u/Anti-Owl

With baby Arthur too young for the measles vaccine and a sibling due in June, the Otwells grew nervous when the threat of the highly contagious virus started affecting their grocery run.

“We go to the Costco that was kind of a hotbed,” said John Otwell after his state health department's warnings of public exposures at the store.

“A lot of people just don’t get it; they think it’s just a cold. It’s not.”

By Arthur’s 9-month checkup, the South Carolina outbreak had exploded into the nation's worst in more than 35 years, surpassing last year's in Texas.

That meant that under state guidance, Arthur could get his first dose of the MMR vaccine — for measles, mumps and rubella — earlier than the usual 12 to 15 months old"

Their new baby won’t be able to get the shot until at least 6 months — a prospect that worries parents of infants wherever measles spreads.

Babies too young to be vaccinated are among the most vulnerable in a measles outbreak. The disease can wreak havoc on their fragile bodies, making them so sick they stop eating and drinking. They can develop pneumonia or brain swelling, and sometimes die.

Babies depend entirely on herd immunity — at least 95% of a community must be vaccinated to prevent measles outbreaks. But dropping vaccination rates have eroded protection in South Carolina and across the nation. In Spartanburg County, the outbreak's epicenter, less than 90% of students have gotten required vaccines.

“Babies become sitting ducks,” said Dr. Deborah Greenhouse, a Columbia pediatrician. “The burden is on all of us to protect all of us.”

But increasingly, some policymakers and officials push a view of vaccination as an issue of individual freedom and parents' rights, rather than one of public health to safeguard the population as a whole.

At the federal level, Health Secretary Robert F. Kennedy Jr., a longtime anti-vaccine crusader, has sought to remake vaccine policy and oversaw billions in public health cuts. And though a temporary ruling from a federal judge has slowed his momentum, a raft of bills has been introduced in states, including South Carolina, that threaten to further reduce vaccination rates.

South Carolina’s measles outbreak, totaling about 1,000 cases, has slowed. But measles is spreading in many states, with 17 outbreaks this year and 48 last year, and the U.S. on the verge of losing its status as a country that has eliminated measles.

Dr. Jessica Early never thought she’d have to deal with measles, but the pediatrician feared for her patients and her own baby when it popped up in her Greer community. She and other doctors began offering an approved infant MMR dose as early as 6 months old. Her practice also started giving the second MMR dose — usually for ages 4 to 6 years old — early.

To the chagrin of many doctors, no one knows how many South Carolina infants have gotten measles or been hospitalized by it.

State officials will disclose only that 253 of the 997 cases were among children 4 and younger; they say they won’t break cases down further for confidentiality reasons. It’s not uncommon to group statistics this way.

Officials also don’t know exactly how many infants were hospitalized with the virus because, as in some other states, hospitals aren't required to report measles-related admissions.

Across the state, doctors said they got many questions about whether it was safe to bring infants to waiting rooms or day care.

Thomas Compton — regional director of Miss Tammy’s Little Learning Center, a child care network operating across the outbreak region — said 18 parents pulled children out of his facilities, though they had no confirmed cases. Some abandoned deposits days before their kids were scheduled to start, forcing the company to lay off a teacher.

Although licensed day cares must require vaccines under state law, families can easily get religious exemptions. About a fifth of Miss Tammy's 300 children have vaccine waivers.

When measles surged, Compton said state officials gave little guidance. His staff scrubbed down surfaces, as they did when COVID-19 was raging; tracked local measles cases on Facebook; and relied on Google for information about the disease.

“A lot of parents were really stressed out,” Compton said. “Anytime that we had a little sickness going on or something, they were like, ‘Do you think it’s the measles?’”

Last year, an Associated Press investigation found that Trump administration officials were directing activists to push anti-science legislation in statehouses. Nationally, around 350 anti-vaccine bills were introduced as of late October, AP found, including at least eight in South Carolina.

This year, a state bill would prohibit requiring vaccines for children under 2.

“In other words, it would get rid of those requirements in the day cares,” pediatrician Greenhouse said. “And for people like me, that is a gut punch that is terrifying.” [...]

During a 2022 field expedition, Peter Larsen, PhD, was asleep in an open-air house in Guyana when he was awakened by the sensation of liquid on his feet, which were pressed against his mosquito net—except it wasn’t raining. He flicked on his headlamp, startled to find that the liquid was blood, and a vampire bat—a species he had gone there to study—was feeding on him.

That experience, along with his work with vampire bats in several Central and South American countries, prompted Larsen to ponder the pathogens the bats might carry. Specifically, as co-director of the Minnesota Center for Prion Research and Outreach (MNPRO), he wondered about vampire bats’ potential role in spreading the prions (infectious misfolded proteins) that cause chronic wasting disease (CWD) in cervids such as deer, elk, and moose.

The fatal disease has been spreading in North America for decades and has now been found as far south as New Mexico and Texas, with a prevalence as high as 11% in mule deer in one area. At the same time, climate change is driving vampire bats northward, and they are predicted to arrive in Arizona, New Mexico, and Texas in the next 10 to 50 years.

Common vampire bats (Desmodus rotundus) in northern Mexico, Larsen thought, may already be feeding on CWD-positive cervids there, further transmitting the prions. “If I had to guess, I would say it's 70% possible that there are already vampire bats feeding on [CWD-] positive animals in Mexico,” he said.

Larsen’s curiosity led him, along with coauthors Lexi Frank, a University of Minnesota PhD student and research assistant, and Jason Bartz, PhD, a professor at Creighton University, to investigate the potential interface of bats and CWD prions, which Larsen called a national security issue. The team published the findings in the Journal of Mammology.

The fist-sized common vampire bats are known to feed on the blood of livestock, wildlife, and people by injecting an anticoagulant through a painless bite with razor-sharp teeth. The bats often regurgitate blood meals to share with other bats in their roosts who didn’t get their own, as well as participate in communal grooming—another potential transmission route.

In addition, captive cervid herds used for hunting, venison, or other byproducts are relatively common in southern Texas and Mexico, representing ample opportunity for the bats to feed. Cervids with clinical CWD, which often features cognitive impairment and limited mobility, would be especially vulnerable.

In fact, speaking with Texas Parks and Wildlife veterinarian J. Hunter Reed, DVM, MPH, the researchers learned that from 2021 to 2025, Texas ranches that were later confirmed to have housed CWD-positive deer shipped hundreds of live white-tailed deer to Mexico, potentially seeding the disease there. CWD can take years to cause symptoms, and prions can persist in the environment for well more than a decade.

That finding begs the question of whether the bats can be infected with certain CWD strains and, if so, if prion characteristics change after passage through the mammals, possibly gaining the ability to infect non-cervid species such as livestock, wildlife, or people.

That scenario is alarming to Brent Race, DVM, scientist at the National Institutes of Health’s Rocky Mountain Laboratories. “This is a speculative concern, but it turns into a nightmare if it's real,” he said. “Their opinion that bats may become a vector for CWD, or even worse, that bats may enhance the host range of CWD, warrants further study.”

Even if vampire bats aren’t susceptible to infection with CWD prions, they could still serve as a disease vector to susceptible species, he said.

Race added that prion mutations are hard to easily describe. “The prion doesn’t really mutate like a virus or bacteria that can change their genome,” he said. “Prions change by misfolding slightly differently. It is possible that if bats were susceptible to CWD, the resulting prion may be folded differently than typical CWD and potentially have an enhanced ability to infect other species, including humans and livestock. This is, of course, very speculative.”

Rodrigo Morales, PhD, of the University of Texas Medical School at Houston, said that the study is interesting and important but still preliminary/hypothetical and didn’t provide enough evidence to raise alarm.

“As written in the article, this is something still hypothetical because there isn’t a very clear or frequent interaction between the infected animals [deer] and the vampire bats they are referring to,” he said. “Unfortunately, there are no models yet suggesting that this could happen. For that reason, interpretations need to be weighed with caution.”

Morales said that if bats and CWD deer do actually interact, there would be reason for concern. But the level of prion infectivity in blood is very low, and the bats would likely break down some of them after passing them through their gastrointestinal tract.

“If we take an infected animal and collect the blood, we may detect it, but that doesn't mean that the amount of prions present in blood will be enough to transmit the disease,” he said. “Along this line, multiple factors, and not purely interaction, must be considered when evaluating potential vectors for disease transmission. Nevertheless, investigation in these and other areas are relevant to either confirm or discount events facilitating CWD dissemination.” [...]

While spring has officially begun, concerns about respiratory viruses are lingering longer than usual, with cases of respiratory syncytial virus (RSV) cropping up later than expected and a new COVID-19 variant spreading across much of the country.

The Centers for Disease Control and Prevention (CDC) said in a recent update that RSV had started later than expected throughout most of the U.S.

“This unusual timing means higher levels of RSV activity may continue into April in many regions. Emergency department visits and hospitalizations for RSV are highest among infants and children less than 4 years old,” the agency stated.

For most people, RSV cases will cause mild flu-like illness, but for young children and older adults, the disease can cause severe illness, leading to hospitalization that could involve being placed on a ventilator. 

“Unlike some other viruses, you’re actually pretty contagious throughout your entire time with RSV. And so, if your kid is coughing and they’ve had RSV and they go to daycare, all of those kids are exposed. And so it is definitely one of those illnesses we worry about,” said Sarah Nosal, a physician and president of the American Academy of Family Physicians. 

There currently are no treatments specifically indicated for RSV, though preventive treatments have been approved in recent years. 

RSV vaccines are available to older adults and pregnant women, with administration to expectant mothers believed to confer some protection to their children before they are born. An RSV monoclonal antibody is also available for infants and young children. 

Nosal noted this past respiratory viral season was also unique in how the flu behaved. 

“Flu sort of had two spikes this year in that we had an early flu A,” she said. “We had what we predicted, and then had a late flu B as well, where we had lots of patients. And I saw those patients in the last month or so who were still getting this tail end of influenza B.”

The strain that circulated later in the season was dubbed a “super flu” in the media. However, physicians emphasized that it was just another strain of the influenza virus, one that presented with somewhat more severe symptoms and appeared to evade immune protection more effectively.

As states deal with a late RSV season, more are also detecting cases of the so-called “cicada” variant of COVID-19, with 25 now reporting the strain. According to the CDC, COVID-19 activity remains low, but some aspects of this strain are of concern.

“This ‘cicada’ variant has had more mutations in the spike protein, which makes it a bit more different. It’s a more distant cousin, and therefore it’s able to evade some of the protection that we’ve had from prior infections and from prior vaccinations. So, it’s finding a place out there and being able to spread,” said William Schaffner, professor of medicine in the division of infectious diseases at the Vanderbilt University School of Medicine.

“Fortunately, it’s not more severe,” he added. “It’s likely to be a variant that is included the next time the covid vaccine is updated.”

Nosal added that the extra mutations observed in the cicada variant, while likely giving it more of an ability to evade the immune system, also indicate it’s ultimately less able to cause infection.

“The actual mutations don’t match as well to like human cellular morphology. It doesn’t kind of match and infect ourselves as easily,” she said.

Schaffner lamented that this past season was affected by the mass layoffs at the CDC carried out by the Department of Government Efficiency.

A study published this year found that among the nearly 40 CDC databases that were no longer being updated, 87 percent were vaccine-related. Among the remaining stagnant databases, four out of five pertained to respiratory diseases.

While respiratory viruses from the winter continue to circulate, springtime allergies are also beginning to hit people, which could play a role in how individuals are affected by lingering viruses.

“There are research studies that show just being exposed to pollen and other allergens, even if you personally don’t get allergy symptoms, increases your inflammation in your mucosal membranes and makes you more vulnerable to viral illnesses,” Nosal said.

She noted many people are prone to dismissing respiratory virus symptoms for allergies during this time of year and advised that they still test themselves if they’re feeling unwell.

Due to the late RSV season, many state and local health departments have extended their RSV seasons and the immunization window for children, at least until the end of April. Schaffner advised that parents consider these options despite it being past the typical respiratory viral season.

“RSV continues to be the leading cause of hospitalization in young infants, so being able to prevent that is very important,” Schaffner said. “And since the RSV season is extending, the recommendations have been to pediatricians and parents to still consider even though it’s kind of late in the season.”

Schaffner and Nosal said planning for each respiratory viral season is essential to better outcomes for people.

[...]

Yesterday the South Carolina Department of Public Health once again reported no new measles cases, as the state marches toward an official end of the largest US measles outbreak in recent history with 997 cases.

The outbreak began on October 2, 2025, and was seeded in a number of private elementary and middle schools where the student body had low vaccination rates. There have been no new cases recorded since March 17.

“There currently are no people in quarantine or isolation. If no new cases are reported, the last day of the outbreak will be April 26,” officials said. “A period of 42 days with no new cases is required to declare an end to a measles outbreak. This is double the number of days for an incubation period (21 days) and a clear indicator of a broken transmission chain.”

Among the 997 cases, 639 are aged 5 to 17, and 264 are under the age of 6. Among those infected, 932 were unvaccinated, 20 were partially vaccinated, 26 were fully vaccinated, and 19 had unknown status.

In similar news, Snohomish County, Washington, this week announced an end to a measles outbreak that began on January 15. A total of 14 measles cases were recorded during the outbreak, and the last reported case was February 17.

So far this year, Washington State has had 33 measles cases.

**Utah reports 24 new cases**

With the outbreak in South Carolina seemingly under control, Utah now has the most active outbreak in the country, with officials recording 24 new cases in the last five days, raising the outbreak case count to 583.

Of those cases, 386 have been recorded this year, with 121 in the last three weeks. The Southwest Health Area has the most cases with 249, followed by Utah County with 93 cases, and Salt Lake County with 62 cases.

So far 47 people have been hospitalized during this outbreak, officials said.

**100 children dead in Bangladesh**

In international measles news, a growing measles outbreak in Bangladesh has hit a grim milestone, with more than 100 children dead. Officials say a drop in newborn vaccination in the South Asian nation is fueling the activity.

The outbreak began on March 15. So far, more than 900 cases have been recorded in three weeks, with one-third of case-patients 9 months of age or under. Country officials said a massive vaccination campaign targeting infants will begin this week.

Promising results from an experimental hookworm vaccine trial offer hope for the more than 400 million who contract the parasitic infection every year.

The phase 2 study, published last month in The Lancet Infectious Diseases, was a double-blind clinical trial. Participants who received the Na-GST 1/Al–CpG vaccine candidate had significantly milder infections than those in the placebo group, as well as volunteers who received one of two other vaccine candidates.

The vaccine specifically targets Necator americanus, which is the most common type of hookworm. By interfering with a certain protein in the worm, researchers say they can prevent N americanus from feeding on the blood of its host’s small intestine, causing the parasite to die.

It’s always a pleasant surprise when a vaccine or medical trial works as well as hoped for, said senior author David Diemert, MD, director of George Washington University’s Vaccine Research Unit.

“I have to say I was not expecting it to be that good,” he said.

Diemert’s results are promising and a good candidate for further testing, said Kaylee Herzog, PhD, a parasite biologist and curator of the parasite collection at the Museum of Southwest Biology at the University of New Mexico who was not involved in the study.

“The road to a safe and effective hookworm vaccine is still a long and winding one,” Herzog told CIDRAP news. “But results like those reported here move us another step further along that road.”

Diemert said researchers on his team are searching for funding so they can conduct another phase 2 trial, which they’ll do in the field and in collaboration with communities where hookworm is endemic. The parasite is a pressing public health issue in tropical countries in which the sanitation infrastructure is poor and medical care can be harder to access.

While some people have no symptoms, a hookworm infection can cause a host of health issues, including abdominal pain, rash, coughing or wheezing, fatigue, nutrient deficiencies, and anemia. Chronic reinfections in kids can slow their physical growth and mental development.

Though the treatment for hookworms is fairly simple, treating someone once doesn’t protect them from future infections. And there’s evidence to suggest these medications are not always effective at clearing infections, especially after repeated use, said Diemert, “It would be much better just to prevent it in the first place from ever happening.”

Repeatedly administering anti-parasitic drugs is also an expensive and laborious process, added Herzog.

While it makes sense that Diemert and his colleagues designed a vaccine to specifically target N americanus, Herzog noted that other hookworm species also cause illness in humans.

“There likely will not be a single vaccine that will be effective against all hookworms,” she said.

Still, if this experimental vaccine comes to fruition, she said it would be a boon for global health.

A population-based study in Canada indicates fungal bloodstream infections are an uncommon but deadly complication in solid-organ transplant patients, researchers reported last month in JAMA Network Open.

Using administrative health care databases from Ontario, researchers from Ajmera Transplant Centre, the University of Toronto, and Public Health Ontario assessed the incidence of Candida bloodstream infection (candidemia) in patients who received a solid-organ transplant from January 2011 through September 2022. While invasive candidiasis is the most common invasive fungal infection in solid-organ transplant patients, and candidemia is the most frequent manifestation of invasive candidiasis, few studies have specifically examined candidemia incidence in this population.

Of the 10,249 transplant recipients (median age, 57 years; 63.9% male) included in the study, most (59.8%) were kidney transplant recipients. Overall, candidemia incidence was infrequent, occurring in 135 patients, with Candida albicans, which was the most frequently reported species (41.5%). The cumulative probability of candidemia among all transplant recipients was 0.87% at one year, 1.33% at five years, and 1.67% at 10 years.

Lung transplant recipients had the highest candidemia incidence, with a 10-year cumulative probability of 4.17%, a finding the study authors suggest could be linked to prolonged stays in the intensive care unit. Kidney transplant recipients had the lowest incidence (0.81%).

Thirty-day mortality in patients with candidemia was 39.3%, and 90-day mortality was 47.4%. After adjusting for baseline variables and comorbidities, candidemia was associated with a nearly sevenfold increase in mortality risk (adjusted hazard ratio [AHR], 6.85) compared with patients without candidemia. The risk was even higher when Candida isolates were resistant to fluconazole (AHR, 11.86).

“Further research is needed to better identify vulnerable subpopulations and to develop targeted strategies for early intervention,” the study authors concluded.