Health News:

• RFK Jr. rescinded the endorsement for certain flu vaccines containing thimerosal, which is only used in a small percentage of shots. (NY Times)
• Meanwhile, medical groups like American Academy of Pediatrics and the largest OB/GYN group are developing their own vaccination guidelines for fall respiratory illness season. (Reuters)
• ICE now has access to Medicaid recipients’ personal information, including home addresses. Health experts worry that it will prevent people from seeking emergency medical help. (AP)
• A CDC report detailed the mass poisoning at a pizza restaurant after workers accidentally used THC-infused oil to make dough, dosing 85 people by mistake. (MMWR)
• Fearing Medicaid coverage loss, some parents are rushing to vaccinate their kids. (KFF Health News)
• A large outbreak of Salmonella Typhimurium with 171 cases, mostly in kids from late 2023 through March 2024, was linked to commercially distributed raw milk. (MMWR)
• Many doctors actually lose money on vaccines, despite RFK Jr.’s claims that they profit off them. (NY Times)
• A new study in ferrets suggests that seasonal flu immunity may help protect against severe H5N1 bird flu infection. (CIDRAP)
• A traveler with measles landed at LAX and stayed in a nearby hotel. (LA Times)
• Kellogg will cut artificial dyes from its cereals, including Froot Loops and Apple Jacks, before 2028. (Bloomberg)
• Minnesota is tracking a rise in human tularemia cases, with 5 cases so far, including two from tick bites and one from a cat bite. (CIDRAP)
  

Mental Health & Substance Use News:

• Teens say they’re turning to AI for friendship and advice. (AP)
• When therapists get sick or die unexpectedly, the shock can be destabilizing for patients. (NY Times)

If you or someone you know may be considering suicide or need help, call 988 or message the Crisis Text Line by texting HOME to 741741.

Best Questions:

Are we seeing a summer COVID wave?

Unfortunately, yes. There are 3 indicators that we look at to see if a surge is coming, and all three are rising right now.

1. Wastewater data: This has been quiet since last fall, but over the past few weeks, wastewater testing has been rising, especially in the South (Texas and Florida lead the pack) and the West (Hawaii is a hotspot and California is rising).
2. Test positivity rates. A higher percentage of people tested for COVID are getting positive tests nationwide, nearly doubling since the low point at the beginning of June.
3. ER visits. In Florida, ER visits have tripled since the end of May. Nationally, this number is still low but rising slightly.
   

This isn’t a major cause for concern just yet, since these numbers are rising from essentially the lowest they’ve been since COVID first started. But for employers who are trying to understand what staffing might look like over the next month or two, these rising numbers indicate that we may see a surge of sick calls in late August or September if they keep going at this rate.

Sources: Outbreak Outlook, YLE, CDC

An employee reported a non-STEC E. coli after travelling internationally. Should we be prepared for a health inspection?

Whether to expect a knock on your door from the local health department depends on what state or country the employee lives in, but generally, we don’t see full inspections for less-concerning strains of E. coli.

Shiga toxins are the main concern for an outbreak. When someone tests positive for E. coli, the health department is mostly concerned about a few specific deadly types, like the infamous O157:H7. These may be called STEC (Shiga toxin-producing E. coli), EHEC (Enterohemorrhagic E. coli), or VTEC (verocytotoxigenic E. coli).

But other types of E. coli are common, including ETEC (Enterotoxigenic E. coli), which is the most common cause of traveler’s diarrhea. In these less-concerning cases, health officials may not require any action at all unless the employee is still symptomatic.

Different health departments have different rules. California and North Carolina, for example, only require reporting for STEC. But in Iowa, all E. coli cases are reportable illnesses, even though not all individual cases will require a public health investigation. Different counties may also have different guidelines, which makes compliance a bear.

One-off non-STEC cases rarely result in a full-scale investigation. We rarely see health departments responding to single non-STEC E. coli positive tests unless there are multiple cases in the community, guest complaints, or a recent less-than-stellar health inspection at that location.

Even non-STEC E. coli can spread through food if proper food safety precautions are missed. It’s important to make sure your employee has completed a full course of antibiotics and is not working while symptomatic. The gold standard for allowing a food handler back to work is two negative stool tests, though some jurisdictions just require someone to be 48 hours symptom-free after finishing their medication.

When in doubt, give ZHH a call and we can support you in figuring out the right next steps with the employee or the health department.

Sources: IDPH, CDPH

Best Watch:

We’ve started to get lots of questions about the upcoming changes to Medicaid work requirements and the impact on employers. While the reporting burden will fall on the employee, we expect this may have impacts on employee turnover, recruitment, and the ability of sick employees to get medical care.

Watch: What Are Medicaid Work Requirements? - KFF Health News