The past week has been pretty wild for public health. On top of our usual New York programming, we’ve been getting a lot of questions about the evolving hantavirus situation on the cruise ship. So yesterday, Katelyn from YLE National and I sat down for a Substack Live to talk through what we’re hearing, what we know so far, and how we’re thinking about the risk.

You can watch that conversation here.

Your Local Epidemiologist

Hantavirus: Situation update and getting nerdy

Thanks to all of you who joined the Substack live today…

Listen now

11 hours ago · 346 likes · 10 comments · Katelyn Jetelina and Marisa Donnelly, PhD

The bottom line up front is that there is currently no risk to New Yorkers. YLE National shared some details earlier this week if you want more information. I’m following it closely and will report back with relevant updates.

Okay, back to New York. Today I’m covering a measles case in Manhattan, what a district court decision means for access to abortion medication by mail, the official closing of Purdue Pharma and the aftermath of the opioid crisis, and “flesh-eating bacteria,” which, spoiler alert, you really don’t need to panic about.

A Measles case in Manhattan

The NYC Department of Health has reported a possible measles exposure in Manhattan this week. Anyone who visited Norma’s Restaurant in Hell’s Kitchen on April 26, 5:00 – 8:00 PM may have been exposed. Monitor for symptoms until May 17th.

Potentially exposed people should contact their health care practitioner if they develop measles symptoms, which usually start like a cold and progress to a rash.

So far, there haven’t been additional cases. If you do develop symptoms, it’s important to call your doctor or clinic before you visit in person so special precautions can be taken to prevent further spread.

In last week’s post, I went into more detail on vaccination recommendations and guidance on titer checks. You can find those details here.

Mifepristone bans and maintaining medical access for New Yorkers

Last week, a federal appeals court in Louisiana ruled that mifepristone, one of the two medications most commonly used for medication abortion, cannot be shipped by mail anywhere in the country. This would mean that patients could no longer receive mifepristone by mail after a telehealth appointment and would need to get it in person from a clinician or other approved clinic.

Almost immediately, one of the companies that makes the drug (Danco Laboratories) filed an emergency appeal. The Supreme Court temporarily paused the ruling for one week, so as of this writing, mifepristone can still be mailed. But the pause is temporary and the situation could change quickly.

It’s important to understand, as YLE National covered in detail this week, that the abortion medication misoprostol is still available to be shipped by mail. Misoprostol is typically used in combination with mifepristone, but it can also be used safely and effectively on its own for medication abortion.

The legal fight matters for New York for a few reasons:

1. Medication abortion accounts for roughly two-thirds of all clinician-provided abortions in the U.S., and mifepristone is used in most of them. So while this sounds like a technical, legal fight, it affects a lot of people, including people you probably know.
2. New York has strong protections for abortion access and has become one of the leading states for mailing abortion medications to patients in other states. That’s because New York passed shield laws protecting clinicians who prescribe abortion medications across state lines. I covered that here.
3. Even in New York, mail access matters. Many rural New Yorkers may depend on mailed medications if they don’t live near a clinic or cannot easily get to an in-person visit. In cities, access may look more stable because abortion medication will still be available through clinics or doctors’ offices. But outside the cities, the mail can be the difference between accessible care and care that is out of reach.

What you need to know:

• Medication abortion access through telehealth is continuing in New York. Both Planned Parenthood of Greater New York and NYC Health + Hospitals are already switching to misoprostol-only kits shipped via telehealth.
• I expect more legal attention on misoprostol in the near future. Given how quickly litigation around abortion medication is evolving, it would not surprise me if opponents of abortion access target misoprostol next.

What to do: If you or someone you know needs medication abortion via telehealth, access continues through Planned Parenthood and NYC Health + Hospitals telehealth. If you have a pending prescription or appointment, contact your provider now to confirm your protocol. I’ll be watching for any Supreme Court updates, and share them as they come—I expect this story to keep evolving relatively quickly.

Purdue Pharma officially shuts down, leaving New York with $250 Million

On May 1, 2026, Purdue Pharma—the company that launched OxyContin in 1996, which fueled the opioid crisis—officially ended its operations.

This follows years of litigation from state attorneys general, including New York’s Letitia James, over Purdue’s misleading and aggressive marketing of opioids. The company faced thousands of lawsuits over its role in the opioid epidemic and has previously pleaded guilty.

Here are the details and what they mean for New York:

• Purdue shut down as part of a $7.4 billion national settlement.
• As part of this, New York secured $250 million specifically from the settlement, plus an additional $3 billion Attorney General Letitia James secured from other opioid manufacturers, distributors, and sellers.
• With Purdue shutting down, the companies’ assets are being transferred to a public benefit corporation called Knoa Pharma. It will continue providing some opioid medications, but doing so under strict oversight, and will be barred from lobbying and advertising. Knoa’s profits are supposed to support state, local, and tribal efforts to prevent opioid misuse.
• The Sackler family, who owned and ran Purdue, will not have a role in Knoa. But they also face no criminal charges, which is a point of ongoing controversy.

This is a landmark moment in the story of the opioid crisis. But the more important question is what comes next. And when I read this news, I breathed a huge sigh of relief.

There are still so many complicated emotions wrapped up in this, including grief, heartbreak, anger, exhaustion, and many others. But right now I’m holding on to hope for the future. Hope that we will continue to support the communities that have been devastated by this crisis. Hope that settlement dollars will actually reach the people and programs that need them. And hope that we can do better to prevent something like this from happening again.

The important question now is: what comes next?

Overdoses in NYC finally dropped in 2024 after years of increases. (I covered it here.) But overdoses are still extremely high—NYC recorded more than 2,000 overdose deaths in 2024. This translates to someone dying of an overdose every few hours. Opioids are still the main driver, with fentanyl being the most common substance involved.

Overdose deaths in NYC. Figure from the NYC Department of Health and Mental Hygiene.

This settlement matters, but only if it reaches the people who need it most. New Yorkers in the Bronx, Brooklyn, Upper Manhattan, and Staten Island have been hit especially hard by overdose deaths. We need to ensure this money is used to expand treatment, harm reduction, prevention, and recovery services for the communities bearing the heaviest burden.

What to do:

• If you or someone you know is struggling with opioid use disorder, call NYC Well at 1-888-NYC-WELL (1-888-692-9355). It’s free, confidential, and available 24/7.
• Carry Narcan (Naloxone). I keep it in my purse in case I encounter someone who may need it. You can get it free at many NYC pharmacies, NYC Health + Hospitals, and community-based programs.
• Keep an eye out for updates here on how this money is being spent. I’ll be tracking it closely.

Flesh-eating bacteria? Sorting through inflammatory headlines

“Flesh-eating bacteria” sounds like something from a horror movie, but it’s a real headline that’s been making the rounds in New York news.

The phrase is scary, and frankly, might be designed to get clicks, but the actual risk to the public is still low.

Here’s what’s going on: Researchers at Stony Brook have detected Vibrio vulnificus in several Long Island waters, including Sagaponack Pond, Mecox Bay, and Georgica Pond. This bacteria naturally lives in warm saltwater or brackish water, especially as water temperature rise.

Most people do not need to worry. Severe infections are rare—about three cases in NYC annually, and about 150-200 cases across the U.S. But when infections happen, they can be serious: CDC notes that about one in five people with Vibrio vulnificus infection die, sometimes within a day or two of becoming sick.

The people who should pay the closest attention are older adults, people who are immunocompromised, and people with liver disease, diabetes, cancer, HIV, or weakened immune systems.

There are two main routes of infection:

1. Through an open cut or wound exposed to warm coastal or brackish water, raw seafood, or seafood juices
2. By eating raw or undercooked shellfish, especially oysters

Symptoms can include watery diarrhea, stomach cramps, nausea, vomiting, fever, or chills. Wound infections can cause redness, swelling, discharge, severe pain, or blistering. Seek care quickly if symptoms develop after water or seafood exposure.

What to do:

• Avoid exposing open cuts, fresh tattoos, or piercings to coastal or brackish water. Cover them with waterproof bandages if you’ll be in or near the water.
• If you are higher risk for severe infection, avoid raw or undercooked shellfish and wear gloves when handling seafood.

Researchers are pointing to nitrogen runoff (from fertilizers), algal blooms, and rising ocean temperatures as potential drivers of the bacteria.

The headlines here are definitely scarier than the risk. But the practical guidance is simple and worth following: keep wounds out of warm coastal water, and seek care quickly if symptoms develop.

Tick and pollen check-in

Tick activity in the Northeast is high and continuing to increase.

Emergency department visits for tick bites in 2025 (black) and 2026 (green). Figure from CDC.

Pollen is high in South New York, but doesn’t look too bad upstate. But take this with a grain of salt—you may be more or less sensitive. For example, even though allergies for NYC are “medium-high,” I feel like they are hitting me like a truck this week.

Pollen levels from pollen.com

Bottom line

You’re all caught up! Have a great end to the week, and I’ll see you next week.

Love,

Your NY Epi

Dr. Marisa Donnelly, PhD, is an epidemiologist, science communicator, and public health expert. This newsletter exists to translate complex public health data into actionable insights, empowering New Yorkers to make informed and evidence-based health decisions.