The Centers for Disease Control and Prevention (CDC) said it has established measures to "identify and assess" any travelers from the Russian region where a possible plague case was reported.

In a statement on Wednesday, the agency noted that roughly 200 travelers from the region arrive in the U.S. over the course of a year. These travelers enter the country through airports where CDC staff are already positioned. 

"CDC is closely monitoring the situation and has established measures in place to identify and assess travelers arriving from the affected region," the CDC's statement read, in part. "CDC has longstanding systems and trained personnel in place to detect and respond to potential public health risks at U.S. ports of entry. We will continue to monitor the situation closely and adjust our public health response as conditions warrant."

Currently, there are no do-not-board orders related to the reported case. The Do Not Board list, which is enforced by the Transportation Security Administration, prevents people from obtaining a boarding pass for a flight into, out of, or within the U.S. for travelers known or suspected to have a contagious disease that poses a public health threat.

During an event on Wednesday, Dr. Erica Schwartz, the CDC's director, said the agency is "well positioned to make sure that we are protected from a potential threat" such as plague.

"We ​are working with Department of Homeland Security, working [with] ⁠Department of State, Department of War and ​other agencies within the government to make sure ​that we know exactly if anyone from that area comes into the United States," Schwartz said at the Wall ​Street Journal's The Future of Health event in ​Washington, D.C.

"We are very confident that the threat to the United States is extremely low," she added. 

It came after World Health Organization (WHO) officials said during a press conference on Wednesday they do not currently have enough information from Russian authorities to conduct a full risk assessment after the death of a plague laboratory worker in Siberia.

Initial media reports suggested a lab worker at Irkutsk Antiplague Research Institute died of the plague, but Russian officials later disputed this, saying the worker died of pneumonia and that the illness was not linked to work in the lab.

During the press conference, WHO Director-General Dr. Tedros Adhanom Ghebreyesus said the agency asked the Russian Federation for more information on Saturday. The Russian Federation replied on Tuesday, saying no case of plague had recently been reported in the Irkutsk Oblast, in southeastern Siberia, and that about 200 contacts had been placed in quarantine.

ABC News' Christopher Boccia and Othon Leyva contributed to this report.

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Pennsylvania is reporting 74 new measles cases since Monday, the state's health department said Wednesday.

A total of 1,078 cases have been reported in the state so far this year. At least 207 people have been hospitalized and five people have died, according to the Pennsylvania Department of Health.

Of the 74 cases added, more than 40 represent individuals who were sick more than two weeks ago and are no longer contagious, but their cases were only recently reported and subsequently confirmed, the DOH said. Wednesday's update "does not reflect a current surge in new infections."

Of the five people who died, two of the deaths were among unvaccinated adults: an 18-year-old and a 40-year-old. The other two deaths were among infants who were too young to have received the measles, mumps, rubella (MMR) vaccine.

The fifth death occurred in an unvaccinated resident of Lancaster County, in southeastern Pennsylvania, but it is unclear how old the individual was. Lancaster County is the epicenter of the state's outbreak, with 401 cases confirmed so far.

One-third of cases are among those under 18 years old and fewer than 1% of cases are among those fully vaccinated with the MMR shot, according to DOH data.

The Centers for Disease Control and Prevention recommends that people receive two doses of the MMR vaccine, the first at ages 12 to 15 months and the second between 4 and 6 years old. One dose is 93% effective in preventing measles infection and two doses are 97% effective, the CDC says.

Infants aged 6 to 11 months living in or traveling to high-risk outbreak areas may receive an early third dose of the MMR vaccine.

CDC data, however, shows vaccination rates have been lagging in recent years. During the 2025-26 school year, 92.4% of kindergartners received the MMR vaccine, according to data. This is lower than the 95.2% seen in the 2019-20 school year, prior to the COVID-19 pandemic.

"State health center staff have administered more than 5,700 MMR vaccinations at 198 pop-up vaccination clinics in the affected communities since the outbreak began in late April," DOH wrote in a press release on Wednesday.

"Dozens of additional vaccine clinics are scheduled for the upcoming weeks and months, based on community interest and need," the press release continued. "In pop-up clinics and at state health centers combined, Department nurses have administered nearly 9,000 MMR vaccine doses to residents across the Commonwealth in 2026."

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As the weather turns colder, it also means respiratory virus season is upon the United States.

In its annual outlook report, the Centers for Disease Control and Prevention (CDC) said it expects the 2026-27 respiratory virus season to have a similar number of peak hospitalizations from influenza, COVID-19 and RSV compared to last season.

Public health specialists told ABC News the best way for people to protect themselves against these viruses is to get vaccinated.

Flu vaccine

The CDC currently recommends that people aged 6 months and older receive an annual flu vaccine.

The seasonal flu vaccine protects against three viruses predicted to circulate during flu season: Type A (H1N1) virus, Type A(H3N2) virus, and Type B/Victoria virus

There are several flu vaccines available this season, with recommendations varying by age and medical history.

"Obviously, we target high-risk groups, so those would be older adults, so over the age of 50, people with chronic medical conditions, individuals who are immunocompromised, individuals that have obesity, or persons who are pregnant or wanting to get pregnant, and healthcare personnel," Dr. Michael Angarone, director of the Infectious Disease Fellowship Program at Northwestern University Feinberg School of Medicine, told ABC News. "But I recommend every patient that I see should get vaccinated for influenza."

Standard-dose inactivated flu vaccines grown either in eggs or cell culture are available for anybody as young as 6 months old.

High-dose and adjuvanted flu vaccines, both of which are egg-based, are available for those aged 65 and older due to their higher risk of severe illness.

Anyone aged 9 and older can receive a recombinant flu vaccine, which is produced without eggs. For those between ages 2 and 49, who don't have certain medical conditions and aren't pregnant, a nasal spray flu vaccine is also available.

Additionally, in August, the Food and Drug Administration approved Moderna's mRNA seasonal flu vaccine to protect those aged 50 and older.

One dose is recommended for children between 6 months and 8 years old who have received two doses in past seasons and everyone aged 9 and older.

Some children under age 9 may require two doses based on prior vaccine history. 

Public health specialists told ABC News they recommend that people receive flu vaccines by the end of October, but that people should get the vaccine even if later in the fall or winter as long as influenza viruses are circulating and unexpired vaccine is available.

Dr. Majd Alsoubani, infectious disease physician at Tufts Medical Center, said that one thing she often hears from patients is that every time they receive the vaccine, they get the flu -- which she says is a combination of misinformation and misunderstanding.

"All the injectable influenza vaccines, they don't have the live virus, it only contains parts of the virus, so it doesn't cause influenza," she told ABC News. "We know that the vaccine needs a couple of weeks just to create protection, so if they were exposed to influenza before the vaccine or right after, they actually might get the flu because the vaccine didn't have time to provide that protection."

COVID-19 vaccine

People aged 18 and older are recommended to receive the COVID-19 vaccine, as are children ages 6 months to 17 years old at increased risk

Parents of all other children should speak to their pediatrician to discuss getting the vaccine.

The updated 2026-2027 COVID-19 vaccines target the XFG strain, a recombinant Omicron variant, meaning it formed through the combination of two Omicron subvariants.

Moderna's mRNA vaccine is approved for those 6 months through 64 years old with an underlying condition and for all adults aged 65 and older. Another Moderna mRNA vaccine that is a lower dosage is available for those ages 12 and older

Pfizer's mRNA vaccine is approved for those 5 years through 64 years old with an underlying condition and for all adults over age 65.

According to the CDC, underlying conditions placing people at risk for higher risk for severe COVID-19 include but are not limited to cancer, asthma, chronic lung disease, diabetes, heart conditions, mental health conditions and pregnancy.

Also available is a vaccine from Novavax, which is a protein-based vaccine, for those aged 12 and older.

Angarone said people can safely get the flu and COVID vaccine during the same visit if they are eligible.

"I recommend to my patients just get it at the same time, or if you don't want to get both at the same time, get [the COVID vaccine] a week apart from the flu vaccine," he said. "So, kind of around this time, October timeframe."

RSV vaccine

"The immunization recommendation kind of follows the people who are at risk of severe disease," Alsoubani said. "So the RSV vaccine currently is only one dose, so you're one and done. It's not an annual vaccine."

The CDC recommends RSV vaccines for all adults aged 75 and older and adults between ages 50 and 74 at increased risk for severe RSV.

It is also recommended for all pregnant people between 32 and 36 weeks' gestation.

For infants under 8 months who are in their first RSV season and whose mother did not receive a maternal RSV vaccine, two monoclonal antibody shots are available.

Monoclonal antibodies are proteins manufactured in a lab that mimic the antibodies the body naturally creates when fighting an infection.

A small group of young children between ages 8-19 months at increased risk for severe RSV may also be eligible.

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Cats live in nearly 80 million American households, but a new study suggests nearly one out of fifteen cats are infected with a common parasite, and one out of five infected cats can transmit it to humans. 

In the study, published in PLoS One, researchers tested over 150,000 samples from cats in 49 states and five Canadian provinces for Giardia duodenalis, a gastrointestinal parasite found in the United States that can cause frequent diarrhea in both animals and humans. 

"Because some strains of Giardia can affect both animal and human health, understanding how commonly it occurs can help support earlier detection, appropriate treatment, and conversations about practical steps pet owners can take to help protect both their pets and their households," Dr. Anne Kimmerlein, co-author of the study and Global Veterinary Epidemiologist at Mars Veterinary Health, told ABC News. 

What is Giardia?

Giardia duodenalis, commonly known as "beaver fever," is a parasite that can infect both humans and animals. The nickname became popular in the 1970s after outbreaks were linked to contaminated water in areas where beavers lived.

Giardia can cause diarrhea up to five times daily, along with other symptoms such as upset stomach and bloating, according to the Centers for Disease Control and Prevention (CDC). Infected pets may exhibit similar symptoms, or no symptoms at all.

Severe cases can cause long-term symptoms lasting years, such as joint inflammation, irritable bowel syndrome, chronic diarrhea or nutritional deficiencies, according to the CDC. 

Individuals with vulnerable immune systems, such as children, are at increased risk of complications.

Giardia live in the intestines of infected people and animals and spread through their stool.

Only a few parasites are needed to make an individual sick, which allows it to spread very easily.

Humans are most often infected after drinking unclean water or being in close contact with the fecal material of infected individuals or pets. 

Symptoms generally begin one to two weeks after exposure and resolve in under six weeks. 

How is Giardia treated?

Giardia infections can sometimes resolve on their own without treatment, particularly in people with mild or no symptoms. 

However, doctors may prescribe medication and supportive therapy for people with persistent symptoms, those at higher risk of complications or those at risk of spreading the infection to others. 

In pets, veterinarians may also prescribe medicine.

"If your cat is diagnosed with Giardia, thoroughly cleaning all litter boxes, water and food bowls is imperative. Clean any areas that accidents may have occurred and keep them separated from young children or immunocompromised individuals until treatment and re-testing is complete," Dr Stevie Aitken, an emergency veterinarian, told ABC News. 

Which cats may be more at risk?

Some cats may be more likely than others to become infected with Giardia, possibly due to differences in environmental exposures or behavior. 

Researchers found that kittens were more likely to test positive than older cats, and male cats were more likely to be infected than female cats. 

Neutered kittens, more often seen in shelters where neutering happens at a younger age, also had a markedly higher likelihood of infection, which may be due to exposure to other rescue animals. 

Where a cat lives and the time of year may also play a role. Giardia was detected less often during the summer months, which researchers said may be because the parasite survives better in cooler and moist conditions.

Cats in the Midwest also had higher rates of infection compared with cats in other parts of the United States, which researchers believe may be due to differences in environment and reporting.

Researchers found that some of the same factors linked to a higher chance of infection were also associated with carrying forms of Giardia that may be able to infect people. 

What do experts recommend?

Because Giardia is easily spread and can infect humans and animals alike, it has the potential to spread among many humans and animals quickly. 

Aitken believes routine testing annually during pet wellness visits or when symptomatic is sufficient but recommends more frequent screening if there are young children or immunocompromised individuals in the house. 

"Giardia, while prevalent and occasionally problematic, is typically very treatable. Wash your hands, don't let animals lick your face or your mouth, and keep kids away from litter boxes. And if you're ever concerned about exposure or your cat's health, call your veterinarian," Aitken said. 

Dr. Allen Chang is a Geriatric Medicine subspecialist at Dalhousie University and a member of the ABC News Medical Unit.

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The World Health Organization (WHO) said on Wednesday it does not currently have enough information from Russian authorities to conduct a full risk assessment after the death of a plague laboratory worker in Siberia.

Dr. Tedros Adhanom Ghebreyesus, WHO director-general, said during a press conference that following media reports of the worker's death, the WHO asked the Russian Federation on Saturday for more information, in accordance with the International Health Regulations (IHR).

The Russian Federation replied on Tuesday, saying no case of plague had recently been reported in the Irkutsk oblast, in southeastern Siberia, and that about 200 contacts had been placed in quarantine.

"As we don't yet have the full picture of this event, we are not able to conduct a full risk assessment," Tedros said in his opening remarks. "Timely, complete and transparent information sharing under the International Health Regulations is essential to clarify conflicting reports and enable an accurate assessment of potential public health risks."

Initial media reports suggested a lab worker at Irkutsk Antiplague Research Institute died of the plague, but Russian officials later disputed this, saying the worker died of pneumonia and that the illness was not linked to work in the lab. 

Tedros said the WHO has requested more information surrounding the death of the lab worker, the tests being conducted on the individual who died, contact tracing of other individuals close to the worker, and other information.

"We don't know exactly how this person died," Dr. Maria Van Kerkhove, director of the department of epidemic and pandemic management of the WHO Health Emergencies Program, told reporters on Wednesday. "We know that she had pneumonia. We know it was a fatal case. We understand that some laboratory tests have been done. They haven't found the causative agent, that we know, and so this is why we need more information."

It appears that the WHO may have leaned heavily on local media reports to better understand what may have occurred.

In response to a reporter's question about a potential incident in the lab, Kerkhove noted, "I know what you know from the media." 

The WHO is awaiting more information from Russian officials regarding the incident, Van Kerkhove said. 

"We expect further answers from Russia. We did get some reports back from them following the IHR verification request, but not yet everything has been provided to us," Van Kerkhove said.

Tedros added that the WHO has offered technical support related to plague and lab biosafety and biosecurity.

On Tuesday, the Centers for Disease Control and Prevention said in a statement, in part, that "at this time, there is no indication of a broader threat to the United States, but CDC and our interagency partners are prepared and will continue to monitor the situation closely."

Plague is a disease caused by the bacterium Yersinia pestis, according to the CDC. There are three types of plague: bubonic, pneumonic and septicemic. Symptoms often include fever, chills and weakness. Plague can be treated with antibiotics. The earlier antibiotics are received, the higher the chances of a full recovery.

The U.S. averages about seven cases of plague each year, mostly in Western states, according to the CDC, which notes it has been more than a century since the U.S. has seen a documented case of person-to-person spread of plague.

ABC News' Youri Benadjaoud contributed to this report.

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New York Gov. Kathy Hochul declared a state disaster emergency on Monday as neighboring Pennsylvania battles its largest measles outbreak in three decades.

As of Oct. 3, New York has recorded 108 measles cases so far this year, 92 of those since mid-July across 18 rural counties where communities are under-immunized, according to Hochul's order.

"After reviewing the latest data on measles cases in New York State, I am declaring a state disaster emergency to strengthen our ongoing efforts to confront this disease," Hochul said in a statement. "No one should get seriously ill or die from a vaccine-preventable disease."

It marks the first time a state has issued an emergency order since measles cases began rising last year. At least 95% of measles cases in the U.S. have been among people who are unvaccinated or whose vaccination status is unknown.

The order allows registered nurses to order the collection and testing of specimens for suspected measles cases.

Early symptoms include cough, runny nose, fever as high as 104 Fahrenheit and red, watery eyes, according to the Centers for Disease Control and Prevention (CDC).

Two to three days after symptoms start, patients may develop Koplik spots, which are tiny white spots that may appear inside the mouth on the inner cheek.

Three to five days after symptoms start, patients may experience a rash, first appearing on the face at the hairline before moving downwards to the neck, chest, stomach, arms, legs and feet. Fever may spike even higher than 104 F when the rash appears, the CDC says.

The order, in effect until Nov. 4, allows pharmacists in New York to vaccinate ⁠children as young as age 2 with the MMR shot. It also expands who can administer MMR vaccines to include emergency medical technicians-paramedics, advanced EMS and midwives.

Additionally, it suspends a previous requirement that health care professionals who administer vaccines to those aged 19 and older receive consent before reporting vaccination to New York City or New York State immunizations registries. All MMR vaccinations of children and adults must be reported within 72 hours.

"Department staff are working closely with local health departments and regional partners to track and contain the current measles outbreak," Dr. James McDonald, commissioner for the New York State Department, said in a statement. "The measles, mumps, and rubella vaccine is the best protection -- protecting nearly all people against disease who receive the recommended doses."

The state said it has administered more than 1,000 MMR shots in rural areas since July.

Meanwhile, Pennsylvania health officials are now reporting more than 1,000 measles cases. Nearly 200 people have been hospitalized and the state has reported five measles-associated deaths, which is the most any state has reported in over 30 years.

This outbreak follows a trend of growing outbreaks in the U.S. over the last two years.

Earlier this year, South Carolina reported the end to a measles outbreak of 997 cases. Last year, Texas reported an outbreak of 762 cases.

Nationally, nearly 4,000 cases have been confirmed this year in the U.S., with infections reported in almost every state, according to the CDC. It's the highest number of illnesses from measles since 1991.

The CDC currently recommends that people receive two doses of the MMR vaccine, the first at ages 12 to 15 months and the second between 4 and 6 years old. One dose is 93% effective in preventing measles infection, and two doses are 97% effective, the CDC says.

Infants aged 6 to 11 months living in or traveling to high-risk outbreak areas may receive an early third dose of the MMR vaccine.

However, CDC data shows vaccination rates have been lagging in recent years. During the 2025-26 school year, 92.4% of kindergartners received the MMR vaccine, according to data. This is lower than the 95.2% seen in the 2019-20 school year, prior to the COVID-19 pandemic.

School vaccine exemptions also reached a record high last school year. Recent CDC data showed that vaccine exemptions for kindergarteners increased to 4.2% during the 2025-26 school year. This is up from 3.6% compared to the previous school year and 2.2% during the 2020-21 school year.

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Measles cases in Pennsylvania have surpassed 1,000 so far this year as the state continues to battle an outbreak of the virus.

Monday's update from the Pennsylvania Department of Health (DOH) brings the total number of 2026 measles cases in the state to 1,004 across 39 counties.

At least 198 people have been hospitalized, and five measles-associated deaths have been reported, DOH data shows.

Two of the deaths were among unvaccinated adults: an 18-year-old and a 40-year-old. The other two deaths were among infants who were too young to have received the measles, mumps, rubella (MMR) vaccine.

The fifth death occurred in an unvaccinated resident of Lancaster County, in southeastern Pennsylvania, but it is unclear how old the individual is. Lancaster County is the epicenter of the state's outbreak, with 391 cases confirmed so far.

Fewer than 1% of the state's cases are among those who are fully vaccinated with the MMR vaccine, according to DOH.

Last week, following confirmation of the fifth death by the Pennsylvania health department, the Centers for Disease Control and Prevention (CDC) told ABC News in a statement it was "deeply saddened to hear of another death" in the state.

"Under Secretary [Robert F.] Kennedy's leadership, CDC has mounted an aggressive response to measles outbreaks across the country. Texas, South Carolina, Virginia, Kansas, New Mexico, and Wisconsin requested CDC Epi-Aids and worked alongside federal teams to help bring their outbreaks rapidly and successfully under control," the statement read.

"CDC has not received a formal Epi-Aid request from Pennsylvania. If requested, CDC stands ready to deploy epidemiologists to support the state's identified needs," the statement continued.

A CDC Epi-Aid is a rapid, short-term field investigation from the federal health agency of an "urgent public health problem." The Epi-Aid provides resources such as, but not limited to, increasing the workforce available for rapid response and building epidemiologic capacity, according to the CDC.

Meanwhile, measles cases in the U.S. have surpassed 3,800 so far in 2026, with cases confirmed in 45 states and Washington, D.C., according to the latest data from the CDC.

The CDC currently recommends that people receive two doses of the MMR vaccine, the first at ages 12 to 15 months and the second between 4 and 6 years old. One dose is 93% effective in preventing measles infection and two doses are 97% effective, the CDC says.

Infants aged 6 to 11 months living in or traveling to high-risk outbreak areas may receive an early, extra third dose of the MMR vaccine.

However, CDC data shows vaccination rates have been lagging in recent years. During the 2025 to 2026 school year, 92.4% of kindergartners received the MMR vaccine, according to data. This is lower than the 95.2% seen in the 2019 to 2020 school year, prior to the COVID-19 pandemic.

In Pennsylvania, more than 8,800 doses of the MMR vaccine have been administered by DOH staff. Of those doses, about 3,500 were administered in August and more than 2,500 were administered in September.

ABC News' Youri Benadjaoud contributed to this report.

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The U.S. State Department is monitoring a reportedly fatal case of "pneumonia of an unknown etiology" linked to a plague research laboratory in Russia.

"We are aware of ​reports of a fatal case of suspected pneumonic plague in Irkutsk Oblast, Russia. We are monitoring the situation closely with the CDC and our other interagency partners," a spokesperson from the State Department said.

"Many details have not been confirmed. We encourage Russian authorities to share accurate information quickly and openly," the spokesperson added.

Where the case of plague has been detected

Health authorities in Russia's Irkutsk region launched anti-epidemic measures after an employee of a plague institute was diagnosed with "pneumonia of an unknown etiology," the country's sanitary watchdog agency, Rospotrebnadzor, confirmed on Sunday.

The lab involved is the Anti-Plague Research Institute in Shelekhov, in southern Siberia, Russia. 

The statement comes after some Russian media and public figures reported a death potentially due to the plague and linked to a lab worker. Russian officials did not provide further details on the worker.

The Russian agency's statement said that "no accidents have been detected at the Irkutsk Anti-Plague Institute while working with pathogenic microorganisms."

Their statement added that "the sanitary and epidemiological situation" in the Irkutsk Region, the cities of Irkutsk and Shelekhov, is "stable."

How Russian authorities are responding

Regional governor Igor Kobzev said in a statement on Friday that people who had contact with a resident who contracted a "particularly dangerous infection" were placed under medical observation.

Responding to the growing speculation, the governor on Monday said that "no microorganisms associated with the woman's professional activities were found in her biomaterials" and that no other lab workers have sought medical help in recent days. 

Officials said none of the identified contacts were showing symptoms so far and their laboratory tests were negative, according to Kobzev.

Before Rospotrebnadzor reported that the employee's illness was due to pneumonia with an unknown cause, Alexei Tsydenov, the head of Buryatia, a region neighboring Irkutsk Oblast, suggested that a woman may have died of the plague.

Citing Buryatia's health officials, Tsydenov wrote in a post on his Telegram channel on Friday that "the woman who died – possibly from the plague – in the Irkutsk Region had not visited Buryatia," assuring Buryatia residents that "there are no plague outbreaks in the republic."

Amid the investigation, some protective measures have been announced in the region. A mask mandate has been implemented at the Irkutsk Aluminum Plant in Shelekhov, according to the plant's director, Artem Fominykh. 

"Better safe than sorry," Fominykh wrote in a post on his Telegram channel on Saturday, asking the employees to "follow the precautions." He added that some conflicting information about the situation is circulating in Shelekhov, and urged the plant employees to seek medical attention immediately if they experience any symptoms.

US response

The Centers for Disease Control and Prevention (CDC) said in a statement on Sunday that it is "monitoring the situation closely" with the State Department.

"The safety and security of U.S. citizens is our highest priority," the CDC said.

"Many details have not been confirmed. We encourage Russian authorities to share accurate information quickly and openly," a State Department spokesperson said in a statement.

"Plague is a known disease and is treatable with common antibiotics, especially when treatment starts early. Cases occur naturally in many parts of the world," the statement added.

What to know about plague and its transmission

Plague is a disease caused by the bacterium Yersinia pestis, according to the CDC.

Humans can contract the disease after being bitten by an infected rodent flea, coming into contact with contaminated fluid or tissue from an infected animal or by inhaling infected droplets in the air.

There are three types of plague: bubonic, pneumonic and septicemic. Symptoms often include fever, chills, and weakness.

Pneumonic is the most serious form and the only one that can potentially spread between people. It occurs when bacteria spread to the lungs of a patient with untreated bubonic or septicemic plague, or when a person inhales infectious droplets, according to the CDC. 

Bubonic plague is infamously responsible for the deaths of millions of people in Europe during the 1300s. While the disease still exists, modern medicine and public health efforts have made it less threatening.

Plague can be treated with a course of antibiotics. The earlier antibiotics are received, the higher are the chances of a full recovery.

The U.S. averages about seven cases of plague each year, mostly on the West Coast in states such as Arizona and New Mexico, according to the CDC. It's been more than a century since the U.S. has seen a documented case of person-to-person spread of plague, per the CDC.

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The Food and Drug Administration (FDA) said on Friday it has found a potential source of the cyclosporiasis outbreak that was tied to lettuce over the summer.

The agency collected samples during its onsite inspections of Taylor Farms de Mexico facilities, it said.

Two samples tested positive for the parasite, Cyclospora, according to the FDA. One positive sample was from a tank that held outgoing wastewater from a processing facility, the agency said. The second positive sample was from a drainage ditch of an iceberg lettuce grower, it noted.

"While there is currently not enough evidence to conclusively determine how contamination occurred in this outbreak, the positive samples show that Cyclospora was present in the environment where lettuce was grown and processed,” the FDA wrote in an update on its website.

"This adds to the strong epidemiological data and traceback convergence supporting the link between this outbreak and recalled shredded iceberg lettuce from Taylor Farms de Mexico," the update continued.

The FDA said its investigation has closed. Health officials say they are confident that all recalled lettuce associated with this outbreak is off the market.  

In a statement, a Taylor Fresh Foods spokesperson said its facility in central Mexico remains closed as the company works with its research team to implement enhanced safety protocols.

"The independent grower where a positive sample was found is no longer part of our supplier program," the spokesperson said. "The sample FDA referenced came from discharged waste and sewer water outside of our processing facility. As FDA noted in its report, there is currently not enough evidence to conclusively determine how contamination occurred or how results for these samples relate to ongoing genotyping of clinical specimens."

The statement concluded: "We remain concerned for the people and families impacted by this outbreak. Millions of families rely on the safety of Taylor Farms produce and we take that responsibility seriously. We know trust is earned by what we do, and we will continue to learn, improve and take action to keep our food fresh and safe." 

At least 12,883 people were infected with cyclosporiasis across 21 states after eating the recalled lettuce, according to the Centers for Disease Control and Prevention (CDC). Thousands more cases were reported but health officials noted difficulties in tying infections to the recalled foods.

A total of 570 people were hospitalized and two people in Michigan died.  

In mid-July, the FDA and the CDC announced they were investigating a multi-state outbreak of cyclosporiasis illnesses linked to shredded iceberg lettuce served at some Taco Bell restaurants.

The lettuce was supplied to Taco Bell by Taylor Farms and sourced from central Mexico.

Taylor Farms de Mexico issued a voluntary recall of all iceberg lettuce sourced from central Mexico, with the recall affecting 27 states. The recalled products were distributed from June 29 through July 16 and have best-if-used-by dates up to Aug. 3.

Taco Bell said it is no longer using lettuce from Taylor Farms de Mexico at any of its restaurants.

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(NEW YORK) -- San Francisco health officials this week reported the city's first flu death of the 2026-27 flu season.

The person was an adult, according to the San Francisco Department of Public Health (SFDPH), but no other information was provided.

"This sad news reminds us that respiratory viruses such as flu and COVID should be taken very seriously, especially for people who are at higher risk of getting sick," Dr. Susan Philip, San Francisco health officer, said in a statement on Thursday. "With fall festivities approaching, we want people to stay healthy and do all the fun and joyful things they want to do. Vaccines help make this happen."

Data from the California Department of Public Health shows 26 individuals have died so far from flu statewide this season. It's unclear if this total includes the San Francisco patient.

The deaths have occurred relatively early in the respiratory virus season. According to the official Centers for Disease Control and Prevention (CDC) tabulation, flu season doesn't start for another two weeks.

Current levels of respiratory virus activity nationally are listed as "very low," according to CDC data. 

Although flu circulates year-round, cases typically increase in the fall and winter months. The CDC advises that people get their flu vaccine before the end of October. 

Everyone over the age of 6 months is currently eligible for a flu vaccine. Older adults -- over 65 years old -- may be eligible for a higher dose version. 

The shots are available at most pharmacies and doctors' offices. The flu vaccine is often free of charge, with most health insurance covering the shot. 

The SFDPH also recommends staying up to date with COVID and RSV vaccines in line with recommendations from the state's health department.

The updated 2026-27 COVID vaccine is recommended for:

• Those ages 6 to 23 months and ages 65 and older
• Those ages 2 to 18 with risk factors or never vaccinated against COVID-19
• Those ages 19 to 64 with risk factors
• Anyone who is planning pregnancy, pregnant or postpartum
• Anyone in close contact with others with risk factors, including healthcare workers

The RSV vaccine is recommended for:

• Previously unvaccinated adults ages 75 and older, and ages 50 to 74 with risk factors
• Previously unvaccinated pregnant people 32 to 36 weeks gestation

Infants younger than 8 months whose mother did not receive a vaccine while pregnant and high-risk children ages 8 to 19 months are eligible to receive an injectable monoclonal antibody shot to protect against RSV.

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(WASHINGTON) -- The Trump administration has begun mailing out $500 Affordable Care Act (ACA) checks to enrollees who were allegedly overcharged for coverage.

The Treasury Department is issuing the checks to 950,000 Americans in 30 states due to marketplace "user fee" overcharges, according to the administration.

In a video posted on X last month announcing the initiative, President Donald Trump claimed without evidence that the Biden administration sat on a pool of unused surplus money.

Here's what to know about who is eligible, where the checks are being sent and when they may arrive.

Who is eligible?

An administration official told ABC News on Thursday that the primary recipients of the checks will be people with incomes "above" 400% of the federal poverty level. The federal poverty level is $15,960 a year for an individual in the contiguous 48 states and Washington, D.C.

However, some recipients are those who earn between 100% and 400% of the federal poverty level who did not receive subsidies, the official said.

Residents in the following states will receive checks: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Hawaii, Indiana, Iowa, Kansas, Louisiana, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, Wisconsin and Wyoming.

The administration official told ABC News that residents in these 30 states "do not operate their own ACA insurance plan exchanges and instead rely on federal exchanges administered by [the Centers for Medicare & Medicaid Services]."

The official said residents in the 20 remaining states will not receive checks "because their states run their exchanges, and thus the federal government did not oversee collecting user fees on them."

Texas and Florida have the highest numbers of individuals who will be receiving refund checks followed by Wisconsin, Arizona and Oregon, respectively, according to data provided by the administration.

Gerard Anderson, a professor of health policy and management at Johns Hopkins Bloomberg School of Public Health, told ABC News he's skeptical the checks will be going to the Americans most in need.

The payment "does not target the people most likely to have been harmed by the policy changes made by the administration, including the end of the tax credits," Anderson said.

The subsidies, or premium tax credits, helped lower or eliminate the out-of-pocket cost of monthly premiums for those who purchase insurance through the health insurance marketplace. They expired at the end of last year and have yet to be renewed.

Anderson added that the check amount is also not tied to a person's medical condition, which has a large impact on the cost of their premiums.

When will the checks be delivered?

Initially, the administration said checks would be sent to eligible Americans beginning in October 2026, but the administration official said the checks were sent out beginning Wednesday.

It's unclear how long it will take eligible Americans to receive the checks.

The checks will also come with a letter, according to the administration official.

"For years, the Biden Administration overcharged you to fund the operation of HealthCare.gov," the letter, viewed by ABC News, reads in part. "That money belongs to hard-working Americans, not the Government, and now, I am returning it to you."

The checks are separate from a proposal Trump made during the GOP midterm convention in Dallas to offer a $5,000 "dividend" to all adult Americans if Republicans keep control of the House and Senate in the midterm elections.

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Breast cancer is the second most common cancer among women, with one in eight developing breast cancer in their lifetime.

It is expected that more than 381,000 new cases of invasive, non-invasive and pre-invasive breast cancer will be diagnosed in women this year and about 42,000 women will die, according to the American Cancer Society (ACS).

Knowing your personal risk of developing breast cancer risk could help you and your doctor choose the right screening schedule and prevention methods.

ABC News is teaming up with the ACS for Breast Cancer Awareness Month.

The American Cancer Society encourages women to take the ACS CancerRisk360 free assessment to learn more about the factors they can change to improve their health and lower their cancer risk.

The tool is available to use for anyone ages 18 and older. The tool asks questions about things that can raise an individual's cancer risk, including:

Individual health historyFamily health historyDaily habits and lifestyleCancer screening history

Based on someone's answers, the tool gives tips on how to lower one's cancer risk.

Cancer risk can be controlled or modified with several lifestyle changes including diet, physical activity, tobacco use, HPV vaccination and sun/UV protection, according to ACS. Certain risk factors -- such as age and family history -- cannot be controlled or modified.

The tool does not cover every type of cancer but does offer steps to lower the risk for cancers such as breast, cervical, colorectal, lung and prostate cancer.

"Understanding your cancer risk should make the next step clearer, not more complicated," Shane Jacobson, CEO of the American Cancer Society, said in a statement. "CancerRisk360 gives people trusted, personalized guidance they can use to start a conversation with their healthcare provider and take practical steps that may help lower their risk."

ACS says the tool is not a substitute for speaking with and getting medical advice from an individual's doctor.

"Always talk to a qualified health care provider who knows your situation and personal health needs," ACS states on its website. "Do not ignore or delay getting professional medical advice because of anything you read in this assessment or in your recommendations."

Copyright © 2026, ABC Audio. All rights reserved.

Oct. 1 marks the beginning of Breast Cancer Awareness Month, putting a spotlight on the second most common cancer diagnosed among women.

Although the rates of women diagnosed with breast cancer have increased, death rates have been declining and five-year survival rates have risen.

It's not just women; men are also diagnosed with the disease. Additionally, disparities persist among races and ethnicities.

Here's what you need to know about breast cancer by the numbers. 

Diagnosis rates

Breast cancer is the most frequently diagnosed cancer among women in the United States, aside from skin cancer, with more than 320,000 new invasive cases expected each year, according to the American Cancer Society (ACS). 

Breast cancer diagnoses have risen with a 1% increase per year in recent years, ACS says.

"Breast cancer is one of the most common cancers in women, but most women diagnosed with breast cancer do very well and outcomes have improved tremendously over the years," Hannah Rose Naughton, breast surgical oncologist at Hackensack Meridian Health, told ABC News. 

Breast cancer accounts for roughly one in every three new cancers diagnosed in women each year and is the second leading cause of cancer death among women in the U.S., behind lung cancer, according to the ACS.

"The earlier we find the cancer, the better the outcome for the patient," Naughton said. 

While breast cancer affects women far more often, the disease can also occur in men. 

"One percent of breast cancer cases occur in men; it's extremely rare," Priya Thomas, breast oncologist at the University of Texas MD Anderson Cancer Center, told ABC News.

Declining death rates

The breast cancer death rate among U.S. women decreased by 44% from 1989 to 2024, preventing an estimated 500,000 to 517,900 deaths, according to ACS.  

"The decrease in breast cancer death rates is probably a combination of our screening advances, as well as advances in the treatments that we have for different subtypes of breast cancer," Thomas said. "Artificial intelligence is also being investigated and possibly can also increase sensitivity and detection." 

Improving survival rates

In the late 1970s, the five-year relative survival rate for women with invasive breast cancer -- which compares how many patients are alive five years after diagnosis with people of the same age who don't have cancer -- was roughly 75%.

As of 2022, it is above 90%, according to the National Cancer Institute (NCI). The increase reflects major advances in screening and earlier diagnosis.

Where breast cancers are found

Stage at diagnosis remains one of the biggest predictors of outcome. 

Most breast cancers are discovered before they have spread to other parts of the body, according to the NCI. 

About 64% of cases are diagnosed at a localized stage, meaning the cancer has not spread beyond the breast. About 27% have spread to nearby lymph nodes or tissue, and about 6% are diagnosed after the cancer has spread to distant parts of the body. About 2% have an unknown stage. 

"If you feel a lump, if you notice a skin change, if you notice nipple discharge or any change that is different from your normal baseline, that warrants an evaluation by your provider," Thomas said.

Persisting disparities

The burden of breast cancer is not shared equally. 

"Black women are more likely to develop triple-negative breast cancer, which can be a more aggressive subtype, and unfortunately they do have a higher breast cancer mortality rate," Naughton said.

As with many other diseases,  the risk of breast cancer increases with age. The average age at breast cancer diagnosis in women is 63, according to the NCI. 

In men, the ACS reports the average age at diagnosis is between 60 and 70. Although for both women and men, the disease can occur at virtually any age, and diagnosis at a younger age is linked to increased mortality.

"I know that recently some of the guidelines, depending on where you're looking, have changed and may recommend mammograms every one to two years, but I still recommend yearly mammograms starting at age 40 for women at average risk,"  Naughton said. 

Beyond regular screening, experts say being aware of changes in your body is important.

"The most important message is that you shouldn't ignore a change in your breast," Naughton said. 

Dr. Tara Howard is a fourth-year dermatology resident and a member of the ABC News Medical Unit.

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(NEW YORK) -- As cases of dengue fever continue to rise in Florida, public health specialists are worried the true number of infections may be greater.

For the week ending Sept. 19, at least 190 cases of locally acquired dengue have been confirmed in the state, an increase of 38 cases from the week before, according to data from the Florida Department of Health (DOH).

Hillsborough County, which includes Tampa, is reporting the highest number of cases at 170 followed by Miami-Dade, Orange, Palm Beach, Pasco and Pinellas counties, DOH data shows.

"There's evidence of local transmission of dengue in several counties in Florida," Natalie Dean, an associate professor of biostatistics and informatics at Emory University's Rollins School of Public Health, told ABC News. "Dengue is not endemic to the United States. That means that it doesn't typically cause local transmission."

She added, "There can be occasional outbreaks in the U.S. but this one is notable for its size."

Last week, DOH reported the state's first death from dengue fever this year but did not provide any details about the patient including name, age, sex or residence.

Three counties -- Hillsborough, Pasco and Pinellas -- declared local states of emergency last week. These allow local governments to waive normal procedures, access emergency resources and strengthen efforts to control mosquito populations.

Pinellas County crews have been going door to door and spraying areas with high mosquito presence, according to local ABC News affiliate WFTS.

"I don't recall a [period] of time when it's been this high in such a sort of concentrated area before," Cameron Wolfe, an infectious diseases specialist and a professor of medicine at Duke University School of Medicine, told ABC News.

Wolfe said there may be an underestimate of the true number of cases in Florida. Cases of dengue can be mild, and people may recover on their own or never be tested. Because dengue can resemble a flu-like illness, patients may never suspect the source of their infection.

Additionally, he said that reporting of confirmed cases to either local state departments or the CDC can lag.

"For every case that we know, there's going to be a bunch that we never find out about," Wolfe said.

Dean added that people can be infected with dengue multiple times over the course of their life, but it's usually the second or later infection that is more severe, leading to further underreporting.

"I always think of like the top of an iceberg," Dean said. "We're only capturing some of the some of the cases."

The Centers for Disease Control and Prevention (CDC) told ABC News in a statement on Tuesday that the agency is "closely tracking dengue activity" and the "unprecedented" number of cases in the Tampa area.

The CDC also said they've provided $800,000 in emergency funds to help with the response.

"Because the types of mosquitoes that spread dengue, Aedes aegypti, are common throughout many areas of the United States, continued local spread of dengue is possible," the CDC statement said. "The best way to prevent dengue is to protect yourself from mosquito bites by using EPA-registered insect repellant, wearing loose fitting clothes, and controlling mosquitoes in and around your home, such as dumping water."

Some research has shown that climate change could be expanding the geographic range and severity of dengue fever.

Rising global temperature coupled with more rainfall and humidity -- leading to standing water pools that serve as breeding grounds for mosquitoes -- could increase the number of cases.

"Global warming and climate change, in fact, leave places like Florida more wet and more capable of housing these mosquito vectors, so I wouldn't be surprised if this becomes a little more of a perpetual thing," Wolfe said.

ABC News' Youri Benadjaoud contributed to this report.

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(NEW YORK) -- At least 13 new measles cases have been confirmed in Pennsylvania since Friday, bringing the total so far this year to 903, according to Monday's update from the state health department.

Cases have been recorded in 39 of Pennsylvania's 67 counties. At least 176 people have been hospitalized, and four measles-associated deaths have been reported, the Pennsylvania Department of Health (DOH) said.

Two of the deaths were among unvaccinated adults: an 18-year-old and a 40-year-old. The other two deaths were among infants who were too young to have received the measles, mumps, rubella (MMR) vaccine.

Fewer than 1% of the state's cases -- four in total -- are among those who are fully vaccinated with the MMR vaccine, according to DOH.

The majority of cases are among those between ages 25 and 49, followed by those between ages 18 and 24, according to state health department data.

Lancaster County in southeastern Pennsylvania has recorded the highest number of cases at 363 followed by Mifflin County, in the central part of the state, with 105.

At least 11 counties show evidence of community transmission, which is when infectious illness spreads through a local population without any known travel history and the specific source of infection cannot be determined.

DOH data shows staff have administered more than 8,300 doses of the MMR vaccine so far this year. Uptake was highest in August with about 3,500 vaccine doses administered, followed by September with about 2,500 doses administered.

Meanwhile, measles cases in the U.S. have surpassed 3,600 so far in 2026, with cases confirmed in 45 states and Washington, D.C., according to the latest data from the Centers for Disease Control and Prevention.

The CDC has reported one death from measles so far this year but did not say where the death occurred. A note on the agency's website said the number "is subject to change."

The CDC currently recommends that people receive two doses of the MMR vaccine, the first at ages 12 to 15 months and the second between 4 and 6 years old. Infants who are between 6 and 11 months old and traveling outside of the country may require an additional vaccination. One dose is 93% effective in preventing measles infection and two doses are 97% effective, the CDC says.

However, CDC data shows vaccination rates have been lagging in recent years. During the 2025 to 2026 school year, 92.4% of kindergartners received the MMR vaccine, according to data. This is lower than the 95.2% seen in the 2019 to 2020 school year, prior to the COVID-19 pandemic.

"If you've been exposed, it is important to talk to a healthcare professional, but don't go into an urgent care or an ER because you may be inevitably spreading it to other vulnerable people," ABC News medical contributor Dr. Alok Patel told "ABC News Live" on Friday.

"People who have been exposed may be instructed to quarantine or keep really close eye on their symptoms for up to 21 days because that's how long it can really take for measles to show itself and you could potentially spread and infect others without even knowing it," Patel added.

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(NEW YORK) -- Insomnia may be linked to an increased risk of stroke, dementia and several mental health conditions, a new study finds.

Researchers from Austria, Germany, Italy and Switzerland analyzed approximately 20 comprehensive review studies, involving millions of participants across multiple countries, to evaluate the impact of insomnia on health. 

The study, published Sunday in the journal Sleep Medicine Reviews, found that insomnia was linked to a 26% increased risk of stroke.

The results, which looked at multiple other studies also showed individuals with insomnia were more likely to have depression and attempted suicide compared to those without insomnia. 

Insomnia, the most common sleep disorder in the United States, makes it difficult to fall asleep, stay asleep or get good quality sleep, according to the National Institutes of Health (NIH).

Researchers also found that people with insomnia had nearly 30% higher odds of being hospitalized for any number of reasons.  

"Insomnia deserves attention as a warning sign of the status of brain and mental health," Luca Vignatelli, lead study author and senior researcher at the IRCCS Institute of Neurological Sciences in Bologna, Italy, told ABC News. 

Issues with sleep are often overlooked when addressing mental health concerns, experts told ABC News. 

"When you have anxiety or depression, it makes it difficult to fall or stay asleep, or it gives you poor sleep. But then when you don't sleep well, it increases that risk of anxiety and depression," Dr. Thanuja Hamilton, a board-certified sleep medicine physician at Advocare, told ABC News. "When you don't sleep well, you're more irritable, you're more anxious, you're less resilient to stress, and so you're vulnerable to depression and anxiety, and that can make it harder to sleep." 

Researchers also found a connection between insomnia and dementia, particularly Alzheimer's disease. 

Sleep has been shown to play an important role in clearing waste products linked to impaired brain function and Alzheimer's disease from the brain, according to the NIH. 

"When you sleep, that's when your brain takes out the trash," Hamilton said, referring to waste products that can accumulate throughout the day. "If you're not getting good quality sleep or enough of it, then you're going to have an excess buildup, increasing that risk of dementia down the line."

Researchers cautioned that the new findings only show associations and do not prove that insomnia directly causes the health problems examined.

"I would like to emphasize that people should not be frightened by these results. An increased risk at the population level does not mean that an individual with insomnia will develop dementia, depression or have a stroke," Dr. Stefan Seidel, one of the study authors and professor of neurology at the Medical University of Vienna, told ABC News. "Instead, the findings give us another reason to take persistent sleep problems seriously, identify possible underlying causes and provide evidence-based treatment when appropriate."

What can people do to improve their sleep?

Habits like making your bed daily, keeping the room cooler and turning off the lights before bed can help improve your sleep, according to experts. 

One of the most important healthy sleep habits, they say, is maintaining a consistent sleep schedule.

"Our circadian rhythm, our internal clock, it likes consistency," Hamilton said. "If you are inconsistent with your sleep, then you confuse your brain. It doesn't know when to start sleep or when to stop sleep."

To support healthier sleep, turn off distractions such as the TV or your phone approximately 30 to 60 minutes before bedtime and avoid consuming coffee or alcohol late. 

"You go down that rabbit hole when you get on the phone," Hamilton noted. "It might distract you, but it's not relaxing you."

People with insomnia can also become anxious about whether they will be able to fall asleep, potentially making the problem worse.

"The harder you try to sleep when you have insomnia, the harder it is to sleep," Hamilton added. 

Cognitive behavioral therapy (CBT) is often the first treatment option for long-term insomnia. CBT focuses on changing thoughts and behaviors that can interfere with sleep and can include techniques such as adjusting sleep schedules and limiting the amount of time spent awake in bed, according to the NIH. 

"The gold standard of treatment for insomnia is CBT, but it's difficult and it's time-consuming and it's a lot of effort, especially for someone with chronic insomnia," Hamilton said. "But it is worth it."

Experts say sleep should become a more routine part of conversations about overall health. 

"Sleep should be a topic to discuss with your doctor when talking about health, at any age," Vignatelli said. "We need to raise public awareness about insomnia and its treatment and ensure that sleep is included in health promotion programs in our communities, schools, and workplaces."

If you or someone you know is having thoughts of suicide -- free, confidential help is available 24 hours a day, 7 days a week. Call or text the national lifeline at 988. 

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(BOSTON) -- About 4,000 registered nurses at Brigham and Women's Hospital (BWH) in Boston voted "overwhelmingly" on Thursday to authorize an open-ended strike.

The Massachusetts Nurses Association (MNA), which represents the nurses, said this could be the largest open-ended registered nurse (RN) strike in state history.

No strike date has been set yet. Before it occurs, the nurses will be legally required to give 10 days' notice. If the strike is held, it would continue until the nurses reach a contract agreement with the hospital.

Nurses say they are seeking a fair contract that will protect patient care, strengthen the workforce and provide affordable health insurance.

"[Mass General Brigham] cannot tell nurses to choose between the care our patients deserve, affordable health insurance, or fair cost-of-living wage increase," Jim McCarthy, RN, a nurse in the post-anesthesia care unit and vice chair of the BWH MNA Bargaining Committee, said in a statement.

The statement went on, "We have offered to negotiate and work toward an agreement, but CEO Anne Klibanski, who makes $9.2 million a year, and the billionaires on MGB's Board of Directors, have refused to bargain. Our vote gives nurses the power to push back hard if the MGB billionaires keep putting corporate greed over safe patient care."

Among the nurses' proposals are limiting the hospital's use of temporary nurses, fair compensation including a cost-of-living increase and affordable health insurance with plan choice.

In July, BWH nurses held a one-day strike. Since then, the nurses say the hospital has refused to "meaningfully negotiate."

MNA said that the hospital told nurses in August it was not willing to negotiate unless significant changes were made to the latest proposal.

"Brigham nurses have made clear that we are prepared to stay on strike for as long as it takes to win a contract that protects our patients and respects the nurses who care for them," Kelly Morgan, RN, a labor and delivery nurse and chair of the BWH MNA Bargaining Committee, said in a statement.

"An open-ended strike is a serious step that will undoubtedly create a healthcare crisis in Massachusetts. MGB can prevent the strike by returning to the table and negotiating the contract our nurses need to keep providing world-class care," the statement continued.

BWH did not immediately return ABC News' request for comment.

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(WASHINGTON) -- Dr. Heidi Overton is appearing before a Senate committee on Thursday for her confirmation hearing as the next commissioner of the Food and Drug Administration.

Overton was nominated in August by President Donald Trump, who described her in a post on social media as a "ROCKSTAR in my Administration."

She is sitting before the Senate Health, Education, Labor, and Pensions (HELP) committee, where she is likely to face questions about childhood vaccines and the abortion drug mifepristone.

If confirmed, Overton will be the second person to lead the FDA after the previous commissioner, Marty Makary, resigned following public clashes with lawmakers, major pharmaceutical companies and Trump over fruit-flavored vapes.

Kyle Diamantas has served as acting FDA commissioner since May 2026.

Sen. Bill Cassidy, R-La., chair of the HELP committee, began the hearing by asking Overton if the measles, mumps, rubella (MMR) vaccine Is lethal. Overton replied it is not.

When asked if the vaccine is safe and effective, Overton reiterated that the vaccine is safe and effective against measles.

"Are there any vaccines on the U.S. market right now which are unsafe?" Cassidy asked.

"Senator, every vaccine on the U.S. market right now is safe and effective, according to the FDA," Overton said.

Cassidy attempted to press Overton on whether she disagreed with the president on the safety and efficacy of the MMR vaccine, but Overton deflected from answering directly.

Sen. Patty Murray, D-Wa., asked Overton if she believes mifepristone is safe and effective. Kennedy launched an FDA safety review of the drug last year.

"I know that it has met the safety and efficacy standard according to the FDA review," Overton replied.

Murray expressed concern over an article she said Overton published three years ago, which she said described medication abortion as dangerous to women.

She also asked if Overton believed an IUD is an abortifacient, which is a substance used to induce an abortion or terminate a pregnancy. Overton did not answer directly.

"If I'm confirmed as FDA commissioner, I'll be fully briefed on all their prior decisions and make determinations according to the standards of safety and efficacy," Overton said.

She has espoused anti-abortion views and supported reductions to the childhood immunization schedule. At the executive order signing, she touted the use of what she called "gold-standard science" and restoring vaccination authority to parents.

Overton was nominated for the job, in part, because she is a loyalist of the president, two sources familiar with the nomination tell ABC News.

She's been described as a loyal staffer, particularly in the presidents' efforts to overhaul the childhood vaccine schedule, according to a former senior administration official.

"Why would you not want your own loyalist in there?" the source said about Trump's choice, adding "She [Overton] kind of goes along with things." The former official supports Overton but has previously acknowledged that, "She's been in the world of politics for a long time and understands everything's about loyalty."

Overton is a physician with a doctor of medicine degree from the University of New Mexico and also holds a doctorate from Johns Hopkins University.

Prior to her role as deputy assistant to the president for domestic policy, she was vice chair of the America First Policy Institute's (AFPI) Center for a Healthy America, where Overton was also the chief policy officer, a nonprofit that aims to advance policies that it says put the American people first. AFPI was run by Agriculture Secretary Brooke Rollins before Rollins was tapped to join the president's Cabinet.

Several Trump administration officials held positions there before he was reelected, including Education Secretary Linda McMahon.

Prior to the hearing, Cassidy expressed "strong concerns" about Overton's nomination because of her participation in the White House executive order overhauling the childhood vaccine schedule.

"That alone is almost disqualifying," Cassidy wrote in a post on X.

Cassidy, a physician and liver doctor, has long championed the efficacy of vaccines and has grilled Trump's health officials on their willingness to stand up to Health and Human Services Secretary Robert F. Kennedy Jr., including recently installed director of the Centers for Disease Control and Prevention Dr. Erica Schwartz.

In a statement to ABC News, Democratic Women's Caucus Chairwoman Teresa Leger Fernández slammed the nomination.

"I call on my colleagues in the Senate to reject her nomination," Fernández wrote, adding "Overton has publicly denied scientific fact and repeatedly launched conspiratorial attacks against our right to abortion access, the safety of mifepristone, and Planned Parenthood."

Fernández added: "She is not qualified to serve as FDA Commissioner, and her extremist beliefs and loyalty to the Trump administration will put the lives of millions of women at risk."

In a statement, Dr. Amesh Adalja, senior scholar at the Johns Hopkins University Center for Health Security, also criticized her nomination.

"The fact that Dr. Overton played a central role in an executive order that shrinks the childhood vaccine schedule and calls for splitting MMR into shots that don't exist, all without new evidence, calls into question her scientific judgement," Adalja said. "The fact that she has garnered the praise of the nation's chief anti-vaccine propagandist, Secretary Kennedy, is also concerning."

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(NEW YORK) -- Missouri health officials are warning of a possible measles exposure at Busch Stadium and nearby local businesses in St. Louis and the larger county.

The Missouri Department of Health and Senior Services (MDHSS) said the possible exposures occurred between Sept. 12 and Sept. 14 and included local bars, a cafe, a restaurant, a sandwich shop, a grocery store and a convenience store.

The health department said exposed individuals should monitor for measles symptoms for 21 days starting from the date of exposure.

If symptoms appear, individuals are recommended to contact their local public health agency. Additionally, those who think they have measles should isolate themselves and call their healthcare provider before arriving to be tested.

The MDHSS did not immediately respond to an ABC News request for comment on the possible exposures.

Earlier this month, MDHSS announced a possible measles exposure at a train station in Sedalia, Missouri, after a vaccinated individual boarded a Chicago-bound train on Aug. 27.

About a week later, the St. Louis County Department of Public Health said a second individual who boarded the train on Aug. 27 was confirmed to have measles. The second individual was fully vaccinated and is the first case of measles in a county resident in 20 years, according to DPH.

The potential measles exposures at Busch Stadium and the St. Louis region is the third case linked to "train exposure in Missouri," the health department said.

"Vaccination is one of the most effective ways to protect ourselves, our families and our community from measles," Dr. Kanika Cunningham, director of the Saint Louis County Department of Public Health, said in a statement. "We encourage residents to review their vaccination status, monitor for symptoms and contact their healthcare provider before seeking care if they believe they may have been exposed."

Measles cases in the U.S. have surpassed 3,400 so far in 2026 with cases confirmed in 45 states and Washington, D.C., according to the latest data from the Centers for Disease Control and Prevention.

The CDC currently recommends that people receive two doses of the measles, mumps, rubella (MMR) vaccine, the first at ages 12 to 15 months and the second between 4 and 6 years old. One dose is 93% effective against preventing measles infection and two doses are 97% effective, the CDC says.

However, CDC data shows vaccination rates have been lagging in recent years. During the 2025 to 2026 school year, 92.4% of kindergartners received the MMR vaccine, according to data. This is lower than the 95.2% seen in the 2019 to 2020 school year, prior to the COVID-19 pandemic.

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(NEW YORK) -- Eating more ultra-processed foods is linked to higher health risks, including death, according to a new study published in Family Medicine and Community Health. 

Researchers found that consuming higher amounts of ultra-processed foods increased the risk of heart disease, strokes, obesity, diabetes, depression and anxiety, digestive issues, and cancer. 

Ultra-processed foods contain “significant amounts of added sugars, salts, fats” and can be hyper-palatable, meaning they are engineered to taste especially appealing, Maya Feller, a registered dietitian, told ABC News. 

Examples include packaged snacks, processed meat products, cookies, cakes, sugary drinks, and many ready-to-eat meals. 

“Ultra-processed food is one of the major problems in public health,” Dr. Xiao Liu, lead author of the study, a physician at Sun Yat-Sen Memorial Hospital and research fellow at Duke-NUS Medical School, told ABC News.

In the study, researchers examined the intake of ultra-processed foods globally, by reviewing over 50 studies that evaluated the diets of nearly 9 million adults worldwide over a timeframe ranging from 2 to 32 years. 

The risk of cardiovascular disease, which is the leading cause of death in the United States, was found to increase by 24% after consuming higher amounts of ultra-processed foods. 

The more people ate ultra-processed foods, the higher their risk of poor health outcomes. Each additional 100 grams a day was linked to a 14% higher heart risk and an 11% higher blood pressure risk. 

Higher consumption of ultra-processed foods was also linked to a higher risk of metabolic diseases, with the risk of diabetes increasing 24% and the risk of obesity increasing 23%.

More than 100 million Americans in the United States are living with obesity and more than 22 million have severe obesity, according to numbers from the CDC. The agency also found that the average American gets over half their daily calories from ultra-processed foods. 

Not all processed foods are the same,  Feller said, using an apple to explain the difference.

“You have a tree with apples, and the apples on the tree are in their whole form. You take the apple off the tree, and that is a step of processing. You slice the apple. That’s another step of processing. You puree the apple. You haven’t added anything to it. That’s also processing,” she said.

As more ingredients are added, the food becomes more processed, she explained.

Canned vegetables, cheese, and freshly made bread are considered processed because salt, sugar, or oil may have been added to preserve them. Unprocessed or minimally processed foods can include fresh or frozen fruits and vegetables, eggs, milk, beans, grains, meat, and fish that do not have salt, sugar, oils or additives.  

When shopping, Feller said consumers can look at ingredient lists to get a better sense of how processed a food is.

“Flip the package over, and if the front says blueberries, then the ingredient list should say blueberries,” she said.

For people trying to limit ultra-processed foods without significantly increasing their grocery bills, frozen and canned foods can still be useful options.

“Go to the freezer section. Look for frozen vegetables, frozen fruits, frozen grains that have nothing added to them,” Feller added. 

She also recommended lower-sodium canned foods and affordable staples such as pasta, rice and beans.

For parents trying to help children make healthier choices, Feller noted that strict control may be less realistic than education and modeling healthy habits at home.

“We can’t control what they do when they have at lunch,” she said. “Once they’ve left the house, it’s about education, positive modeling and open conversation.”

She added that family meals give parents more control over the foods children are exposed to at home, while conversations about nutrition can help guide the choices they make on their own.

Feller says that people do not need to eliminate all ultra-processed foods from their diets. Instead, the research points to the potential benefits of reducing overall intake as a more reachable goal.

“Don’t expect that you’re going to swap your pantry over or your refrigerator overnight,” Feller said. “Choose two or three things that you eat on a regular basis that are ultra-processed and think about swapping those out for things in their whole or minimally processed form.” 

The researchers noted that people can lower their risk of these health conditions by improving their diets, which include limiting ultra-processed foods and eating more vegetables and fruits. 

“In our modern society, our diet and food is maybe not safe… we should eat more vegetables and reduce the ultra-processed food to make us healthier,” said Liu. 

Dr. Ashley Thomas is board-certified in internal medicine, board-eligible in occupational and environmental medicine, and a member of the ABC News Medical Unit.

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