The number of measles cases in an outbreak in the South Plains region of northern Texas has grown from 24 illnesses to 48 in just the past 3 days, the Texas Department of State Health Services (DSHS) reported today. 

Thirteen patients (27%) have required hospital care. All patients are unvaccinated, or their measles vaccine status remains unknown. The first cases in the region were confirmed on January 23. Since then, the DSHS reported 6 cases on February 5 and 24 cases on February 11.

Gaines County is the hardest hit, with 42 of the 48 cases. Other affected counties are Terry (3 cases), Yoakum (2), and Lynn (1).

More cases likely

"Due to the highly contagious nature of this disease, additional cases are likely to occur in Gaines County and the surrounding communities," the agency said today. "DSHS is working with South Plains Public Health District and Lubbock Public Health to investigate the outbreak."

"The best way to prevent getting sick is to be immunized with two doses of a vaccine against measles, which is primarily administered as the combination measles-mumps-rubella [MMR] vaccine," the agency added. "Two doses of the MMR vaccine are highly effective at preventing measles."

The South Plains region comprises 24 counties, extends south of the Texas Panhandle, and includes Lubbock. It is an agricultural region known for its high cotton production and cattle ranches.

Over the past 2 days, the US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) reported more H5N1 avian influenza outbreaks in poultry in nine states, including more layer farms in Ohio, one of the states hit hardest over the past several weeks.

Other states reporting outbreaks at commercial poultry farms include Colorado, as well as Pennsylvania and Indiana—two states that have also reported numerous recent outbreaks. Pennsylvania’s latest outbreaks include duck and broiler farms, and the latest event in Indiana affected a layer farm in Jay County that has nearly 1 million birds.

Separately, the Iowa Department of Agriculture and Land Stewardship yesterday reported an outbreak in a turkey flock in Buena Vista county, the state’s third of 2025.

APHIS said the virus also continues to hit backyard flocks in several states, with the most recent detections in Delaware, Michigan, Minnesota, Wyoming, and New York.

Since the virus first emerged in US poultry in early 2022, outbreaks have led to the loss of a record 159 million birds across all 50 states and Puerto Rico. 

Wisconsin among states warning of wild bird detections

Meanwhile, states continue to note detections in wild birds and have urged the public to avoid handling wild birds.

The Wisconsin Department of Natural Resources today said a wild merganser from Milwaukee County has tested presumptive positive for H5 avian flu and that it has received reports of sick or dead waterfowl, mostly mergansers, along the Lake Michigan shoreline in Milwaukee, Racine, and Kenosha counties.

Since the middle of December, the state has reported wild bird detections in six counties, mostly involving swans and Canada geese.

Jasmine Batten, the group’s wildlife supervisor, said this winter’s detections have remained relatively low, but the recent detections are a reminder that the virus is still in Wisconsin. “The best advice we can give is to remain aware and avoid handling wild birds as much as possible.”

Drugmakers Sanofi and Johnson & Johnson announced yesterday that they're pulling the plug on a phase 3 trial of their joint vaccine candidate for extraintestinal pathogenic Escherichia coli.

The companies said in a news release that in a scheduled review of the E.mbrace 3 trial, an independent data monitoring committee (IDMC) determined that the vaccine—ExPEC9V—was not sufficiently effective at preventing invasive E coli disease (IED) compared with placebo and recommended discontinuing the study. Initiated in 2021, the trial was testing the efficacy, safety, and immunogenicity of the vaccine in preventing IED, which includes sepsis and bloodstream infections, in adults 60 and older.

Extraintestinal pathogenic E coli causes an estimated 10 million cases of IED annually and is a leading cause of sepsis, particularly in older adults with chronic illnesses. 

Disappointing findings

"E. coli sepsis is a devastating disease and there are no preventative measures available to date," said Jean-Francois Toussaint, PhD, MBA, Sanofi's global head of vaccine research and development. "We are disappointed to see that the vaccine was not associated with sufficient efficacy to support the trial continuation, and we will work tirelessly to understand the factors behind the IDMC's finding and to share further analysis once available." 

Sanofi entered into agreement with Johnson & Johnson in October 2023 to co-fund future research and development costs for the vaccine, which was developed by Johnson & Johnson subsidiary Janssen Pharmaceuticals. 

No safety events related to the vaccine were identified in the trial, and investigators said participants who developed IED received prompt treatment and care.

An analysis of data from US hospitals found that ceftolozane-tazobactam and ceftazidime-avibactam are the most frequently used new antibiotics, researchers reported this week in Open Forum Infectious Diseases.

Using data from the PINC-AI database, researchers from the University of Maryland performed a retrospective cohort study of discharges from 832 hospitals from June 2022 through May 2023. The aim of the study was to describe the use of new gram-negative antibiotics—which evidence suggests have been underused—in a recent period, understand the clinical indications for which of these antibiotics are used, and compare the characteristics of patients treated with the new antibiotics against those treated with piperacillin-tazobactam, a widely used older gram-negative antibiotic.

Newer drugs used in only a fraction of new admissions

Overall, more than 3.8 million admissions across 832 hospitals included an antibiotic prescription. New antibiotics were prescribed in 9,768 admissions (0.25% of antibiotic-prescribing admissions) across 537 hospitals, while piperacillin-tazobactam was prescribed in 731,719 admissions (18.8%) and colistin in 570 (0.01%). 

Use of new antibiotics was clustered among a small subset of hospitals, with 10 hospitals accounting for 25% of new-antibiotic-associated admissions.

Ceftolozane-tazobactam was prescribed in 4,157 admissions (42.6%), ceftazidime-avibactam in 3,660 (37.5%), eravacycline in 1,213 (12.4%), cefiderocol in 1,060 (10.9%), meropenem-vaborbactam in 456 (4.7%), omadacycline in 104 (1.1%), and imipenem-relebactam in 99 (1.0%). Nearly half (46%) of new antibiotics were started in the first 3 days of hospital admission, and 70% were used as definitive therapy. Sepsis (76%), pneumonia (46%), and urinary tract infection (39%) were the most common clinical indications. On average, patients treated with new antibiotics had eight more comorbid conditions and longer hospital stays (median 13 vs 6 days) than patients receiving piperacillin-tazobactam.

The authors say the finding that new antibiotics are being used more frequently than polymyxins suggests that practice is finally catching up with evidence. But newer antibiotics are still being underused.

"Though new Gram-negative antibiotics are not used nearly as frequently as workhorses like piperacillin-tazobactam, their use has largely surpassed less effective and more toxic antibiotics like colistin," they wrote. "However, the newest antibiotics, such as cefiderocol, meropenem-vaborbactam, and imipenem-cilastatin-relebactam, remain rare in clinical practice."

A buck in Packer Township, Pennsylvania, has tested positive for chronic wasting disease (CWD), marking the first case for Carbon County, the Pennsylvania Game Commission reported yesterday.

The severely emaciated deer was found dead on private property located more than 10 miles away from any other CWD-positive cases. Carbon County is in the east-central part of the state.

Second county in as many weeks to announce first detection

Last week, the state announced the first CWD detections in adjoining Luzerne County in two bucks, one harvested by a hunter and one identified on a deer-breeding farm. Pennsylvania's first CWD case was found in Adams County in 2012.

A fatal neurologic disease of cervids such as deer, moose, and elk, CWD is caused by infectious misfolded proteins transmitted through direct contact or environmental contamination. Standard sterilization methods and cooking temperatures cannot kill prions, and hunters are urged to have their harvested cervids tested before eating meat from them.