The current US hot spots for measles activity both reported new confirmed cases over the weekend, including exposures at a high school and an international airport. 

Officials in Utah, which has been battling a simmering outbreak in the southwestern part of the state, confirmed five new measles patients in Wasatch County in the north, east of Provo. They are the first measles patients identified in that county this year. 

All five patients are students at Wasatch High School, according to The Salt Lake Tribune. Two more possible cases are being investigated, the newspaper reported. 

At least one student attended school activities and classes while infectious. The cases will push the Utah measles case count over 90. 

10 children now dead in Israel 

In South Carolina, officials late last week reported three new cases in the Upstate area, raising the state total to 55 and the Upstate outbreak to 52. 

"Two of the cases are household members of known cases. A third is the result of unknown community transmission," officials said. Additionally, state officials said travelers at the Greensboro-Spartanburg International Airport may have been exposed to measles by an infectious employee during the week of November 10. 

Finally, in international news, a tenth child in Israel has died from measles as part of a large, ongoing outbreak. The child was 18 months old and unvaccinated. He had arrived at an emergency department yesterday in critical condition.

California health officials say they have identified cases of infant botulism with exposure to powdered infant formula that occurred prior to the current multistate outbreak.

In a statement, a spokesperson for the California Department of Public Health (CDPH) said the state has identified at least six cases of infant botulism with exposure to ByHeart powdered infant formula that occurred from November 2024 to June 2025. The 15-state outbreak currently being investigated by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA), which includes four sickened infants in California and 31 nationwide, began on August 1, 2015.

"CDPH is continuing investigate, but at this time we cannot connect any pre-August 1 cases to the current outbreak," the CDPH spokesperson said.

The statement explained that in early 2025 there was not enough evidence to immediately suspect a common source among the six suspected cases, and that the number of cases were within expected case numbers based on previous years' trends.

CPDH has played a critical role in investigation

Infant botulism occurs when a baby swallows Clostridium botulinum spores, which can grow in the intestine and produce toxins that cause constipation, poor feeding, loss of head control, and difficulty swallowing. 

CDPH's detection of C botulinum in an opened can of ByHeart Whole Nutrition Infant Formula on November 8 led the FDA to recommend a recall of the product. Prior to the outbreak investigation, no powdered infant formula had tested positive for C botulinim in the United States.

CDPH said that, from August 1 through November 19, 107 infants nationwide have received treatment with BabyBIG, a human plasma-derived treatment for infants with botulism. That includes confirmed cases and infants who were being treated while awaiting test results. 

CPDH developed and is the only source of BabyBIG. The CDC and FDA began their investigation into the outbreak after officials with CPDH's Infant Botulism Treatment and Prevention Program alerted them to an increase in requests for the treatment.

Despite the global expansion of antibiotic awareness campaigns over the past decade, the public's understanding of antibiotics remains insufficient, researchers reported last week in Clinical Microbiology and Infection.

In a systematic review and meta-analysis, researchers from Australia, Nigeria, and the United Kingdom identified 227 studies from 98 countries that reported the knowledge of antibiotic use and resistance among the public. They found that 73.2% of the 322,492 participants correctly recognized that antibiotics are effective in treating bacterial infections and 72.5% knew that excessive antibiotic use reduces the effectiveness of antibiotics.

But only 42.1% knew that antibiotics were not effective against viruses, and that number was significantly lower in countries such as Laos (7.2%), Myanmar (11.7%), and Bangladesh (12.5%). Similarly, only 35.1% of respondents knew that antibiotics don't speed up recovery from cold and flu. 

The study authors note that a systematic review conducted in 2015—the year the World Health Organization declared antimicrobial resistance (AMR) a top 10 global health threat—reported that 46.1% of the public was aware that antibiotics are ineffective against viruses, which suggests a decade of public awareness campaigns has had little impact.

"This persistent misconception will continue to drive the misuse of antibiotics for viral infections, a widespread issue in many regions globally, thereby contributing to the broader challenge of AMR," they wrote. "The low levels of public knowledge regarding the ineffectiveness of antibiotics against viral infections suggest that current efforts and campaigns aimed at addressing antibiotic resistance remain insufficient."

Multifaceted strategies are needed

In addition, while 58.4% of respondents acknowledged antibiotic resistance as a global health threat, only 39.1% understood that antibiotic-resistant bacteria can be transmitted between individuals.

"Understanding that resistant bacteria can be transmitted from person to person is crucial, as interpersonal spread represents a key mechanism by which antimicrobial resistance propagates within communities," the authors wrote.

The authors conclude that multifaceted strategies are needed to enhance public knowledge of antibiotics.

"These strategies should include patient education by healthcare professionals, targeted outreach, mass media and digital campaigns, formal education, community-based interventions, robust policy and regulatory measures, and international collaboration," they wrote.