Measles has topped 5,000 cases, flu season started early and the federal agency hospitals rely on for guidance is losing leaders. Here are seven infection threats hospital infection prevention teams are tracking as winter approaches:
1. Measles has topped 5,000 cases for the first time in 35 years. The CDC has recorded 5,182 cases this year, the highest total since 1991, including 5,164 across 45 states and Washington, D.C., and 18 among international visitors, according to its Nov. 6 update. About 96% of cases were among people who were unvaccinated or whose vaccination status was unknown. Pennsylvania remains the hot spot, with 1,426 cases as of the CDC’s Oct. 31 report and five measles-associated deaths. The CDC’s national tally includes three deaths, and the agency is working with state epidemiologists on a standard case definition for measles deaths. The U.S. is also days away from a review by the World Health Organization’s regional office, the Pan American Health Organization, that will determine whether the country keeps its measles elimination status, a decision that was postponed from April.
2. Dengue could be making a comeback. The size of the dengue outbreak in Florida could indicate that the disease is making a comeback in the U.S. at levels not seen for decades, experts told The New York Times. Experts are unsure what is causing the local transmission. In the continental U.S., dengue cases are usually tied to mosquito bites while traveling, but the current outbreak includes locally acquired infections. About 2,678 people have been infected with dengue in the U.S. and its territories. Of those, 880 cases are in Florida and about 503 were acquired in the U.S., compared with the previous high of 189 in 2023. Most people infected with dengue show no symptoms, and most patients with symptoms recover. In a small number of cases, dengue can lead to shock, hemorrhage and organ failure.
3. Flu season started early and is accelerating. The trend has been building since October, when the hospitalization rate hit its highest mid-October level since 2010 and weekly hospitalizations nearly tripled from early September. Epic Research found flu rates reached the same level seven weeks earlier than in the past two seasons, and GoodRx’s antiviral tracker shows fills well above the prior-season average for this point in the season. Flu accounted for 1.7% of emergency department visits in the week ending Oct. 31, up from 1.2% the week before, with increases in every age group. H1N1 accounted for 97.7% of subtyped influenza A viruses, replacing last season’s dominant H3N2, and the number of metro areas at high or very high activity more than doubled to 22 from nine. Two more pediatric deaths were reported, bringing this season’s total to three. The CDC estimates at least 1.7 million illnesses, 25,000 hospitalizations and 1,400 deaths so far and has classified the season as low severity for now, noting that an earlier rise does not necessarily mean a higher peak.
4. Six drug-resistant pathogens drive most hospital concern. The CDC’s 2026 Antimicrobial Resistance Threats Report, published Oct. 27, estimates that 19 drug-resistant pathogens cause 9.7 million infections and 50,800 deaths a year, but infectious disease leaders told Becker’s six are of greatest concern to hospitals. They are pathogens that spread easily in healthcare facilities: Candida auris, carbapenem-resistant Acinetobacter, carbapenem-resistant Enterobacterales, C. diff, MRSA and multidrug-resistant Pseudomonas aeruginosa. A larger concern may be the shrinking antibiotic pipeline: Matthew Sims, MD, PhD, of Corewell Health William Beaumont University Hospital, said many drugmakers have left antibiotics because drugs used sparingly do not make economic sense.
5. Congenital measles has reached Pennsylvania. The state health department’s Oct. 19 advisory says congenital measles has been identified for the first time in decades. It advises that neonates born within 14 days of the mother’s rash onset be managed in airborne isolation, tested for measles and given immunoglobulin, and that pregnant patients needing inpatient care go to hospitals with maternal, neonatal and infection control capacity. Federal scientists have sought to issue a national alert on measles in pregnancy, but it has not been approved by the CDC director’s office.
6. The CDC is losing leaders. Deputy Director Jennifer Shuford, MD, is leaving after six months, amid scrutiny of vaccine policy and delays in updating measles data. She is the latest in a series of leadership changes since August 2025.
7. The Congo Ebola outbreak continues to grow. Confirmed Ebola cases in the Democratic Republic of Congo have climbed above 10,000, raising concerns about further spread across the region. Five countries have reported cases linked to the outbreak. A British physician recently tested positive for Ebola after treating patients in Congo and is being transported to the U.K. for treatment, The New York Times reported. Meanwhile, Kenya has reported nine Ebola cases and two deaths. The World Health Organization has added two new Ebola vaccine candidates to its trials in Congo.
