The South Carolina Department of Public Health on September 26 reported the state’s fourth measles case of the year, an upstate resident who is unvaccinated.

In a statement, the SCDPH said the patient doesn’t have any known exposure to an earlier case, and the individual has completed the isolation period. An investigation is underway to identify contacts and notify people who may have been exposed. It added that the patient’s illness has no known connection to the state’s three earlier cases.

Elsewhere, the New York State Department of Health on September 27 issued a measles alert after the virus was detected in wastewater earlier in the week from a treatment center that serves the city of Oswego and surrounding areas in the upstate area. Health officials urged health providers to be aware and look for clinical signs and symptoms. 

James McDonald, MD, MPH, state health commissioner, said in the statement, “This detection does not mean there is an outbreak. It is, however, a timely reminder to make sure you and your family are up to date on the MMR [measles, mumps, and rubella] vaccine and to keep an eye out for symptoms."

Israel reports sixth child measles death

In international developments, Israel’s health ministry yesterday reported the death of a sixth child—an unvaccinated toddler—in the country’s ongoing outbreak. Four of the six deaths were reported over the past week. All of the children were younger than 30 months old.

So far, 24 patients have been hospitalized, mostly children younger than 6 years old who aren’t vaccinated. Seven of them are in the intensive care unit (ICU). The outbreak areas are Jerusalem, Beit Shemesh, Bnei Brak, Harish, Modi’in Illit, Nof HaGalil, Kiryat Gat, and Ashdod.

The health ministry urged unvaccinated people, as well as parents of infants who have only received one MMR vaccine dose, to avoid large gatherings. Officials are offering walk-in vaccine clinics as part of the outbreak response.

Three new illnesses, and one additional death, have been reported in a multistate Listeria outbreak linked to packaged meals.

In an outbreak update late last week, the Centers for Disease Control and Prevention (CDC) said 20 people from 15 states have now been sickened in the Listeria monocytogenes outbreak, up from 17 since the agency's last update on June 18. Of the 20 case-patients, 19 have been hospitalized and 4 have died. One pregnancy-associated illness resulted in fetal loss.

The outbreak has been tied to packaged pasta meals made by FreshRealm. The initial cases identified by the CDC's PulseNet system were traced to consumption of FreshRealm chicken fettucine alfredo heat-and-serve meals, which tested positive for the outbreak strain and were recalled on June 17. In its update, the CDC said the pasta in FreshRealm's beef meatball marinara linguini meals, made by Nate's Fine Foods, has also tested positive for Listeria, but the product has not been distributed.

"Pasta that went into the beef meatball marinara linguine meals has tested positive for Listeria, but additional information is pending to determine if the samples taken from the pre-cooked pasta is the same strain making people sick," the CDC said. The Food and Drug Administration (FDA) and US Department of Agriculture (USDA) are also involved in the investigation.

In a statement emailed to reporters today, a company spokesperson said whole-genome sequencing has confirmed that the Listeria strains in the cooked pasta are identical to the outbreak strain.

"We now know the source was cooked pasta," the statement said. "FreshRealm promptly shared these results with USDA, FDA and the CDC and will continue to work closely with these agencies.”  

True number of illnesses could be higher

The affected states are California, Florida, Illinois, Indiana, Louisiana, Michigan, Minnesota, Missouri, Nevada, North Carolina, Ohio, South Carolina, Texas, Utah, and Virginia. The age of patients ranges from 4 to 92 years. Illnesses date back to August 1, 2024.

State and local public health officials are continuing to interview people about the foods they ate in the months before they got sick to determine whether other products may have been involved. Of the 13 people interviewed, 7 reported eating pre-cooked meals and 4 reported eating chicken fettucine alfredo.

The CDC says the true number of people sickened in the outbreak is likely much higher, since some people recover from listeriosis without medical care and never get tested.

Editor's note: This story was updated at 5:10pm.