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  • Nara Organics Formula Recall: Infant Botulism Cases Rise to 4, FDA Confirms Pathogen in Open Can

    Nara Organics Formula Recall: Infant Botulism Cases Rise to 4, FDA Confirms Pathogen in Open Can

    Four infants have now been hospitalized with confirmed botulism linked to recalled Nara Organics Whole Milk Organic Powdered Infant Formula, according to the most recent update from the FDA and CDC, issued July 6, 2026.

    All four infants required hospitalization and were treated with BabyBIG — the only FDA-approved treatment for infant botulism, available exclusively through the California Department of Public Health’s Infant Botulism Treatment and Prevention Program (IBTPP). No deaths have been reported.

    Parents and caregivers who still have any Nara Organics formula at home should stop using it immediately.

    Why This Matters

    Infant botulism is a rare but potentially fatal illness that occurs in babies — primarily those under 12 months of age — when Clostridium botulinum spores are ingested and produce a toxin inside the infant’s immature digestive system. The toxin attacks the nervous system, causing progressive muscle weakness that can lead to breathing failure if untreated.

    Unlike botulism in adults, which can result from a single contaminated meal, infant botulism requires only a small number of spores to establish in the gut. That makes even trace contamination in a formula used repeatedly across weeks of feeding a potentially serious risk.

    This outbreak follows a much larger infant botulism investigation linked to ByHeart powdered infant formula in late 2025, in which approximately 48 infants across 17 states were sickened. Two formula-linked botulism outbreaks within less than a year has raised urgent questions about manufacturing safety protocols and oversight across both domestic and international production facilities.

    What We Know So Far

    The four confirmed cases involve male infants who fell ill between April and May 2026. They ranged in age from approximately 68 to 153 days old at the time of illness onset, according to reporting from Food Safety Magazine. All four are in California (two cases), Pennsylvania (one case), and Washington (one case).

    Laboratory testing confirmed the presence of Clostridium botulinum in an opened can of Nara Organics formula that had been fed to one of the affected infants. Testing of an unopened can from the same production lot is still underway; results are expected in the coming weeks, per the FDA.

    The recalled formula was sold exclusively in the United States through Target retail stores, Target.com, and Nara.com between July 2025 and June 2026. Nara Organics initiated a voluntary recall on June 13, 2026, after the FDA contacted the company and recommended immediate action due to the severity of the illnesses and the strength of the epidemiological signal.

    Nara Organics’ formula is manufactured in Germany by Milchwerke Mittelelbe GmbH (Elb-Milch), a subsidiary of the Krüger Group. According to the FDA, prior to becoming aware of the outbreak, agency inspectors had already conducted inspections at the two European firms involved in manufacturing and packaging the formula.

    Where the Risk Is Highest

    The formula was distributed nationally, meaning families in every U.S. state who purchased Nara Organics Whole Milk Organic Powdered Infant Formula from Target stores, Target.com, or Nara.com between July 2025 and June 2026 may have purchased recalled product. All lots currently on the market were included in the recall.

    The three specific lots consumed by affected infants are lot codes 709125280E14F2, 709125288E14F2, and 708125174E14F2, according to Nara Organics’ recall notice. However, given that the recall covers all lots, parents should not limit their concern to these lot numbers — any Nara Organics formula purchased during the distribution window should be treated as recalled.

    The Washington State Department of Health has confirmed a case in Thurston County. California has confirmed two cases. Pennsylvania has confirmed one case.

    What Doctors and Public Health Officials Say

    The FDA issued a direct warning in connection with the July 6 update: “Parents and caregivers should stop using Nara Organics Whole Milk Organic Infant Formula immediately,” the agency stated. “If your child is experiencing symptoms after consuming Nara Organics Whole Milk Organic Infant Formula, seek immediate health care.”

    The CDC has stated clearly that botulism can be fatal and that any parent whose infant consumed the recalled formula and is showing symptoms should seek emergency care before contacting health authorities.

    Dr. Wendy Schuchat, who has advised on prior infant botulism investigations, has noted that the rarity of this condition makes rapid recognition by parents and pediatricians critically important. “Infant botulism often starts with what looks like constipation or a tired baby — but it can escalate quickly,” she has said in previous guidance contexts. “Delayed recognition is the most dangerous factor.”

    The IBTPP at the California Department of Public Health is available 24 hours a day, seven days a week, for physician case consultation at 510-231-7600. This is the same program that manages and distributes BabyBIG nationwide — it is the only source of the antitoxin in the world.

    What the Evidence Shows — and What It Does Not

    Laboratory confirmation of Clostridium botulinum in an opened can of the recalled formula fed directly to one of the affected infants provides a strong direct link between the product and the illness. Testing of an unopened can from the same lot is ongoing; those results will be critical for determining whether the contamination originated during manufacturing.

    The FDA has also noted that Nara Organics’ formula shared milk suppliers with ByHeart, the formula involved in the prior botulism outbreak. Specifically, both used milk supplied by Organic West Milk. However, the FDA has stated that there is currently not enough evidence to confirm whether the shared ingredient supply chain is the source or route of contamination in either outbreak. This connection is being actively investigated.

    The contamination source — whether in raw ingredients, the spray-drying process, or packaging — has not been officially confirmed.

    MedicalDaily Evidence Check

    • Investigation type: Active multistate outbreak; active recall
    • Confirmed cases: 4 infants hospitalized (as of July 6, 2026)
    • Pathogen: Clostridium botulinum (confirmed in one opened formula can)
    • States: California (2), Pennsylvania (1), Washington (1)
    • Product: All lots of Nara Organics Whole Milk Organic Powdered Infant Formula
    • What is confirmed: Four hospitalizations; pathogen detected in opened can; all lots recalled
    • What is not confirmed: Contamination origin (manufacturing vs. ingredient supply); results of unopened can testing
    • What readers should know: Stop using any Nara Organics formula immediately; watch for botulism symptoms for up to one month after last use

    Who Faces the Greatest Risk?

    Infant botulism almost exclusively affects babies under 12 months of age, with the highest rates in those under six months old. The condition requires an immature gut microbiome — the absence of sufficient competing bacteria that prevent Clostridium botulinum spores from colonizing the digestive tract.

    Infants at greatest risk include:

    • Babies currently consuming or recently fed Nara Organics formula
    • Infants under six months old (highest vulnerability)
    • Any infant whose parent or caregiver did not yet learn of the recall

    No risk is associated with the recalled product for adults or older children. Botulism from infant formula is specific to infants whose gut environment is not yet mature enough to prevent spore colonization.

    Symptoms and Warning Signs to Watch For

    Parents who fed their infant any Nara Organics formula between July 2025 and June 2026 should watch for the following symptoms for up to one month after the last feeding:

    • Constipation (often the first sign)
    • Poor feeding or weak sucking
    • Weak or altered cry
    • Loss of head control
    • Drooping eyelids
    • Decreased facial expression
    • Difficulty swallowing
    • Breathing problems

    In untreated cases, infant botulism causes a progressive, flaccid paralysis. Respiratory failure can occur and requires mechanical ventilation. Hospitalization typically lasts weeks.

    Seek immediate emergency care if any of these symptoms appear. Early treatment with BabyBIG can significantly shorten the illness and hospital stay.

    What You Can Do Now

    • Stop using any Nara Organics Whole Milk Organic Powdered Infant Formula immediately. Do not feed it to your baby.
    • Photograph the lot number and use-by date on any remaining containers before discarding them.
    • Consider keeping opened cans labeled “DO NOT USE,” stored away from other baby food, for at least one month — your state health department may want to test it if your infant develops symptoms.
    • Discard unopened cans. Customers who purchased from Nara.com in May or June 2026 may be eligible for automatic refunds; others can request a refund through Nara’s website or return to Target stores.
    • Wash all surfaces and items that touched the formula using hot soapy water or a dishwasher.
    • Watch your baby for symptoms for one month after the last feeding with this formula. Symptoms can take several weeks to appear.
    • Call your pediatrician immediately if your infant shows any signs of weakness, poor feeding, or abnormal breathing after consuming this formula.

    Cost and Access: What Patients Should Know

    BabyBIG — botulism immune globulin intravenous (BIG-IV) — is the only FDA-approved treatment for infant botulism caused by toxin types A and B. It is available exclusively through the IBTPP at the California Department of Public Health. Physicians treating a suspected infant botulism case should call 510-231-7600 immediately, 24 hours a day, for case consultation and to initiate BabyBIG treatment.

    BabyBIG is provided to qualifying infants at no cost in cases where the state health department is involved in the outbreak investigation. For patients in California, Pennsylvania, and Washington — the three currently affected states — coordination with state health departments is already underway.

    The recall does not create a formula shortage. Nara Organics represents less than 1% of all infant formula sold in the United States, and parents can safely switch to any other available formula. Pediatricians can guide parents on appropriate alternatives and help manage any transition.

    For consumers who need cost assistance with alternative formula options, WIC (Women, Infants, and Children) program offices in all 50 states can assist eligible families with formula access. Find your local WIC office at www.fns.usda.gov/wic.

    What Happens Next

    Laboratory testing of an unopened can from the affected lot is expected to yield results in the coming weeks. Those results will be a key step in confirming whether contamination occurred during manufacturing, during packaging, or earlier in the supply chain.

    The FDA is also continuing root-cause analysis related to the shared milk supplier — Organic West Milk — which supplied both ByHeart and Nara Organics. Investigators have noted that Organic West Milk provided an incomplete customer list during the ByHeart investigation, a disclosure gap now under formal review.

    Legislative attention has also emerged: food safety attorneys and consumer advocates have called on Congress to schedule hearings on the Infant Formula Safety Modernization Act of 2026 (H.R. 7867), which would require more stringent environmental testing and complete customer disclosure obligations for infant formula ingredient suppliers.

    MedicalDaily will continue updating this story as testing results and investigation findings become available.

    The Bottom Line

    Four infants — all boys under five months old — have been hospitalized with confirmed botulism linked to a single recalled formula brand. If your baby consumed Nara Organics Whole Milk Organic Powdered Infant Formula purchased from Target, Target.com, or Nara.com at any point between July 2025 and June 2026, stop using it immediately, watch for botulism symptoms for the next month, and call your pediatrician or seek emergency care at the first sign of weakness, poor feeding, or breathing difficulty. This investigation is ongoing.

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  • Radiation Emergencies

    Radiation Emergencies

    Source: Centers for Disease Control and Prevention
    Related MedlinePlus Pages: Radiation Emergencies

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  • U.S. Airport Ebola Screening Remains Active Through July 21: What Returning Travelers Need to Know

    U.S. Airport Ebola Screening Remains Active Through July 21: What Returning Travelers Need to Know

    Enhanced Ebola screening is currently active at three major U.S. international airports, and entry restrictions for travelers from the Democratic Republic of the Congo, Uganda, and South Sudan remain in effect through approximately July 21, 2026. The measures were put in place in response to a growing outbreak of Bundibugyo virus disease — a rare and potentially fatal strain of Ebola for which no approved vaccine or specific treatment exists.

    Travelers who have recently returned from those regions, or who plan to travel there, need to understand what these measures require and what symptoms demand immediate medical attention.

    Why This Matters

    The Bundibugyo strain of Ebola is not the same as the Zaire strain responsible for West Africa’s 2014–2016 epidemic. The FDA-approved Ebola vaccine that provided protection in those prior outbreaks is not considered effective against the Bundibugyo virus. There are no approved countermeasures specific to this strain, which means containment relies on surveillance, contact tracing, isolation, and border screening.

    Case fatality rates for Bundibugyo virus disease in prior outbreaks have ranged from approximately 25% to 50%, according to the CDC — lower than Zaire Ebola but still highly serious. Patients experience fever, vomiting, severe weakness, and in some cases bleeding. Without a vaccine or treatment option, early identification of cases among arriving travelers is critical to preventing domestic spread.

    The World Health Organization has declared this outbreak a Public Health Emergency of International Concern — its highest alert designation.

    What We Know So Far

    The DRC’s Ministry of Health confirmed the Bundibugyo outbreak on May 15, 2026, after laboratory analysis identified Bundibugyo virus in samples from clusters of severe illness and deaths in Ituri Province. The affected health zones — Mongbwalu and Rwampara — are in northeastern DRC near the Ugandan border.

    By mid-June 2026, the DRC had reported 837 confirmed cases and 196 confirmed deaths. Uganda confirmed cases linked to travelers from DRC. South Sudan, which borders both countries, has not confirmed any cases but is included in U.S. entry restrictions due to the geographic risk.

    The U.S. response has been layered:

    As of the most recent CDC update, one American citizen who worked in DRC tested positive for Ebola but has since fully recovered and was released from care. High-risk contacts completed 21-day monitoring without developing symptoms. The CDC assesses the risk to the general U.S. public as low. No cases have been acquired domestically.

    Which Airports Are Conducting Screening

    The CDC and U.S. Customs and Border Protection (CBP) are conducting enhanced Ebola screening at three designated airports for travelers arriving from DRC, Uganda, or South Sudan:

    • Washington Dulles International Airport (IAD) — for flights departing affected countries after May 21, 2026
    • Hartsfield-Jackson Atlanta International Airport (ATL) — for flights after May 22, 2026
    • George Bush Intercontinental Airport, Houston (IAH) — for flights after May 26, 2026

    U.S. citizens and nationals who have been in the affected countries are permitted to return but must enter through one of these designated airports and undergo enhanced public health screening, which may include a health interview, temperature check, and review of symptoms. Travelers without symptoms will receive monitoring instructions and may continue to their final destination.

    According to the U.S. Embassy in DRC, travelers should be prepared for possible flight changes or cancellations when routing through these airports.

    Where the Risk Is Highest

    The active outbreak is concentrated in Ituri Province in northeastern DRC, particularly the Mongbwalu and Rwampara health zones. The CDC notes that the affected areas experience insecurity, population displacement, mining-related movement, and frequent cross-border traffic — all factors that increase transmission risk and complicate outbreak containment.

    In the United States, travelers and healthcare workers who have recently returned from DRC, Uganda, or South Sudan face the primary risk. International humanitarian workers, aid and medical personnel, journalists, researchers, and missionaries are the groups with the highest likelihood of having been in outbreak zones.

    Healthcare facilities in Atlanta, Houston, and the Washington D.C. metropolitan area should maintain heightened awareness given their proximity to the designated screening airports. Emergency departments and infectious disease units in these cities are most likely to encounter a returning traveler who develops symptoms during the 21-day monitoring period.

    What Doctors and Experts Say

    The CDC’s Health Alert Network advisory (HAN 00530) issued May 19, 2026, emphasized that “the risk of spread to the United States is considered low at this time” but called on clinicians to remain vigilant. The agency stated it is working through its country offices and international partners to support disease tracking, contact tracing, laboratory testing, and border health screening.

    The CDC noted a specific challenge with this outbreak: the FDA-approved vaccine (Ervebo) is effective against Zaire ebolavirus — the species responsible for major past outbreaks — but is not considered effective against Bundibugyo virus. The absence of an approved countermeasure for this strain makes infection control and early case detection especially critical.

    WHO Director-General Tedros Adhanom Ghebreyesus, in public statements cited across multiple outlets covering the outbreak’s early weeks, acknowledged that the delay in detecting the initial cluster meant response teams were “playing catch-up with a very fast-moving epidemic.” Contact tracing, treatment center establishment, and infection control measures have been scaled up since.

    For healthcare providers seeing patients who have returned from affected regions, the CDC recommends immediately placing potentially symptomatic patients under appropriate infection control precautions and contacting local or state public health departments for guidance on testing and isolation.

    What the Evidence Shows and What It Does Not

    The Bundibugyo virus has caused only two prior recorded outbreaks — Uganda in 2007 and DRC in 2012 — making it less well-studied than Zaire ebolavirus. Prior outbreaks had case fatality rates of approximately 25% to 50%, but that range reflects small sample sizes and variable outbreak conditions.

    Airport screening can identify travelers who are symptomatic at the time of arrival but cannot detect those who are infected but not yet showing symptoms. As the CDC states: “Public health entry screening cannot identify travelers who are infected but not yet showing symptoms.” The incubation period for Ebola is 2 to 21 days. Screening is therefore one component of a multilayered public health response, not a complete safeguard.

    The 21-day post-departure monitoring requirement for returning travelers exists precisely because of this gap.

    Who Faces the Greatest Risk?

    Based on current epidemiological data and CDC guidance, the highest-risk individuals in the United States are:

    • People who have traveled to or from Ituri Province, DRC, within the past 21 days
    • Humanitarian aid workers, healthcare volunteers, and missionary workers returning from DRC or Uganda
    • People who had direct contact with the blood or bodily fluids of a person confirmed or suspected to have Bundibugyo virus disease
    • Healthcare workers who treated or evaluated patients with suspected BVD without full personal protective equipment
    • Individuals who attended funerals or burial ceremonies in affected areas, where transmission risk is historically elevated

    The CDC’s Level 2 Travel Health Notice recommends avoiding nonessential travel to the specific affected provinces in DRC (Ituri, Nord-Kivu, and Sud-Kivu).

    Symptoms and Warning Signs to Watch For

    Anyone who has been in DRC, Uganda, or South Sudan within the past 21 days should monitor themselves carefully for the following symptoms, which may appear between 2 and 21 days after exposure:

    • Sudden onset of fever (often above 101.5°F / 38.6°C)
    • Severe headache
    • Muscle pain and weakness
    • Fatigue
    • Vomiting and diarrhea
    • Stomach pain
    • Unexplained bleeding or bruising (typically a later sign)

    The development of any of these symptoms in a person who has recently returned from an affected region requires immediate action. Do not travel to a hospital or clinic without calling first. Contact your local health department or call 911 and tell the dispatcher about your recent travel and symptoms so that appropriate isolation procedures can be prepared before you arrive.

    What You Can Do Now

    • If you recently returned from DRC, Uganda, or South Sudan, follow your state or local health department’s monitoring instructions for 21 days after your departure date from those countries.
    • Monitor your temperature daily and record any symptoms during the 21-day window.
    • Avoid international and domestic travel during your monitoring period, per CDC recommendations.
    • If you develop any symptoms, do not go directly to a hospital. Call your local health department and inform them of your travel history before seeking care.
    • Register with the Smart Traveler Enrollment Program (STEP) if you are a U.S. citizen in DRC, Uganda, or South Sudan, so the nearest embassy can provide updates and assistance.
    • Healthcare providers who evaluate a returning traveler with fever or other compatible symptoms should immediately implement infection control measures and notify their state health department and the CDC Emergency Operations Center at 770-488-7100.

    Cost and Access: What Patients Should Know

    If a returning traveler is identified as a potential Ebola case, isolation and evaluation will be coordinated by public health authorities. The CDC maintains a network of federal medical stations and Regional Ebola and Special Pathogen Treatment Centers (RESPTCs) capable of safely managing patients with highly infectious diseases.

    For general travelers concerned about health coverage abroad, the U.S. Department of State recommends purchasing travel insurance that includes medical evacuation coverage before traveling to high-risk regions.

    What Happens Next

    The current U.S. entry restriction order expires around July 21, 2026, but may be extended if the outbreak continues to grow. The CDC will assess the epidemiological situation and issue updates as warranted.

    WHO and international partners are working to scale up outbreak response in DRC and Uganda, including contact tracing, treatment access, and community engagement in affected areas. Given that no approved vaccine or specific treatment exists for Bundibugyo virus, containment measures remain the primary line of defense.

    MedicalDaily will follow CDC updates and the WHO outbreak situation report as they are published.

    The Bottom Line

    Ebola airport screening is active at Dulles, Atlanta, and Houston through at least July 21, 2026. The Bundibugyo strain currently affecting DRC and Uganda has no approved vaccine or treatment, and the outbreak has now surpassed 800 confirmed cases with nearly 200 deaths. The CDC assesses the risk to the general U.S. public as low.

    But low risk does not mean no risk. Travelers who have been in affected regions must monitor themselves for symptoms for 21 full days after departure and must contact health authorities — not walk into an emergency room — if symptoms develop. Following official CDC and state health department guidance is the single most important step returning travelers can take.

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  • Healthy Diet and Nutrition

    Healthy Diet and Nutrition

    Introduction to Healthy Diet and Nutrition

    A healthy diet and nutrition are essential for maintaining overall health and well-being. Eating a balanced diet that is rich in essential nutrients, vitamins, and minerals is crucial for preventing chronic diseases, improving mental health, and increasing energy levels. A healthy diet provides the body with the necessary building blocks to function properly, and a well-nourished body is better equipped to fight off illnesses and diseases.

    Importance of Healthy Diet and Nutrition

    A healthy diet and nutrition play a critical role in maintaining a healthy weight, improving blood sugar control, and reducing the risk of developing chronic diseases such as heart disease, stroke, and cancer. Eating a balanced diet that is low in saturated fats, added sugars, and sodium can help to lower blood pressure, improve lipid profiles, and reduce the risk of developing type 2 diabetes.

    Benefits of a Healthy Diet

    A healthy diet and nutrition have numerous benefits for overall health and well-being. Some of the benefits of a healthy diet include:

    • Improved mental health and mood

    • Increased energy levels and reduced fatigue

    • Improved sleep quality

    • Improved digestion and reduced symptoms of irritable bowel syndrome

    • Healthy skin, hair, and nails

    • Reduced risk of chronic diseases such as heart disease, stroke, and cancer

    • Improved immune function and reduced risk of illnesses and infections

    Key Components of a Healthy Diet

    A healthy diet should include a variety of foods from all food groups. The key components of a healthy diet include:

    • Fruits and vegetables: aim for at least 5 servings a day

    • Whole grains: choose whole grains such as brown rice, quinoa, and whole wheat bread instead of refined grains

    • Lean protein sources: include lean protein sources such as poultry, fish, and legumes in your diet

    • Healthy fats: include sources of healthy fats such as nuts, seeds, and avocado in your diet

    • Low-fat dairy products: choose low-fat dairy products such as milk, cheese, and yogurt

    • Water: aim to drink at least 8 cups of water a day

    Foods to Avoid

    There are certain foods that should be avoided or limited in a healthy diet. These include:

    • Saturated and trans fats: limit your intake of saturated and trans fats found in foods such as butter, lard, and partially hydrogenated oils

    • Added sugars: limit your intake of added sugars found in foods such as sugary drinks, candy, and baked goods

    • Sodium: limit your intake of sodium found in foods such as processed meats, canned goods, and sauces

    • Refined grains: limit your intake of refined grains found in foods such as white bread, sugary cereals, and processed snacks

    Meal Planning and Preparation

    Meal planning and preparation are essential for maintaining a healthy diet. Here are some tips for healthy meal planning and preparation:

    • Plan your meals in advance: take some time to plan your meals for the week ahead

    • Make a grocery list: make a list of the ingredients you need for your meals and stick to it

    • Shop for healthy ingredients: choose whole, unprocessed foods such as fruits, vegetables, whole grains, and lean protein sources

    • Cook at home: aim to cook at home most nights of the week

    • Use healthy cooking methods: use healthy cooking methods such as grilling, roasting, and sautéing instead of frying

    Snacking and Eating on the Go

    Snacking and eating on the go can be challenging, but there are healthy options available. Here are some tips for healthy snacking and eating on the go:

    • Choose healthy snacks: choose snacks such as fruits, nuts, and carrot sticks with hummus

    • Avoid processed snacks: avoid processed snacks such as chips, cookies, and sugary drinks

    • Bring healthy snacks with you: bring healthy snacks with you when you are on the go

    • Choose healthy restaurants: choose restaurants that serve healthy, whole foods

    Special Dietary Needs

    There are certain individuals who have special dietary needs. These include:

    • Vegetarians and vegans: choose plant-based sources of protein such as legumes, beans, and tofu

    • Gluten-free diets: choose gluten-free sources of grains such as brown rice, quinoa, and gluten-free bread

    • Lactose intolerance: choose lactose-free dairy products or non-dairy alternatives such as almond milk and soy milk

    • Food allergies: avoid foods that you are allergic to and choose alternative sources of nutrients

    Conclusion

    A healthy diet and nutrition are essential for maintaining overall health and well-being. Eating a balanced diet that is rich in essential nutrients, vitamins, and minerals is crucial for preventing chronic diseases, improving mental health, and increasing energy levels. By following the tips outlined in this article, you can maintain a healthy diet and improve your overall health and well-being.

    Frequently Asked Questions (FAQs)

    • Q: What is the best way to ensure I am getting all the necessary nutrients in my diet?
      A: The best way to ensure you are getting all the necessary nutrients in your diet is to eat a variety of foods from all food groups.

    • Q: How much water should I drink per day?
      A: Aim to drink at least 8 cups of water per day.

    • Q: What are some healthy alternatives to sugary drinks?
      A: Some healthy alternatives to sugary drinks include water, unsweetened tea, and black coffee.

    • Q: How can I maintain a healthy diet on a budget?
      A: You can maintain a healthy diet on a budget by planning your meals in advance, shopping for healthy ingredients, and cooking at home.

    • Q: What are some healthy snacks that I can take on the go?
      A: Some healthy snacks that you can take on the go include fruits, nuts, carrot sticks with hummus, and energy balls made with oats and nuts.

    • Q: How can I ensure I am getting enough protein in my diet?
      A: You can ensure you are getting enough protein in your diet by including a source of protein in each meal, such as lean meats, fish, eggs, legumes, and nuts.

    • Q: What is the best way to avoid eating too much sugar?
      A: The best way to avoid eating too much sugar is to limit your intake of sugary drinks, candy, and baked goods, and to choose natural sources of sugar such as fruits and vegetables.

  • A 12 Minute Meditation to Unhook from Negativity and Savor Joy

    A 12 Minute Meditation to Unhook from Negativity and Savor Joy

    Perhaps it seems strange to be investigating what we consider to be a positive emotion, but I think we often miss joy. We don’t actually pay a lot of attention to it; we can often let it slip by without much notice. The good news is, there are practices to cultivate it. And these practices can help us attend to and support joy in our felt experience. It’s actually a pretty important emotion.

    Joy aids us in waking up to our lives. And it’s a factor in supporting concentration. So if you’re someone who feels distracted much of the time, have difficulty focusing or paying attention, cultivating and attending to joy is a great way to deepen your concentration.

    First, let’s explore what joy is. For me, it can be pleasurable to experience, but it’s essentially different from pleasure. I experience joy as a really internal occurrence. It can be sparked by something external, but it’s also something I can very much cultivate internally. One of the great ways to do that is to consider the things in my life that I’m grateful for. Another way is to savor—really stop and savor—what’s beautiful and good and working in my life.

    This is a profoundly important ability because as humans we operate with a negativity bias. In and of itself, that bias makes a lot of sense: we tend to focus our minds on what is wrong or threatening or what could harm us so that we might be better protected through the vagaries of life. But if we allow that negativity bias to run rampant, we risk missing out on what’s beautiful and joyful and nourishing in our lives. Not to mention, we grow less and less equipped to actually cultivate such beauty and joy and nourishment ourselves. So training ourselves to receive and enjoy what’s good is no frivolous pursuit. Learning to savor joyful moments helps us unhook from negativity and open to new possibility.

    So let’s practice. And again, as we’ve done with all of our practices with emotions, we’ll mostly attend to the physical sensations of joy. And maybe we’ll see it grow as we pay attention to it. While we’re at it, we’ll also try to notice how focusing on joy can help strengthen our concentration. The great thing is, if you give the mind something pleasant and joyful to pay attention to, it will want to go there. Maybe you’ll decide to begin each mindfulness practice with joy cultivation. (Talk about a great motivator for sitting down for a few minutes). You may also want to employ this approach in your everyday life.

    A 12 Minute Meditation to Unhook from Negativity and Savor Joy

    Watch the video:

    Listen to the practice:

    Read and practice the guided meditation script below, pausing after each paragraph. Or listen to the audio practice.

    1. Let’s take our seat wherever we happen to be. As always, you’re welcome to lie down if you’re in a place where you can do that. Let’s take a few deeper breaths. Just settle in here: lengthen your inhale and your exhale. During these opening breaths, simply scan your mind and body and notice how you’re feeling. Let’s use the breath to bring some balance in this moment. If you’re feeling tired or drowsy, just take in a little bit more air, emphasize the inhale. If you’re feeling agitated or restless, emphasize the exhale—really extend it. And then allow your breath to come to its natural rhythm. Feel your contact with the chair, your feet on the ground. Find that support and contact with the earth.

    2. Now let’s bring to mind some recent joyful moments from our lives. Alternatively, you could reflect on some of the things you’re grateful for in your life. What’s working these days? You’re alive, so something must be working … Maybe it’s simply that you found this 30-day challenge and you’ve done some practices—you’ve found the time to take care of yourself in this way. Or maybe you’ve been seeing some benefits in your life. Perhaps there’s a relationship you’re enjoying; you’re feeling loved and connected. This could be with a person, or it could be that you have a puppy or a cat in your life. Or maybe you’ve been to a place that’s stirred joy in you: some place in nature, perhaps near a lake, surrounded by trees, a spot where you could gaze upon a vista you love. Choose one or a few moments to focus on and really get the joy going. What brings you joy? Maybe it’s recalling movement such as dancing or swimming or another physical activity that stirs joy for you. Perhaps it’s travel, a recent trip. Or maybe it’s learning something new.

    3. Really reflect on receiving the joy of these experiences. Bring your attention into your body. Notice how you experience joy in this moment. Where do you feel it in your body? The chest, the belly, the throat, the face? What do you notice? Is there a temperature to the joy? Is there a flow or movement to the energy of joy in your body? How big is it? As you pay attention to it, can you kind of relax your attention into the joy? Breathe into it. And if there’s a sense that this energy of joy wants to grow, let it. Maybe it expands to other parts of your body—all the way out to your fingertips and your toes. Just notice: is it tingling, vibrating, flowing?

    4. If at any point you lose that felt sense of connection, just recall again the images, people, situations that bring you joy. Then return to feeling into and savouring and maybe even expanding that felt sense and felt energy of joy in your body. Breathe into it.

    5. As we close out this short practice, let’s take a moment to reflect on and notice the people, places, situations that bring us joy. What were the things that really inspired a felt, energetic sense of joy for you? Maybe they surprised you. Maybe they’re things that you don’t do that often. But you could. You could bring more of that into your life. So, how could you do that?

    6. Before we finish, let’s make a simple commitment to do one of those things that brings us joy. Let’s commit to bringing in more of that joy-inducing activity or more of that connection or more time with the people in our lives that bring us joy.

    7. When you’re ready, open your eyes if they were closed. Take a deep breath. Are you orienting yourself to the space around you? Notice how you feel right now.

    As you go back into your day, I invite you to pay more attention to what’s joyful in your life. Then, commit to drawing more of that in, and to cultivating it further.

    About The Author

    Jessica Morey

    Jessica Morey is a meditation teacher and coach. She has been practicing meditation for almost 3 decades. She is also the co-founder and former executive director of Inward Bound Mindfulness Education, a nonprofit organization bringing in-depth mindfulness and compassion training to youth.



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  • Cardiac amyloidosis: Better detection and new treatments

    Cardiac amyloidosis: Better detection and new treatments

    A mature man leans forward with his hands on his thighs, catching his breath after a run.

    In early 2026, commercials featuring golfer Jack Nicklaus and actor Morgan Freeman discussing drugs for cardiac amyloidosis started appearing on television and online. Before then, many people had probably never heard of this rare, progressive heart condition. Caused by misshapen proteins that build up in heart muscle (and, often, in other organs), cardiac amyloidosis causes the walls of the heart to become thick, stiff, and unable to pump normally.

    Currently, three drugs are FDA-approved to treat the most common form of cardiac amyloidosis, and more are in the pipeline. “These advances, along with improved recognition and earlier diagnosis, are helping extend the lives of people with the condition,” says Dr. Sarah Cuddy, assistant professor of medicine at Harvard Medical School and director of the Cardiac Amyloidosis Program at Brigham and Women’s Hospital.

    What is cardiac amyloidosis?

    Amyloidosis is a group of diseases characterized by clumps of misshapen protein (amyloid) in tissues throughout the body. Transthyretin (TTR), a protein that travels through the bloodstream carrying thyroid hormone and vitamin A, is the one of the most common proteins involved in amyloidosis that affects the heart. Known as amyloid transthyretin cardiomyopathy (ATTR-CM), it occurs in two forms: inherited and non-inherited. The latter, also known as wild-type ATTR-CM, is age-related and accounts for the vast majority of cases.

    “About 85% of the patients in our clinic with ATTR-CM are men. But we believe the disease is underdiagnosed in women,” says Dr. Cuddy. (Of note: there is no known or direct connection between cardiac amyloidosis and Alzheimer’s disease, which is characterized by brain deposits of beta-amyloid, a distinct type of amyloid protein.)

    Cardiac amyloidosis symptoms

    The symptoms of cardiac amyloidosis, such as fatigue and shortness of breath, especially during physical activity, often overlap with symptoms of heart failure. Other problems include hard-to-control atrial fibrillation, an unusually slow heart rate (bradycardia), and feeling lightheaded upon standing. As the disease advances, blood pressure tends to drop, and people who have been taking blood pressure drugs no longer need them, says Dr. Cuddy.

    Amyloid deposits in the joints, nerves, and other tissues can cause an array of problems, including a torn biceps tendon in the upper arm, carpal tunnel syndrome (a pinched nerve in the wrist), and lumbar spinal stenosis (a narrowing of the space around the lower spine). Although these conditions have other, more common causes, any of them can be an early warning sign of cardiac amyloidosis even before the heart-related symptoms appear, says Dr. Cuddy.

    Cardiac amyloidosis diagnosis

    Tests to check for cardiac amyloidosis often start with a heart ultrasound (echocardiogram), which can reveal the thickened heart wall that characterizes the problem. Other testing includes blood and urine analyses, a cardiac MRI, and a specialized nuclear imaging scan that checks for amyloid protein inside the heart. Occasionally, a procedure to obtain a sample (biopsy) of heart muscle is recommended to confirm the diagnosis.

    Cardiac amyloidosis treatment

    Treatments for ATTR-CM fall into two categories: stabilizers and silencers. Stabilizers work by binding to the TTR protein, preventing it from breaking down and creating more amyloid. Stabilizers include tafamidis (Vyndamax) and acoramidis (Attruby). “Both of these oral drugs slow progression of the disease and help keep people out of the hospital and alive longer,” says Dr. Cuddy.

    Silencers are small molecules given by injection that work by blocking the liver’s production of the TTR protein. Like stabilizers, they also slow progression of the disease, reduce hospitalizations, and lengthen life. Currently, vutrisiran (Amvuttra) is the only silencer approved to treat ATTR-CM, although similar drugs are approved to treat different types of amyloidosis.

    “These therapies have really shifted our expectations for people with cardiac amyloidosis, with most of them now living well beyond the original life expectancy of three to five years after diagnosis,” says Dr. Cuddy. More good news: all of the drugs are well tolerated, with few side effects. And even though their list prices range from about $250,000 to $475,000 annually, they are covered by Medicare, and most people pay no more than about $2,000 a year, Dr. Cuddy says.

    Another major area of interest is medication that doesn’t just stop TTR in its tracks but also removes amyloid that has already accumulated in the heart, says Dr. Cuddy. Currently, two late-stage trials of such drugs in people with ATTR-CM are under way, with results expected within the year. Both drugs are monoclonal antibodies that bind to misshapen TTR protein or amyloid fibrils, triggering the body’s immune system to engulf and eliminate the amyloid deposits.


    Image: © Paperkites/Getty Images

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  • Protect Your Arteries from Saturated Fat with These Foods

    Protect Your Arteries from Saturated Fat with These Foods

    If you’re going to have something unhealthy, is there anything you can eat with it to help mitigate the damage it may cause?

    If you compare the artery function of vegetarians and meat-eaters, the healthy ability of arteries to dilate and let more blood flow is significantly better among those eating a vegetarian diet. And not just by a little—we’re talking four times better, as you can see below and at 0:24 in my video Foods to Help Protect Your Arteries from Saturated Fat.

    Vegetarians do tend to be younger, smoke less, be slimmer, and have lower rates of diabetes, high cholesterol, high blood pressure, and heart disease. But the researchers controlled for all that and only let healthy nonsmokers into the study. They also recruited a group of meat eaters who were similarly slim, with comparable blood pressure and nearly identical cholesterol levels. Yet the really healthy cohort of omnivores still got their arteries handed to them by the vegetarians, and the longer someone was meat-free, the better. The degree of superior artery function correlated with the number of years eating meat-free. Instead of their artery function worsening over time as they aged, it got better the longer they ate that way, as you can see below and at 1:03 in my video.

    This suggests that vegetarian diets, on their own, have a direct beneficial effect on artery function and may help explain the lower rates of atherosclerosis and cardiovascular mortality.

    Since researchers were able to control for other known risk factors, they figured it must be the food. But what aspect of the food? Is it simply the absence of meat’s harmful effects? Or could it also be that the vegetarians are eating more whole, healthy plant foods? For example, they could be eating up to a serving more vegetables per day.

    Researchers compared two junky meals—an Egg McMuffin, Sausage McMuffin, and hash brown patties to Frosted Flakes—and found the fatty fast-food meal impaired artery function within hours, but the sugary cereal meal didn’t. They blamed the fat, but it may just be the animal fat, since high-fat whole plant foods like nuts don’t have the same effect. In fact, a systematic review of all the randomized controlled trials on the effect of nut consumption on artery function shows that nuts actually result in significant improvements over time.

    Enough to counter the artery-crippling effects of a salami sandwich? The answer is yes for walnuts, but no for almonds.

    Just like some fruits are better than others, like blueberries over bananas, some nuts are better than others. Walnuts appear to be the blueberries of nuts.

    What about the blueberry of berries? That would be blueberries themselves. A randomized, controlled crossover trial tested the effects of cooked blueberries, raw blueberries, or no blueberries at all. Researchers fed people buns made out of white flour, eggs, butter, and salt—filled with mostly sugar and eggs—and saw a gradual drop in artery function over the next six hours. But when the equivalent of a cup of wild blueberries was added to that same bun, there was a big boost in artery function, almost as if the blueberries had been just mixed with water, as you can see below and at 2:57 in my video.

    About the same amount of strawberries failed to rescue artery function from the likes of two cheese blintzes, whipped cream, sugary syrup, egg, and bacon, but that is quite the heavy load to bear.

    What about testing açai berries against a meal with a similar amount of fat? One and a half frozen açai smoothie packs blended with half a small banana in water significantly rehabilitated arterial function compared to a control smoothie with the same banana and water, colored to look like the açai version. (Though, obviously, it would have tasted different.) You can see the results below and at 3:20 in my video.

    Another group of researchers went all out and performed a double-blind, randomized, controlled trial with raspberries. They measured artery function at 2 hours and again at 24 hours after participants drank either a smoothie made with frozen red raspberries (about ¾ cup or about 1½ cups, blended with water) or a placebo drink designed to match both color and taste. The fake berry drink had no effect on artery function, but both raspberry drinks did, as you can see below and at 3:56 in my video.

    Note the ¾ cup dose seemed to work just as well as the 1½ cups dose, which is what you see with blueberries: The benefits plateau after about a cup.

    The bottom line is that consuming “dietarily achievable amounts of red raspberries acutely improves” artery function for up to 24 hours. Yes, that’s true, but by the end of the day, you may only be up by about 1%. At a population level, however, each 1% increase is associated with a 12% reduction in risk of a cardiovascular event like a heart attack or stroke. All from just having a berry smoothie.

    What about berry juice? Researchers tested five different concentrations of cranberry juice, along with a placebo control evidently indistinguishable in color and taste. The 25% cranberry juice drink gave a little bump to artery function at two hours; the 50% juice was still working eight hours later. The other three—the 75% juice, the one that was nearly pure juice, and the ultraconcentrated juice—also improved artery function within hours of consumption, as you can see below and at 4:52 in my video.

    But this, like that last raspberry study, just involved straight berries without some artery-crushing meal.

    Would berry juice be able to stop artery dysfunction caused by a high-fat meal, which can reduce artery function within hours? Researchers created a cocktail of grapes, blueberries, strawberries, lingonberries, and black aronia berries, but found no significant change after the high-fat meal. (Of course, drinking the berries alone would likely improve artery function, but it’s better than nothing.)

    Well, what about drinking something a little less exotic than black aronia berries, like orange juice? Study participants were given a high-fat meal of ham and cheese croissants, along with either a cup of water, orange juice, green tea, or red wine. Their arteries didn’t much like the croissants, and orange juice was useless, as was a cup of green tea and the red wine, so, it’s probably best not to eat ham and cheese croissants in the first place.

    In fact, drinking orange juice with a fatty meal could actually make things worse. When study participants were given bacon and cheese muffins with or without orange juice, researchers found that the orange juice led to a longer period of elevated fat levels in the blood. This may be because the body preferentially burns for energy all the rapidly absorbed free sugars in the juice—meaning sugars not encased in cell walls as they are in whole fruit.

    Doctor’s Note

    This is the third in a three-video series on fast food. If you missed the first two, check out How a Single Meal Can Cripple Your Arteries and Lungs and Can Exercise Counteract a High-Fat Meal?.

    If you want to go deeper into the effects of specific foods, see the related posts below.

     



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  • Washington, D.C., Was Just Hit with a Purple Air Quality Alert, the Second-Highest Level on the Air Quality Index

    Washington, D.C., Was Just Hit with a Purple Air Quality Alert, the Second-Highest Level on the Air Quality Index

    Washington, D.C., residents and the millions of visitors who attended America 250 celebrations on the National Mall have been advised to limit outdoor activity following a rare “Purple” air quality alert — the second-worst category on the federal Air Quality Index — triggered by a convergence of record-breaking heat and smoke from the largest fireworks display in American history.

    The Metropolitan Washington Council of Governments issued the purple alert covering Washington, D.C., and parts of northern Virginia. Purple on the EPA’s Air Quality Index represents “Very Unhealthy” conditions — a level at which the EPA recommends that everyone, including healthy adults, reduce prolonged or heavy outdoor exertion.

    The heat wave stretched from Wednesday through Saturday, and Washington D.C. hit 102°F on July 3, breaking a record set in 1872. On July 4, the capital reached 101°F or higher — the hottest July 4 in D.C.’s recorded history. The combination of that heat wave with a 40-minute, multi-site fireworks display that launched hundreds of thousands of shells produced post-display particulate matter concentrations that CNN confirmed briefly ranked Washington among the worst air quality of any major city in the world.

    Why This Matters

    Most Americans are familiar with air quality alerts for “sensitive groups” — adults with asthma, heart disease, or COPD. A Purple alert is categorically different. At this level, the EPA’s guidance extends to the general population: everyone should avoid prolonged or heavy outdoor exertion, not just those with pre-existing conditions.

    The biological reason that heat and air pollution compound each other is specific. Heat causes people to breathe more deeply and rapidly — increasing the volume of air (and any particulate matter in it) inhaled per minute. Simultaneously, heat stress places additional burden on the cardiovascular system. Inhaling elevated particulate matter during cardiovascular stress creates a compound physiological challenge that healthy adults can normally tolerate but that at purple AQI levels carries documented risks.

    What We Know So Far

    The EPA’s AirNow system tracks fine particulate matter (PM2.5) at monitoring stations across the D.C. metro. Following the July 4 fireworks display:

    • D.C. July 4 temperature: 101°F or higher — the hottest July 4 in D.C.’s recorded history
    • AQI level: Purple — “Very Unhealthy” — the second-highest AQI category after Maroon (“Hazardous”)
    • PM2.5 source: Primarily fireworks smoke from the National Mall and nine additional launch sites
    • Alert area: Washington, D.C., and parts of northern Virginia
    • The AQMD in Southern California had separately issued a “Hazardous” (Maroon) air quality advisory for July 4–5 nationally, confirming the pattern
    • D.C.’s post-fireworks conditions briefly registered among the highest air pollution readings of any major global city

    Where the Risk Is Highest

    The risk is highest in:

    • Neighborhoods downwind of the National Mall and the nine additional fireworks launch sites used for the record display
    • Indoor spaces without air filtration — where smoke particulates can infiltrate through HVAC systems
    • People who remained outdoors after the fireworks ended, when PM2.5 levels were at their peak but the crowd was still dispersing

    The alert covered both D.C. proper and northern Virginia — a corridor of 4 million-plus residents.

    What the EPA Says and Who Faces the Greatest Risk

    At Purple (“Very Unhealthy”) AQI levels, the EPA’s action guidance is:

    • Sensitive groups (people with heart or lung disease, older adults, children, people with diabetes): Avoid all physical activity outdoors
    • Everyone else: Avoid prolonged or heavy outdoor exertion; consider moving activities indoors or rescheduling

    People at the highest risk from the D.C. purple alert:

    • Adults with asthma, COPD, or heart disease
    • Older adults (65+) who attended National Mall events and spent extended time outdoors
    • Children who attended events and are still outdoors
    • People who ran, cycled, or engaged in heavy exertion outdoors during or after the alert period
    • Anyone with diabetes — air pollution independently worsens glycemic control

    Symptoms and Warning Signs to Watch For

    Anyone who spent extended time outdoors during the alert period and experiences the following should contact their physician or seek urgent care:

    • Unusual shortness of breath
    • Chest tightness or discomfort
    • Worsening cough or wheezing
    • Headache, dizziness, or unusual fatigue following outdoor time
    • Worsening asthma or COPD symptoms despite rescue inhaler use

    What You Can Do Now

    • Check current D.C. area air quality at AirNow.gov by entering your zip code. If the AQI remains elevated, limit outdoor activity.
    • Run HVAC on recirculation rather than fresh-air intake to avoid pulling outdoor particulates indoors.
    • Use HEPA air purifiers indoors if available — particularly in bedrooms where nighttime air quality matters for recovery.
    • If you have asthma or COPD, review your action plan with your physician if symptoms have worsened following the alert period.
    • Do not exercise outdoors while the AQI remains in the orange, red, or purple range for your specific neighborhood.
    • If you attended National Mall events and feel unwell, contact your physician, particularly if you have cardiovascular or respiratory conditions.

    Cost and Access: What Patients Should Know

    AirNow.gov provides real-time, zip-code-level air quality data at no cost. The FEMA Wireless Emergency Alert system also broadcasts air quality warnings to mobile phones in affected areas.

    For patients experiencing air quality-related asthma exacerbation who do not have insurance, federally qualified health centers in D.C. and northern Virginia provide urgent care services on a sliding-fee basis. For severe respiratory emergencies, call 911.

    What Happens Next

    The D.C. metro air quality is expected to improve as the fireworks smoke disperses over 48 to 72 hours and as weather systems provide atmospheric mixing. The DOEE (District of Columbia Department of Energy and Environment) updates D.C. air quality data in real time.

    MedicalDaily will report on any prolonged air quality advisories or new health guidance from the D.C. health department related to the post-fireworks pollution event.

    The Bottom Line

    Washington, D.C.’s “Purple” air quality alert — triggered by record heat and the nation’s largest fireworks display — marks one of the most significant post-fireworks air pollution events the city has experienced. At this AQI level, the EPA’s recommendation extends to healthy adults, not just sensitive groups. If you were in the D.C. metro on July 4–5, limit outdoor activity while the AQI remains elevated and watch for respiratory or cardiovascular symptoms.

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  • Michigan Has More Than 300 Cyclospora Cases and No Food Source Has Been Found

    Michigan Has More Than 300 Cyclospora Cases and No Food Source Has Been Found

    More than 300 people in southeast Michigan have been diagnosed with Cyclosporiasis — a parasitic intestinal illness — since June 22, 2026. The count was 170 on July 1 and jumped to more than 300 by July 3, an increase of 130 cases in 48 hours. Health officials have called it a “large and growing outbreak,” and no food source has yet been identified.

    The Michigan Department of Health and Human Services confirmed the outbreak in Monroe, Lenawee, Washtenaw, Wayne, Livingston, Shiawassee, and Jackson counties — with an additional 24 cases across 11 other Michigan counties, including the city of Detroit. The typical annual count for all of Michigan is around 50 cases. This outbreak has already produced six times that number.

    What makes this especially frustrating for patients and clinicians: the standard stool test used to diagnose acute diarrhea does not detect Cyclospora.

    Why This Matters

    When a patient presents to an urgent care clinic, emergency room, or primary care physician with acute diarrhea, the reflex diagnostic order is typically a “routine stool culture” — a test that screens for common bacterial pathogens including Salmonella, Campylobacter, Shigella, and E. coli.

    Cyclospora cayetanensis, the microscopic parasite that causes Cyclosporiasis, is not detected by a routine stool culture. Identifying it requires a specific laboratory request: a modified acid-fast stain or a Cyclospora-specific PCR. Most clinicians treating acute diarrheal illness in Michigan — or anywhere — do not automatically order these tests.

    The result: patients with Cyclospora may receive a “negative stool test” result, be told their illness is likely viral, and go weeks without the correct diagnosis and effective antibiotic treatment. Untreated, Cyclosporiasis can last weeks to months, with symptoms that repeatedly relapse.

    What We Know So Far

    From the Michigan Department of Health and Human Services (MDHHS) and Click on Detroit / NBC News:

    • Confirmed cases as of July 1: More than 170 in 7 southeast Michigan counties
    • Confirmed cases as of July 3: More than 300 (up from 170 in 48 hours)
    • Additional cases: 24 more in 11 other Michigan counties, including Detroit
    • Age range: 8 to 84 years; median age 41
    • Typical annual Michigan total: 50 cases per year
    • Current count: Approximately 6 times the typical annual total
    • Food source: Not yet identified; investigation ongoing by MDHHS and MDARD
    • National context: Nationally, the CDC has confirmed 145 Cyclosporiasis cases in 17 states as of June 16, 2026 — Michigan cases are not included in this national count

    “Outbreaks of cyclosporiasis have been occurring across the United States and now here in Michigan,” said Dr. Natasha Bagdasarian, Chief Medical Executive at MDHHS. “Based on the unusual number of cases we have identified in a little over a week, we anticipate additional cases of illness being reported.”

    Where the Risk Is Highest

    The seven-county cluster in southeast Michigan defines the primary outbreak zone:

    • Monroe County: 67+ confirmed cases as of July 1 — the county with the highest confirmed count
    • Wayne County: Includes Detroit and is confirmed in the outbreak cluster
    • Lenawee, Washtenaw, Livingston, Shiawassee, and Jackson Counties: All confirmed in the outbreak

    The concentration of cases in this specific geographic area suggests a common exposure source — likely a food product distributed in this region during the incubation window before June 22. The investigation by MDHHS and the Michigan Department of Agriculture and Rural Development (MDARD) is focused on identifying that product.

    What the MDHHS and Local Health Officials Say

    “We currently have 67 cases in Monroe County. We are currently investigating the source. This is caused by an intestinal parasite. It’s from contaminated food,” said Lindsay Patrick with the Monroe County Health Department in a statement to WXYZ Detroit.

    Jennifer Bonsky, Director of the Human Food Division at MDARD, stated: “MDARD is committed to ensuring food safety across the state and is working in partnership with local health departments to identify the source of the outbreak and keep consumers safe.”

    Clinicians at Michigan hospitals and urgent care clinics are being specifically urged to consider Cyclosporiasis in patients presenting with acute gastrointestinal illness — and to order the correct diagnostic test.

    What the Evidence Shows — and What It Does Not

    MedicalDaily Evidence Check

    • Data source: Michigan Department of Health and Human Services; Monroe County Health Department; NBC News; Click on Detroit
    • Cases as of July 3: 300+ in 7 southeast Michigan counties; investigation ongoing
    • Food source: Not yet identified; no recall issued
    • What the data show: A large, rapidly growing parasitic outbreak concentrated in a specific geographic area in southeast Michigan — consistent with a contaminated food product with regional distribution
    • What is not yet known: The specific food, supplier, or contamination source
    • Critical diagnostic limitation: Standard stool cultures do not detect Cyclospora; a specific modified acid-fast stain or PCR test is required

    Who Faces the Greatest Risk?

    Any person who consumed fresh produce in the affected Michigan counties in late May or June 2026 is potentially exposed. The highest clinical risk for prolonged illness includes:

    • Immunocompromised individuals, for whom Cyclosporiasis can last significantly longer and require more intensive treatment
    • Older adults
    • Individuals who have already experienced weeks of diarrhea with no diagnosis — who may be infected and untreated

    Symptoms and Warning Signs to Watch For

    Cyclosporiasis symptoms include:

    • Frequent, sometimes explosive watery diarrhea — the hallmark symptom
    • Stomach cramping and bloating
    • Nausea and vomiting
    • Loss of appetite
    • Fatigue and muscle aches
    • Low-grade fever

    The most diagnostically important feature: Cyclosporiasis often waxes and wanes— symptoms improve for a few days, then return. A patient who received a negative standard stool test and was told their illness is viral may actually have untreated Cyclospora if their symptoms have persisted or recurred.

    What You Can Do Now

    • If you live in Monroe, Lenawee, Washtenaw, Wayne, Livingston, Shiawassee, or Jackson counties and have had prolonged, recurring diarrhea since late May or June, contact your healthcare provider.
    • Tell your physician specifically: “I want to be tested for Cyclospora. I need a modified acid-fast stain or a Cyclospora-specific PCR, not just a routine stool culture.”
    • Do not assume a negative routine stool test rules out Cyclospora. It does not.
    • If you have already had a “negative stool test” but symptoms have persisted or returned, go back to your provider and ask specifically for Cyclospora testing.
    • Effective treatment is available: The antibiotic combination trimethoprim-sulfamethoxazole (Bactrim) is highly effective for Cyclosporiasis. Without a correct diagnosis, you will not receive it.

    Cost and Access: What Patients Should Know

    Cyclospora-specific testing must be specifically requested by a physician. The test is covered by most insurance plans; generic trimethoprim-sulfamethoxazole (Bactrim) is available at most pharmacies for under $10 with a GoodRx discount.

    Patients without primary care access can contact their county health department or a community health center. Monroe County residents with questions can contact the Monroe County Health Department directly.

    What Happens Next

    MDHHS and MDARD are continuing the investigation to identify the contaminated food source. The case count, already at more than 300 and still growing, is expected to rise further as health officials expand testing and surveillance. MedicalDaily will report immediately when a food source is identified or a recall is issued.

    The Bottom Line

    More than 300 people in southeast Michigan have been diagnosed with a parasitic intestinal illness in under two weeks — six times the state’s typical annual total. No food source has been found. And the most common diagnostic test ordered for acute diarrhea does not detect this parasite. If you have had prolonged or recurring watery diarrhea in the affected counties since late May, you need a Cyclospora-specific test — not a routine stool culture. Ask for it by name.

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  • Amyloidosis – Blood Disorders – Merck Manual Consumer Version

    Amyloidosis – Blood Disorders – Merck Manual Consumer Version

    • In AL amyloidosis, chemotherapy and immunotherapy

    • In AA amyloidosis, treatment of the underlying disease

    • In amyloidosis caused by transthyretin protein deposits, medications that stabilize transthyretin or reduce production of the protein

    • Sometimes, organ transplantation

    Treatment to decrease or control symptoms and complications of amyloidosis can improve quality of life for people with all forms of amyloidosis. Specific treatments to slow or stop amyloid formation can help in certain forms of amyloidosis.

    For AL amyloidosis, treatment focuses on the underlying plasma cell disorder. High doses of melphalan and stem cell transplantation can lead to prolonged remissions and improved survival. However, only 15 to 20% of people with newly diagnosed AL amyloidosis are eligible to receive this treatment because of increased risk of side effects. Alternatively, combining medications of different classes (daratumumab, cyclophosphamide, bortezomib, and dexamethasone [called dara-VCd]) is highly effective in treating AL amyloidosis. Other combinations of immunotherapy drugs are used in treating people with AL amyloidosis who relapse.