By Russell R. Barksdale, Jr
The current surge in infectious diseases is reigniting critical discussions surrounding vaccination coverage and global disease transmission. Notably, this increase is not related to COVID-19 and extends beyond the United States, underscoring the persistent threat of infectious pathogens in a globally interconnected world.
Since the onset of the COVID-19 pandemic in 2019, infectious disease specialists and public health economists have been closely monitoring epidemiological patterns to anticipate future outbreaks. Optimistically, advancements in surveillance, diagnostics, and response protocols have been strengthened to contain infectious threats; however, the resurgence of multiple pathogens this season should be disconcerting—especially when they were believed to be eradicated in the United States. Experts had anticipated that future outbreaks would be sporadic and contained; however, emerging trends emphasize the need for continuous vigilance and adaptive response strategies.
Connecticut is currently facing what public health officials are calling a “quad-demic,” with significant case increases in three of the four—norovirus, influenza, and respiratory syncytial virus (RSV). Thankfully, COVID-19 cases have declined. The concurrent circulation of these viruses places considerable strain on hospitals, schools, and workplaces, potentially disrupting essential services. Although the newest COVID-19 variant, B.1.1.7 (commonly referred to as the UK variant), remains active, severe cases have declined in comparison to the other three viral pathogens currently in circulation. Beyond seasonal respiratory viruses, additional infectious disease outbreaks present further challenges to public health infrastructures.
In Kansas, one of the largest tuberculosis (TB) outbreaks in U.S. history is unfolding, with over 70 latent TB cases identified and more than 300 individuals actively undergoing monitoring, testing, and treatment. Latent TB infections, while asymptomatic, pose a significant risk for future disease activation, necessitating early intervention. Notably, drug-resistant TB strains have re-emerged in the same region that experienced an outbreak from 2021 to 2022. These resistant strains complicate treatment efforts and highlight the ongoing threat of antimicrobial resistance. Although TB cases in the U.S. are frequently linked to global transmission, the Kansas outbreak accounts for less than 1% of all national cases. Epidemiological data indicate that approximately two-thirds of TB cases in the U.S. are identified in individuals born outside the country.
Simultaneously, Texas is experiencing a measles outbreak, with at least 40 confirmed cases, frequently affecting school-aged children. Alarmingly, some cases have required hospitalization. This resurgence is particularly concerning given that measles was declared eliminated from the United States in 2000 due to widespread vaccination efforts. However, declining immunization rates since the COVID-19 pandemic have created conditions conducive to measles transmission. Reports indicate that vaccine exemption requests in Texas have doubled between 2018 and 2024, further exacerbating vulnerability to outbreaks.
Beyond the United States, emerging infectious disease threats are being reported across Europe. In the past five months, four EU/EEA countries (Finland, Germany, Poland, and Spain) and the United Kingdom have detected a genetically linked cluster of circulating vaccine-derived poliovirus type 2 (cVDPV2) in environmental surveillance samples. Reportedly, this marks the first documented presence of cVDPV2 in environmental samples in these regions, raising concerns about potential transmission in Europe and the United States.
The precise drivers behind the rise in measles, tuberculosis, and polio detections remain complex and multifactorial. Potential contributing factors include declining vaccination rates, increased global mobility, population displacement, and growing anti-vaccine sentiment. Given the political sensitivity surrounding these issues, scientific analysis must remain objective and evidence-based, avoiding speculative conclusions.
Regardless of the underlying causes, healthcare systems must be prepared to rapidly identify, isolate, treat, and trace infectious cases to mitigate disease spread. The stakes remain high, and complacency is not an option. A proactive, science-driven public health response is imperative to safeguarding communities. As we have seen with COVID-19, the spread of infectious diseases from outside of the U.S. can quickly cross our borders.
Russell R. Barksdale, Jr., Ph.D, MPA/MHA, FACHE is President & CEO of Waveny LifeCare Network
