Unannounced drills using professional patient actors (mystery patients) have been used to evaluate health care facility management of patients with infectious diseases of public health concern. Ongoing outbreaks and the expanding role of urgent care centers highlight the need to evaluate the ability of health care facilities to rapidly identify, isolate, and safely manage patients with transmissible diseases. During January-June 2026, 73 drills were conducted in three jurisdictions within U.S. Department of Health and Human Services Region 2 (New Jersey, New York, and the U.S. Virgin Islands) using a simulated avian influenza A(H5) scenario. During these drills, facilities conducted symptom screening in 68 (93%) drills and obtained travel history upon patient arrival in 58 (80%) drills. Among 60 (82%) drills during which the patient was appropriately masked, the median interval from arrival at the facility to masking was 2 minutes (IQR = 1.0-6.0 minutes) (target = 1 minute), and among 52 (71%) drills during which the patient was isolated, the median interval from arrival to isolation was 11 minutes (IQR = 8.0-19.2 minutes) (target = 10 minutes). Both masking and isolation occurred in 44 (60%) drills. The clinical team planned to notify infection prevention and control teams in 40 (54%) drills. The clinician wore all recommended personal protective equipment in 17 (25%) drills. These drills provided an opportunity for facilities to examine implementation of the principles of identification, isolation, and informing. Findings from these drills will help guide future public health interventions to improve readiness among regional health care facilities for emerging and reemerging infectious disease threats.

In 2023, approximately 23,000 persons died of homicide and 49,000 persons died of suicide in the United States, according to the National Vital Statistics System. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) on violent deaths and suicides that occurred in the 50 states, the District of Columbia, and Puerto Rico in 2023.

The first 100 days after identification of an outbreak are important to understanding transmission dynamics, impact of early public health interventions, and trajectory of potential future cases and deaths. A large Ebola disease outbreak in the Democratic Republic of the Congo (DRC), which has become the country's largest and deadliest, is ongoing. To better understand the current outbreak, this report compared metrics from the first 100 days of this outbreak with those of four past Ebola outbreaks. The historic outbreaks of Ebola disease selected for this comparison include the two largest (the 2014 outbreak in West Africa and a 2018 outbreak in DRC), and the only two previous outbreaks caused by Bundibugyo virus (the 2007 outbreak in Uganda and the 2012 outbreak in DRC). This activity was reviewed by CDC, deemed not research, and conducted consistent with applicable federal law and CDC policy.

In early June 2025, approximately 80 persons attended a wedding at a venue in York County, Pennsylvania. Within 3 days, multiple attendees reported experiencing gastrointestinal illness. On June 23, the Pennsylvania Department of Health (PDOH) and the Pennsylvania Department of Agriculture (PDA) contacted CDC to request assistance after PDOH became aware of a laboratory-confirmed Campylobacter jejuni infection and reports of approximately 20 additional symptomatic attendees, with epidemiologic information implicating exposure to untreated spring water at the venue as a common exposure source. The focus of this report is on environmental inspection, testing, and identification of pathogens. This activity was reviewed by CDC, deemed not research, and conducted consistent with applicable federal law and CDC policy.

Beginning in early 2025, Florida Department of Health (FDOH) staff members noted an unusually high proportion of reported hepatitis A cases among travelers who had recently been in Cuba. Hepatitis A outbreaks have been reported in Cuban local news media; however, government reports are limited. FDOH investigated to characterize hepatitis A cases associated with travel to Cuba among Florida residents (including four patients who had recently emigrated from Cuba). FDOH found that among 249 confirmed hepatitis A cases identified during June 2024-February 2026, 76 (31%) patients reported recent travel to Cuba before symptom onset. Among patients with Cuba travel-associated hepatitis A, the median age was 39 years, 70% were male, 87% were White, and 92% were Hispanic or Latino. Patients lived in 13 (19%) of Florida's 67 counties. Among 29 patients who completed supplemental travel questionnaires, 55% had visited Havana; other travel destinations included eight additional Cuban provinces. Hepatitis A virus (HAV) genotyping of 18 isolates from unique patients with outbreak-associated cases identified 15 (83%) isolates that matched HAV genotype IA outbreak strain 1, two (11%) that matched IB strain 1, and one (6%) that matched IA strain 2. These findings are consistent with what would be expected were widespread hepatitis A transmission affecting multiple regions of Cuba. CDC recommends hepatitis A vaccination or receipt of immune globulin before travel to Cuba. Providers' consideration of hepatitis A among patients returning from Cuba who have hepatitis A-compatible signs and symptoms, together with elicitation of a detailed travel history, might aid diagnosis of Cuba travel-associated cases.

Since 2017, syphilis cases have increased substantially across the United States, including in Alaska. Nationwide, prevalence of syphilis tends to be higher among incarcerated persons than among the general population. During 2023-2025, opt-out screening for syphilis in Alaska correctional facilities (i.e., routine testing unless a person specifically declines) found reactive rapid plasma reagin (RPR) results, which often indicate a past or current syphilis infection, in 240 (4.6%) of 5,163 persons screened. Among persons with reactive RPR results, 114 (47.5%) had newly identified syphilis cases (2.2% of all persons screened), based on the 2018 Council of State and Territorial Epidemiologists definition. Among persons with newly identified syphilis, 88 (77.2%) were known to have completed treatment by September 2025. Among 1,020 women incarcerated in Alaska who were screened (19.6% of all persons screened), 95 (9.3%) had reactive RPR results. Among those 95 persons, 37 (3.6% of women screened) had newly identified confirmed or probable syphilis, and the remaining 58 (5.7% of women screened) had positive treponemal test results, demonstrating a high current or past syphilis prevalence among women incarcerated in Alaska. Implementing opt-out screening and treatment in correctional facilities could improve syphilis detection and treatment among persons in correctional facilities, and thereby reduce community syphilis transmission and help prevent congenital syphilis.

Sudden unexpected infant death (SUID) accounts for approximately 3,400 deaths among infants aged <1 year in the United States annually. To reduce SUID risk, the American Academy of Pediatrics recommends that infants be placed to sleep supine on a flat, firm, nonshared surface, without soft bedding. SUID vital statistics data do not include details on sleep environment and other contextual factors that are critical for SUID surveillance and prevention. CDC's SUID and Sudden Death in the Young Case Registry (case registry) helps fill this gap. The case registry, a multijurisdictional, population-based active surveillance system, builds on child death review programs, compiling detailed information on deaths in persons aged 0-18 years from multiple data sources. CDC analyzed 2020-2024 case registry data to describe 1) SUID by sociodemographic and sleep environment characteristics, 2) the case registry classification algorithm SUID categories, and 3) death investigation components. Among the 4,861 SUIDs included in this analysis, most decedents were aged 0-3 months, male, Black or African American or White, born full-term, and insured by Medicaid. Unsafe sleep factors were present in at least three fourths of SUIDs. Almost all infants had an autopsy and death investigation, although completed components varied. This newly reported, detailed case registry information can be used by public health professionals and clinicians to improve death investigations, increase understanding of etiologies and risk factors, and enhance focused prevention efforts to reduce SUIDs.

Sub-Saharan Africa and South Asia have the highest rates of stillbirths and rates of death among children aged <5 years, with many countries in those regions unlikely to meet the 2030 goal of ending preventable deaths among newborns and children aged <5 years. Conventional mortality surveillance (determining cause of death through interviews with family members or caregivers [i.e., verbal autopsy] and vital registration) in areas with high mortality often lacks laboratory confirmation of causes and incompletely identifies maternal contributors and comorbid conditions, providing information that is insufficiently specific to guide prevention efforts.

In the United States, cannabis is the most commonly used drug that is illegal under federal law*; in 2024, an estimated 64.2 million persons aged ≥12 years used cannabis (1). Frequent cannabis use is associated with various adverse health effects, including memory impairment, cannabis hyperemesis syndrome, chronic psychosis disorders, and cannabis use disorder (i.e., cannabis use leading to clinically significant impairment or distress) (2,3). Although cannabis alone rarely causes fatal overdoses (2), detection on postmortem toxicology testing among overdose deaths might help identify populations at high risk for other adverse health consequences (e.g., substance use disorders), including death, and help guide tailored prevention efforts. It is not known how often cannabis is detected among overdose deaths and whether detection varies by age.