As H5N1 bird flu continues to spread wildly among California dairy herds and farmworkers, federal health officials on Thursday offered some relatively good news about Missouri: The wily avian influenza virus does not appear to have spread from the state's sole human case, which otherwise remains a mystery.

On September 6, the Missouri Health department announced that a person with underlying health conditions tested positive for bird flu, and later testing indicated that it was an H5N1 strain related to the one currently circulating among US dairy cows. But, state and federal health officials were—and still are—stumped as to how that person became infected. The person had no known contact with infected animals and no contact with any obviously suspect animal products. No dairy herds in Missouri have tested positive, and no poultry farms had reported recent outbreaks, either. To date, all other human cases of H5N1 have been among farmworkers who had contact with H5N1-infected animals.

But aside from the puzzle, attention turned to the possibility that the unexplained Missouri case had passed on the infection to those around them. A household contact had symptoms at the same time as the person—aka the index case—and at least six health care workers developed illnesses after interacting with the person. One of the six had tested negative for bird flu around the time of their illness, but questions remained about the other five.

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One person is dead and 48 others across 10 states have been sickened in an E. coli O157:H7 outbreak that appears to be linked to McDonald's Quarter Pounders and the slivered onions used on the burgers, according to the Centers for Disease Control and Prevention.

McDonald's has paused distribution of the slivered onions and removed Quarter Pounders from the menus of restaurants in areas known to be affected. As of now, those areas include Colorado, Kansas, Utah, and Wyoming, as well as portions of Idaho, Iowa, Missouri, Montana, Nebraska, Nevada, New Mexico, and Oklahoma.

However, the CDC was quick to note that the size and span of the outbreak are likely larger than is currently known. "This outbreak may not be limited to the states with known illnesses, and the true number of sick people is likely much higher than the number reported," the agency said in its outbreak notice posted Tuesday afternoon.

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Enlarge / A recall notice is posted next to Boar's Head meats that are displayed at a Safeway store on July 31, 2024, in San Rafael, California. (credit: Getty | Justin Sullivan)

A third person has died in a nationwide bacterial outbreak linked to Boar's Head brand deli meats. Last week, the company recalled more than 7 million pounds of its meats, which was in addition to a recall of over 200,000 pounds of meat from July 26. In all, 71 types of products made between May 10, 2024, and July 29, 2024, and sold nationwide have been recalled.

According to an update Thursday from the Centers for Disease Control and Prevention, the outbreak has now sickened a total of 43 people, an increase from 34 last week. There have been 43 hospitalizations, up from 33 last week. The illnesses are reported from 13 states. The three deaths in the outbreak include one from Illinois and one from New Jersey, and the newly reported death is from Virginia. The CDC expects the tally of illnesses so far to be a significant undercount of actual cases, and additional states may be affected.

The illnesses in the outbreak are caused by Listeria monocytogenes, a foodborne bacterium that is particularly dangerous to people who are pregnant, people age 65 years or older, and people who have weakened immune systems. In these high-risk groups, the bacteria are more likely to move beyond the gastrointestinal system to cause an invasive infection called listeriosis. During pregnancy, listeriosis can cause miscarriage, stillbirth, premature delivery, or a life-threatening infection in newborns. For non-pregnant people who develop listeriosis, nearly 90 percent require hospitalization, and 1 in 6 die.

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Enlarge / The Birthday Cake flavored bar.

One person may have died from eating Diamond Shruumz microdosing candies, which were recalled last week amid a rash of severe illnesses involving seizures, intubation, and intensive care stays.

According to an update this week from the Food and Drug Administration, the cluster of cases continues to increase across the country. To date, 48 people across 24 states have fallen ill after eating the candies, which include chocolate bars, gummies, and candy cones that were sold online and in retail locations, such as smoke and vape shops. Of the 48 people sickened, 46 were ill enough to seek medical care, and 27 were admitted to a hospital.

For now, the death noted in the FDA's latest update is only "potentially associated" with the candies and is still under investigation. No other information is yet available.

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