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Northeast is here! Fall viruses, measles “disaster emergency,” Legionella, and well safety

NE Dose (Oct 8)

Julia Tellerman, Asuka Koda, and Katelyn Jetelina Oct 8

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Hi everyone! Julia Tellerman here–epidemiologist in Rochester, New York–and I’m so excited to bring you the first edition of YLE Northeast!

Your most burning question so far: What exactly is the “Northeast”?

A regional perspective means we’ll look at issues defined not by borders, but by shared concerns across the Northeast. When we talk about summer insects, nor’easter storms, flu season, and foodborne illness in New York, we’re talking about issues that affect many communities connected by a shared climate, coast, commute, or supply chain. (New Jersey, we see you!) But each state has its own health story, too, unique to its geography, policy, and people. Join us as we figure it out together. If something’s happening in your corner of the Northeast that you think we should cover, let us know at [email protected] or put it in the comments.

This week, fall respiratory season may be starting early. We’ll also cover measles in New York and well water in Connecticut.

As always, a lot is happening in the Northeast, so let’s dig in.

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Regional disease “weather” report

Flu season may be here early

In the Northeast, the number of people testing positive for flu is still very low, but increasing. This is especially true in HHS Region 1 (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont).

If growth continues, this year’s season is nine weeks earlier than last year. Test positivity is 3.2%, which is noteworthy because the “start of flu season” is typically indicated at ~3%.

Compared to the rest of the country, the Northeast is a bit behind other regions, but this is normal. The Northeast often lags behind other regions as flu spreads across the country, though the order varies season to season.

Number of flu tests coming back positive for HHS Region 1 (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont). Source: CDC; Annotated by Your Local Epidemiologist.

Number of flu tests coming back positive for HHS Region 2 (New Jersey, New York, Puerto Rico, U.S. Virgin Islands). Source: CDC; Annotated by Your Local Epidemiologist.

What this means for you: It’s time to get your flu vaccine. There are a few options, so visit YLE National flu vaccine options to help you choose the one that’s right for you.

Covid is elevated and still rising in some states

Covid-19 transmission—measured by wastewater levels—is variable across the Northeast region. Most states are still at “very low” levels, except CT and MA, which are at “high” levels. Covid-19 hasn’t peaked in the Northeast yet either, as many states are still increasing (see purple below).

SARs-CoV-2 Wastewater Levels (left) and growth rates (right) over time. Source: CDC.

What this means for you: The updated Covid-19 vaccine is also now available. It’s safe and effective to get both the flu and the Covid-19 vaccine together (but you may have more short-term side effects, like a sore arm).

And then there are the colds

The common cold is surging much higher than anything else right now, in part because school has started and the petri dishes (i.e., kids) are mixing. This is similar to national trends. We hope and expect to see this peak soon.

Percent of positive tests for U.S. Health and Human Services Region 2 (NY, NJ, Puerto Rico, and the Virgin Islands). Source: CDC; Annotated by YLE.

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State and local updates

We’ve heard from many of you asking when we’ll bring YLE Northeast to your part of the region (or expand to the Midwest, the Northwest, and the South). We want this as much as you do! But it takes resources to make that happen. Paid subscribers, donors, and local partners are helping us get there. If you’re a community foundation, local health department, or philanthropist, reach out to [email protected]. We’d love to work with you to keep growing our team of on-the-ground experts.

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New York City: More Legionella?

Legionella is a bacterium that grows in warm water. People get sick when they breathe in contaminated mist from sources like cooling towers, showers, and hot tubs.

Legionella seems to keep popping up in the City this year. Cases aren’t higher than last year, but both years are higher than before. There are also definitely more headlines right now, too (second graph), which makes it feel worse.

Legionellosis cases reported to CDC by week, 2022-present. Data source: CDC NNDSS, Image generated by YLE and Claude.

NY state and local news coverage on Legionella from 2020 to 2026. Source: Media Cloud.

Right now, there are two small clusters:

• Two residents at North Shore Towers in Queens tested positive for Legionella.
• Separately, two residents at Staten Island’s Castleton Park Apartments tested positive.

These are different from this summer’s larger outbreaks on the UES and South Bronx, which came from outdoor cooling towers. Cooling towers spray mist into the air outside. The current clusters appear tied to the buildings’ own water systems, so we think it will stay small.

Image created by Julia. Data source: NYC DOHMH

How does this keep happening? Since 2015, NYC has required cooling towers to be registered, tested, and inspected by the city. But water systems inside residential buildings get far less oversight, so prevention largely falls to building management. As Gothamist reported, residents at Castleton Park often struggle to get support from management.

What this means for you: Drinking water remains safe during Legionella outbreaks. If you live or work in an affected building cluster be sure to follow health department guidance.

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New York State: Measles is now a “disaster emergency”

Measles was just declared a New York state emergency. Since July 15, 93 people have gotten sick (109 total in 2026). This is more than double last year but still low compared to other states.

So why declare an emergency? It allows health departments and health care workers to respond faster with the supplies, manpower, and testing needed to get ahead of this.

A few things about this stand out to me:

1. Equipping trusted nodes with tools. This declaration allows more providers to administer the MMR vaccine. Paramedics, advanced EMTs, and licensed midwives can now give the vaccine to anyone who meets the criteria. That’s big for rural areas where accessing a clinic or pharmacy can be difficult.
2. The unusual trend among adults: Unlike past outbreaks, which largely affected kids, adults now make up two-thirds of cases. We don’t know exactly why, but there are some possible explanations:
   • Testing bias: Adults may be more likely to go see a doctor and get tested.
   • Protection gaps: New York ended non-medical vaccine exemptions in 2019, which raised MMR rates to 98%. But adults who were opted out as kids before then may still be unprotected.

3. Measles spreads in tight social networks. Cases are concentrated in rural communities, many of which border or are close to Pennsylvania, where the Amish and Mennonite communities have been hit especially hard. More than 1,000 people have confirmed measles, and five have died. New York also has a large Amish population, but the state has only confirmed that spread is happening in “under-immunized” communities.

   Map of measles cases (per 100,000 people) in New York as of October 3. Source: NYC DOHMH, NYS DOH. Image generated by YLE and Claude.

What this means for you: Check your vaccination status, especially if you are at higher risk. YLE National’s FAQ covers checking immunity and extra doses. NY’s Vaccines for Adults Program also offers the MMR.

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Connecticut: Fall = low wells = check water quality

With fall comes the virus season, but also something nearly 1 in 4 Connecticut residents need to consider: private wells. Groundwater drops after months of heavy summer use. And parts of the state have been dry this year. Changing water levels can affect water quality. When rain returns after a dry spell, runoff can carry bacteria into wells, and lower water levels can concentrate naturally occurring contaminants. So, fall is a good time to check that your water is safe.

PFAS (often called “forever chemicals”) also turn up in some Connecticut wells. In Killingworth, state environmental officials (DEEP) discovered PFAS in 2021 near the town firehouse, likely from firefighting foam used there for years. When DPH tested 95 nearby wells, 25 had PFAS at levels high enough to require action.

What this means for you: Unlike public water systems, private wells aren’t routinely tested, so owners are responsible for their own water’s safety. If you have questions about your well water, contact your local health department. UConn Extension also offers free PFAS testing in select areas. Check eligibility here: s.uconn.edu/pfas-testing.

Bottom line

The start of the fall season means everything from viruses to wells. Stay healthy out there, Northeast!

Love,
The NE YLE team

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Julia Tellerman, MPH, is an epidemiologist in Rochester, NY. Asuka Koda is a health journalist in CT. This newsletter is free to everyone, thanks to the generous support of fellow YLE NE community members. To support the effort, subscribe or upgrade below:

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As of October 3, there have been seven confirmed cases in New York City and 101 in New York State outside of NYC (Rest of State) for 108 total cases this year, amid a global and domestic increase in measles cases.

Since July 15, there have been 92 cases reported among under-immunized, rural communities in 18 counties. Since then, local health departments have administered over 1,000 doses of the MMR vaccine across rural areas of New York State.

INCREASE IN MEASLES SAID CAUSED BY DECREASE IN VACCINATIONS DUE TO MISINFORMATION

New York State Department of Health’s Measles Dashboard

Today’s announcement builds on the State’s ongoing measles response efforts, including the launch of a Measles Dashboard allowing the public and healthcare officials to track local health risks and raise awareness about measles.

Executive Order Expands Network of Vaccine Administrators, Adding Paramedics, Advanced EMS, Midwives and Pharmacists; Adds Flexibility for Nurses To Order Testing

 Executive Order Is Available Here

Governor Kathy Hochul issued an Executive Order today declaring a State Disaster Emergency in response to the growing number of measles cases across rural areas of New York and neighboring states.

The Executive Order enables the State to respond more swiftly to the outbreak and allows healthcare professionals to take additional steps that will help get more New Yorkers vaccinated and tested, if needed.

The Governor also received her seasonal flu shot and urged all New Yorkers to receive this year’s flu vaccine to protect against infection. The Governor is committed to putting New Yorkers’ health and safety first and has directed the New York State Department of Health to share frequent public notifications and resources throughout this flu season.

“After reviewing the latest data on measles cases in New York State, I am declaring a State Disaster Emergency to strengthen our ongoing efforts to confront this disease,” Governor Hochul said.

“No one should get seriously ill or die from a vaccine-preventable disease. That is why I have taken steps to increase the number of health professionals who can vaccinate and test. These emergency measures will protect New Yorkers and support our community partners as they work tirelessly to address the spread of this disease.”

New York State Department of Health Commissioner Dr. James McDonald said,

“I appreciate Governor Hochul’s swift action to help address ongoing measles cases. Department staff are working closely with local health departments and regional partners to track and contain the current measles outbreak. The measles, mumps, and rubella vaccine is the best protection — protecting nearly all people against disease who receive the recommended doses. I urge New Yorkers to check their vaccination status and make sure that they and their families are protected. I also ask health providers to be prepared to diagnose and treat any measles cases they encounter.”

State Senator Gustavo Rivera said, “The concerning rise in measles cases is due to a decrease in childhood vaccines driven by misinformation and is causing a public health emergency.

I support Governor Hochul’s efforts to expand vaccine access and join her in calling on all New Yorkers to get their vaccinations to prevent the spread of diseases like measles and the flu, which pose a greater risk to vulnerable populations. Help keep fellow New Yorkers safe and get your shots!”

Assemblymember Amy Paulin said, “Measles is preventable, and the MMR vaccine is safe and effective. I commend Governor Hochul for taking action to expand vaccine access across New York State.”

New York State Department of Health’s Measles Dashboard

Today’s announcement builds on the State’s ongoing measles response efforts, including the launch of a Measles Dashboard allowing the public and healthcare officials to track local health risks and raise awareness about measles.

In addition to clinical education and guidance for providers, epidemiological support for case investigation and contact tracing, and expedited laboratory testing, the State Department of Health continues to support local health departments with vaccines, community outreach efforts to increase awareness, data analytic support, and clinically accurate and culturally meaningful immunization education.

As of October 3, there have been seven confirmed cases in New York City and 101 in New York State outside of NYC (Rest of State) for 108 total cases this year, amid a global and domestic increase in measles cases.

Since July 15, there have been 92 cases reported among under-immunized, rural communities in 18 counties. Since then, local health departments have administered over 1,000 doses of the MMR vaccine across rural areas of New York State.

Monitoring and investigation activities, such as contact tracing, are ways public health officials work to keep affected communities safe from the spread of infectious diseases. Anyone who is contacted during these activities is encouraged to be responsive so that important information can be shared to prevent more infections.

All New Yorkers are urged to protect themselves by making sure they are up to date on their measles, mumps, and rubella (MMR) vaccines and be aware of health advisories if traveling with unvaccinated individuals, especially young children. Infants 6 to 11 months old can receive an early dose of the MMR vaccine for protection before travel or if they are otherwise at risk of being exposed.

Causes of Measles and Symptoms To Monitor For

Measles is a highly contagious, serious respiratory disease that causes rash and fever. In some cases, measles can reduce the immune system’s ability to fight other infections like pneumonia. This disease is caused by a virus that is spread by coughing or sneezing into the air. Individuals can catch the disease by breathing in the virus or, less commonly, by touching a contaminated surface, then touching the eyes, nose, or mouth.

Serious complications of measles include hospitalization, pneumonia, miscarriage, preterm birth, brain swelling, immune amnesia and death. Long-term serious complications can also include subacute sclerosing panencephalitis, a type of brain inflammation resulting from an earlier measles infection that can lead to permanent brain damage years after the initial infection.

The best protection against measles is the measles, mumps and rubella (MMR) vaccine.

Those traveling domestically or internationally should plan to be fully vaccinated against measles at least two weeks before departure.

One dose provides 93 percent protection while two doses provide 97 percent protection.

Babies as young as 6 months should get one dose of the MMR vaccine if they are traveling abroad or to an area where measles is prevalent. After travel, these babies should then continue to get their next two MMR vaccines on schedule for a total of three vaccines. Anyone who is not protected can get measles while traveling and can easily spread it to others when they return home.

The Department has released a health advisory for healthcare providers on clinical guidance for measles.

A person with measles can pass it to others as soon as four days before a rash appears and as late as four days after the rash appears. The incubation period for measles is up to 21 days. People who are exposed to measles should quarantine for 21 days after exposure, and those who test positive should isolate until four days after the rash appears.

Symptoms of measles can include the following:

Seven to 14 days, and up to 21 days after a measles infection

• High fever
• Cough
• Runny nose
• Red, watery eyes

A rash can occur 3-5 days after symptoms become apparent:

• The rash usually begins as flat red spots that appear on the face at the hairline and spread downward to the neck, trunk, arms, legs, and feet.
• Small, raised bumps may also appear on top of the flat red spots.
• The spots may become joined together as they spread from the head to the rest of the body.
• When the rash appears, a person’s fever may spike to more than 104° Fahrenheit.

How Individuals Can Protect Themselves

• Individuals should check their vaccination status. Anyone who is unsure of their vaccination status should contact a healthcare provider or local health department.
• Know the symptoms. Measles often begins with fever, cough, runny nose, and red, watery eyes. A rash typically appears several days later, starting on the face and spreading across the body. Those who are sick should call ahead before visiting a clinic, urgent care, or emergency department so infection-control steps can be taken.

Immunization Guidance

• The MMR vaccine is highly effective and is the best protection against measles.
• Most people born before 1957 are considered immune because they were likely exposed to the virus. Those who received the vaccine between 1963 and 1967 may have received a vaccine that wasn’t as effective and should talk to their health care provider about getting revaccinated.

The Department’s travel advisory urging New Yorkers to ensure they are fully vaccinated against measles before international travel or travel to an area in the U.S. experiencing an outbreak can be found here.

Healthcare providers should report suspected measles cases to their local health department.

Visit the Department’s dedicated measles website here for information about measles, current case numbers, immunization data and information for providers.

More information about the measles vaccine can be found here.