Cyclospora lettuce outbreak reaches 11,458; Pennsylvania measles reaches 460: Health risk update, Aug. 22–28, 2026

The week's signal

From August 22 through August 28, 2026, official notices added several immediate checks for households and healthcare facilities. The alfalfa-sprout outbreak remains open at 55 illnesses in 15 states, while a recalled iceberg-lettuce investigation reached 11,458 illnesses in 20 states. Pennsylvania reported 460 measles cases across 31 counties. WHO kept the Democratic Republic of the Congo's Bundibugyo virus disease epidemic at the level of a public health emergency of international concern, and CDC updated the travel rules for people who have recently been in the DRC. 1 2 3 4

The first household check is the refrigerator and freezer. CDC says the recalled alfalfa sprouts were sold under the Calco and Everything Sprouts brands. People should throw them away or return them, then wash items and surfaces that touched them. The recalled product can cause E. coli or Salmonella illness; CDC lists bloody diarrhea, prolonged diarrhea, high fever, dehydration, and inability to keep liquids down as reasons to call a healthcare provider promptly. 1

This digest covers official pages published or materially updated during August 22–28. Counts below retain the date on which the agency says the data were current.

Actions for households, travelers, and facilities

Alert	Who should act	What to do now
Calco and Everything Sprouts alfalfa sprouts	Households, retailers, restaurants, and foodservice operators with recalled product	Do not eat, sell, or serve the recalled sprouts. Throw them away or return them. Wash and sanitize items and surfaces that touched the sprouts. 1
Iceberg lettuce linked to the Cyclospora outbreak	Anyone who bought or received recalled products; restaurants and retailers handling recalled lettuce	The recalled lettuce should already be off the market. Clean and sanitize surfaces and containers that touched it. Contact a healthcare provider about persistent or recurring diarrhea, especially after eating shredded iceberg lettuce. 2
Donutful Chocolate Dipped Vanilla Cake Donuts	Consumers with a milk allergy or severe milk sensitivity	Discard or return the 7.05-ounce carton containing five 1.41-ounce pouches if the package has UPC 3 50041 39210 3, best-if-used-by date September 15, 2026, and lot 26078. The recalled lots were distributed nationwide and through Amazon. 5
Baxter 0.9% Sodium Chloride Injection, 500 mL	Hospitals, clinics, distributors, and other healthcare facilities	Check product code 2B1323Q, lot Y495523 or Y495523A, expiration 31-Oct-2027, NDC 0338-0049-03. Immediately stop using affected units and return them through the facility's process. The recall concerns possible fiberglass particulate matter. 6
Baxter 70% Dextrose Injection, 2,000 mL	Hospitals, compounding pharmacies, homecare facilities, and distributors	Quarantine product code 2B0296H, lot Y495066, NDC 0338-0719-06, expiration 31-Jul-2027. Stop using it and arrange a return. Homecare facilities that used the lot in parenteral-nutrition solutions should contact affected patients and replace those solutions. 7
Pennsylvania measles outbreak	Residents and visitors in Pennsylvania, especially people without documented immunity and anyone with a possible exposure	Review MMR records. Pennsylvania reported 460 confirmed cases in 31 counties, 83 hospitalizations, and 2 deaths on August 28. Anyone who thinks they were exposed and develops symptoms should call a healthcare provider or the state hotline before arriving. 3
Ebola Bundibugyo virus disease in the DRC	People planning travel to or transiting through the DRC, Uganda, or South Sudan; travel and clinical teams	Avoid travel to Ituri and North Kivu, which CDC rates Level 4. Reconsider nonessential travel to Haut-Uele and Tshopo, which CDC rates Level 3. Follow enhanced precautions elsewhere in the DRC or Uganda. A person who has been in the DRC within 21 days of a flight to the United States cannot board a commercial flight with a U.S. destination. Monitor for symptoms during travel and for 21 days after leaving an affected area. 8
Diphtheria in Sub-Saharan Africa	Travelers to Chad, Guinea, Niger, Nigeria, Mali, Mauritania, Senegal, or Somalia	CDC's travel page was last reviewed August 25 and lists Level 1, Practice Usual Precautions. Check that diphtheria vaccination is current at least one month before travel. Seek care immediately for symptoms and call ahead with travel history. 9
Paratyphoid fever in Yemen	Travelers to Yemen and clinicians evaluating returning travelers	CDC's page was last reviewed August 26 and reports cases in returning travelers. Use safe food and water practices. Typhoid vaccination is recommended for most travelers to Yemen, but there is no recommended vaccine that specifically prevents paratyphoid fever. Seek care for high fever, weakness, stomach pain, headache, constipation, or diarrhea during or after travel. 10

What the counts mean

The 11,458 illnesses in the iceberg-lettuce investigation are an outbreak total, not a count of people who became sick during August 22–28. FDA's August 27 update says the cases came from 20 states, with 495 hospitalizations and 2 deaths. The last illness onset in that outbreak was August 15. FDA says most illnesses began before the July 17 recall, and the investigation added people after interviews continued. 2

CDC's broader Cyclospora surveillance page, updated August 25 with data through August 24, counted 17,180 laboratory-confirmed U.S.-acquired cases, 922 hospitalizations, and 2 deaths in 48 states plus the District of Columbia. The total includes the iceberg-lettuce outbreak and other cases. CDC also listed at least 11,844 additional cases that were not laboratory-confirmed or still required analysis. 11

CDC says it can take about six weeks for information to move from symptom onset to the national case count. The median symptom-onset date on the surveillance page was July 7, with a range beginning May 1. A case reported on August 25 therefore may represent an illness that began weeks earlier. Families should follow a product-specific recall when one exists. Clinicians should consider Cyclospora in prolonged or recurring watery diarrhea and ask about food and travel exposures. 11 12

The alfalfa-sprout count follows the same rule. CDC's page, updated August 24, lists 55 illnesses, 4 hospitalizations, and 0 deaths in 15 states. Illnesses began from May 31 through August 8. The August 22 recall and August 24 CDC update are new actions in this window; the illness dates reach back into the spring and summer. 1

Travel and vaccine watch

WHO's August 24 temporary recommendations place the DRC at very high risk, neighboring states with land borders at high risk, and other states at low risk for the Bundibugyo virus disease epidemic. WHO recommends discouraging nonessential travel to areas with community transmission, preventing suspected or confirmed cases and their contacts from international travel except for medical evacuation, and maintaining exit screening and contact coordination at points of entry. WHO does not recommend a blanket travel ban or denial of entry to travelers from affected states. 13

WHO's August 28 meeting report says the epidemic continues to meet the criteria for a public health emergency of international concern, while it does not meet the criteria for a pandemic emergency. As of August 18, about 5,000 cases had been reported in the DRC. WHO said the outbreak had expanded from 3 health zones in May to 55 by August 12, including 49 with active transmission. Uganda had detected no new cases since July 16, and the risk of spread outside Africa remained very low in the report's assessment. 4

WHO's August 25 polio statement kept polio as a PHEIC and extended temporary recommendations effective August 21. The statement reports 16 new wild poliovirus type 1 cases since the committee's January meeting: 14 in Afghanistan and 2 in Pakistan. The recommendations apply chiefly to affected states and their residents or long-term visitors. A clinician advising travel to an affected country should check the destination-specific polio vaccination and International Certificate of Vaccination or Prophylaxis rules before departure. 14

The checked CDC ACIP recommendations page carries no 2026 update; its latest page update is August 8, 2025. The page therefore supplies no new U.S. routine schedule change for this window. Families should use the current clinician-verified schedule for MMR, influenza, COVID-19, and other routine vaccines, while travelers should check the destination-specific CDC notice before departure. 15

State and clinical signals

Pennsylvania's August 28 release adds 36 confirmed cases since August 26 to a cumulative total of 460. The state reports 83 hospitalizations and 2 measles-associated deaths across 31 counties. Pennsylvania says the MMR vaccine provides 97 percent protection after two doses and directs people with a possible exposure and symptoms to call a healthcare provider or 877-PA-HEALTH before arriving. 3

The DRC Ebola update also matters to clinical and travel teams because the CDC page was updated August 28 with a current data date of August 27. CDC lists Level 4 for Ituri and North Kivu, Level 3 for Haut-Uele and Tshopo, and Level 2 for other parts of the DRC or Uganda. The page says no U.S. case has been associated with this outbreak and rates the likelihood of spread to the United States as very low. A returning traveler with compatible symptoms should call ahead, report the travel history, and follow public-health instructions before entering a clinic or emergency department. 8

FDA's two Baxter recalls give healthcare facilities a concrete inventory task. The saline recall covers product distributed to selected U.S. states from July 31 through August 3. The dextrose recall covers product distributed from July 25 through July 28, including Alabama, Georgia, and Tennessee. Both notices describe particulate contamination and direct facilities to stop using and return the affected units. 6 7

Bottom line

Check refrigerators, freezers, restaurants, and foodservice storage for recalled Calco and Everything Sprouts alfalfa sprouts. Discard or return them and sanitize anything they touched.
Treat the iceberg-lettuce count as a delayed surveillance total. Seek care for persistent or recurring diarrhea after a possible exposure.
Check Donutful cartons for UPC 3 50041 39210 3, lot 26078, and the September 15, 2026 date when a household member has a milk allergy.
Have facilities quarantine Baxter saline lot Y495523/Y495523A and dextrose lot Y495066, then arrange returns and review any related patient or compounding records.
Review MMR records in Pennsylvania and other measles-exposure settings. Call ahead before seeking care for compatible symptoms.
Before a DRC, Uganda, South Sudan, Yemen, or Sub-Saharan Africa itinerary, check the destination notice, vaccination status, entry rules, and post-travel monitoring instructions.