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  • Backyard Poultry Drives Multi-State Salmonella Outbreak, with Texas Among Hardest Hit

    Backyard Poultry Drives Multi-State Salmonella Outbreak, with Texas Among Hardest Hit

    A multi-state Salmonella outbreak linked to backyard poultry continues to affect Texas and surrounding states as of May 2026, with children accounting for a significant proportion of confirmed cases.

    According to CDC outbreak investigations, at least 180–200 people across more than 30 states have been infected, with a notable concentration in southern states, including Texas. Centers for Disease Control and Prevention reports indicate that exposure is primarily associated with handling chicks, ducklings, and backyard poultry environments.

    Texas health officials report clusters in suburban and rural counties where backyard poultry ownership has increased in recent years. Many cases involve young children who were exposed while handling animals at home or in community settings.

    Salmonella infection typically causes diarrhea, fever, abdominal cramps, and nausea. While most cases resolve without treatment, severe infections can require hospitalization, particularly in young children, older adults, and immunocompromised individuals.

    Public-health investigators emphasize that the outbreak is not food-based in most cases, but instead tied to direct animal contact. Poultry can carry Salmonella bacteria even when they appear healthy, making prevention dependent on hygiene practices rather than animal appearance.

    The CDC has repeatedly warned against allowing young children to handle poultry unsupervised. Handwashing after contact and avoiding indoor housing of birds are key prevention measures.

    Texas hospitals have reported increased pediatric visits for gastrointestinal illness consistent with Salmonella exposure. While fatal cases remain rare, hospitalizations have occurred in multiple states during the current outbreak cycle.

    Experts note that backyard poultry ownership has expanded significantly since the pandemic period, increasing the potential for repeated exposure events in suburban communities.

    The outbreak highlights an often-overlooked public-health risk: zoonotic transmission from domestic animals that are not traditionally considered high-risk.

    As May concludes, health officials continue urging caution and improved hygiene practices among households with backyard poultry.

    Sources

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  • HEALTH ALERT: Houston’s Summer Heat Season Begins With a 329% Surge in ER Visits — And Officials Fear the Worst Is Still Ahead

    HEALTH ALERT: Houston’s Summer Heat Season Begins With a 329% Surge in ER Visits — And Officials Fear the Worst Is Still Ahead

    HOUSTON — As the first days of meteorological summer descend on Southeast Texas, the Houston Health Department (HHD) and Harris County Public Health are bracing for what is shaping up to be another potentially lethal heat season. The numbers are stark: heat-related emergency room visits in Harris County have surged 329% between 2019 and 2023, according to a landmark study by Harris County Public Health. With the 2026 summer just beginning, there is no credible reason to believe that trajectory has reversed.

    The HHD has activated its annual Summer Surveillance program, an interactive dashboard that tracks heat-related illness (HRI) across Harris, Fort Bend, and Montgomery counties on a weekly basis. The dashboard is designed to identify vulnerable populations and trigger protective interventions — but as public health advocates have repeatedly warned, surveillance is only as valuable as the policy response it generates.

    A 329% Increase: What the Data Actually Tells Us

    The Harris County Public Health study, covering 2019 through 2023, is not a projection. It is a documented record of real emergency room visits by real Houstonians who required medical care because of the heat. The 329% jump over four years represents a compounding crisis — one that accelerated dramatically in 2024, when Hurricane Beryl knocked out power for up to 2.7 million customers in the middle of a heatwave. Houston-area hospitals reported about twice their normal ER patient load during that period, with more than 320 patients suffering heat-related illness — roughly triple the seasonal norm.

    The study found that older adults accounted for 39% of heat-related illness cases — a demographic that is disproportionately likely to live alone, to lack air conditioning, or to be unaware they are overheating until it is too late. Workers who labor outdoors — construction workers, landscapers, delivery drivers — represent another heavily affected group, as do children who may be left in vehicles or who lack access to air-conditioned spaces during the day.

    Dr. Jennifer Kiger of Harris County Public Health noted that the correlation between high heat index values — when temperature and humidity combine to reach life-threatening levels — and ER visits is unmistakable. Four of the past five summers in Houston ranked among the top 10 warmest on record. The National Weather Service regularly issues Excessive Heat Warnings for the region when heat indices are expected to exceed 108°F for multiple consecutive days.

    West Nile Virus: The Additional Threat

    Heat is not the only compounding risk this summer. The Texas Department of State Health Services (DSHS) has already confirmed the state’s first West Nile virus case of 2026 in a Harris County resident — diagnosed with neuroinvasive West Nile disease, the most severe and potentially fatal form of the illness. Neuroinvasive West Nile can cause encephalitis (brain swelling), meningitis, and permanent neurological damage. There is no specific treatment or vaccine.

    West Nile spreads through the bite of infected mosquitoes, which thrive in exactly the hot, standing-water conditions that Houston’s summer reliably produces. Flooding from summer storms — a near-annual occurrence — creates breeding grounds for Culex mosquitoes throughout the Houston metro. Public health officials are urging residents to eliminate standing water on their properties, use EPA-registered insect repellents, and wear long sleeves and pants during peak mosquito activity at dusk and dawn.

    The Systemic Problem: Heat Undercounting and Infrastructure Gaps

    Experts believe Texas is significantly undercounting heat-related deaths. Medical examiners frequently list the immediate physiological cause of death — cardiac arrest, organ failure, respiratory collapse — rather than the underlying heat exposure that triggered the cascade. The CDC uses Maricopa County in Arizona as its national model for heat death investigation methodology; Texas counties vary dramatically in their capacity and willingness to code heat as a contributing cause of death, which means the true toll in Houston and across Texas is almost certainly higher than official figures reflect.

    The infrastructure problem is equally acute. After Hurricane Beryl’s 2024 devastation exposed the fragility of CenterPoint Energy’s grid — leaving half a million people without power in triple-digit heat for more than a week — calls for accountability were loud but action was slow. The city’s cooling center network, while improved, remains inadequate for the scale of need: not all centers are open 24 hours, and transportation access to them remains a major barrier for the elderly, the disabled, and the unhoused.

    What Houston Residents Must Do This Summer

    The Houston Health Department’s advice for the 2026 summer heat season is urgent and practical:

    • Never leave children, elderly persons, or pets in parked vehicles — even briefly.

    • Check on elderly neighbors, especially those living alone or without air conditioning.

    • If your home loses power during a heat event, go to a cooling center immediately. Find locations at the Houston Office of Emergency Management website.

    • Drink water consistently throughout the day — do not wait until you feel thirsty, especially during physical activity.

    • Know the signs of heat exhaustion (heavy sweating, weakness, cold/pale/clammy skin, weak pulse, nausea) and heat stroke (hot/red/dry skin, rapid/strong pulse, unconsciousness), which is a medical emergency requiring immediate 911 contact.

    Monitor the Houston Summer Surveillance dashboard at houstonhealth.org for weekly updates on heat-related illness trends across the region.

    Conclusion: Houston Is Running Out of Time to Treat Heat as a Public Health Emergency

    A 329% surge in ER visits in four years is not a weather story. It is a public health emergency with a predictable, data-confirmed trajectory. The city of Houston and Harris County have surveillance tools, a published Summer Surveillance program, and years of mortality data. What has been slower to materialize is the political will and the infrastructure investment to match the scale of the crisis — particularly for the city’s most vulnerable residents, who are disproportionately low-income, elderly, or living without stable housing.

    As June approaches, the window for preparedness is closing. Houston’s emergency rooms deserve more than a summer of predictable overcrowding. The residents who end up in them deserve more than reactive care after a preventable crisis.

    RELATED ON MEDICALDAILY.COM

    • Houston’s Deadly Heat Season Is About to Begin — and the City’s ERs Are Already Behind

    • Phoenix Heat Deaths: Maricopa County Confirms First Fatality of 2026

    • West Nile Virus: What You Need to Know This Summer

    • Climate Change and Urban Heat Islands: How American Cities Are Becoming Death Traps

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  • Necrotizing Skin Infections – Infections

    Necrotizing Skin Infections – Infections

    Necrotizing skin infections, including necrotizing cellulitis and necrotizing fasciitis, are severe forms of cellulitis. These infections cause infected skin and tissues to die (necrosis).

    • The infected skin is red, warm to the touch, and swollen, and gas bubbles may form under the skin.

    • The person usually has intense pain, feels very ill, and has a high fever.

    • The diagnosis is based on a doctor’s evaluation, x-rays, and laboratory tests.

    • Treatment involves removing dead skin and tissue, which sometimes requires extensive surgery, and giving intravenous antibiotics.

    (See also Overview of Bacterial Skin Infections.)

    Most skin infections do not result in the death of skin and nearby tissues. Sometimes, however, a bacterial infection can cause small blood vessels in the infected area to clot. This clotting causes the tissue fed by these vessels to die from lack of blood. Dead tissue is termed necrotic. Because the body’s immune defenses that travel through the bloodstream (such as white blood cells and antibodies) can no longer reach this area, the infection spreads rapidly and may be difficult to control. The infection can be fatal, even with appropriate treatment.

    Some necrotizing skin infections spread deep in the skin along the surface of the connective tissue that covers muscle (fascia) and are termed necrotizing fasciitis. Other necrotizing skin infections spread in the outer layers of skin and are termed necrotizing cellulitis. Several different bacteria, such as Streptococcus and Clostridia, may cause necrotizing skin infections, but in many people the infections are caused by a combination of bacteria. The necrotizing skin infection caused by streptococci in particular has been termed “flesh-eating disease” by the lay press, but it differs little from the others. Gas gangrene (also called clostridial myonecrosis) is a type of necrotizing skin infection that affects the muscle and surrounding tissues and is typically caused by Clostridia.

    Some necrotizing skin infections begin at puncture wounds or other skin injuries, particularly wounds contaminated with dirt and debris. Other infections begin in surgical incisions or even in healthy skin. Sometimes people with diverticulitis, intestinal perforation, or tumors of the intestine can develop necrotizing infections of the abdominal wall, genital area, or thighs. These infections occur when certain bacteria spread from the intestine and into the skin. The bacteria may initially create an abscess (a pocket of pus) in the abdominal cavity and spread directly outward to the skin, or they may spread through the bloodstream to the skin and other organs. People with diabetes, cancer, an alcohol use disorder, injection drug use, or chronic kidney disease or who have a weakened immune system are at increased risk of necrotizing skin infections.

    Symptoms of Necrotizing Skin Infections

    Symptoms of necrotizing skin infections often begin as the common skin infection, cellulitis. The skin may look pale at first but may quickly become red or bronze and warm to the touch and swollen. Pain is intense.

    Later, the skin turns violet, often with the development of large fluid-filled blisters (bullae). The fluid from these blisters is brown, watery, and sometimes foul smelling. Areas of dead skin turn black (gangrene).

    Some types of necrotizing skin infection, including those caused by Clostridia and mixed bacteria, produce gas. The gas creates bubbles under the skin and sometimes in the blisters themselves, causing the skin to feel crackly when pressed. Initially the infected area is extremely painful, but as the skin dies, the nerves stop working and the area loses sensation, so pain goes away of decreases. The muscles may be affected as the infection worsens.

    The person usually feels very ill and has a high fever, a rapid heart rate, and mental deterioration ranging from confusion to unconsciousness. Blood pressure may fall because of toxins secreted by the bacteria and the body’s response to the infection (septic shock). People may develop toxic shock syndrome.

    Diagnosis of Necrotizing Skin Infections

    • A doctor’s evaluation

    • Laboratory tests

    A doctor makes a diagnosis of necrotizing skin infection based on its appearance, particularly the presence of gas bubbles that can be seen under the skin. X-rays may show gas under the skin as well.

    A blood test usually shows that the number of white blood cells has increased (leukocytosis). The specific bacteria causing the infection are identified by laboratory analysis of blood or tissue samples (culture). However, doctors begin treatment before they have the laboratory test results.

    Treatment of Necrotizing Skin Infections

    The treatment of necrotizing fasciitis and gas gangrene is surgical removal of the dead tissue plus antibiotics given by vein (intravenously). Large amounts of skin, tissue, and muscle often must be removed, and, in some cases, affected body parts may have to be removed (amputated).

    People may need large volumes of intravenous fluids before and after surgery.

    Prognosis for Necrotizing Skin Infections

    Necrotizing skin infections are fatal in about 20 to 30% of people who receive appropriate treatment. Without treatment, these infections are almost always fatal.

    Older adults, those who have other chronic medical disorders, and those in whom the infection has reached an advanced stage have a poorer outcome. A delay in diagnosis and treatment and insufficient surgical removal of dead tissue worsen the prognosis.

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  • Are Shame and Guilt Bad—Or Do We Just Need a Different Relationship With Them?

    Are Shame and Guilt Bad—Or Do We Just Need a Different Relationship With Them?

    In the new Apple TV series, Margo Has Money Problems, Michelle Pfeiffer, in a comeback performance, plays a mom, Shyanne, who got pregnant after a one-night stand with a married man. Now her daughter, Margo, whom she raised on her own, has herself given birth to a child with a married man who’s not in the picture.

    At one point, in a parking lot outside the chain restaurant where Margo works, Shyanne has a total breakdown. Having failed at her first stint babysitting her grandchild, she hands over the boy to Margo and shouts that she is a horrible grandmother just as she was a horrible mother: “I wish I could be a better person, but I’m not!…and I will not be judged, by him or anyone else.”

    As much as we may recoil from shame and guilt, these emotions are a part of being human. Yet so many of us, maybe most of us, handle them very poorly.

    This is a classic shame spiral. We start feeling bad about something we’ve done or are unable to do, then leap straight to the appraisal—not of our wrongdoing or inability, but of ourselves: We are bad and we want to hide away because of it, lest we be judged even more.

    Guilt and shame are dirty words, painful words. As much as we may recoil from them, though, these emotions are a part of being human. Yet so many of us, maybe most of us, handle them very poorly. We beat ourselves up psychologically. We beat others up verbally (and in extreme cases physically) in an effort to inflict guilt and shame and retribution for wrongdoing. At a global level, wars are fought and people die out of vengeance—simply because we have so much trouble dealing with how to respond when we do something wrong or are wronged.

    Taking a Closer Look at Guilt and Shame

    Yes, these are tricky emotions, and this is likely not the first time you’ve considered them, but it never hurts to contemplate the thornier sides of life with a fresh mind. If you meditate, you spend your life doing that. Each time, hopefully, with a more open mind.

    To begin, it helps to distinguish guilt and shame.

    Meditation teacher Caverly Morgan expresses the difference succinctly in her book The Heart of Who We Are: “When you feel guilty, there’s a judgment that something you’ve done is wrong. When you feel shame, you believe that your whole self is wrong.”

    Is it realistic to think that an emotion that’s been around as long as anyone can imagine is just going to be removed from the human toolbox?

    Brené Brown, author of the groundbreaking book on human vulnerability, Daring Greatly, says on her website that while guilt is “adaptive and helpful” and can spur accountability for our actions, shame, “the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging” is neither helpful or productive. She goes on to “call for an end to shame as a tool for change.”

    I’m a huge Brené Brown fan, so I get where she’s going. Shame is so damaging. It ruins whole lives and families (witness Shyanne’s breakdown in the parking lot). And it is quite often wildly ineffective in bringing about change. I’m sure we’ve all tried to shame someone into better behavior only to have it backfire.

    Yet, is it realistic to think that an emotion that’s been around as long as anyone can imagine is just going to be removed from the human toolbox?

    If They’re Not Going Anywhere…How Do We Learn to Live With Them?

    Other researchers are not quite as ready to completely eliminate shame from the spectrum of human responses. Rather, they simply caution us to notice the ways our responses are so very often maladaptive.

    In his recent book, The Power of Guilt, developmental psychologist Chris Moore says we have guilt in the first place to motivate us to repair harms and heal relationships. Shame, he goes on to say, by contrast, tends to make people shy away from interacting with others, leaving a relationship damaged, perhaps permanently. This tendency to descend into a deep dark place makes shame into a dangerous drug.

    Psychologist June Tangney, co-author of Shame and Guilt, however, admits to being shame-prone herself and counsels that it’s possible to be resilient in the midst of shame and divert ourselves from spiraling. In other words, we might be better off accepting that shame is going to emerge and figure out how to work with it more effectively.

    Our problem with shame, then, may not be that as a group we have no need for it, but rather we have a bad habit of taking it way too far.

    Evolutionary psychologists like Dacher Keltner see shame as part of a family of human responses known as the self-conscious emotions—guilt, shame, pride, and embarrassment—that all play a role in regulating social behavior. According to these students of human behavior, “…shame serves the important function of appeasing observers of social transgressions, a function which reestablishes social harmony.” In other words, publicly blushing when you’ve done something wrong signals to others that you know you’ve made a mistake and you care. To say, for example, that someone “has no shame,” means they don’t care what others think about their behavior. Think of certain world leaders who seem to do and say whatever they want, regardless of how immoral or illegal it is, and without concern for the harm those actions cause.

    Our problem with shame, then, may not be that as a group we have no need for it, but rather we have a bad habit of taking it way too far. A very little bit of shame can go a long way. Even a little bit too much can be destructive. The lesson then, seems to be: Shame is likely to be a part of life, respond appropriately and in proportion to that feeling, and focus entirely on action in the future.

    In other words: Do not beat yourself up. Meet the feeling, but don’t build a home there.

    Focusing on Repair

    Knowing how guilt and shame tear at the heart and sever the bonds that hold communities together, spiritual traditions developed forms of atonement—honest acknowledgment of harm, repairing the harm if possible, and vowing not to repeat it.

    Catholics have the confessional and the season of Lent. Judaism has Yom Kippur, the day of atonement. In Islam, tawba, repentance, is practiced continuously, but especially in the last ten days of Ramadan. Twelve-step programs devote several steps to atonement and making amends. While the place of confession in Buddhism is little known, the ancient code of monastic discipline calls for regular acknowledgement of wrongdoing, including in some traditions the collective wrongdoing that has occurred “since beginningless time.”

    It’s not necessary to engage in one of these traditions to develop a healthy relationship with guilt and shame—but it can certainly help to examine our own experience to see how we might be easier on ourselves and on others while still addressing the feelings that emerge when things go wrong.

    Guilt—that uneasy feeling about doing something wrong or not fully showing up—can be a motivator. But as all the researchers, teachers, and commentators here note, it too can gnaw away at us and morph into shame. Fortunately, a practice like mindfulness can help interrupt the descent into needless shame and help us focus on our future actions. In mindfulness practice, we can begin to see what’s happening more clearly and as the ancient prayer goes, forgive our trespasses as we forgive those who trespass against us.



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  • HEALTH ALERT: Los Angeles Drinking Water Tested Positive for Lead and Cancer-Linked Chemicals — City Council Demands Emergency Investigation

    HEALTH ALERT: Los Angeles Drinking Water Tested Positive for Lead and Cancer-Linked Chemicals — City Council Demands Emergency Investigation

    LOS ANGELES — In a unanimous 10-0 vote that sent shockwaves through City Hall, the Los Angeles City Council has demanded an immediate investigation by the Department of Water and Power (LADWP) and the city’s Housing Authority after samples of drinking water in the Watts neighborhood were found to contain elevated levels of lead. The discovery has drawn national comparisons to Flint, Michigan — where a decade-long water contamination crisis poisoned a generation of children — and has raised urgent questions about the safety of tap water across one of America’s largest and most densely populated cities.

    An analysis of LADWP’s own 2026 water quality data, reviewed by the Environmental Working Group (EWG), reveals a troubling picture: several contaminants are present at levels that exceed the EWG’s health guidelines, even if they remain within the EPA’s more permissive regulatory limits. The distinction matters enormously for public health — particularly for children, pregnant women, and communities with the least access to filtered or bottled water alternatives.

    Lead in Watts: The Crisis That Triggered a City Council Vote

    The Watts neighborhood — one of Los Angeles’s most historically marginalized communities, with a majority-Black and Latino population — has experienced chronic environmental health challenges for decades. The discovery of lead in tap water samples collected from Watts public housing units was not entirely surprising to residents who have complained about water quality for years. What was surprising was the speed and unanimity of the City Council’s response: a 10-0 vote demanding emergency action.

    Lead is a potent neurotoxin. There is no safe level of lead exposure for children, according to the CDC, which lowered its reference blood lead level threshold to 3.5 micrograms per deciliter (mcg/dL) in 2021 — acknowledging that even previously “acceptable” levels cause measurable cognitive and developmental harm. For children under 6, whose brains are still developing, lead exposure causes irreversible reductions in IQ, increased impulsivity and aggression, and long-term learning disabilities.

    The primary suspected source of the lead in Watts’s water is aging infrastructure: lead service lines and lead solder in the plumbing of older buildings. Many housing units in Watts were constructed before 1978, the year lead-based paint was banned nationally, and before the widespread replacement of lead plumbing. When water sits in lead pipes overnight, it leaches the metal, delivering it straight to the morning’s first glass or the baby’s formula.

    Beyond Lead: Chromium-6 and PFAS in LA’s Water Supply

    Lead is not the only contaminant of concern in Los Angeles’s water. The LADWP’s 2026 water quality data shows that Chromium-6 — the carcinogenic industrial chemical made internationally infamous by the Erin Brockovich case — has been detected in LADWP water at levels below California’s proposed regulatory standard of 10 parts per billion (ppb), but significantly above the EWG’s health guideline of 0.02 ppb, which is based on National Toxicology Program studies linking chromium-6 to gastrointestinal tumors.

    The sources of chromium-6 in LA’s water include natural chromium in the geology of Eastern Sierra source water areas, historical industrial use of chromium compounds in the San Fernando Valley, and regional industrial contamination that has leached into groundwater. Standard activated carbon filters — like Brita pitchers used by millions of Americans — do not remove chromium-6. Only reverse osmosis or anion exchange resin filtration systems are effective.

    PFAS (per- and polyfluoroalkyl substances, commonly called “forever chemicals”) contamination is also a growing concern in the greater LA region, particularly in groundwater sources in the San Gabriel and San Fernando Valleys. PFAS are associated with kidney cancer, thyroid disease, immune suppression, and developmental harm in children. For more information on PFAS in drinking water, visit the EPA PFAS resource page.

    Who Is Most at Risk — and What They Can Do

    The residents most at risk from LA’s water quality issues are those who lack the economic resources to purchase bottled water, install filtration systems, or move to neighborhoods with newer plumbing. That demographic overwhelmingly overlaps with the populations already bearing the greatest burden of environmental harm in Los Angeles: low-income communities of color in South LA, East LA, and the San Fernando Valley.

    For residents concerned about lead exposure specifically, the following precautions are recommended by the Los Angeles County Department of Public Health and the EPA:

    • Use only cold tap water for drinking, cooking, and making baby formula. Hot water leaches more lead from pipes.

    • Flush your tap for at least 30 seconds to 2 minutes before using it for the first time each morning, or after extended periods of non-use.

    • Consider installing an NSF-certified water filter rated specifically for lead removal. Pitcher-style filters (Brita, Pur) do NOT reliably remove lead. Look for filters certified under NSF Standard 53.

    • Have children under 6 and pregnant women tested for blood lead levels. Talk to your pediatrician or call the LA County Department of Public Health.

    Residents can also request a free lead-in-water test kit from the LA County Department of Public Health. More information is available at publichealth.lacounty.gov.

    Conclusion: The Watts Crisis Is a Preview of a Citywide Reckoning

    The Watts water contamination episode is not an isolated plumbing problem. It is a symptom of a systemic failure to prioritize infrastructure investment in communities that have long been told their concerns would be addressed “eventually.” Flint, Michigan waited years for “eventually.” The lesson from Flint — that regulatory compliance thresholds protect utilities, not people — must not be repeated in Los Angeles. The EWG’s data makes clear that LA’s water contains chemicals that exceed science-based health guidelines even when they technically comply with EPA rules.

    A city as wealthy and as large as Los Angeles has both the resources and the obligation to close the gap between what the law permits and what public health demands. The unanimous City Council vote is a first step. The work of actually replacing aging lead lines, upgrading filtration, and ensuring equitable access to clean water for all 4 million residents of the city is the much harder task that lies ahead.

    RELATED ON MEDICALDAILY.COM

    • Flint Happened There. Now It’s Los Angeles: The Ongoing Lead and Toxic Chemical Crisis in LA’s Drinking Water

    • What Are PFAS “Forever Chemicals” and Why Are They in Your Drinking Water?

    • Lead Exposure in Children: The Invisible Epidemic Still Harming American Kids

    • Chromium-6 in Drinking Water: A National Problem with Local Consequences

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  • Overview of Bacterial Skin Infections – Infections

    Overview of Bacterial Skin Infections – Infections

    The skin provides a remarkably good barrier against bacterial infections. Although many bacteria come in contact with or reside on the skin, they normally do not cause an infection. When bacterial skin infections do occur, they can range in size from a tiny spot to spots or sores over the entire body surface. They can range in seriousness as well, from harmless to life threatening.

    Bacterial skin infections develop when bacteria enter through hair follicles or through small breaks in the skin that result from scrapes, punctures, surgery, burns, sunburn, animal or insect bites, wounds, and pre-existing skin disorders. People can develop bacterial skin infections after participating in a variety of activities, for example, gardening in contaminated soil or swimming in a contaminated pond, lake, or ocean.

    Classification of Bacterial Skin Infections

    Some infections involve just the skin, and others also involve the soft tissues under the skin. Relatively minor infections include:

    More serious bacterial skin and skin structure infections include:

    Staphylococcal scalded skin syndrome, scarlet fever, and toxic shock syndrome are skin-related complications of bacterial infections.

    Causes of Bacterial Skin Infections

    Many types of bacteria can infect the skin. The most common are Staphylococcus and Streptococcus.

    Methicillin-resistant Staphylococcus aureus (also known as MRSA) is a common bacteria that causes skin infections in the United States. MRSA is resistant to many commonly used antibiotics because it has undergone genetic changes that allow it to survive despite exposure to some antibiotics. Because MRSA is resistant to several antibiotics that used to kill it, doctors tailor their treatment based on how often MRSA is found in the local area and whether or not it has been found to be resistant to commonly used antibiotics.

    Risk Factors for Bacterial Skin Infections

    Some people are at particular risk of developing skin infections:

    • People with diabetes, who are likely to have poor blood flow (especially to the hands and feet), have a high level of sugar (glucose) in their blood, which decreases their ability to fight infections

    • People who are hospitalized or living in a nursing home

    • People who are older

    • People who have human immunodeficiency virus (HIV), AIDS or other immune disorders, or hepatitis

    • People who are undergoing chemotherapy or treatment with other medications that suppress the immune system

    • Children under 5 years of age

    • Adults over 85 years of age

    Skin that is inflamed or damaged is more likely to become infected. In fact, any break in the skin predisposes a person to infection.

    Children under 5 years of age and adults over 85 years of age are at a particularly higher risk of developing a bacterial skin infection.

    Treatment of Bacterial Skin Infections

    • Antibiotics

    • Drainage of abscesses

    Doctors prescribe an antibiotic ointment for minor skin infections. They prescribe antibiotics that are taken by mouth (orally) or given by vein (intravenously) if a large area of skin is infected.

    Abscesses are often cut open (incised) by doctors and allowed to drain, and they surgically remove any dead tissue.

    Prevention of Bacterial Skin Infections

    Preventing bacterial skin infections involves keeping the skin undamaged and clean. When the skin is cut or scraped, the injury should be washed with soap and water and covered with a sterile bandage.

    Petroleum jelly may be applied to areas where small wounds are open or where the skin has peeled off to keep the tissue moist and to try to keep bacteria out. Doctors recommend that people do not use antibiotic ointments (prescription or nonprescription) on uninfected minor wounds because of the risk of developing an allergy to the antibiotic.

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  • HEALTH ALERT: Phoenix Confirms First Heat Death of 2026 as Extreme Heat Warning Tops 108°F — Maricopa County on Track for Another Lethal Summer

    HEALTH ALERT: Phoenix Confirms First Heat Death of 2026 as Extreme Heat Warning Tops 108°F — Maricopa County on Track for Another Lethal Summer

    PHOENIX — Maricopa County health officials have confirmed the first heat-related death of 2026, an older adult male whose passing serves as a grim annual marker that the desert Southwest’s deadliest season has officially begun. The announcement came in April, following a historic March heatwave that sent multiple days above 100°F — a jarring early signal in a region where triple-digit temperatures typically don’t arrive until late May or June.

    Then, in the second week of May, the National Weather Service issued a formal Extreme Heat Warning for the entire Phoenix metro area, with forecasted highs of 104°F on Saturday, 106°F on Sunday, and 108°F on Monday, May 11–13, 2026. That event affected more than 2 million people and triggered immediate activation of emergency protocols: trail closures at Camelback Mountain and Piestewa Peak between 8 a.m. and 5 p.m., expanded cooling center hours across Phoenix, Glendale, Chandler, Mesa, and Tempe, and emergency public health messaging urging residents to hydrate constantly and seek air-conditioned shelter.

    The Death Toll in Context: A City That Has Been Here Before

    Maricopa County recorded 427 heat-related deaths in 2025, down from 608 in 2024 and 645 in 2023. That downward trend is real and reflects genuine effort: the city of Phoenix invested nearly $185 million over five years in capital projects and homeless service operations, created a dedicated Office of Heat Response and Mitigation, and added more than 1,880 temporary and permanent shelter beds since 2022. The county’s Maricopa Heat Relief Network, which launched May 1, 2026, coordinates cooling centers and water distribution points across the county.

    But even 427 deaths — the “improved” figure from 2025 — represents a staggering toll. Since 2013, more than 4,320 people have died from heat exposure in Arizona. The annual heat death toll in Maricopa County has risen approximately threefold since 2019. These are not natural disasters in the traditional sense. As public health experts consistently emphasize, heat deaths are preventable — each one represents a failure of the systems designed to protect the most vulnerable.

    The county tracks heat-related deaths and illness in near real-time through the Maricopa County Heat-Related Illness and Death Dashboard, which updates weekly and is publicly accessible. The dashboard draws on data from the county medical examiner, local hospitals, and the National Weather Service — providing a granular, transparent picture of the crisis that few other counties in the nation match.

    Who Is Dying and Where

    The demographics of Phoenix’s heat deaths tell a story about housing policy and social safety nets as much as they tell a story about weather. In 2023’s deadliest year on record, at least 45% of those who died were unhoused — sleeping behind dumpsters, in parking lots, or on sidewalks baking at temperatures above 150°F at ground level, on days when ambient air temperatures reached 115°F or higher. Senior citizens accounted for roughly one in three deaths.

    Geographic analysis of the data shows a stark pattern: neighborhoods with lower tree canopy coverage, more asphalt and concrete, and fewer green spaces — characteristics strongly correlated with lower household income — consistently record higher heat intensity than wealthier, leafier parts of the city. The urban heat island effect in Phoenix is not distributed equally.

    Outdoor workers — construction laborers, landscapers, agricultural workers, delivery drivers — represent a third major at-risk group. Arizona has no state-level outdoor heat standard for workers with the force of law; federal OSHA’s heat standard, still relatively new and being phased in, provides national-level protections that are subject to enforcement resources and political will.

    The Cooling Infrastructure Gap: What Still Isn’t Working

    Despite genuine progress, Phoenix’s heat response infrastructure has documented gaps. Not all cooling centers are accessible 24 hours — a critical problem because nighttime temperatures in Phoenix rarely drop below 90°F during peak summer, meaning overnight heat exposure is itself lethal, particularly for those sleeping outside. Transportation access to cooling centers remains a significant barrier for elderly residents, people with disabilities, and those without vehicles.

    The concern that federal pandemic-era funding supporting the heat relief network would expire in 2026 — as noted by the county’s own medical director — has materialized. The loss of that funding creates pressure on a system that, by every data point, still needs expansion, not contraction. The city of Phoenix simultaneously faces a $130 million reduction in tax revenue due to a change in Arizona state law, creating a fiscal environment hostile to scaling up heat response services.

    How to Protect Yourself During Extreme Heat Warnings in Phoenix

    • Check the Maricopa County Heat Relief Network for cooling center locations: maricopa.gov/heat.

    • Never leave children, elderly people, or pets in a parked vehicle. Car interiors can exceed 150°F within minutes.

    • Drink water before you feel thirsty — by the time thirst registers, dehydration is already underway.

    • If you see someone showing signs of heat stroke (hot, red, dry skin; confusion; loss of consciousness), call 911 immediately and move them to shade while waiting.

    • If your home lacks air conditioning and you cannot reach a cooling center, call 211 (Arizona’s social services helpline) for assistance.

    Current heat advisories and warnings for the Phoenix metro area can be accessed at weather.gov/phoenix.

    Conclusion: Phoenix Cannot Afford a “Good Enough” Heat Strategy

    Phoenix sits at the intersection of multiple accelerating crises: a warming climate, an unhoused population that grew during the pandemic and has not fully recovered, aging housing stock without central air conditioning, and now a tightening municipal budget. The tools to prevent heat deaths exist — cooling centers, early warning systems, targeted outreach to the elderly and unhoused — but they require sustained political will and adequate funding to deploy at the scale the problem demands.

    The first confirmed heat death of 2026 arrived in April. Summer doesn’t officially begin until June 21. If the pattern of recent years holds, thousands more emergency calls, hundreds more hospitalizations, and an unknown number of additional deaths lie ahead before the season ends. Maricopa County’s data-driven approach is a model worth emulating nationally — but even the best surveillance system is useless if the resources to act on what it finds are not there.

    RELATED ON MEDICALDAILY.COM

    • Houston’s Deadly Heat Season Is About to Begin — and the City’s ERs Are Already Behind

    • Extreme Heat and the Unhoused: America’s Most Preventable Crisis

    • Urban Heat Islands: Why Some Neighborhoods Are Dramatically Hotter Than Others

    • Heat Stroke vs Heat Exhaustion: Know the Difference Before It’s Too Late

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  • Mindfulness and Hypnosis: Tools for Navigating Chronic Illness

    Mindfulness and Hypnosis: Tools for Navigating Chronic Illness

    Several years ago, I experienced what at the time I did not realize was the beginning of a life-changing journey into chronic illness. 

    It started with noticing shortness of breath when I bent over to pick something up off the floor, and rapidly snowballed. It felt as if I had stepped into an alternate reality, where I went from being a healthy person whose life was punctuated with hiking, dancing, and travel, to someone whose body would no longer cooperate with life. At my worst, my heart rate spiked throughout the day and night to levels that would send healthy friends running to the ER. I was exhausted and at times too weak to walk.

    Already a Buddhist meditation teacher and hypnotherapist, I found myself on a crash course in treating a complex medical condition and learning how to live a meaningful life inside a body that had fundamentally changed.

    This was the beginning of a complex condition involving almost every system in my body, eventually traced back to my time living in a small cottage that unknowingly housed an uninvited tenant: black mold. At the time, I couldn’t have imagined how profoundly this experience would change my body, my life, and my work.

    Already a Buddhist meditation teacher and hypnotherapist, I found myself on a crash course in treating a complex medical condition and learning how to live a meaningful life inside a body that had fundamentally changed. 

    Over the years that followed, I worked to carve out spaces of healing, resilience, and joy, rebuilding a life that in many ways felt happier and more free than the one I had lost. I also found myself supporting more clients navigating complex illnesses themselves. Again and again, I saw how mindfulness and hypnosis could help people feel a renewed sense of hope, agency, and capacity to relate to their lives and bodies differently.

    A Nervous System Mobilizing Against Threat

    When we live with chronic illness or pain, it can often feel like we are stuck on high alert—and with good reason. The body is designed to detect danger and mobilize quickly against threat. We have survived across generations of human evolution because of this finely honed system. It’s an incredible gift—until it’s not.

    Pain, stress, illness, and other issues can send signals throughout our body communicating that something is profoundly wrong. It’s our system’s way of saying, “Hey! Stop! Please take care of me.” 

    “Maladaptive neuroplasticity” happens when the body and mind begin to reorganize in order to address the ongoing threat that is occurring. Unfortunately, we don’t always reorganize in a way that helps us long-term or feels particularly good. To our brain and body, it’s about one thing and one thing alone: our survival. 

    But in chronic conditions occurring over time, this repeated activation can make our nervous system extra sensitive to threat. Our body’s warning system begins to fire over and over, responding to even small changes in posture, environment, or life conditions as if they were a five alarm fire. This is part of why hypnosis and meditation have been shown to be highly supportive for chronic illness and pain, when used in complement with appropriate medical care.

    You’ve probably heard the term “neurons that fire together wire together,” meaning that when we repeat anything over and over, we build strong neural pathways that operate automatically. This trait is fantastic in so many situations: we effortlessly remember how to drive a car, we see the face of someone we love and a feeling of warmth washes over us, we wake up and go to our meditation cushion because it’s a habitual part of our routine.

    Our brains are incredibly efficient. They want to save energy, so they create shortcuts to do so. This is often helpful, but when it comes to chronic pain and illness, this can result in heightened sensitivity, and what some researchers call maladaptive neuroplasticity. 

    What does that mean for us? Essentially, the body and mind begin to reorganize in order to address the ongoing threat that is occurring. Unfortunately, we don’t always reorganize in a way that helps us long-term or feels particularly good. To our brain and body, it’s about one thing and one thing alone: our survival.

    Over time, an inner algorithm is created in the brain, body, and nervous system: We get exposed to a trigger or feel the beginning of the symptom and automatically, a cascade of chemical, physiological, and emotional responses fire up within a fraction of a second. Emotions are heightened, thought loops start spinning, discomfort worsens, and the neural pathways connecting things like fear, grief, hopelessness, frustration, and physical symptoms grow stronger. 

    The wonderful thing about neuroplasticity is that you have agency over more of this process than you might imagine, especially when it comes to navigating habitual thoughts and reactions, distress, and overwhelm.

    Neuroplasticity Means You Have More Power Than You Know

    It’s understandable that these processes can feel big, automatic, and beyond our control, but that’s not the full picture. The wonderful thing about neuroplasticity is that you have agency over more of this process than you might imagine, especially when it comes to navigating habitual thoughts and reactions, distress, and overwhelm.

    This is where mindfulness and hypnosis can offer real support. Both practices help you notice when the alarm bells start going off, so that you can interrupt the cascade of reactivity and learn to steer it in a different direction. Through relaxation, breath, focused attention, visualization, and active work with the subconscious mind, you can begin to support the nervous system and create space where triggers, symptoms, and recurring attitudes and thoughts can be met and worked with. 

    The more you practice cultivating and resting in qualities like safety, compassion, kindness, and relaxation, the more hardwired and automatic they become. Just like you’ve strengthened the muscles of stress and overwhelm, you can strengthen the muscles of ease, trust, and permission to rest and take care of yourself.

    One of my clients has described this process as being able to access her “own little sanctuary”—a place where even in the midst of years-long, complex illness, she is able to rest, remember her wholeness, and feel relief. With that, her sleep has significantly improved along with her overall sense of hope, personal power, and wellbeing.

    Addressing the Whole Person

    Of course, this does not mean thinking we can just “meditate away” a condition that needs treatment. These practices are best done in conjunction with medical care, because they allow us to navigate the full spectrum of our experience—from stress around doctor’s appointments and treatment protocols, to changes in our relationships and career, to celebrating the wins and progress when they do come. Living with pain and illness touches our bodies but also our identities, spirituality, and outlook on the world. These practices can allow us to show up for all parts of it. 

    Adding meditation and hypnosis to our chronic illness care regimen can reveal that we have more power than we think: the ability to interrupt familiar thought loops, to create moments of relief and inner safety, and even to reshape the emotions, beliefs, and patterns that can make life with chronic illness feel harder than it already is.

    Adding meditation and hypnosis to our chronic illness care regimen can reveal that we have more power than we think: the ability to interrupt familiar thought loops, to create moments of relief and inner safety, and even to reshape the emotions, beliefs, and patterns that can make life with chronic illness feel harder than it already is.

    This is so powerful because in the type of mind states available through meditation and hypnosis, the mind becomes more flexible, creative, and adaptive. In fact, early research suggests that mind-body practices like meditation and hypnosis may influence brain-derived neurotrophic factor (BDNF), a molecule linked to neuroplasticity, learning, pain modulation, and the nervous system’s capacity to adapt in response to stress. 

    When we add these practices to our toolbox, we are partnering with the subconscious mind so that we can remodel our relationship to illness from the inside out.



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  • Is Personalized Genetic Testing Worth It?

    Is Personalized Genetic Testing Worth It?

    Overrated “precision medicine” may just be serving vested interests, and consumer DNA testing can be useless—or even worse.

    Today, you can get your DNA sequenced—the letters of your entire genetic code spelled out—for about a thousand dollars, a bargain compared to the $100 million or so it cost 20 years ago. And for around a hundred dollars, you can get partial DNA sequencing. Direct-to-consumer genetic testing is “only a click away,” like 23andMe, for “ancestry, health, love…and more.” Unfortunately, many tests that are available today haven’t been validated properly. And, as a result, the buyer may be buying something “that is ultimately useless.” Or, results may just be just flat-out wrong.

    There is growing public demand for direct-to-consumer genetic tests, but when put to the test, researchers found an “alarmingly high false-positive rate.” Test results indicated that people carried a high-risk gene, but it simply wasn’t true. And this happened 40% of the time, especially with the BRCA breast cancer gene (the one Angelina Jolie publicly revealed she carries), which you can see below and at 1:08 in my video Should You Get Personalized Genetic Risk Testing?.In addition to the 40% false-positive rate, some variants the tests did identify correctly were misclassified as being high risk when, in actuality, they weren’t high risk at all. You can see how it’s in these companies’ best interest to give scary outlier results, so customers will think the money spent was worth it and maybe even pay for additional testing. But false-positive results and variant misclassification can have serious consequences for a person, including unnecessary stress and even unnecessary medical procedures. What if you got a preventive double mastectomy because you falsely thought you were at high risk when you didn’t even have the BRCA mutation?

    Yes, now, these genome-wide association studies have identified thousands of common genetic variants that affect the risk of complex diseases, as I talked about in my video on personalized nutrition. “Nevertheless, the discovered gene variants do not markedly expand our predictive ability compared with what can be achieved by using only information from long-known traditional risk factors.”

    Take type 2 diabetes, for example. Researchers have identified about 50 genes that are linked to increased diabetes risk, but even when considered collectively, “obese persons with the lowest genetic risk for diabetes were nearly 5 times more likely to develop the disease than normal-weight persons with the highest genetic risk.” In other words, this would send out the wrong message to someone who is obese, giving them a false sense of security. Knowledge about type 2 diabetes genetic susceptibility based on what we know so far has “no implications for decisions about who should be targeted for intensive lifestyle interventions.” Everyone with excessive body fat, regardless of genetics, needs to slim down to reduce the risk of diabetes.

    What about the famous study that purported to show that personally tailored dietary interventions could improve blood sugar responses, to the extent that some commentators said it raised questions about the usefulness of universal dietary recommendations? But if you actually read the study, the results do not show high interpersonal variation in relative blood sugar responses; do not show the model is superior to current methods of detecting high blood sugars; and do not show that personalized nutrition advice is better than standard dietary advice to manage high blood sugar responses after meals.

    But what about personalized genetic risk counseling to at least motivate diabetes prevention? “In a somewhat forlorn bid to regain credibility, ‘knowledge’ of individual genetic risk profile has been touted as effective in motivating test-positive individuals to commit more strenuously to relevant disease prevention efforts….” However, again, available evidence doesn’t support that claim. And indeed, it did not seem to help those at risk for diabetes.

    Researchers randomized people to get genetic tests worth hundreds or thousands of dollars to profile their subtle differences in risk for up to 40 different diseases. In this case, it was Navigenics that described its goal as empowering people with personal genetic insights to help motivate them to improve their health. Yet, it didn’t work. There were no measurable changes in diet or lifestyle, even in the short-term.

    Randomizing people to personalized nutrition insights is like determining who might genetically benefit particularly well from eating more greens or eating to lower their cholesterol, yet when researchers put it to the test, there were no significant changes in diet at month six compared to those who didn’t get that personalized info, or even at month three. So, it’s no surprise there were no differences in weight, belly fat, cholesterol, or any of the other biomarkers.

    Put all the studies together, and what do we find? There are no significant benefits to telling smokers who are at particular risk for lung cancer, or who need to eat especially healthy, or who should be more physically active. The bottom line: Expecting that being aware of DNA-based risk estimates will change behavior is not supported by existing evidence. However, that was the stated reason for the big presidential push for precision medicine in 2015: to empower individuals to take a more active role in their own health.

    It is not surprising that the theme of personal empowerment is invoked. It’s great for marketing, but it’s not particularly empowering. In fact, if anything, it leaves patients even more reliant on authority, and it is not even very personal since the genetic contributions we know of are so small compared to how we actually live our lives. Then why is patient empowerment emphasized as a “cardinal virtue”? Because “it exploits the appeal…to generate political and public support” for an “increasingly industrialized medical-industrial and scientific complex, which moves trillions of dollars around the globe.”

    This isn’t some grand conspiracy theory; it’s just the way the system works. “Healthy living directly threatens many powerful corporations….” Eat less sugar? Eat less meat? Healthier populations, after all, only reduce the demand for doctors and drugs. “Seemingly willfully blind to this evidence, the United States continues to spend its health dollars overwhelmingly on clinical care,” cleaning up our lifestyle-induced messes. So, it’s not surprising that we far outspend other countries while at the same time having worse outcomes. While major new taxpayer gifts were being promised to high-tech medicine about a decade ago, the United States had already sunk to the bottom among comparable countries with respect to disease experience and life expectancy. “Overrated ’precision medicine’ promises may be serving vested interests,…justifying the exorbitant healthcare expenditure in our finance-based medicine.” In lots of ways, the U.S. health care system is the most advanced in the world, but all our “whiz-bang technology just cannot fix what ails us.” “Let’s start with the basics. Eat your broccoli, take the stairs, and don’t worry about whether you have a 5.6 percent or 7.7 percent lifetime risk for a grave disease because either way, a sensible lifestyle is the healthiest choice.”

    Doctor’s Note

    The video I mentioned is Friday Favorites: How Useful Is Personalized Nutrition?.



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