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2 deaths, even as Cyclospora slows

Michigan reported the first two deaths linked to the multi-state iceberg lettuce-related outbreak, though test positivity rate is tanking nationwide, indicating that cases have slowed. As summer marches on, we’ll also cover rare tick-borne diseases on the rise nationwide, and some locally-acquired dengue in Florida.

August 4, 2026

Cyclospora News:

  • We're up to 17,000 cases nationwide, but Cyclospora cases are definitely slowing, with the percentage of positive tests dropping off quickly. (YLE)

  • Michigan reported the first two U.S. deaths related to Cyclospora, and the statewide case count is slowing but has still increased to over 11,000. (AP, MDHHS)

  • …and no, we don’t endorse the “cyclospora skinny” social media trend, in which people intentionally try to infect themselves to get explosive diarrhea. (Hill)

  • Concerns about lettuce have pushed more Americans to their local farmers markets. (WSJ)

Health News:

  • New York state has its first case of Bourbon virus, a very rare and potentially fatal tick-borne disease. (People)

  • Meanwhile, also in Long Island, NY, there are 3 new cases of “rabbit fever,” also known as tularemia, another rare tick-borne disease. (NBC)

  • Palm Beach and Miami-Dade counties have both reported cases of locally acquired dengue fever. (WUSF)

  • In a setback, Moderna’s phase 3 trials for their new norovirus vaccine were unsuccessful; additional trials will be needed. (Yahoo Finance)
  • Measles cases are continuing to climb, with 49 new cases last week. PA led the pack with 28 new cases last week, plus clusters in WA and OR. (MedPage Today)
  • A seventh person died in the Manhattan Legionnaires’ outbreak, but the city confirmed that there have been no new cases since July 21 and the sources have been eliminated. (NBC)

Best Question:

I’ve now heard of multiple new tick-borne diseases. Are we discovering new ones, or just getting more bites? 

Emergency room visits for tick bites are higher in the U.S. this year than they have been in over a decade. Just this week, New York state had its first case of the rare tick-borne Bourbon virus. This past spring, a person in Northern California was identified as the state’s third case - and only the fourth ever worldwide - of another rare, newly discovered tick-borne disease. 

In California, the culprit was the Rickettsia lanei bacteria, which causes symptoms similar to Rocky Mountain spotted fever (RMSF). It was first discovered in 2018. It’s probable that many more people have had this, but the symptoms are so similar to RMSF that it’s likely underreported. 

Rickettsia lanei, RMSF, and Bourbon virus can all cause serious illness, hospitalization, and even death. Symptoms are similar and can include fever, muscle aches, headache and rash. Severe disease can progress to gangrene, brain inflammation, or even coma. 

Spotted fevers, but especially RMSF, can be particularly deadly - with up to a 50% case fatality rate. Granted, that stat is from a study of the Americas as a whole, particularly in Mexico and Brazil, so the survival rate is likely higher in the U.S. But if it’s anywhere close to that number, it’s more deadly than hantavirus, measles, and even the current strain of Ebola in Congo. Bourbon virus is so rare that we can’t give a case fatality rate with confidence, but there have been 2 deaths out of only 6 known cases. 

Ultimately, this is probably not the mutation of brand new bacteria and viruses, but rather chalked up to changing climate. Tick season is longer, and their survivable habitat range has gotten much bigger over the past decade. Plus, as suburbs expand into previously forested areas, humans come into more contact with ticks on their own turf. As more people get bitten, more diseases carried by these little buggers get discovered – at least 8 since 2000. 

The only way to prevent these tick-borne diseases is to prevent tick bites. Wear long sleeves and pants outdoors, stay out of tall grass, shower and check for ticks after outdoor activities, and keep your pets up on their tick meds. 

Sources: LA Times, SFGate, CDPH, CDC, NIH, Atlantic

Best Read:

We loved this very realistic portrayal that sounds a lot like what our ZHH Clinical Team experiences regularly. While contact tracing for COVID and measles may not be met with enthusiasm, the reality in most foodborne illness investigations is that people love to be heard…even (especially?) about their bowel movements.

Nurses Chase Cyclospora, Aided by Interviews, Fast-Food Receipts — And the Messy Details - KFF Health News