Late last week the Centers for Disease Control and Prevention (CDC) reported that 34 people in 13 states have been sickened in an outbreak of Salmonella Saintpaul tied to backyard poultry.

So far no deaths have been associated with this outbreak, but 13 people have been hospitalized. 

Michigan has the most cases, with six, followed by Wisconsin and Ohio, each of which have five cases. Indiana, Kentucky, and Maine each have three cases. Illnesses started on dates ranging from February 26, 2026, to March 31, 2026.

41% of cases in children under 5 

“Children younger than 5 years old shouldn't handle the birds (including chicks and ducklings) or anything in the area where the birds live and roam. They are more likely to get sick from Salmonella,” the CDC said. 

Forty-one-percent of case-patients in this outbreak are under the age of 5 years, and, of the 29 people interviewed by investigators, 23 (79%) reported contact with backyard poultry in the days prior to illness.

“Of 14 people who reported owning backyard poultry, 13 (93%) bought or obtained poultry since January 1, 2026,” the CDC said. “People reported getting their poultry from various places, including agricultural retail stores.”

The CDC said it will continue to investigate the hatcheries associated with cases. 

Cases of pneumococcal pneumonia surged in 2022 and 2023. The bacterial infection attacks the lungs, causing air sacs to become inflamed and fill with fluid.

New findings published today by the American Academy of Pediatrics show that this post-COVID increase was largely driven by a specific subtype of the Streptococcus pneumoniae bacteria: Serotype 3 is associated with severe complications, including meningitis. 

These findings are especially salient for young children, older adults, and those with weakened immune systems, as these groups have the highest risk.

Finding the culprit

There are more than 100 distinct subgroups of S pneumoniae, though most hospitals lack the laboratory capacity to determine which serotype is causing an infection.

However, the study found that among 190 kids with pneumococcal pneumonia from 2017 to 2023, serotype 3 infected 32% of patients. 

Researchers note that serotype 3 was, "The only individual serotype with a significantly higher rate in 2022–2023 compared with 2018–2019." (Rate ratio, 3.0)

The findings don’t surprise the study's lead author, Eric E. Engstrom, MD, at Children's Hospital of The King's Daughters in Norfolk, Virginia. The pediatric infectious diseases specialist told CIDRAP News that he and other clinicians have noticed that more pneumococcal pneumonia patients are suffering from severe infections, which is indicative of Serotype 3.

Parents get impatient. Patients get impatient. And certainly, the providers get impatient.

Engstrom said these findings can inform clinical decisions because while patients with serotype 3 take longer to improve, this form of S pneumoniae responds well to common antibiotics, including penicillin.

"Parents get impatient. Patients get impatient. And certainly, the providers get impatient," he said.

But as the findings suggest, sometimes patience is the right course rather than prescribing broader, potentially more harmful antibiotics.

A study of children enrolled in Medicaid found a high rate of outpatient antibiotic use in kids with medical complexity, researchers from Boston Children's Hospital reported late last week at the annual meeting of the Pediatric Academic Societies (PAS).

Using the multistate MarketScan Medicaid Database, the researchers examined outpatient antibiotic claims in more than 2.3 million children ages 0 to 18 years who were enrolled in Medicaid in 2023. They categorized the children into five groups—healthy; non-complex chronic condition; and one, two, and three or more complex chronic conditions (CCCs)—and compared antibiotic prescribing rates across groups.

Antibiotics are the most commonly prescribed medication in children, but little is known about antibiotic use in kids with medical complexity, who are prone to infection.

Nearly 40% filled at least 1 antibiotic prescription

Of the children included in the analysis, 39.3% filled one or more antibiotic prescriptions over the study period. Annual prescription rates per 1,000 children rose more than fivefold across the five groups as the level of medical complexity increased, rising from 514 in healthy children to 2,882 in children with three or more CCCs. Children with medical complexity were also far more likely to be prescribed broad-spectrum antibiotics. Penicillins, cephalosporins, and macrolides accounted for 93% of antibiotics prescribed to healthy children, while children with three or more CCCs had substantially more prescriptions for sulfonamides, quinolones, and aminoglycosides.

The researchers said that children with three or more CCCs have the highest annual antibiotic prescription rate of any population, pediatric or adult.

"These findings suggest that children with medical complexity may be a high-impact population for future antibiotic stewardship efforts,” lead author Kate Snow, MD, an instructor at Boston Children's, said in a PAS press release.