Cyclospora widens across 31 states

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.

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. 12

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

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. 1415

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

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 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.

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. 2728 Owners and clinicians in affected areas should treat unexplained animal wound infestations as reportable until ruled out by veterinary or agriculture authorities. 27