Happy Tuesday! We're back after a week off. Did we miss anything? (Don't answer that.)

Lots to dig into: Ticks are top of mind and showing up at a higher-than-normal rate this year, while the stomach flu is at its seasonal peak, and measles could be quietly becoming endemic in Utah. Plus: a CDC rabies testing pause that’s less scary than the headlines suggest but points to a major problem underneath the surface, and, as always, some genuinely good news.

Here’s what’s circulating and, most importantly, what you can do about it.

Ticks are having a year

Tick season is off to an unusually bad start. Emergency department visits for tick bites are running at roughly 71 per 100,000 people per week, more than double the typical rate at this time of year (around 30 per 100,000).

Will the trend continue? It’s hard to say because three factors are colliding:

1. Weather. A bad tick season usually follows a mild winter, since ticks can only be killed by sustained temperatures below 10°F for several days. Northeasterners who just endured the region’s harshest winter in a decade may be skeptical, but much of the West and South saw record warmth, which could keep the national average high.

2. Reach. Ticks are expanding into new geographies.

3. Detection. Health systems are getting better at identifying tick-borne diseases.

All of which makes this trend worth watching as the season unfolds.

Tracking tick-borne diseases is hard because no single system captures the full picture. CDC tracks confirmed diagnoses reported by doctors and hospitals, and separately tracks ED visits, but both have limitations.

Field surveillance fills in another piece: one method is the “tick drag"— literally dragging a sheet through tick areas to test them. Shout-out to the Illinois Department of Public Health's vector surveillance team, who brought the public along for a day in the life of tick surveillance.

What this means for you: Keep enjoying the outdoors! But if you’re in a tick-prone area, take that extra minute to do a tick check. The most important thing is removing the tick properly (use fine-tipped tweezers, grab close to the skin, pull upward, no twisting, no Vaseline, no matches). Then watch for symptoms: fever, rash, fatigue, joint aches. If you find an attached tick and are in a high-risk area for Lyme disease, it’s worth calling your doctor if it was attached for more than 36 hours.

I recently stumbled upon the PA Tick Research Lab, where you can submit your tick for testing to identify the species and screen for tick-borne pathogens. Testing is free for Pennsylvania residents; $50 for everyone else.

Norovirus is (hopefully) peaking

Norovirus (think diarrhea, vomiting, and nausea) is currently at its seasonal peak. There are early signs of a decline, but it will likely take another month or two to come down meaningfully.

What this means for you: This is never a fun one for a household to get, because it’s extremely contagious. Wash your hands. Hand sanitizer doesn’t help.

RSV is late—parents of infants should pay attention

RSV typically peaks in winter and is gone by March. This year, it's still elevated across much of the country in April. This matters because RSV is the leading cause of hospitalization in infants.

This late wave is not only unusual but also has real practical implications. The window for infants to receive monoclonal antibodies for proactive RSV protection typically closes in March, at the end of RSV season. Now that we’re in April, many parents and clinicians are left uncertain about whether to act:

1. Should my infant get RSV protection now, or wait until fall? If your baby is around 1 month old, the guidance from the American Academy of Pediatrics is clear: don’t wait. Younger age and first-season administration should always be prioritized. For older infants who missed protection earlier this season, the calculus is harder, but given that RSV is still circulating at elevated levels, the case for acting now rather than waiting until fall is strong.

2. Will insurance cover it this late in the season? It should. Coverage for RSV monoclonal antibodies should remain in place through at least April 30. Private insurers and state Medicaid programs have signaled that they recognize the disease trend has shifted later this year, so barriers to coverage should not be an issue. And for the clinician readers out there, the Vaccines for Children program should also continue to pay for these immunizations, but we, of course, want to hear from you if you’re experiencing otherwise on the ground (comment below).

Measles: one outbreak ends, another grows

The United States tally is currently at 1,748 confirmed measles cases. Two important developments this past week:

1. South Carolina’s outbreak is winding down, coming at a staggering cost.

South Carolina has not reported any new measles cases since March 17, bringing the total to 997 since the outbreak began in October 2025. If no new cases are reported, the state could officially declare the outbreak over by April 26.

The cost was staggering: an estimated $35.5 million in response spending as of early March, plus significant school disruption, missed workdays, and caregiver burden.

2. Utah is now the epicenter of measles in the United States.

Utah’s measles outbreak began in June 2025, with now 597 confirmed cases, and more than half of those have been diagnosed just this year.

What’s most concerning are two things:

• This outbreak has been spreading for more than 10 months.

• Many of the people who are getting sick had no known contact with anyone else who was infected. That means the virus isn’t just jumping from person to person in traceable clusters anymore. It’s circulating quietly through the community.

Both of these point to a disease becoming endemic, meaning it’s no longer an outbreak but a permanent presence.

Utah’s MMR vaccination coverage among kindergartners sits at roughly 88% (well below the 95% threshold for herd immunity), and around 10% of in-person kindergartners have a non-medical exemption or missing documentation. Utah has the second-highest exemption rates in the country.

The CDC paused rabies testing. How worried should the U.S. be?

The headlines have been scarier than the immediate risk, but there is a serious underlying problem.

The testing pause: CDC posted a list of more than two dozen types of testing that have become unavailable, including rabies and mpox. This is a temporary pause for a quality review. This is not the first time the CDC has paused some of its lab testing, but it is pausing more kinds of tests than ever before. Testing should be back up and running in a few weeks.

Human rabies specifically: This pause is not raising major red flags for me. Human rabies is extraordinarily rare (<5 cases per year), and the CDC typically tests only a few dozen people annually. The testing that was paused is confirmatory testing for people who are already sick, and by that point in a rabies infection, there is usually very little that can be done. Critically, post-exposure prophylaxis (PEP), the treatment you get after a potential rabies exposure, is based on epidemiological factors, not on waiting for lab confirmation. So the management of exposures continues as normal.

Where I do have concern: About 1.5 million people seek medical care for animal bites each year, and rabies risk should be considered for most of them. Nearly all of those risk assessments are handled by clinicians or state and local health departments. The cases that reach the CDC are the most complicated ones—a bat found in a room with a sleeping child, a mass exposure at a summer camp—situations that are time-sensitive and require deep expertise.

But due to DOGE and budget cuts, CDC’s rabies and pox virus staff will soon be down to just one person to advise on these complex consultations. That could mean unnecessary treatment for some and missed treatment for others.

The erosion of specialized public health capacity at the federal level makes it harder to respond to rare but serious events when they do occur.

Good news

1. The Artemis II crew splashed down safely, a beautiful reminder of what humanity can accomplish when thousands of people work in precise coordination toward a single extraordinary goal, through decades of scientific investment, expertise, and discipline. At a moment when the world can feel small and fractured, sending humans around the moon is a quiet insistence that we are still capable of choosing something bigger.

2. Menthol restrictions are working. Massachusetts data show that restricting menthol cigarette sales has reduced smoking prevalence by 1.4% since 2020. Although seemingly small, this reduction is estimated to have saved $200 million in health care costs over ten years.

3. Global maternal mortality has fallen by more than 40% since 2000, and deaths among children under five have dropped by over 50%. Maternal conditions that were once life-threatening (elevated blood pressure, cancer, HIV) are increasingly manageable, extending and improving lives worldwide.

4. NIH funding fight resolved: The Trump administration dropped its court fight to cap NIH payments for research overhead costs, effectively ending the 14-month standoff that had threatened universities, hospitals, and academic medical centers. (Read the YLE deep dive on indirect costs here.)

Bottom line

Stay safe out there, do your tick checks, and remember that the public health system, even a strained one, is full of people working hard to keep you well.

Love, YLE

Your Local Epidemiologist (YLE) is founded and operated by Dr. Katelyn Jetelina, MPH PhD—an epidemiologist, wife, and mom of two little girls. YLE reaches over 425,000 people in over 132 countries with one goal: “Translate” the ever-evolving public health science so that people will be well-equipped to make evidence-based decisions. This newsletter is free to everyone, thanks to the generous support of fellow YLE community members. To support the effort, subscribe or upgrade below: