Officials say this is expected as tick exposures in Pennsylvania generally increase during spring and summer months.

In addition, an increase in persons seeking care for Lyme disease (LD) and other tickborne diseases is anticipated in the coming weeks to months as the peak period for the onset of LD and other deer tick related illnesses is late May through early August.

LD reporting in Pennsylvania is entirely based on laboratory reports DOH receives directly from lab based reporting, not clinical reports.

Throughout Pennsylvania, LD is the most commonly reported tickborne disease. Pennsylvania annually ranks in the top 10 nationally for the number of LD cases reported by population. In 2024, 16,624 LD cases were reported in Pennsylvania, representing an incidence of 128.3 cases/100,000 persons. Most (53%) were reported between May and August.

All Pennsylvania counties reported LD, ranging from <5 cases in Montour County to 2,628 cases in Allegheny County.

Recent tick collections during 2024-2025 by the Pennsylvania Department of Environmental Protection (DEP) documented the presence of Ixodes scapularis (known commonly as the blacklegged tick or deer tick) infected with Borrelia burgdorferi (the bacterium that causes Lyme disease) in all 67 Pennsylvania counties.

Anaplasmosis, a bacterial disease transmitted by deer ticks, is on the rise in the United States and Pennsylvania. Anaplasmosis cases doubled nearly every year for the past five years and are now found in almost every county in Pennsylvania. DEP tick studies found deer ticks infected with Anaplasma phagocytophilum in every Pennsylvania county. In 2024, Pennsylvania reported 1,071 anaplasmosis cases.

Several other non-Lyme tickborne diseases are also reported annually in Pennsylvania, including babesiosis, ehrlichiosis, and spotted fever rickettsiosis. Additionally, human cases of Powassan virus disease, a tickborne arbovirus, were documented in 2011 and 2017-2024.

Statewide, thirty-two cases with onset in 2026 have been reported in individuals with travel history to a chikungunya-endemic area in the two weeks prior to onset: Alachua, Hernando, Hillsborough (6), Miami-Dade (17), Monroe (2), Orange (2), and Palm Beach (3).

31 of the cases had a travel history to Cuba and one was from Brazil.

During the same period in 2025, one travel-associated chikungunya case was reported in Florida. But that changed as cases accumulated over the course of the year with more than 400 travel-associated cases were recorded for the entire year.

Of the 402 cases reported, 389 were linked to travel to Cuba.

One locally acquired case was also reported in 2025.

Chikungunya virus is spread by two mosquito species: Aedes aegypti(primarily) and Aedes albopictus, both found in Florida.

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An infected person will typically become ill 3-7 days after the mosquito bite, but symptoms can begin anywhere from 2-12 days post-bite. These symptoms can last 3-10 days.

Up to 28% of people who are infected will not have any symptoms (asymptomatic), although they can still be infectious to mosquitoes for a short time if bitten.

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Treatment is symptomatic or supportive.

• Sudden high fever (usually higher than 102º F) which may be continuous or intermittent

• Severe joint pain that commonly involves the hands and feet

• Joint swelling

• Back pain

• Rash usually 2-5 days after fever starts

• Other symptoms may include headache, body ache, nausea, vomiting, and redness around the eyes. In unusual cases, infection can involve the brain, eyes, heart, kidney, and other organs

• Fatal infections are rare, however many patients have chronic joint pain, arthritis, loss of energy, and depression lasting weeks to years

Nationally in 2025, the CDC reported 466 travel-associated chikungunya cases and one locally-acquired case.

To date, 13 confirmed cases have been reported. Six people required hospitalization for their illness.

Reported symptoms include diarrhea, vomiting, abdominal pain and chills.

Officials say another 44 people have reported symptoms consistent with salmonella infection after eating at the restaurant but those cases have not yet been confirmed through lab testing.

Salmonella and Food safety with Trevor Craig

No specific food item has been confirmed as the source of the illness so far.

As part of the investigation, Hamilton Public Health ordered the temporary closure of Piper Arms Stoney Creek effective April 13, 2026, to support the ongoing investigation and protect public health.

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Public Health has worked closely with the operator to review food handling and sanitation practices and has collected food samples for laboratory testing. At this time, no specific deficiencies requiring corrective action have been identified; however, the closure allows Public Health to complete the investigation and ensure the premises is operating safely before reopening.

The San Francisco Department of Public Health (SFDPH) reported significant declines in syphilis, chlamydia, and gonorrhea cases in 2025.

In 2025, San Francisco saw a 24% decrease in reported syphilis cases (892>678), an 18% decrease in chlamydia cases (4,219>3,467), and a 5% decrease in gonorrhea cases (4,812>4,578) compared to 2024.

A syphilis primer

The steepest declines in STI cases were among men who have sex with men and transgender women. The decline of STI cases in these populations has followed the implementation and use of doxy‑PEP, an antibiotic taken after sex that is highly effective at preventing syphilis and chlamydia.

“We are excited to see the progress being made in lowering STI diagnoses in San Francisco,” said San Francisco Health Officer Dr. Susan Philip. “This STI Awareness Week, we encourage the public to keep up the momentum by taking actions — such as getting tested — to protect their sexual health.”

“The remarkable drop in STI cases in San Francisco is due in large part to the trailblazing work that made the rollout of doxy-PEP possible,” said Dr. Stephanie Cohen, Director of STI and HIV Prevention and Control. “Doxy-PEP shows us that by investing in research and innovative programming, and by collaborating with healthcare providers and the community, we can improve public health in our City.”’

Clade I mpox

The San Francisco Department of Public Health (SFDPH) confirmed the first case of clade I mpox in a San Francisco resident this week.

The case occurred in an unvaccinated adult who was hospitalized and is improving. The individual reported close contact with someone who traveled internationally.

Monkeypox Livestream

SFDPH strongly encourages people at risk for mpox to receive both doses of the mpox vaccine. The vaccine provides the best protection against the mpox virus and protects against both clade I and clade II. At this time, mpox exposure risk is low for individuals who are not in higher‑risk groups.

The mpox vaccine is available through healthcare providers and local pharmacies. Those who do not have insurance or are having difficulty accessing care may visit the locations listed at sf.gov/mpox.

On Friday, The North Carolina Department of Health and Human Services reported 310 cases in 2025, a 54 percent increase, prompting officials to raise awareness.

Legionnaires’ disease is a serious type of pneumonia caused by a bacteria called Legionella. These bacteria often live in wet environments like natural bodies of water, moist soil and man-made water systems such as hot tubs, decorative fountains, cooling towers, hot water tanks and misting devices that have been poorly maintained.

Legionnaires' disease and Legionella, Part One

Legionnaires’ disease and Legionella, Part Two

People get Legionnaires’ disease by inhaling mist or vapor contaminated with Legionella, not through person-to-person contact. Most healthy people exposed to Legionella do not get sick, but those at higher risk of illness include:

• People age 50 and older

• People who are current or former smokers

• People with certain health conditions or issues such as chronic lung disease, kidney failure, and diabetes

• People with compromised immune systems

The primary way to prevent Legionnaires’ disease is to control the growth and spread of Legionella in home water systems and in facilities with shared water systems. Steps you can take for prevention in your home include:

• Flush faucets or showerheads if they have not been used for three or more days, or if the home water system was turned off for plumbing work.

• Ensure proper maintenance and disinfection of hot tubs and follow manufacturer guidance.

• Use water following the manufacturer’s recommendations for in-home medical equipment such as humidifiers and CPAP or BIPAP machines. Clean the equipment parts and accessories regularly.

• Follow the manufacturer’s instructions for cleaning and replacing all water filters, including point-of-use filters (tap or refrigerator water/ice maker).

• Drain garden hoses to avoid stagnant water. People at particularly high risk should talk to their doctor about if wearing a mask while doing gardening work would be beneficial.

• Use proper windshield wiper fluid as Legionella can grow in the wiper fluid tank if tap water is added.

In March 2020, the first confirmed case of C. auris in Pennsylvania was detected in a patient admitted to a Philadelphia short-term acute care hospital. Since then, a total of 511 C. auris cases have been reported to PDPH, including 204 clinical infection cases and 307 colonization cases.

In both 2024 and 2025, there was a significant increase in the number of C. auris cases reported to PDPH. A total of 103 C. auris cases were reported in 2024 and 221 in 2025, representing increases of 129% and 115% compared to the previous year, respectively.

The increased volume may be partially explained by increased C. auris screening capacity in Philadelphia healthcare facilities, including admission screening programs in some high-risk facilities and hospital units, but that is not the only underlying cause. Clinical infection cases have increased as well, by 117% in 2024 and by 74% in 2025, demonstrating that the observed increases are not solely driven by increased detections of C. auris colonization but reflect an overall increase in C. auris prevalence among patients seeking care at Philadelphia healthcare facilities.

Cases have been detected at acute care hospitals, long-term acute care hospitals (LTACHs), and ventilator-capable skilled nursing facilities (vSNFs), in both colonized and clinically ill persons. C. auris has been detected in all LTACHs and vSNFs serving high-risk patients in the Philadelphia metropolitan area, and many of these facilities have experienced further transmission.

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C. auris is an emerging fungus that presents a serious global health threat for the following reasons:

• It is often multidrug-resistant, meaning that it is resistant to multiple antifungal drugs commonly used to treat Candida infections, resulting in significant morbidity and mortality in affected patients. Some strains are resistant to all three available antifungal classes.

• Both patients who are colonized and patients who are infected spread C. auris onto surfaces around them and to other patients.

• C. auris persists on surfaces for many months and is not killed by many common disinfectants.

• It spreads easily in healthcare settings and can cause outbreaks, particularly in vSNFs and LTACHs. For this reason, it is important to quickly identify C. auris so that healthcare facilities can take appropriate precautions to stop its spread.

As of April 9, there were eight confirmed cases and one probable case linked to a school and a church in Bedford County. Additionally, there were two cases in Bedford County and one case in Fulton County with unknown exposure sources.

To prevent the spread of vaccine preventable diseases like pertussis, the DOH reiterates the importance of people of all ages to remain up to date on all vaccines, including pertussis vaccine.

Pertussis is an acute bacterial disease caused by Bordetella pertussis, a gram-negative bacillus. It is spread person to person through respiratory droplets. The incubation period is typically 7-10 days with a range of 5-21 days. The patient is infectious from the beginning of symptoms until 3 weeks after the start of the paroxysmal cough.

The clinical course of the illness is divided into three stages:

• Early Stage- Catarrhal Stage (1-2 weeks)

• Onset of coryza (runny nose), sneezing, low grade fever, and a mild cough.

• As this stage continues, the cough becomes more severe.

• In infants and young children, this stage can present as apnea and cyanosis.

• Later Stage-Paroxysmal Stage (1-6 weeks) o Cough becomes the classic ‘whooping cough’ in which a patient has paroxysms of cough followed by a long inspiratory effort ‘the whoop’.

• Patients can become cyanotic during the paroxysmal cough.

• Post coughing vomiting can occur.

• Paroxysmal cough episodes are more frequent at night.

• Recovery- Convalescent Stage (weeks to months) o Cough gradually lessens over 2-3 weeks.

West Nile virus can cause serious illness and lead to hospitalization or death; however, most cases cause no symptoms and go undetected.

According to the Centers for Disease Control and Prevention, people over age 60 are the most likely to develop severe illness when infected with West Nile virus.

West Nile virus has been detected in mosquito samples captured in the majority of ZIP Codes in Shelby County.

The Health Department urges all residents to protect themselves by wearing insect repellents that contain DEET when outdoors.

The individual was treated and has recovered.

This is the first confirmed case of this disease in Apache County since 2015 and fourth case since 2006.

Public health officials are working with partners and the patient to assess environmental risks and ensure appropriate response measures are in place.

Plague is a rare but serious bacterial infection caused by Yersinia pestis. It is most commonly transmitted through the bites of infected fleas that live on rodents such as prairie dogs, squirrels, and rats. In rare cases, it can also spread through direct contact with infected animals. Plague is a naturally occurring disease in the southwestern United States, including Arizona, where it persists in rodent populations and their associated fleas.

Symptoms typically appear within 2–6 days after exposure and may include: • Sudden onset of fever and chills • Headache and muscle aches • Fatigue or weakness • Swollen, painful lymph nodes (commonly called “buboes”) • In more severe cases, cough, difficulty breathing, or bloodstream infection Anyone experiencing these symptoms after possible exposure to rodents or fleas should seek medical care promptly.

Plague is treatable with antibiotics, especially when identified early.

Residents can reduce their risk by taking the following precautions:

• Avoid contact with wild rodents and their burrows

• Use insect repellent when outdoors

• Keep pets free of fleas and avoid allowing them to roam or hunt rodents

• Do not handle sick or dead animals

• Keep yards clean and free of debris that may attract rodents

To put that number in perspective, 14,209 measles cases were reported in all of 2025 from the three countries.

Let’s look at each of the three countries in 2026 to date:

Canada

In 2026, a total of 650 measles cases (595 confirmed, 55 probable) have been reported by 7 jurisdictions (Alberta, British Columbia, Manitoba, Nova Scotia, Ontario, Quebec, Saskatchewan), as of March 21, 2026.

The two provinces reporting the bulk of the cases are Manitoba (392) and Alberta (209).

In all of 2025, Canada saw 5,463 measles cases (5,081 confirmed, 382 probable) with more than 2,000 cases reported in Ontario and Alberta.

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United States

According to the Johns Hopkins measles dashboard, 1,698 confirmed measles cases have been reported to date.

South Carolina, while they have not reported a measles case in over two weeks, still leads the country with 668 cases. This is followed by Utah (370), Texas (175), Florida (143) and Arizona (71).

In all of 2025, 2,286 measles cases were reported in the United States.

Mexico

The Mexico Ministry of Health has reported 8,638 confirmed cases through April 2.

Jalisco state has recorded more than 5,000 cases (5006), followed by Chiapas (717) and Mexico City (681).

In addition, nine fatalities have been reported in seven states in 2026 to date (Jalisco-3, Mexico City-1, Michoacán-1, Guerrero-1, Sinaloa-1, Durango-1 and Tlaxcala-1).

In all of 2025, Mexico reported 6,460 confirmed cases and 27 deaths.

The Winnebago County Health Department (WCHD) encourages residents to take steps to prevent tick bites and watch for symptoms of illness after being outside in the yard or walking in wooded or grassy areas.

Symptoms of Powassan can show up one week to one month after being bitten by an infected tick. Many people who become infected with Powassan virus don’t have any symptoms.

Common early signs and symptoms include:

• Fever

• Headache

• Nausea

• Vomiting

• Muscle weakness

• Stiff neck

Severe illness can include:

• Confusion

• Loss of coordination

• Paralysis

• Speech difficulty

• Seizures

• Memory loss

• Encephalitis (inflammation of the brain)

• Meningitis (inflammation of the membranes around the brain and spinal cord)

Powassan virus causes death in about 10% of severe cases. Half of those who survive severe disease have permanent or long-term neurologic symptoms. These can include recurring headaches, memory problems, and muscle weakness or loss.

Currently, there isn’t a treatment or vaccine for Powassan virus. Over-the-counter pain relievers may help with symptoms. In severe cases, patients may need supportive treatment in a hospital.

Health officials advise the public to take the following steps to prevent illness:

• Avoid high tick locations such as wooded areas or areas with tall grass and weeds.

• Wear long, light-colored clothing including socks, shoes, and pants when outdoors. • Apply insect repellents approved by the US Environmental Protection Agency (EPA)

• Consult a physician before using on infants.

• For children, only use repellents containing 10% or less of DEET and do not let children apply alone.

• Always follow label directions.

• Reduce ticks in yards o Place a 3ft wide barrier of wood chips or gravel between lawns and wooded areas. o Construct fences to discourage animals (such as deer and raccoons) from entering. o Remove leaves, furniture, mattresses, or trash from the yard that may give ticks a place to hide.

• Perform regular tick checks while outdoors by scanning your legs and arms for climbing ticks. o Don’t forget to regularly check your pets for ticks, too.

From January 1 to March 25, the Ministry of Health reports 8,021 confirmed cases and eight fatalities.

Since the outbreak began in early January 2025, 14,481 confirmed cases and 35 deaths have been reported.

In 2026, 58 percent of the total confirmed cases have been reported from Jalisco state (4668), followed by Chiapas (671) and Mexico City (624).

In the cumulative count of confirmed cases for 2025–2026, all 32 states have reported measles cases distributed across 451 municipalities.

The total measles cases in North America is more than 10,000 in the first months of the year (United States - 1582 and Canada- 582).

Regarding deaths, 35 cumulative cases have been confirmed for the 2025–2026 period, distributed across 10 states: Chihuahua (21), Jalisco (4), Sonora (1), Durango (2), Michoacán (1), Tlaxcala (1), Mexico City (2), Chiapas (1), Guerrero (1), and Sinaloa (1).

These are the first known clade I mpox cases in Missouri and the thirteenth and fourteenth cases nationally. Both individuals had recent international travel to countries where mpox is more prevalent. The public health investigation showed that the two cases are unrelated to one another and are not believed to be connected to any locally acquired mpox cases.

State epidemiologist, Dr. George Turabelidze said, “While risk to the general public remains low, mpox is still active. We recommend those who are at risk for mpox infection to get vaccinated and ensure they complete the 2-dose series.”

Mpox is a disease caused by two different genetic types of the mpox virus, called clade I and clade II. Clade II mpox has continued to circulate at low levels in the United States since a widespread outbreak occurred in 2022.

Officials say the clade I virus is more likely to cause severe illness and death, especially in people who are immunocompromised.

Both types of the virus spread primarily through direct physical contact with a symptomatic person with mpox or through contact with used items contaminated with the mpox virus.

Vaccination reduces the risk of getting mpox and can reduce symptoms if infected. People at risk for mpox should get 2 doses of the JYNNEOS vaccine to maximize protection. The second dose should be administered at least 28 days after the first dose. Those who have already had mpox do not need to get vaccinated.

The bulk of the cases reported since the beginning of the year are from from Jalisco state (4,358), followed by Chiapas (644), Mexico City (538) and Sinaloa (249).

In fact, the total confirmed measles cases since the outbreak began in early 2025, is more than 5,000 to date, the most of any state.

In total, 13,855 confirmed cases have been reported since the beginning of 2025.

In the cumulative count of confirmed cases for 2025–2026, all 32 states have reported measles cases distributed across 437 municipalities.

The age group with the highest number of cases is 1 to 4 years (1,833 cases), followed by the 25-to-29 age group (1,628 cases) and the 5-to-9 age group (1,610 cases).

The highest incidence rate is observed in children under one year of age, with 67.69 cases per 100,000 inhabitants, followed by the 1-to-4 and 5-to-9 age groups, with rates of 21.39 and 15.21, respectively.

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Regarding deaths, 35 cumulative cases have been confirmed for the 2025–2026 period, distributed across 10 states: Chihuahua (21), Jalisco (4), Sonora (1), Durango (2), Michoacán (1), Tlaxcala (1), Mexico City (2), Chiapas (1), Guerrero (1), and Sinaloa (1).

Blastomycosis is an uncommon, but potentially serious fungal infection. It primarily affects the lungs, and is caused by the fungus Blastomyces. There are different signs and symptoms of blastomycosis that can result from exposure to Blastomyces.

Approximately 50% of people who are infected with Blastomyces will not have symptoms. Among the infected people who develop symptoms, the symptoms vary from mild to severe, and can be fatal.

Symptoms usually start 2 to 15 weeks after a person breathes in the spores. Some people may not have symptoms. Early symptoms can feel like a cold or respiratory illness, including: Cough, fever, chills, muscle aches, joint pain and chest pain.

A very serious progressive illness involving multiple organ systems can occur in an untreated patient.

People who smoke, have lung disease, or have a weak immune system may have a higher risk of getting sick. Blastomycosis does not spread from person to person.

People are usually treated with antifungal medicine. The medication needs to be taken for several months.

The fungus lives in wet soil and in rotting wood or leaves. People can get sick when they breathe in tiny fungal spores in the air. These spores can be released when soil is moved or disturbed.

Pay special attention when dirt is:

• Near a water source and has been disturbed.

• Moved by gardening, camping, hunting, hiking, riding all-terrain vehicles, or clearing brush.

• Near an excavation or construction site.

Health officials report the individual has been recovering well and is isolating until symptoms have resolved.

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There is no current evidence of community spread of clade I mpox in NYC.

Since the global mpox outbreak in 2022, clade II mpox has continued to circulate in NYC, with 398 reported cases in 2025 and 45 reported cases between January 1 and March 10, 2026.

Officials say the dog received veterinary care and has recovered.

Plague is a bacterial disease that circulates in wildlife and is commonly transmitted through flea bites. Plague symptoms in cats and dogs include fever, lethargy and loss of appetite. There may be swelling in the lymph node under the jaw.

“Pets can be infected with plague if they eat an infected animal or are bitten by infected fleas,” said Dr. Erin Phipps, state public health veterinarian for NMDOH. “Humans can also get plague from flea bites or direct contact with infected animals, including rodents, wildlife and pets.”

Plague symptoms in humans include sudden onset of fever, chills, headache and weakness. In most cases, there is a swollen, painful lymph node in the groin, armpit or neck area.

New Mexico reports first hantavirus case of 2026

Prompt diagnosis and antibiotic treatment greatly reduce the risk of death in people and pets.

Prevent plague by:

• Using a veterinarian-approved flea control product on your pets.

• Cleaning up areas near the home where rodents could live, such as woodpiles, brush piles, junk and abandoned vehicles. Put hay, wood and compost piles as far away from your home as possible.

• Do not leave pet food and water where rodents and wildlife can get to it.

• Ensuring that sick pets are examined promptly by a veterinarian.

• Contacting your medical provider about any unexplained illness involving a sudden and severe fever.

• Avoiding sick or dead rodents and rabbits, and their nests and burrows.

13 of Florida’s 67 counties have reported cases: Alachua (2), Broward (2), Collier (98- mostly linked to Ave Maria University), Duval (6), Escambia (5), Hillsborough (2), Lee (2), Manatee (3), Miami-Dade (1), Osceola (1), Pasco (1), Pinellas (5) and St. Johns (3).

In fact, if Collier County were a US state, they would have the third most cases in the US (#4. Texas- 93).

In all of 2025, Florida recorded seven measles cases.

Since 2022, mpox activity in Toronto has only involved the IIb strain of the virus. Clade Ib has been associated with outbreaks in parts of Central and Eastern Africa and has been identified in a small number of travel-related cases internationally, including several European countries.

Both clade Ib and IIb mpox can cause painful skin lesions, fever and other flu-like symptoms. Prevention and treatment are also the same for both types of mpox.

While mpox cases have been reported across the city, Toronto Public Health recorded a higher concentration of cases among residents in the downtown core. In 2025, 155 mpox cases were confirmed in Toronto.

Getting vaccinated is the best way to help prevent further mpox transmission. TPH reminds eligible residents to get vaccinated against mpox as the virus continues to circulate in Toronto and internationally. TPH recommends that the second dose be taken 28 days after the first dose. For those who have been exposed to the virus, mpox post-exposure treatment is available. If an individual has already received a smallpox vaccine in the past, they should still get vaccinated for mpox, as they may not be protected.

This is the first hantavirus case reported in New Mexico this year. Since 1993, New Mexico has reported 143 cases, the most in the country.

Hantavirus pulmonary syndrome (HPS) is a severe respiratory disease which is fatal in approximately a third of affected people. New Mexico recorded seven cases in 2025, with three of them fatal.

In New Mexico, deer mice are the primary carriers of hantavirus, though it can be found in other rodents. The virus is found in mouse droppings and urine. People are typically exposed to hantavirus around their homes, cabins or sheds, especially when cleaning out or exploring areas where there are mouse droppings.

“It is important to air out cabins, sheds, garages and other spaces before any spring cleaning,” said Dr. Erin Phipps, state public health veterinarian for the New Mexico Department of Health (NMDOH). “While hantavirus cases remain rare, they can be fatal, so we urge New Mexicans to take preventative measures when cleaning areas where rodents may be.”

Symptoms of HPS typically develop within one to six weeks after exposure and may feel like the flu or a stomach bug. People with HPS may go on to experience fever and muscle aches, possibly accompanied by chills, headache, nausea, vomiting, diarrhea, abdominal pain and cough, which can progress to severe illness.

Reduce the risk of contracting hantavirus by following these guidelines:

• Air out closed‐up buildings such as cabins and sheds, as well as abandoned or stored vehicles, before entering.

• Soak nests and droppings with a disinfectant such as a 10% bleach solution before wiping them up with paper towels. Be sure to use gloves.

• Do not sweep up rodent droppings because that can spread virus particles into the air where they can be inhaled.

• Put hay, wood, and compost piles as far as possible from your home and dispose of trash and junk piles.

• Trap mice and seal up homes to prevent rodents from entering.