Katelyn Jetelina's latest edition of "The Dose" covers three concurrent infectious disease stories: a COVID uptick in the western U.S., a measles case count approaching 2025's full year total with five months to go, and a Cyclospora outbreak that has sickened over 11,000 Americans from contaminated lettuce. The reporting is clear, sourced, and grounded in epidemiological data. But the most important thread running through all three stories isn't any single pathogen. It's the erosion of the public health infrastructure that's supposed to catch these things early.
Wastewater surveillance and emergency department visits are ticking up, concentrated in western states. Levels are still low in absolute terms. Each successive wave has been smaller than the one before, though Jetelina rightly notes that waning immunity could change the pattern.
What to do with thisHer advice is targeted and appropriate: adults over 65 who skipped their spring COVID vaccine should get one now. She doesn't oversell the threat. She doesn't minimize it either. This is what good surveillance communication looks like.
Jetelina reports 2,278 measles cases as of July 19. CDC's own tracker confirmed 2,030 cases as of June 4, and independent trackers show the count approaching 2,288 (the full 2025 total) by mid-July. The trajectory checks out. Utah has been in endemic spread for 12 months. Pennsylvania leads with 111 cases. 96% of cases are among the unvaccinated.
Why this mattersWe're on pace to surpass the worst measles year in three decades with five months of summer travel still ahead. The 96% unvaccinated figure is the data point that should end most debates about whether this is a vaccine problem. It is a vaccine problem.
Over 11,000 cyclosporiasis cases across 46 states. Michigan alone: 6,148 cases and 102 hospitalizations, compared to a normal year of about 50. The CDC's formal investigation page confirms 1,644 cases linked specifically to the Taco Bell/Taylor Farms traceback across 5 states, with the broader case count still climbing. Taylor Farms issued a recall of shredded iceberg lettuce across 27 states. The produce originated from Mexico.
Where it got complicatedThe FDA initially announced a positive Cyclospora test on Taylor Farms lettuce. Then walked it back as a false positive. This is the kind of thing that makes food safety communication nearly impossible. The epidemiological evidence (the traceback, the timing, the geographic clustering) remains strong. But a retracted lab result gives every skeptic a talking point, and it muddied a story that was already hard to follow because Cyclospora has a two-week incubation period.
Jetelina correctly notes that Taylor Farms used coded language in their recall notices rather than transparent lot numbers, making it harder for consumers to act on the information. She also flags that the FDA and CDC both lack permanent directors and face staffing and lab capacity cuts. This isn't just context. It's the mechanism by which outbreaks get bigger than they need to be.
Jetelina does what she always does well: translates surveillance data into actionable guidance without either panic or dismissiveness. She gives specific recommendations (skip shredded iceberg lettuce, get your COVID vaccine if you're 65+, vaccinate your kids against measles) and distinguishes between what we know and what we're still figuring out. The Cyclospora section is particularly good at walking readers through why a false positive lab result doesn't invalidate the broader epidemiological investigation. That's a nuance most outlets botched.
Her newsletter has 475,000 subscribers for a reason. She's built a track record of being right more often than she's wrong, and of correcting herself clearly when she is.
This is a roundup, not a deep dive, so each topic gets compressed. The COVID section is the thinnest. It's accurate but doesn't add much beyond "keep watching." A reader unfamiliar with wastewater surveillance wouldn't learn here how to interpret those data or what thresholds matter.
The 11,000 Cyclospora figure deserves a bit more sourcing clarity. The CDC's formal investigation page (as of this writing) confirms 1,644 cases specifically linked to the traceback. The 11,000 figure appears to aggregate all reported cyclosporiasis nationally, including cases not yet formally linked. Both numbers are real and alarming, but the gap between them is worth flagging for precision.
The "Good News" section (Uganda's Ebola outbreak ending, Lipfendra's FDA approval) feels tacked on. The Lipfendra mention is especially thin. This is the first oral PCSK9 inhibitor ever approved. It delivered 56 to 59% LDL reductions in trials. For a newsletter that covers science for educated lay readers, that's worth more than a one-liner.
Take this seriously, with a caveat about depth. Each of these three stories is accurate and well sourced. Jetelina's real contribution isn't any single data point. It's showing how COVID waves, measles resurgence, and a food safety crisis are all symptoms of the same underlying problem: a public health system losing capacity, leadership, and public trust simultaneously. The pathogens are different. The vulnerability is the same.
Primary article: Jetelina K. "Covid-19 waking up, Cyclospora marches on, and measles is close to hitting a milestone." Your Local Epidemiologist, July 21, 2026. yourlocalepidemiologist.substack.com
Cyclospora investigation: CDC. "Investigation Update: Cyclospora Outbreak, July 2026." cdc.gov
Taylor Farms recall: CNBC. "Taylor Farms recalls iceberg lettuce in 27 states." July 18, 2026. cnbc.com
False positive context: Forbes. "Here's Where The Cyclosporiasis Outbreak Stands After Taylor Farms' False Positive." July 20, 2026. forbes.com
Measles tracker: CDC. "Measles Cases and Outbreaks." cdc.gov
Measles 2026 pace: Medical Daily. "U.S. Measles Cases Hit 2,231 in 2026, Matching Last Year's Total." medicaldaily.com
Lipfendra approval: FDA. "FDA Approves First Oral PCSK9 Inhibitor." July 17, 2026. fda.gov
Michigan Cyclospora data: Michigan DHHS. "Cyclosporiasis Outbreak 2026." michigan.gov