The Centers for Disease Control and Prevention (CDC) yesterday added 3,285 infections to its 2026 Cyclospora total, which includes all outbreaks, raising the tally to 17,180 cases, compared with 1,180 cases through August last year. The CDC also said it is investigating an additional 11,844 cases that are not yet lab-confirmed. 

“Recent illnesses may not yet be reported due to the time it takes to identify and report Cyclospora cases. It can take about six weeks from the start of symptoms to when CDC receives the case information,” the CDC said. 

Historically the cyclosporiasis season in the United States is May 1 through August 31, so cases should dwindle as summer ends, the CDC said. To date at least two people have died during the summer’s Cyclospora outbreak and 922 have been hospitalized. 

The largest outbreak this summer was in Michigan and surrounding states and linked to tainted iceberg lettuce. Several other clusters and outbreaks also occurred, the CDC said.

Last week, Michigan noted a 3% increase in cases, for a state total of 14,277 cases.

From 1999 to 2023, the US age-adjusted adult death rate from influenza and pneumonia plummeted 29.2%, with the only statistically significant rise in crude death rates in adults aged 55 to 64, per a study published in Medicine.

Researchers in China examined the Centers for Disease Control and Prevention’s WONDER public death repository to identify those caused primarily by flu or pneumonia. 

“Influenza and pneumonia form a paired respiratory hazard that imposes enduring public health pressure within the United States, generating extensive annual cases, premature deaths, and overloading local medical service systems year after year,” the authors wrote. 

“Influenza viral infection often weakens lower respiratory tract defenses, raising the risk of secondary pneumonia development,” they added.

Declines align with investment, advances in prevention

The total number of influenza and pneumonia-related deaths fell from 63,006 in 1999 to 44,625 in 2023, a 29.2% reduction. The national age-adjusted death rate for flu and pneumonia declined from 35.9 to 16.5 per 100,000 residents (average yearly decline, 3.2%). 

Further research incorporating individual-level risk factors, vaccination data, and pathogen-specific coding is needed to clarify the drivers of these trends and disparities.

Death rates were consistently higher for men than for women (43.7 vs 31.4/100,000 in 1999 and 19.5 vs 14.2/100,000 in 2023). Black adults had the highest death burden in 1999 (38.7/100,000) but saw the most marked relative reduction by 2023 (19.0/100,000). 

Rural counties had higher age-adjusted death rates than metropolitan areas (40.0 vs 35.1/100,000 in 1999 and 23.5 vs 19.3/100,000 in 2020). Adults 85 and older had the highest crude death rate, which peaked at 751.8/100,000 people in 1999. Of note, people aged 55 to 64 made up the only group with a statistically significant rise in crude death rate (average annual change, 0.8%). 

The declines align with nationwide advances in respiratory disease prevention and sustained investment in public health infrastructure, the researchers said.

“These findings highlight key population-level patterns and inequalities,” they concluded. “Further research incorporating individual-level risk factors, vaccination data, and pathogen-specific coding is needed to clarify the drivers of these trends and disparities.”

The Infectious Diseases Society of America (IDSA), eight other professional societies, and a patient advocacy group yesterday released a position paper aimed at improving sepsis outcomes in US hospitals.

The recommendations, published in Clinical Infectious Diseases by a multidisciplinary panel of experts from the groups, focus on infection-related aspects of sepsis management and cover six domains: diagnostic testing and pathogen detection, antimicrobial management and delivery, surveillance and performance metrics, adjunctive therapy, program infrastructure and organizational support, and infection prevention.

Sepsis occurs when the immune system overreacts to an infection, setting off a chain of events that can lead to tissue damage, organ failure, and death. Approximately 1.7 million US adults develop sepsis each year, and at least one in five die during hospitalization. 

Early recognition and treatment ‘only part of the solution’

Specific recommendations include implementing rapid molecular testing paired with antimicrobial stewardship support; implementing hospital workflows to ensure that patients with septic shock receive immediate antibiotic therapy; monitoring both inadequate and unnecessarily broad empiric antibiotic therapy in patients with suspected sepsis; implementing electronic sepsis surveillance; and establishing a multidisciplinary sepsis governance structure.

Early recognition and treatment remain a cornerstone of sepsis care, but they are only part of the solution.

Clinical guidelines and federal initiatives, like the Centers for Medicare & Medicaid Services’ Severe Sepsis and Septic Shock Early Management bundle, have focused on improving early recognition and treatment of sepsis. But the paper’s authors say clear reductions in sepsis mortality have not been demonstrated following implementation of these strategies, and that more guidance is needed to strengthen sepsis management across the continuum of care.

“Early recognition and treatment remain a cornerstone of sepsis care, but they are only part of the solution,” Chanu Rhee, MD, MPH, associate professor at Harvard Medical School and chair of the panel, said in an IDSA press release. “Hospitals also need systems that support timely and accurate diagnosis, optimal antimicrobial management, timely source control, infection prevention and continuous quality improvement. We hope these recommendations help hospitals build stronger sepsis programs that consistently deliver high-quality care and improve patient outcomes.”

The Michigan Department of Agriculture and Rural Development today confirmed the identification of chronic wasting disease (CWD) in farmed white-tailed deer in Calhoun, Kent and Mackinac counties.

Calhoun County is located in southwestern Michigan, while Kent is on the Lower Peninsula, and Mackinac is on the Upper Peninsula.

While Kent County has previously documented the fatal neurologic disease in both farmed and free-ranging deer, the detections are the first in Calhoun and Mackinac counties. The infections were identified after routine surveillance detected the Calhoun and Kent county cases, the former of which led to the discovery of the Mackinac County case.