The Montgomery County Department of Health, which includes the Philadelphia area, yesterday reported a measles case in an unvaccinated resident, a child who rode a shuttle bus from John F. Kennedy International Airport in New York City.

In a statement yesterday, health officials said they are tracing contacts and examining exposures related to the shuttle bus, as well as at two health facilities, including a pediatrics office in Plymouth Meeting and an emergency department in King of Prussia. The case appears to be Pennsylvania’s first of 2025.

Texas infant had traveled internationally 

Elsewhere, health officials in Austin, Texas, reported the first case in Travis County since 2019, which involves an unvaccinated infant who was exposed to the virus during a vacation overseas. In a statement, Austin Public Health said it doesn’t expect that any exposures will be connected to the case and that the infant’s family members are all vaccinated and isolating at home.

Desmar Walkes, MD, with the Austin-Travis County Health Authority, said he called on the community to ensure that they are protected against the vaccine-preventable disease. “Leaving yourself unvaccinated means more than just a rash, measles can put you in the hospital and can even lead to death as we’ve seen already in Texas.”

The two cases come amid sporadic travel-related cases in a handful of states, along with a few outbreaks, including a large one centered in the South Plains area of west Texas that has resulted in 146 cases since late January, one of them fatal.

The US Centers for Disease Control and Prevention in its latest weekly update reported 71 more measles cases, raising the total for 2025 to 164 from nine jurisdictions. Of the total, 153 are part of three outbreaks, most of them related to the ongoing event in western Texas. Most of the patients are unvaccinated or have unknown vaccination statuses. Thirty-two of the patients were hospitalized.

Wild Coast Raw, based in Olympia, Washington, on March 1 announced a recall of certain lots of its frozen raw pet food for cats after an investigation into severe cat illnesses in Oregon and Washington turned up the outbreak strain of H5 avian flu in some of the company’s products.

The voluntary recall involves certain lots of Wild Coast’s boneless free-range chicken formula, which was distributed to pet food retailers in Oregon and Washington. Six of the affected lots have best buy dates of December 25. The initial alert in the middle of February from Washington’s agriculture department had applied to two lots of the implicated formula.

Last week, Washington’s agriculture department announced more illnesses in domestic cats who were exposed to the food.

Earlier this year, California officials tied cat H5 avian flu illnesses to a different locally produced raw pet food brand, and in late 2024, Oregon health officials linked a cat illness to Northwest Naturals, a raw pet food brand sold nationwide.

More poultry detections in 3 states

In other H5N1 developments, the US Department of Agriculture (USDA) Animal and Plant Health Inspection Service today confirmed more H5N1 detections in poultry from three states, all involving backyard birds. Affected states include New York (Suffolk County), North Carolina (Dare County), and Ohio (Portage County). 

A systematic review and meta-analysis found a high level of antimicrobial resistance (AMR) in bacteria isolated from cancer patients, researchers reported late last week in BMC Infectious Diseases.

Although cancer patients are known to be at increased risk of infections caused by drug-resistant pathogens, there has been no systematic review of the global prevalence of AMR in the common pathogenic bacteria known to cause infections in cancer patients. To address this gap in knowledge, researchers from the University of Ghana Medical School reviewed studies published from 2000 to 2024 on cancer patients with infections caused by Staphylococcus aureus, Streptococcus pneumoniae, Enterococcus faecium, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterobacter spp.

The review identified 132 articles involving 49,638 cancer patients in 39 countries. Most studies (67%) reported AMR in multiple pathogens, while 33% reported resistance in single pathogens. For E coli, resistance prevalence was highest for penicillins (81.8%), followed by cotrimoxazole (65.8%) and monobactams (61.6%). For K pneumoniae, the highest prevalence of resistance was observed for penicillins (99.0%) and cotrimoxazole (70.9%), while A baumannii had high resistance prevalence to multiple antimicrobial classes, including third-generation cephalosporins (84.1%), fourth-generation cephalosporins (80.8%), carbapenems (82.6%), fluoroquinolones (80.4%), beta-lactam/beta-lactamase inhibitors (79.2%), cotrimoxazole (75.8%), and aminoglycosides (64.1%).

Enterobacter spp and E faecium showed high resistance prevalence to penicillins, at 91.8% and 90.6% respectively, while P aeruginosa had a high prevalence of resistance to third-generation cephalosporins (49.4%), and S aureus showed high prevalence to macrolides (55.6%) and methicillin (45.3%).

Better infection prevention, antimicrobial stewardship needed

The study authors suggest possible underlying factors for high AMR levels among cancer patients include immunosuppression, prolonged antibiotic exposure, invasive medical devices, and intensive treatments such as chemotherapy and radiation therapy.

"These procedures and treatments can weaken their immune system, increasing their susceptibility to infections," they wrote. "Moreover, the acquisition of resistant bacteria from healthcare settings is significant, considering that cancer patients spend a substantial amount of time in these facilities."

"The pronounced resistance prevalence observed, especially among ESKAPE pathogens, underscores the urgent need to improve infection prevention and antimicrobial stewardship in cancer care globally," they added.

Over the weekend the World Health Organization (WHO) announced a new setback in Uganda's Ebola Sudan outbreak. The country reported a new fatal case, which involved a 4-year-old child who died on February 25.

According to the Associated Press, there were no other details about the death, and local health officials were not commenting on the case. The child died while hospitalized in Kampala, the same city where the index patient, a male nurse, was hospitalized briefly before dying from the virus in late January.

Case count rises to 10

Last month, health authorities maintained that the outbreak was under control after eight patients had recovered, but there is still no clarity about how and where the index patient acquired Ebola. All eight patients had been case contacts of the index case.

The new case raises the death toll to 2, and the case count to 10 in this outbreak. This is the sixth Ebola Sudan outbreak in Uganda's history, with the most recent outbreak identified in 2022. 

• Four countries reported new polio cases last week, including Pakistan, which reported another wild poliovirus type 1 (WPV1) case, a patient from Sindh province who’s paralysis symptoms began on February 6, according to the latest weekly update from the Global Polio Eradication Initiative. The country, one of two where WPV1 is still endemic, has now recorded three cases for 2025. Elsewhere, Chad (6), Ethiopia (5), and Yemen (2) reported more circulating vaccine-derived poliovirus type 2 (cVDPV2) cases, all of which had onsets in 2024 and are included in case totals for the previous year. In other developments, three European countries reported more environmental detections of cVDPV2, most involving samples collected this year. 
• The Department of Health and Human Services is evaluating a $590 million contract to Moderna to develop and test mRNA vaccines against pandemic flu threats, including H5N1, Stat reported today, based on a confirmation from the HHS’ communication director. The development was first reported by Bloomberg News. The contract from the HHS Biomedical Advanced Research and Development Authority (BARDA) was made in January on one of the final days of the Biden administration. 
• Investigators in Bangladesh have detected the country’s first Zika virus cluster, which occurred in Dhaka, the country’s capital, according to study findings reported yesterday by the country’s International Centre for Diarrhoeal Disease Research, Bangladesh (ICCDR,B). The study was based on screening in 2023 on 154 patients from Dhaka who had fever or other Zika virus symptoms. The virus was present in five samples, which the team said should prompt wider screening to gauge the true burden of Zika virus in the country. All five patients lived within 1 km of each other and had not traveled outside the country. One was co-infected with dengue virus. Genetic sequencing determined the viruses belonged to the Asian clade, which has been linked to microcephaly and other neurological complications.