Whole Milk Organic Powdered Infant Formula sold through Target, Target.com, or Nara.com from July 2025 through June 2026. 4
MeaslesCDC reported 2,231 US measles cases in 42 jurisdictions as of July 9, up 61 from July 2. 5Families, schools, camps, clinicians, travelersCheck measles, mumps, and rubella vaccination records before travel, camp, or school planning. 5
Food allergen recallsBakr cookie dough was recalled for undeclared soy, and ALDI Fusia Kimchi & Tofu Kimbap was recalled for undeclared tuna. 6 7People with soy or fish allergyCheck package identifiers, then discard or return affected products for a refund. 6 8
Travel noticesCDC removed the Level 1 Thailand and Montserrat notices on July 7; DRC Ebola, Yemen malaria, French Guiana chikungunya, Mayotte malaria, Haiti diphtheria, and global dengue notices remained active. 9International travelers and travel clinicsRecheck the CDC destination page before departure because notice status can change between booking and travel. 9

Cyclospora becomes the domestic lead

Cyclospora is a parasite that can cause prolonged diarrheal illness, and this outbreak now has a wide domestic footprint. Michigan reported 1,562 cases and 44 hospitalizations, far above its usual annual baseline of about 50 cases. 10 Ohio reported 364 cases and 46 hospitalizations across 51 counties, with 306 cases in Toledo-Lucas County alone. 11 New York reported 394 cases since May 1, including 273 in New York City and 121 elsewhere in the state. 12
State updates are moving faster than CDC's public page. CDC's public surveillance page still reflected 145 cases through June 16 when CIDRAP reported on July 9 that cases were mounting and federal tracking was lagging. 13 CIDRAP also reported that Cyclospora surveillance became optional in FoodNet on July 1, 2025, while Salmonella and Shiga toxin-producing E. coli remained mandatory. 13
The source investigation has not narrowed to one product. NBC News reported that CDC had no evidence of a single multistate outbreak linking all cases, and Food Safety News reported that some Taco Bell locations removed lettuce, cilantro, onions, pico de gallo, and guacamole from menus while federal agencies had not issued a formal recall for those items. 1 2
Without a named product, the household step is symptom monitoring rather than pantry removal. A formal recall tells a consumer which product to remove; this investigation currently tells consumers and clinicians to watch symptoms, ask about recent produce exposure, and consider Cyclospora testing for diarrhea that persists for several days. 1

Ebola grows in DRC; US action stays targeted

The Bundibugyo Ebola outbreak in the Democratic Republic of the Congo continued to grow sharply this week. CDC reported 1,792 confirmed DRC cases, 625 confirmed deaths, and a 34.9% case fatality ratio as of July 8, compared with 1,460 cases and 452 deaths on July 1. 3 Uganda remained stable at 20 confirmed cases and 2 confirmed deaths as of July 9, with the last confirmed case reported on June 21 after travel from DRC. 3
The geographic concern widened. Reports citing DRC and international health officials described spread into Tshopo Province's Kisangani area and Haut-Uele Province's Wamba area, including suspected cases with links to Ituri's Nia-Nia health zone and one suspected Kisangani case without a clear geographic link. 14 15
Two response developments moved in opposite directions. The PARTNERS randomized treatment trial began on July 2 at the Evangelical Medical Center in Bunia, testing remdesivir, MBP134, the combination, or standard care for Bundibugyo virus disease. 16 WHO also listed the first Bundibugyo Ebola diagnostic test for emergency use on July 2, and CIDRAP reported that DRC testing capacity increased from about 200-400 tests per day to more than 2,000 tests per day. 17
At the same time, Ebola responders in Ituri protested over unpaid wages on July 6-7, and AP reported that affected groups included surveillance, security, community outreach, and burial teams. 18 CIDRAP reported that CDC acting director Jay Bhattacharya escalated the agency response to Level 1 activation on July 7, meaning the response could require maximum staffing around the clock. 19
For US readers, Ebola does not call for broad household changes. Travelers with recent or planned travel to affected areas should check CDC Ebola updates before departure and after return, and clinicians should keep travel-history screening active for febrile or hemorrhagic illness compatible with Ebola exposure. 3

Recalls and kitchen checks

ProductHow to identify itRisk and statusWhat to do
Nara Organics Whole Milk Organic Powdered Infant FormulaProduct sold through Target, Target.com, and Nara.com from July 2025 through June 2026. 4FDA confirmed 4 infant botulism cases in California, Pennsylvania, and Washington; all 4 infants were hospitalized, and CDPH detected C. botulinum in an opened can. 4Do not use the recalled formula; seek urgent care for poor feeding, weak cry, constipation, limpness, or breathing problems after possible exposure. 4
ALDI Fusia Asian Inspirations Kimchi & Tofu Kimbap8.1 oz package, best-by OCT.08.2027, sold at ALDI in 19 states and Washington, D.C. 7 8The product was recalled for undeclared tuna, a fish allergen, with no illnesses reported. 7People with fish allergy should not eat it; return it to ALDI for a refund. 8
Bakr Brown Butter Chocolate Chunk Ready To Bake Cookie Dough8 oz blue pouch, lot 2606022, sold at Target stores in Southern California, Southern Nevada, Arizona, and Utah starting June 11. 6The product was recalled for undeclared soy after S'mores cookies were packed into the wrong pouch; no illnesses were reported. 6People with soy allergy should not eat it; return it for a refund or call 1-800-697-BEAR. 6
Zapp's and Dirty potato chipsAbout 650,000 bags across 7 varieties, with best-by dates from July 27 through August 31, 2026. 20FDA classified the recall as Class I on July 1 because seasoning could contain Salmonella; no illnesses were reported. 20Do not eat affected bags; discard them or use the manufacturer's refund channel. 20
Clover Hill Dairy cheesesRecalled brands include Clover Hill, Kesso, Quesos La Ricura, Izalco, De Mi Pueblo, Rio Lindo, La Colonia, and Selectos Latinos, with distribution to Maryland, New Jersey, New York, North Carolina, Virginia, and Washington, D.C. 21The Listeria outbreak remained at 12 cases, 10 hospitalizations, and 1 death across Illinois, Maryland, New York, and Virginia. 21Do not eat the recalled cheeses; clean refrigerator surfaces, containers, and counters that touched them. 21
The Nara formula investigation also has a policy tail. HR 7867 would require FDA to develop a pathogen testing list for infant formula, set testing frequency, require contamination reports within one day, and strengthen recordkeeping. 22 That bill does not change immediate household instructions; it explains why the recall is now part of a broader formula-safety debate.

Measles, vaccine policy, and clinical notes

Measles remains the vaccine-preventable disease to check before school, camp, and travel planning. CDC reported 2,231 confirmed US measles cases across 42 jurisdictions as of July 9, including 32 outbreaks and 61 new cases since July 2. 5 The 2026 total was 58 cases below the 2025 full-year count of 2,289 cases, although weekly reported cases had fallen to 9 for the week of July 5 after 24 for the week of June 28. 5
US vaccine governance remained unsettled. CIDRAP reported on July 9 that the Advisory Committee on Immunization Practices still lacked a quorum and that the June 24 ACIP charter revision changed member requirements from explicit vaccine research experience to a balanced range of scientific, clinical, and public health expertise. 23 Dr. Erica Schwartz was scheduled for a July 15 Senate HELP Committee confirmation hearing as CDC director. 23
MMWR released two clinician-facing reports on July 9. One reviewed acute flaccid myelitis surveillance from 2020 through 2025, finding 17-48 cases per year despite EV-D68-associated respiratory disease increases in 2022, 2024, and 2025. 24 The other described outbreaks among residents and staff at the Eaton wildfire evacuation shelter, including 104 norovirus cases, 56 COVID-19 cases, 29 influenza cases, and 30 unspecified respiratory illness cases. 25
Philadelphia's health department posted a July 10 advisory on West Nile virus and other arbovirus testing and reporting requirements, and it also posted a July 6 measles clinical-management advisory for summer travel. 26 Clinicians in the region should use those advisories for testing, reporting, and isolation workflows rather than relying on general patient-facing guidance.

Travel and animal-health watch items

CDC's travel notice page removed Level 1 notices for Thailand and Montserrat on July 7, while Level 3 Ebola notice coverage for DRC and Level 2 notices for Ebola in DRC/Uganda, malaria in Yemen, chikungunya in French Guiana, and malaria in Mayotte remained active. 9 Haiti diphtheria and global dengue remained Level 1 notices. 9 Travelers should check the destination page again shortly before departure, especially when children, pregnant people, older adults, or immunocompromised travelers are included in the itinerary.
New World screwworm remained mainly an animal-health concern, but it matters for pet owners, livestock owners, veterinarians, and animal import/export planning. USDA APHIS status reporting and state updates kept attention on detections in Texas and New Mexico, while Delaware's agriculture department said on July 8 that it was monitoring the Texas situation and that Delaware had no current risk. 27 28 Owners and clinicians in affected areas should treat unexplained animal wound infestations as reportable until ruled out by veterinary or agriculture authorities. 27

참고 출처

  1. 1NBC News: What is cyclosporiasis? Symptoms, total cases, map and latest as parasite outbreaks reach 31 states
  2. 2Food Safety News: Taco Bell pulls fresh produce at some locations because of cyclospora outbreak
  3. 3CDC: Ebola Outbreak: Current Situation
  4. 4FDA: Outbreak Investigation of Infant Botulism: Powdered Infant Formula
  5. 5CDC: Measles Cases and Outbreaks
  6. 6AOL / PRNewswire: Bear Stewart LLC issues allergy alert on undeclared soy in Bakr Brown Butter Chocolate Chunk Ready To Bake Cookie Dough
  7. 7Food Safety News: Aldi kimchi recalled because of undeclared fish
  8. 8USA TODAY: ALDI recalls kimbap sold in 19 states over potential fish allergen
  9. 9CDC: Travel Health Notices
  10. 10Michigan Department of Health and Human Services: Infectious Disease Outbreaks
  11. 11Cincinnati Enquirer: Taco Bell updates menu as Ohio deals with explosive diarrhea outbreak
  12. 12NBC New York: Cyclosporiasis in New York climbs to 394 cases since May 1
  13. 13CIDRAP: US Cyclospora cases mount as CDC lags on tracking
  14. 14Saudi Gazette / Xinhua: DRC says Ebola outbreak yet to peak as virus spreads to new areas
  15. 15NPR: Ebola death toll in Congo reaches 600
  16. 16Forbes: New Clinical Trials Offer Hope In The Fight Against Ebola In The Democratic Republic Of Congo
  17. 17CIDRAP: Ebola deaths top 500 as DR Congo health workers threaten to strike
  18. 18Washington Post / AP: Some health workers in Congo's Ebola outbreak go on strike over pay issues as deaths near 600
  19. 19CIDRAP: Ebola workers strike as CDC head says agency's response will last months
  20. 20lohud / USA TODAY NETWORK: FDA issues highest-risk warning for recalled potato chips
  21. 21AOL / USA TODAY: See cheeses added to 'do not eat' list amid deadly listeria outbreak
  22. 22The Philadelphia Inquirer: Federal legislation would increase pathogen testing for infant formula following botulism cases
  23. 23CIDRAP: Still no ACIP quorum, collapsing lawsuits, and vaccine questions answered
  24. 24CDC MMWR: Acute Flaccid Myelitis Surveillance - United States, January 2020-December 2025
  25. 25CDC MMWR: Norovirus, COVID-19, and Influenza Outbreaks Among Residents and Staff Members at the Eaton Wildfire Evacuation Shelter
  26. 26Philadelphia Department of Public Health: Health Alerts
  27. 27USDA APHIS: Current Status of New World Screwworm
  28. 28Delaware.gov: DDA's Poultry and Animal Health Section monitors impact of New World Screwworm within U.S.

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