Ticks, allergies, measles, top nutrition scientist resigns, covid.gov gets a rebrand, and the HHS budget proposal.
The Dose (April 21)
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Goodbye, respiratory season. Hello, ticks, allergies, and spring cleaning. Meanwhile, public health gutting continues: the administration’s top nutrition scientist resigned due to concerns over censorship, the Covid.gov website underwent a dramatic shift in direction, and a huge $40 billion cut proposal for Health and Human Services.
Here’s the context and what it means for you.
It’s spring! Enter tick season
Emergency department visits for tick bites are climbing, but remain middle-of-the-road for now. By year’s end, more than 500,000 people will likely be diagnosed and treated for Lyme disease.
Ticks thrive in warm, lush spring environments and can carry pathogens responsible for over a dozen diseases—including Lyme disease, which can cause flu-like symptoms and, if untreated, serious complications like neurological or cardiac issues.
Not all ticks carry disease. Risk depends on the species, geography, and the duration of a tick’s attachment. Currently, tick-borne illnesses are most concentrated in the Northeast, with emergency department (ED) visits at 115 per 100,000 people.
What does this mean for you? You can take several steps to protect yourself from ticks, including applying DEET or picaridin, treating clothing and gear with products containing 0.5% permethrin, and conducting thorough tick checks after engaging in outdoor activities. Here is a YLE deep dive.
Cue: A rough allergy season
The Asthma and Allergy Foundation of America (AAFA) says it’s going to be a brutal year. 41% of the U.S. is currently experiencing medium-high allergy levels—especially in the South and East. Cities like Atlanta and Houston have already set records for pollen. Below is a live allergy map for 2025, showing pollen counts across the country that shift over time in your area.
Allergy season is becoming longer—plants are releasing pollen earlier in the year (about 40 days earlier) and stopping pollination later in the year (about 2 weeks longer)—due to rising temperatures. It’s also more pollen because of the increased amount of CO2 in the atmosphere.
What does this mean for you? You’re getting exposed to more “pollen grains,” and your immune system may be irritated by them. Dr. Zach Rubin, an allergy doctor, joined us on our podcast America Dissected last week and gave great tips on managing allergies:
Rinse your nose with saline water (just like we brush our teeth)
Go with second-generation antihistamines, like Zyrtec, instead of Benadryl. Benadryl was made in the 1940s as one of the first antihistamine drugs, but it has a lot of side effects. Always chat with your doctor for more information.
The measles game of whack-a-mole continues.
Measles cases are climbing exponentially. The U.S. has 839 cases and 7 active outbreaks, spanning states like Montana, Indiana, Michigan, Ohio, and Texas.
The outbreak in Texas, New Mexico, Oklahoma, and Kansas is growing rapidly. My concern about spreading in urban areas is coming to fruition. The El Paso outbreak is spreading fast. Within 11 days we rose from 2 cases to 11, signaling exponential growth. In Lubbock, cases are also on the rise. In particular, a cluster has been identified in the Tiny Tots daycare, resulting in 7 cases and 2 hospitalizations thus far.
This outbreak has also extended into Mexico (the country; not to be confused with New Mexico), with 451 cases reported, primarily in Chihuahua, and Canada, with 1,045 cases, mainly in Ontario. The Canada outbreak has been traced back to a large gathering in New Brunswick last fall that was attended by guests from Mennonite communities.
For those who want a deeper dive, go here for the SITREP (situation report):
Other sporadic cases continue to emerge across the country, often linked to international travel (see map above).
What does this mean for you? Keep up on vaccinations. If you plan to travel with a child under 12 months, be sure it’s not to a high-risk area (either nationally or internationally).
H5N1 is still quiet. And we don’t know why
Many of you have asked for an update: H5N1 is currently pretty quiet. Over 1,000 dairy cow herds across 17 states have been infected with H5N1. However, new infections have slowed considerably—both in cows and poultry. The most recent human case was in December 2024.
We don’t know why, but there are a few epidemiological guesses:
It began to run out of herds to infect.
Expanded milk testing is allowing faster containment.
It was an oddly active winter, so a spring spike hasn’t appeared.
The virus burned through enough of the migratory fowl.
Unknown unknowns.
I don’t think anything is being hidden, especially on the human side. That would be near impossible to keep under wraps.
What does this mean for you? Bird flu isn’t something that should be top of mind. The pandemic risk has decreased for now, although scientists continue to monitor it.
NIH loses a top nutrition scientist—and that’s bad news
In 2019, Dr. Kevin Hall authored arguably the most important study—a randomized controlled trial, the gold standard—showing that ultra-processed foods (UPF) lead to weight gain. He then did the next natural thing: run studies on why. Was it because UPFs are addictive or something else? A follow-up study of his found that UPF may not be inherently addictive, as indicated by the brain’s dopamine response. Another study, still in progress, suggests that UPF is problematic due to its high calorie density and hyperpalatability (heightened taste pleasure).
These follow-up studies directly contradict RFK Jr.’s narrative—that UPF is addictive. Hall was initially restricted from publicly sharing the results. Once he was allowed to comment, the NIH press office edited his response, downplaying the significance. So, he announced his early retirement, citing censorship. He has been at NIH for 21 years.
What does this mean for you? When scientists are muzzled, it hurts the public’s health and doesn’t move us toward a healthier world and better food system. This also follows a concerning pattern echoing recent departures like Dr. Peter Marks (FDA vaccines) and Kevin Griffis (CDC communications).
Spring cleaning: Don't forget your medicine cabinet
Last week was National Clean Out Your Medicine Cabinet Day, and April 26th is National Drug Take Back Day. These are great reminders to clean out your medicine cabinet.
Why is this important?
Errors. People often take multiple medications, which doctors can frequently adjust to different doses. It can be confusing for anyone to keep track of. When a medicine cabinet is cluttered with older and current medications, it’s easy to make a mistake. Medications have powerful effects on our bodies, and it can be dangerous to take too little, too much, or the wrong combinations.
Misuse and abuse. For example, you don’t want the leftover opioid pain killers prescribed for your root canal hanging around. These are powerful and addictive substances, and even a few pills can have devastating effects in the wrong hands.
Effectiveness. Expired meds lose potency at different rates.
Safety. Curious kids could stumble upon them.
Here is a flush list. Medications not listed on this list can be disposed of in the trash. Our friends, The Nerdy Girls, have put together helpful tips.
Covid.gov website has an unhelpful rebrand, to say the least
The newly redesigned Covid.gov replaced vaccine and prevention information with a page focused on the lab leak—with no concrete calls to action for safety improvements. It’s political theater and a direct jab at scientists, as there isn’t any new evidence, and certainly doesn’t help the public navigate Covid-19.
With the lab leak theory, I always try to take the 30,000-foot view:
The origin of Covid-19 is an ongoing scientific debate. Scientific consensus has not settled. We can all agree that the Wuhan market was an amplification event (i.e., super spreader), but I don’t think we will ever know how it got there. Disproving the lab leak will be close to impossible.
The debate is another example of false dichotomies. In reality, opinions range from “natural spillover” to “lab leak.” I lean more towards natural spillover, but I’m certainly not 100%. (I’m a ~70% given ongoing evidence.) I think everyone should recognize where they land on this spectrum and why. Also recognize that conflicts of interest are present everywhere.
We continue to overlook the larger issue. Underlying all of this is the possibility of a lab leak, and a possibility of a natural spillover, and a possibility of intentional lab leaks. We need to address all of these to ensure a safer future.
Quick government watch: Executive branch proposes HHS cuts
Last week, a document leaked revealing that the Trump administration plans significant cuts ($40 billion) to the Health and Human Services, which includes the elimination of programs focused on maternal health, rural health, Head Start, and other areas.
Unlike previous executive actions, these cuts are moving through the normal budget process—making them harder to block and more dangerous long term. They are very dramatic compared to previous budget proposals. Importantly, this is a recommendation and/or political pressure from the Executive Branch. It’s not law or a guarantee. The next step is for Congress to draft, debate, and vote on actual funding bills. Then it’s put into law.
What does this mean for you? This is the ideal time to reach out to your congressional representatives about the issues that matter most to you. I’ll host a webinar soon with a few staffers (from both the Democratic and Republican parties) to maximize your effectiveness.
Question grab bag
I’m in a lot of mom groups on Facebook. Do you have recommendations on whether to respond (and if so, what) to a mom who posts something like, "Does anyone have a recommendation for pediatricians who allow delayed or modified vaccine schedules?"
My biggest piece of advice: Don’t pick arguments about vaccines, especially when people have already said they are interested in something different. One approach would be to say something like: “I’m sorry you’re having trouble finding a pediatrician. For what it’s worth, my child got the routine schedule and did well, and I’ve had great experiences with his/her pediatrician.” And provide the contact information.
It’s also okay to add, “All the pediatricians that I recommend also recommend the routine schedule because it maximizes protection at the right times. They also listen to and respect your questions and concerns.”
Bottom line
You’re all caught up! Have a great week.
Love, the YLE team
Your Local Epidemiologist (YLE) is a public health newsletter with one goal: to “translate” the ever-evolving public health science so that people feel well-equipped to make evidence-based decisions. This newsletter is owned and operated by Dr. Katelyn Jetelina— an epidemiologist and mom. This is free to everyone, thanks to the generous support of fellow YLE community members. To support the effort, subscribe or upgrade below:
The importance of vaccines cannot be stressed enough. As a retired pediatrician I feel that one problem is that these diseases are anecdotes to young parents. They have never met anyone who had Polio, Measles, or Diphtheria and are skeptical of the need for vaccines. My practice had a firm rule either be fully immunized by 24 months or find another doctor. We spent hours debating vaccines with people with opinions but no knowledge. In the ere before vaccines at least 10% of all newborns never celebrated their second birthday.
It’s good these days to find sources of accurate information that make me feel informed yet not panicked. Thank you for your work, your pragmatic approach, your reasonable tone and your compassion for public health.♥️