Wisconsin is experiencing its first outbreak of measles cases of the year, as part of a resurgence of the preventable disease across the country.

Wisconsin’s Department of Health Services confirmed 15 cases as of Thursday, and said there are another six probable cases that have not yet been confirmed through testing. All but one of the measles cases are in Iowa County in the southwestern part of the state, and the other case is in neighboring Lafayette County.

Dr. Peter Bornstein, director of infection prevention for Fairview Health Services’ system, said that Minnesotans don’t need to fear traveling to Wisconsin, but he stressed the importance of vaccination against the serious, highly contagious, and possibly deadly disease.

“The best thing for people to do is to be up to date on their measles vaccination,” Bornstein said. “And it's the first line of protection for newborns. They can't get the vaccine, so the only way to protect newborns from getting measles, which can be fatal, is for the older children and adults around them to be vaccinated.”

According to the Centers for Disease Control and Prevention, 96 percent of the cases this year occurred in people who were unvaccinated or had only had one of the vaccine’s two doses, and nearly 20 percent of the cases were in children under the age of five years old.

To ensure people are protected through community immunity, also known as herd immunity, more than 95 percent of people have to be vaccinated. According to CDC data, only 87 percent of Minnesota kindergartners were vaccinated in the 2024-2025 school year.

“The vaccine reluctance is unfortunately due to a lot of disinformation about the safety and effectiveness of the vaccines,” Dr. Bornstein said. “The MMR vaccine has been around for decades. It's probably the most heavily studied vaccine. There have not been any robust studies that indicate it's especially dangerous. I can't emphasize enough how safe and effective the MMR vaccine is, and how important it is for people to get it.”

Measles cases seem to be spiking across the country in recent years, as the anti-vaccine movement has grown. The CDC has reported 2,566 cases so far this year, already surpassing last year’s total count of 2,289. It’s the highest number of reported cases of measles in the U.S. since 1991.

“Unfortunately, measles is one of the most contagious viruses around,” Bornstein said. “ It's way more contagious than COVID, for example, or influenza. If someone has measles and they're coughing. It can linger in the air for hours, even after the person's left.”

The symptoms of measles can include a high fever, cough, runny nose, red and watery eyes, and a rash three to five days after other symptoms begin. The illness can be especially dangerous for babies and young children. Serious cases can lead to pneumonia, meningitis, brain swelling and even death.

“While the majority of people who do get measles will recover, some of them may not recover,” Bornstein said. “They may be permanently disabled or die from the measles.”

Health insurance premiums for thousands of Minnesotans are expected to increase in 2027.

The proposed rate hikes are primarily driven by rising healthcare costs, inflation, and the expiration of enhanced Affordable Care Act tax credits that previously made coverage more accessible for many consumers.

Premium increases would affect Minnesotans who purchase either individual or small group health insurance directly from insurers or through MNsure, Minnesota’s health insurance marketplace.

Insurers in the ACA marketplace are requesting a median rate increase of about 15 percent across all 50 states in 2027. This marks the second consecutive year of double-digit premium hikes, according to an analysis by KFF, a nonprofit health policy research, polling, and news organization.

Preliminary rate filings from the Minnesota Department of Commerce indicate that the state’s insurers are seeking average premium increases ranging from 10 percent to 13 percent for 2027 plans on the individual market, and between 7 percent and 21 percent on the small group market.

“We had some unprecedentedly high rate increases last year. But these are still on the higher end; they're over 10 percent, and that's significant for a lot of Minnesotans,” Minnesota’s temporary commissioner of commerce Julia Dreier said.

Rate increases would affect hundreds of thousands

About 200,000 Minnesotans get health insurance through the small group market, which includes businesses with two to 50 full-time employees. Additionally, around 190,000 state residents are covered by the individual health insurance market, available to those who do not qualify for employer-sponsored plans or public programs like Medicare or Medicaid.

One of the state’s carriers, Medica, has proposed the highest increase in the individual market at 13 percent, while others, including Blue Plus, HealthPartners and Quartz, are requesting adjustments between 10 percent and 12 percent.

Health insurance costs can vary based on where a person lives in the state and their family's specific needs.

“We have rating regions,” Dreier said. “So, if you live in Duluth, you might pay a different rate for the same plan than what you would pay in the Twin Cities metro area.”

She also mentioned that insurance companies can adjust prices based on age, within certain restrictions, and may charge higher premiums to older individuals.

Expiring tax credits add pressure

The proposed rate increases follow President Donald Trump’s extensive tax and spending package that cut nearly $1 trillion from Medicaid last year, a move that is expected to have widespread consequences, resulting in nearly 12 million Americans becoming uninsured over the next decade.

At the end of 2025, Congress chose not to extend the federal ACA enhanced premium tax credits.

Congress created the enhanced subsidies in 2021 during the COVID-19 pandemic. They increased the value of existing ACA tax credits and eliminated the previous income cap, allowing more people to qualify for financial assistance through marketplaces such as MNsure.

The expiration of these tax credits led to a decrease in enrollment in 2026, according to KFF. Healthier enrollees were more likely to drop their coverage as a result. Consequently, MNsure health insurance enrollment fell by over 17,000 in May 2026 compared to May 2025. Insurers in the individual market expect further deterioration in 2027 due to the expiration of these enhanced tax credits.

Data from the Minnesota Health Access Survey show that the percentage of Minnesotans who went without health insurance increased from 3.8 percent in 2023 to 5.8 percent in 2025. This represents approximately 116,000 additional individuals without insurance, indicating that the state’s uninsured rate has climbed from an all-time low to the highest level in six years.

The trend has raised concerns that rising premiums and reduced financial assistance could lead to further losses in coverage.

Final rates expected in October

The proposed rates are not yet final. The Minnesota Department of Commerce is reviewing insurers' filings to determine whether the requested increases are supported by the companies' underlying data and projected costs.

Dreier said insurers can adjust their proposed rates during the summer as the review continues.

The state is expected to release final 2027 health insurance rates by Oct. 1. The new rates will apply to coverage beginning Jan. 1, 2027.

Minnesotans can submit public comments as part of the rate review process by emailing HealthInsurance.DivisionRequests@state.mn.us.

Hantavirus. Ebola. West Nile. Measles. And, of course, cyclospora — that stomach parasite making people miserable across the country. Americans have plenty to worry about this summer.

But remember COVID-19? It may not be surprising that many people may have almost forgotten about COVID. Unfortunately, COVID hasn't forgotten about us.

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"We're now in the midst of a growing summer surge of COVID here in the United States," says Dr. John Brooks, an infectious disease doctor at Emory University in Atlanta, Ga., who used to work at the Centers for Disease Control and Prevention. "I think most of us kind of feel like it's fading away and are certainly very grateful for that. But nationally we're seeing it ticking up pretty much everywhere."

The virus is spreading the most again in the South and West, but is also on the rise in the Northeast and Midwest. The good news is the virus is still at very low levels. And so far this summer's wave seems to be continuing the trend of getting milder each year, sending fewer people to the hospital and causing fewer deaths.

"What we're seeing is very likely evidence of growing herd immunity if you will," Brooks says. "More and more people have had one or more infections that give them some immunity against the virus and have had more than one vaccination, or maybe both. And all of that really has begun to offer us a lot of protection."

Now, that doesn't mean people don't have to worry about COVID at all anymore. The disease still makes lots of people feel awful for a week or two, foiling their summer vacations and forcing them to miss work and school.

And COVID can still cause serious disease for some people, sending them to emergency rooms, causing hospitalizations and even sometimes still causing death.

"COVID-19 is still dangerous, particularly for older adults, infants and people who are immunocompromised," says Caitlin Rivers, an epidemiologist at Johns Hopkins University in Baltimore, Md. And that is a lot of Americans. "In a typical office, if you have 20 colleagues, it's likely that one or two of them have some degree of immunocompromise. So it's very common that people have risk factors that make COVID-19 dangerous."

Unlike the flu, which only surges during the winter each year, COVID sees spikes twice a year – both in the summer and winter. The reason for that remains unclear.

"It's a big mystery as far as I'm concerned. It is the only seasonal respiratory virus that has a summer season," River says. "To my knowledge, we don't know what is causing this seasonality."

Rivers says she still masks up when she's in crowded places like busy airports, and recommends that people stay up to date on their vaccines. The next shots look like a good match for the dominant strain of COVID that's circulating and should start becoming available soon.

Unlike previous years, the CDC hasn't issued updated recommendations for the vaccines because of litigation over the Trump administration's efforts to overhaul immunizations in the U.S. The administration no longer recommends that everyone aged 6 months and older routinely get an annual shot.

But major medical groups still do recommend it. And insurers have indicated they will keep covering vaccines. The shots are likely to remain available for free through government programs like the Vaccines for Children program.

Public health experts worry that conflicting messages will cause confusion, discouraging people from getting another shot.

"The message is that COVID vaccine and flu vaccine will be available, they're covered by insurers, they're recommended by medical societies. People should get them and get them for their kids," says Clare Hannan, executive director of the Association of Immunization Managers, which advocates for immunization programs.

There's also even a new drug, called Xocova, that people can take right after they've been exposed to the virus to cut their chances of actually getting sick from COVID.

"It is something for people to just have in the back of their mind," Brooks says. It is expected to be a useful tool in hospitals and nursing homes when exposures happen to vulnerable people.

Copyright 2026, NPR

The average residential addiction treatment program can take 30 to 90 days. For people with pets, the inability to find a temporary home for their dogs or cats could be a barrier to getting help. A local animal rescue organization is helping people find a foster parent for their pet so they can be reunited after treatment.

The Bond Between’s respite foster program has been around since 2024 and offers up to 90 days of free temporary foster care for people going through tough life circumstances such as domestic violence or addiction treatment. They recently partnered with the Hazelden Betty Ford Foundation, an addiction treatment center, to help people seeking addiction treatment find pet care.

The Bond Between executive director and founder Rachel Mairose said the most important thing is keeping families together.

“I just think there's so many people out there that love their pets, and they are in a critical situation, and a lot of the reason they keep going is because they have the pets. And in those situations, the worst thing we can do is ask them to give up a family member,” Mairose said.

Mairose’s first respite foster case was with an unhoused man who lived in his car with his Boston Terrier. She said the dog gave birth to puppies in his car during the winter, and he didn’t know what to do.

“I ended up taking her whole family and raising them, and then she and him were reunited, and that reunification was like the most beautiful thing I've ever seen. I mean, she was crying in her little Boston Terrier way, and he was sobbing,” Mairose said. “Because I was able to provide that 60 days of care to raise her puppies, he was able to work overtime, wasn't worried about getting back to his car to take care of her secured housing.”

Mairose said the man now has a fiancé, a house and six pets.

New partnership

Hazelden will now list the Bond Between and the respite foster program as a resource. Hazelden’s staff will be trained to give out contact information for the Bond Between when a potential patient or a current patient cites pet care as a barrier to either entering or continuing treatment.

“I'm anticipating that now that the word is out, people who hadn't even thought about going to treatment because of a pet care situation now will see this as an opportunity that they could do that, and we'll be seeing a lot more of the folks who need it as well,” Hazelden executive director Lydia Burr said.

Burr said some people opt for outpatient treatment instead of residential treatment because of their pets, even though outpatient treatment is sometimes a lower level of care than what they need.

“Oftentimes, pet care is what gets people out of bed in the morning,” she said. “Addiction, substance use disorder, mental health concerns — these are issues, they’re diseases and diagnoses that really breed in isolation. So sometimes, all they have left is their pets, and that's what's getting them out of bed in the morning. That's what's getting them going during the day, that's their reason for continuing.”

Twenty percent of the Bond Between’s respite clients are working through treatment somewhere in the Twin Cities metro area, the organization’s vice president of community engagement Carrie Openshaw said. Last year, they had about 110 respite animals in their care with a 95 percent reclamation rate.

Taking care of an average foster pet can cost about $500 between vet care and supplies, Openshaw said.

“Pets are well cared for in our program, and we provide all the food and supplies too, so pet owners shouldn't have to worry about anything. And, hopefully, we're returning pets to them in better shape than they came into us. Because we're trying to catch up on any vetting that might have been missed while they were going through whatever they're going through,” she said.

One of the respite pets is Stella, a 1-year-old French bulldog who’s wearing a pink diaper because she was recently spayed. Leia Simon, a marketing manager at the Bond Between, has fostered her for the last month and a half.

“I just saw her sitting in her little cage, and I'm like, ‘You can't sit in there, you're too tiny.’ So I brought her home,” Simon said. “She has been delightful ... She's been a delightful little addition to our home.”

Stella’s nickname in the office is “snorty potato” because Simon can tell where she is from her snorting. Before working for the Bond Between, Simon fostered pets for them as a volunteer for the last 10 years. But Stella is her first respite foster.

“It's not just for me; it's for others, and that's the point,” she said. “If it's giving an animal its last loving home, or it's giving an animal a place to go so its owner can take care of themselves, all those things feel really good to me personally.”

The Bond Between said their goal is to hit double the number of respite animals they foster, which would bring them to 200 cases within the next year.

Chip Rankin was eight days into his new job as Brainerd school superintendent when a 13-year-old student at Forestview Middle School died by suicide.

Just three weeks earlier, an 11-year-old student at the same school had also taken her own life.

Rankin and other school officials faced a grieving community asking: How did this happen, and what can be done to keep it from happening again?

“It’s hard because raw emotions come, and people grieve,” Rankin said. “But people want to know, why, why? Because it's hard. It just makes no sense whatsoever.”

The parents of the Brainerd students who died, Ava Starr and Alexis Thornton, say they were bullied by classmates. Rankin said the district has no record of any formal complaints, but that doesn’t mean that it didn’t happen.

The district has hired an independent attorney to review the schools' bullying policies and how complaints are handled.

And by the start of the school year, the district will have an online system to anonymously report bullying, Rankin said. A new state law gives districts two years to adopt an anonymous threat reporting system, but Brainerd isn't waiting.

“I want to make sure we improve, because there are 1,500 kids coming back to (Forestview) in about three and a half weeks,” he said. “And I want to make sure if there's anything we could do slightly better, we're going to do it.”

But the rise in youth suicide extends beyond Brainerd, and some say it needs a broader response. Rankin said the Brainerd district has limited resources to address challenges beyond the school walls.

“This isn't a Brainerd issue,” he said. “This unfortunately is a teen issue. The research is really clear.”

Last year, Minnesota's suicide rate for children ages 10-14 was more than twice as high as the previous five years, according to the Minnesota Department of Health. The rate is even higher in rural communities like Brainerd, which often lack mental health services.

Suicide is growing fastest among children ages six to 12, said Tracie Rutherford Self, an associate professor at Minnesota State University in Mankato and associate director of the Center for Rural Behavioral Health.

“Is it horrifying to think of? Yes. Do kids know how to do it? Yes. There's enough online. There's enough access. There's enough pain,” Self said. “I think that's the key point is we don't realize how much pain some of these younger kids are in.”

An increase in traumatic childhood experiences – such as abuse, neglect or family dysfunction – could be a contributing factor. Bullying can also play a role, Self said.

Adults need to have honest conversation with younger kids about mental health and suicide, she said. Despite common fears, research shows those conversations don't put the idea of suicide in kids' heads.

“The moment we start having open, honest conversations, people suddenly feel free to talk about it,” Self said. “Before, they're ashamed, they're embarrassed, they don't want to have those conversations because they're afraid of freaking people out or burdening others.”

Technology can aggravate problems

Smartphones and social media mean problems that once ended at school can now follow kids home, Rankin said. He recently learned about a seventh grader at Forestview who received more than 400 bot messages in five minutes telling him to kill himself.

“What if you're in the wrong place that day – just mentally feeling down, not feeling good about yourself?” Rankin asked. “These are adolescents. Their range of emotions can really vary.”

The school district is hiring a social worker dedicated to Forestview to help connect families to resources. And Rankin said cell phones will be off limits during the school day for students in kindergarten through eighth grade.

On his desk is a copy of Jonathan Haidt's book, “The Anxious Generation.” Haidt argues that the transition from flip phones to smartphones with front-facing cameras and social media has triggered a mental health crisis, especially among teenage girls.

As a principal, Rankin supported giving every student a device to take home. Now, as a parent, he questions how much screen time and online access are healthy.

“I think parents really have to arm themselves with the research to see what could we do better, because we're going to have to,” he said. “This is a partnership.”

Limited resources

The Brainerd school district has limited funding and staffing to tackle mental health, Rankin said.

The district has just one counselor for every 1,000 students. That’s well below Minnesota’s average student-to-counselor ratio of 558 to 1, which is one of the worst in the nation, according to the American School Counselor Association.

The Brainerd district also contracts with a mental health clinic for services, but community resources are also stretched thin.

“It's kind of like healthcare if all you do is rely on an emergency room when you're in a crisis, and you don't go to the clinic,” Rankin said. “I feel like right now we're funded and staffed for emergency situations.”

The shortage of school counselors is a statewide problem, says Marcus Schmit, executive director of the National Alliance on Mental Illness.

“We need to continue to reach kids where they're at with mental health education,” Schmit said. “And we know that schools are one of the most effective places to get connected to students.”

Parents, teachers and coaches also need training to recognize when a child is struggling, and know how to start a conversation, Schmit said.

“Kids understand it. They're open about it. They talk about it,” he said. “We have to do more to equip the adults around them to provide them with that support.”

Enlisting the community

In Brainerd, Rankin said it will take an all-hands-on-deck approach to prevent more deaths.

He's launching a program to bring 500 community volunteers into schools – greeting students, being present in the hallways or helping with homework.

Sometimes, one caring adult can make a difference and keep a struggling student from losing hope, Rankin said.

“I think during COVID we we pulled up the drawbridge and closed our castle and said, ‘Everybody stay out. We're going to social distance,’” he said. “Then we never put it back down.”

If you or someone you know is in crisis or needs immediate mental health support, call or text the Minnesota Lifeline at 988.

President Donald Trump signed an executive order Monday related to childhood vaccines in an Oval Office ceremony, flanked by top health officials and a conservative commentator who talked about her child and her current pregnancy. Those attendees called the move "historic" and "a big deal."

But what's different today when it comes to childhood vaccine policy in the U.S.? Not much. There's no new research, no new vaccines available and no immediate change to insurance coverage or school requirements.

And so far, pediatrician Dr. Jennifer Shu in Atlanta says parents in her practice aren't asking her about what the executive order means for their kids.

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"At the very beginning, when the administration started making changes, people were concerned about — gosh, are we no longer going to have access to certain vaccines?," she says. "But I'm not hearing that anymore."

She says since some of the biggest swings from the White House – including an effort to reduce the number of federally-recommended vaccines for children – were blocked by courts and never took effect, "I'm feeling like a lot of parents are kind of wanting to see what the final result is before they get too concerned."

Still, the potential for confusion is real, she says. Here are the answers to five questions parents might be having about the executive order.

1. Are the same shots still available?

"Yes — as of right now, yes," Shu says. All of the shots in the childhood vaccine schedule backed by pediatricians are still available.

The Trump administration has tried — first through a panel of hand-picked advisors and then unilaterally — to change the list and timing of these vaccines, but has not been successful so far. The new executive order calls for certain things to be researched and reports to be written, but it makes no immediate changes.

All of that highlights the limits of the federal government in this area, says Jen Kates, senior vice president and director of the Global and Public Health Policy Program at the nonpartisan health research organization KFF.

"It's up to states and individual parents," she says. "States are going to make these decisions about school entry and then parents can make their own decisions about timing." In fact, she explains, "in all states but five, parents can opt out of vaccines or they can get a nonmedical exemption.

"So parents actually have quite a bit of choice already, and nothing about this will diminish or expand their choice," she adds.

2. Does this affect which vaccines are covered by insurance?

No, health insurance coverage is unchanged for all vaccines in the American Academy of Pediatrics' vaccine schedule. Nearly all families can receive vaccinations with no copays, including families without health insurance.

In a statement from May, AHIP, the trade association that represents health insurance companies, said that health plans would cover vaccines recommended by the CDC through the end of 2027.

3. Why is this vaccine order happening now?

It's not entirely clear why this executive order is being rolled out now, especially so close to the November midterms elections, since some Republican pollsters have warned vaccine changes are politically hazardous. The timing also intersects with the beginning of the school year.

At the signing, Trump seemed to indicate that his administration was making another move in this area because it matters a lot to him, and because past efforts have been blocked in the courts.

"I believed in this a long time," Trump explained as he signed the executive order Monday. When vaccinating his own children, Trump told reporters, he made extra doctors' appointments to spread out the number of shots they got at one time. "It's inconvenient, it's five stops, but it's something that I think will have a huge impact on autism," he added.

The executive order does not actually address autism and vaccines, but Trump made multiple references to it at the press conference, as did Health Secretary Robert F. Kennedy Jr., a longtime anti-vaccine activist. The links between autism and vaccines have been debunked by many studies.

"There's nothing new," Shu says. "Nothing has changed with the science." She adds that the effort to change the vaccine schedule is "based on misinformation."

4. What's the idea behind spacing out children's shots?

Shu says she does see families who ask about spacing out the vaccine schedule the way Trump describes doing with his own children.

"What I tell parents is that splitting the vaccines has not been studied — putting the vaccines together as scheduled has been proven to be safe and effective," she says. "And sometimes combining vaccines at one visit may help some work better together."

Spacing the vaccines out has downsides, she adds. "Splitting them up leaves a kid more vulnerable to certain infections if they get exposed before they're fully protected by the vaccine, it means more visits to the doctor's office, it means more time off that the parents take — things like that."

5. Could the MMR shot be split into three shots?

Maybe, but it would take a while. The executive order calls for the measles, mumps and rubella vaccine to be divided into three separate shots, but right now separate shots for those vaccines are not available in the U.S. A White House official told reporters on background Monday that the administration would be working with private drugmakers to explore making those available.

"There's no evidence whatsoever that that vaccine should be split, in fact, it raises all kinds of challenges and potential downsides," Kates from KFF says. She points out that one of the complaints raised by Trump is that children get too many shots, yet this change would increase the numbers of shots for the same amount of protection.

Kates adds that Trump's statements during the press conference about the dangers of the MMR shot could have a bigger impact on public health than the policy specifics of splitting up these vaccines. KFF polling shows most parents are supportive of vaccines, Kates says, but even a small group that becomes concerned or confused about vaccines can make a difference when it comes to public health.

"As we can see with the measles outbreak, as soon as you start to bring vaccine coverage down, even a slight amount, that is where you start to see breakthrough [infections] — that's the risk here," she says.

Copyright 2026, NPR

President Donald Trump on Monday announced he was signing an executive order calling for revamped childhood vaccine recommendations that promote his long-held belief that childhood shots should be spaced out into separate medical visits.

The order will recommend separating the measles, mumps and rubella (MMR) vaccine into three different shots administered in separate visits, and direct the nation's health department to improve vaccine research, says a White House fact sheet, first reported by The Daily Caller.

Trump also said in an event at the Oval Office on Monday afternoon that one-year-olds should have their shots separated out into five separate visits, though it wasn't clear whether he was talking about all the vaccines they receive or specific ones.

Public health experts have raised concerns that spacing out shots as Trump suggests can lead to an increased risk that children become infected with a vaccine-preventable disease before returning for another visit. Childhood vaccines — and how and when to give them in combination — go through rigorous studies, and safety tracking continues for years as the shots are used.

Separate measles, mumps and rubella vaccines for children, which Trump said he wants kids to receive, are not currently available in the U.S.

“Today’s executive order does not substitute the longstanding process through which vaccine recommendations have historically been developed — an independent, transparent evaluation of safety, effectiveness and disease burden by scientific experts,” Vaccine Integrity Project’s executive director Michael Osterholm said in a statement in response to today’s White House executive order on vaccines.

Even as the order calls for revised vaccine recommendations, states, not the federal government, have the authority to require vaccinations for schoolchildren. The order will advise states with school vaccine mandates to consider updating their laws to reflect the administration's recommendations, the fact sheet said.

Last December, Trump ordered HHS to review how peer nations approach vaccine recommendations and consider revising U.S. guidance accordingly. The department responded by cutting the number of vaccines it recommends for every child, a move that has since been blocked in court.

In the months leading up to Monday's announcement, Trump’s administration had largely pivoted away from talking about vaccine policy in favor of less polarizing topics like healthy eating and efforts to lower drug prices ahead of November’s elections. Polls show most Americans still support school vaccine requirements, though Republicans are less likely than Democrats to see them as important.

Still, Trump has been fixated on connecting autism to vaccines. He has recently ramped up pressure on Health Secretary Robert F. Kennedy Jr. to identify the cause of autism, something Kennedy had pledged to do with new research unveiled last year. Trump publicly prodded the health secretary for an update on autism research in a Cabinet meeting last month.

“How are you doing on the autism research?” Trump asked.

“We will have an answer for you,” Kennedy said.

Scientific consensus and decades of studies have firmly concluded there is no link between childhood vaccines and autism.

Monday's order comes as school years are starting around the country and the nation contends with a measles outbreak that experts say could result in the U.S. losing its measles elimination status.

“Parents deserve clear, evidence-based guidance about how to protect their children, not competing recommendations issued through political processes,” Osterholm said. “When families receive conflicting messages, confidence in vaccination suffers, and children ultimately bear the consequences.”

Smokes 4 Less in Fargo is stocked full with a rainbow of colorful products like vapes, pipes and bongs. But one shelf, deep in the store, is completely bare.

It’s been that way since last Wednesday, when North Dakota’s ban on kratom took effect.

Kratom is a substance derived from the leaves of a Southeast Asian tree. Sold in a wide range of products such as pills, beverages and powders, people use it recreationally and to help with pain. Some also say it helps treat their mental health problems.

But kratom-related calls to North Dakota’s Poison Control tripled last year, from seven in 2024 to 22 in 2025, according to reporting from the North Dakota Monitor.

North Dakota Gov. Kelly Armstrong and Attorney General Drew Wrigley announced a ban on kratom products Aug. 3, citing the “addictive dangerous, and potentially deadly nature of kratom.”

Other states, including Kansas and Tennessee banned kratom products outright earlier this summer. Minnesota’s new regulations on kratom products raise the purchase age from 18 to 21.

The executive order highlights the state’s different approaches to products derived from natural kratom leaf and synthetic, concentrated products containing higher doses of a compound called 7-hydroxymitragynine or 7-OH.

The governor signed an emergency rule from North Dakota’s Board of Pharmacy that classifies 7-OH as a Schedule I drug, echoing a temporary federal action from the Drug Enforcement Agency.

The rule is valid for 180 days and triggers a rulemaking process. At the same time, the sale, use and possession of all kratom products has been banned by an emergency order that is effective for thirty days, according to Armstrong.

A special legislative session is set for early September where lawmakers will propose and vote on permanent regulation or prohibition.

Lawmaker reactions in Fargo

Fargo-area lawmakers said they’ve been hearing a lot from their constituents since the ban’s announcement.

“I hear from constituents or other people that live in my state that tote the benefits of kratom to PTSD or other mental health issues,” said Rep. Austin Foss, a Democrat in Fargo. “But then on the other side of that, I've had people reach out to me saying really terrible stories, [of] their son overdosing on kratom and how it is a very addictive drug and how it should be banned.”

Fargo lawmakers on both sides of the aisle said some regulation is necessary, as kratom has largely been legally available without regulations or age restrictions.

“The ban should be for the synthetic version,” said Sen. Michelle Powers, R-Fargo. “All synthetic versions should probably be banned and put an age limit on the purchasing of [natural] kratom.”

But both Foss and Powers disagreed with the governor’s emergency order and said the issue could’ve been tackled during the next regular legislative session.

“There is really no emergency on it, as far as I'm concerned,” Powers said. “We have far more deaths from alcohol than we do from kratom, and we're never, ever, ever going to ban alcohol.”

But Kyle Davison, a Republican representing south Fargo, thinks it was the right call. He said he and other lawmakers still need more education and information before making a decision on how to regulate kratom.

“He's putting a short-term stop to it … so that we can wrap our arms around it,” he said. “I think we'll learn together during the session.”

Regardless of what regulations lawmakers decide on, they might not be as effective in Fargo since people over 21 can easily head across the Red River to buy or consume Kratom in Moorhead, Minn.

“Whether we ban it or not might not matter in the long run,” Foss said.

It's a longstanding dynamic, Powers said, that has also surfaced around marijuana and alcohol sales, which Minnesota and North Dakota regulate differently

“Minnesota, a long time ago the alcohol was sold at 19, and everybody went over there,” she said. “It's nothing new under the sun. People will go wherever they can get it. We can't regulate every state.”

Foss said he’d support some sort of collaboration with Minnesota lawmakers to compromise and align laws across border cities, but thinks it's unlikely that’d ever happen.

“Historically, we have not been very cooperative with the state to the east of us, Minnesota, because a lot of my colleagues on the other side of the aisle really see us as an anti-Minnesota state,” he said.

And that might be a boon for shops on the Moorhead side, even if they don’t sell Kratom. Gabriel Hernandez is general manager at Beezwax Dispensary in Moorhead and said he’s expecting more marijuana customers because of North Dakota’s kratom ban.

“The majority of my customers come in, they say they're trying to treat pain,” he said. “So I absolutely think anyone who's trying to treat something non-medically, we’ll see more business from them, especially if their preferred becomes unavailable, i.e. kratom, which is very popular in the area.”

A woman who suffered salmonella poisoning after eating takeout from a Twin Cities Chipotle is suing the restaurant chain.

According to her civil complaint filed Wednesday, Kristen Behne ordered a chicken burrito bowl from the Chipotle location in Roseville on June 24.

Three days later Behne lost consciousness, her temperature rose to 102 degrees Fahrenheit, her heart rate skyrocketed to 145 beats per minute, and she suffered severe diarrhea.

“She was very, very sick. Dehydration and the toll that salmonella takes on the body can be very serious,” Behne’s attorney Lindsay Lien said in an interview Thursday. “When bacteria gets in the bloodstream, complications can be serious and sometimes fatal.”

“These sort of infections take a long time for people to recover from, and so she’s working through that,” Lien said.

Behne, 28, was hospitalized for two days, and doctors diagnosed her with sepsis and an inflamed colon. She received two liters of intravenous fluid and was treated with the antibiotic ciprofloxacin.

The Minnesota Department of Health and the Centers for Disease Control and Prevention traced the salmonella bacteria that Behne ingested to jalapeño peppers in Chipotle's salsa.

Health officials have identified at least 110 cases in Minnesota and connected the majority to Chipotle. MDH has said that Chipotle has been cooperative with the investigation.

The CDC said Tuesday that the outbreak has infected 345 people in 27 states. Three dozen people were hospitalized. No deaths were reported.

The restaurant chain has said that it removed the jalapeños linked to the outbreak. MPR News requested comment from Chipotle on Behne’s lawsuit.

State and federal authorities continue to investigate a recent coordinated cyberattack on Minnesota municipal water systems.

Hackers disrupted technology controls at water towers and treatment plants in more than 30 Minnesota communities last week. And the FBI says water and wastewater companies in at least six other states have reported incidents.

MPR News guest host Catharine Richert talks with her guests about what we can do to protect the water systems, power grids and other public services we rely on.

Guests:

• Jeremy Schwarzrock is the manager of information security for Titan Machinery, an agricultural and construction equipment dealer based in Fargo, North Dakota with locations across North America, Europe, and Australia. He is also an adjunct professor of computer science and information systems at Minnesota State University Moorhead.

• Manuel Teodoro is a professor at the La Follette School of Public Affairs at the University of Wisconsin – Madison. He works with government, community, and industry leaders to improve water utility regulation and management. He is also the author of the recently published open-access book, “Safe Drinking Water Act: The Next Fifty Years.”

Subscribe to the MPR News with Angela Davis podcast on: Apple Podcasts, Spotify or RSS.

Use the audio player above to listen to the full conversation.    

Minnesotans between the ages of 21 and 64 who apply for Medicaid will need to demonstrate that they have been working, attending school or volunteering for at least 80 hours each month to qualify for or retain health insurance under the joint federal-state program.

This requirement comes after President Donald Trump signed a sweeping tax and spending bill into law last July. State Medicaid programs must update their existing rules to comply with the new requirements set by the U.S. Centers for Medicare & Medicaid Services.

The new work rules will take effect on Jan. 1, 2027. This change is expected to result in an increase in uninsured individuals in the state.

To assist residents, the Minnesota Department of Human Services has launched a new tool available until Aug. 31. It is designed to help individuals navigate the upcoming federal Medicaid work requirements.

The state has technical resources to support the tool only until the end of August and is exploring additional options.

While Medicaid enrollees can still report exemptions and qualifying activities after Aug. 31, they may need to call or visit their county, tribe or the Minnesota Department of Human Services for guidance.

Medicaid, known as Medical Assistance in Minnesota, provides health coverage for 1.2 million residents, offering affordable health insurance to more than one in five Minnesotans, including children, people with disabilities and seniors.

To qualify for Medical Assistance, individuals must still meet specific income requirements based on factors such as age, pregnancy status and family size. Enrollees do not pay a premium for coverage, nor do they share costs for comprehensive health services.

Currently, Medicaid enrollees are required to prove their eligibility at least once a year. But the new law will change this, mandating states to check recipients' eligibility every six months. Some individuals may lose their eligibility or decide to opt out of Medicaid as these changes roll out over the coming years.

Individuals enrolled in Medical Assistance can check whether they meet the federal work reporting requirements set for 2027, as well as review a list of exemptions by using the new lookup tool provided by DHS.

To prepare for their 2027 renewal, Medical Assistance enrollees can report how they plan to qualify for an exemption from work requirements or how they will fulfill a qualifying activity.

The human services department said many people may already meet the requirements or qualify for an exemption, and sharing this information will not affect current coverage.

“Insurance supports people’s overall health, and these new federal administrative barriers will make it harder for some Minnesotans to get and keep Medical Assistance,” DHS’s temporary commissioner John Connolly said in a statement. “While most Medicaid recipients already work or meet the requirements in other ways, we are encouraging people to prepare now for the challenges of more paperwork. We want all eligible Minnesotans to keep their coverage.”

Approximately 243,000 Minnesotans on Medical Assistance will be required to meet federal work requirements. A significant number of these individuals are expected to lose their health coverage, according to DHS, because they may not meet the requirements or may fail to submit the necessary paperwork demonstrating compliance every six months.

A 2023 analysis by KFF shows that most Medicaid enrollees in the U.S. are employed.

According to the Urban Institute, about 91 percent of enrollees are working, enrolled in school, searching for employment or dealing with health issues that limit their job opportunities.

Work requirements do not apply to individuals receiving Medical Assistance due to a disability, parents living with children under the age of 19, individuals who are 65 or older, those who are 20 or younger, and pregnant people.

Certain exemptions from work requirements include American Indian or Alaska Native individuals, those living in a household receiving Supplemental Nutrition Assistance Program benefits who are subject to SNAP work rules and individuals who meet the work requirements for the Minnesota Family Investment Program.

Exemptions also apply to those participating in drug or alcohol treatment and rehabilitation programs, individuals who are medically frail or living with a serious, complex, or chronic medical condition, or who are undergoing regular therapy, as well as caregivers of disabled individuals.

Minnesota's health department is investigating a salmonella outbreak linked to Chipotle and other quick-service Mexican restaurants.

As of Wednesday morning, state health officials have identified 110 cases and they say jalapeños may be the source.

Minnesota Department of Health epidemiologist Dana Eikmeier joined MPR News guest host Kelly Gordon to share more about the situation.

Use the audio player above to listen to the full conversation.

Subscribe to the Minnesota Now podcast on Apple Podcasts, Spotify or wherever you get your podcasts.

We attempt to make transcripts for Minnesota Now available the next business day after a broadcast. When ready they will appear here.

Public office has always been demanding, but the stress of leadership seems to be taking a bigger toll on elected officials’ mental health.

Several city council members in Minnesota recently shared their struggles with mental health, including a Minneapolis council member who took a break to attend to depression and anxiety. Earlier this year, St. Paul’s city council president resigned, citing “the “constant stressors of public leadership.”

At a national level, a U.S. representative from New Jersey disclosed in June that he was being treated for depression after a four-month absence from Congress.

MPR News host Angela Davis talks with a therapist and a city council member about burnout and stress among elected officials and what to do about it.

Guests:

• Aurin Chowdhury is a member of the Minneapolis City Council representing Ward 12 in southeastern Minneapolis. She was elected in 2023 after serving as manager of constituent services for a state senator and a policy aide for two Minneapolis council members. She recently shared her struggles with her mental health in a newsletter with constituents.

• Noel Nix is a therapist with Vibrant Life Therapy working toward a professional clinical counseling license. He has a master’s degree in counseling psychology from the University of St. Thomas and previously worked for more than a decade in municipal government as a city council aide and in public engagement for the City of St. Paul.

Subscribe to the MPR News with Angela Davis podcast on: Apple Podcasts, Spotify or RSS.

Use the audio player above to listen to the full conversation.    

Chipotle Mexican Grill said Tuesday that it had removed jalapeños from some of its restaurants after determining the peppers could potentially be tied to a salmonella outbreak public health officials are investigating.

In a brief statement, Chipotle maintained that the “health and safety of our guests and employees is our highest priority” — and that it had pulled the jalapeños out of an abundance of caution and “replaced them with product from different growers” in all locations where a previous common lot had been distributed.

The company did not specify where the initial peppers came from but noted that the jalapeños in question were sent across multiple states to several retailers.

The Minnesota Department of Health on Tuesday confirmed that it was investigating a salmonella outbreak tied to several Mexican-style, quick-service restaurants — with jalapeños as the suspected source. Officials identified 110 cases in the state. Chipotle made up the majority of those where they were able to reach impacted consumers for an interview — who ate at the chain between mid-June and mid-July — but not all.

“Based on all the evidence so far, the food that made people sick was served at other restaurants as well,” Carlota Medus, senior epidemiologist supervisor in the Minnesota Department of Health's Foodborne Diseases Unit, said in a statement.

Medus said Chipotle had been cooperative over the course of the investigation — and that given the measures the company put in place, her department was not concerned about the chain at this time. Still, she said it was “too soon for us to know if the outbreak is ongoing” and that it's possible contaminated food is being served elsewhere.

The Minnesota Department of Health noted that other states are contributing to the investigation, without elaborating further. On the federal level, the Food and Drug Administration is conducting the traceback probe, covering but not limited to jalapeños.

The FDA on Tuesday confirmed it initiated its traceback investigation “of multiple ingredients” on July 22, in response to a cluster of salmonella illnesses identified by both state officials and the federal Centers for Disease Control and Prevention. In a statement, the agency said it appreciated Chipotle's cooperation and that it would “provide additional information if and when there is an actionable public health update.”

The CDC did not respond a request for further comments Tuesday afternoon.

Symptoms of salmonella poisoning include diarrhea, fever, severe vomiting, dehydration and stomach cramps. Most people who get sick recover within a week. Infections can be more severe in young children, older adults and people with weakened immune systems, who may require hospitalization.

Chipotle has been battered by larger outbreaks in years past — notably between 2015 and 2018, where a string of E coli., norovirus and food poisoning illnesses sent sales plunging. The California-based company has since boasted stronger food safety practices.

The latest salmonella outbreak arrives at a tough time for restaurant-goers and the dining industry nationwide. A handful of fast-casual chains are still wrestling with the fallout of a separate, wider cyclospora outbreak linked to shredded lettuce that has sickened thousands of Americans.

Chipotle hasn't been tied to or named by government investigations into those cyclospora illnesses. Still, the company is among those bracing for lower sales because of that outbreak.

Shares of Chipotle Mexican Grill plunged nearly 10% Tuesday.

A new Minnesota law raises the legal age to buy kratom from 18 to 21, marking the state's first major step toward regulating a substance that's become widely available in gas stations and smoke shops.

Kratom is a plant native to Southeast Asia that's sold in capsules, powders, gummies and drinks marketed as energy boosters or pain relievers. Supporters of the law say increasingly potent, chemically altered kratom products can be addictive and pose greater health risks.

“We've seen a lot of people under 18 can just buy this," said Rep. Jessica Hanson, DFL-Burnsville, who authored the law. "The way it's marketed, there's no label on it informing consumers of its dangers."

Poison Center calls on the rise

The Minnesota Regional Poison Center has seen an increase in kratom-related calls involving withdrawal symptoms, bad reactions and overdoses. The federal U.S. Drug Enforcement Administration has moved to temporarily ban several highly concentrated, synthetic compounds derived from kratom, including 7-hydroxymitraginine, a more concentrated form of kratom that can have opioid-like effects.

Ryan Fuchs, the poison center’s associate medical director, said officials began tracking calls involving 7-hydroxymitragynine in early 2025.

“It was recognized that this is another sort of substance of abuse, or another psychoactive substance, that may have a separate or important clinical effect,” he said.

Research on 7-hydroxymitragynine is still limited, but Fuchs said some evidence suggests it is highly potent, which could increase the risk of dependence and withdrawal.

"We've received at least two-and-a-half times the number of calls from 2024 to 2025, and we're on a similar trend in 2026," he said. "We've already almost matched the number of calls from all of 2025."

Reported symptoms include nausea, vomiting, confusion, agitation and seizures, Fuchs said. Some patients require prolonged hospital treatment.

"These products are very risky, highly concentrated and generally underregulated," Fuchs said. "If they're kept in the home, they should be kept away from children and pets."

Consumer awareness

The American Kratom Association, which advocates for legal kratom sales, supported Minnesota's new age restriction. Mac Haddow, the association’s senior public policy fellow, said bad actors are creating more potent products containing 7-hydroxymitraganine.

“Every consumer needs to be aware of the products they're buying,” he said. “If they pick up a product and it doesn't have labeling that's clear that describes what's in the product and recommends a serving size, they should not purchase that product.”

But he said traditional kratom use can help people boost energy or increase focus. In some cases, it can help users wean off opioid use, he said.

“There are 24 million Americans who regularly and safely consume kratom in the United States,” Haddow said. “That is the standard that we want to maintain in terms of the safety profile for each one of those consumers.

More state regulation of kratom could come next year. Hanson said she plans to introduce legislation covering product labeling, licensing and where kratom can be sold.

The wind whips up sewage dried to a powder that's been dumped for years onto an arid riverbed near the fishing settlement of Rehri Goth, on the outskirts of the Pakistani port city of Karachi. In an alley, a man squats over a pile of trash. He fishes out a battered peach and eats it.

It's here that Sughran lives in a dusty compound with her extended family. She's only got one name. She doesn't know her age. Some dozen children mill about in tattered clothes. Five are hers. They're the survivors.

On the day we meet, Sughran says it has been seven days since she buried her baby Gulshan. He was born at seven months gestation. She says when she felt her contractions quicken, her husband took her to a hospital miles away in Karachi. But she says they wouldn't admit her because she wasn't their patient. So she rushed to a local hospital, but it was closed for the night.

"So my family told me to go to another hospital," she recalls. "I said that I would not go anywhere and decided to deliver the child at home."

Baby Gulshan was cold by morning.

She buried him in the graveyard near his baby brother Roshan, who died last year. He was also preterm: Sughran says he was also born around 7-months gestation too. "One was alive for eight days, and the second was alive for two hours," she laments.

While premature babies born in the West have an excellent chance of survival — particularly those born after 32 weeks gestation, or at around 8 months — it's not the same in low-income countries. The World Health Organization says some half of all premature babies born in poor countries at around 32 weeks are likely to die. Many survivors suffer life-long impacts to their vision and hearing as well as learning problems.

The prematurity rate in Rehri Goth is among the highest in Pakistan: about one in four babies here are born early — before 37 weeks of gestation, according to Dr. Fyezah Jehan, chair of Paediatric Infectious Diseases at Agha Khan University in Karachi, who specializes in maternal health. That's nearly double Pakistan's nationwide average of just over 14% percent, already among the world's highest.

It's evident why women and girls in this community are having babies prematurely: They're clearly malnourished. Other factors contribute to early birth, such as the extreme heat and poor sanitation.

Other countries do have the same conditions but prematurity rates aren't as high as Pakistan's, says Jehan. "So the question that naturally came to us was, why are the rates so high?"

Jehan says her department "got interested in the microbiome" –- the collection of all the microbes in a human body –- because "we are seeing more and more that the microbiome has a huge role in these adverse pregnancy outcomes."

Microbes extract vital vitamins and other nutrients, teach the immune systems to recognize dangerous invaders and produce helpful anti-inflammatory compounds and chemicals that can stave off bugs that could make us sick.

The problem was, "we have several studies on the gut microbiome and pregnancy from Western populations, [but] we didn't have any data from Pakistan."

And that is key to trying to solve this prematurity puzzle, because a person's microbiome is partly formed by their diet and local environment.

So Jehan's team looked at the microbiome of Pakistani women who had just given birth –- by examining their stool. Her team selected 108 samples of feces collected from the area around Rehri Goth over the past two decades. About half were from women who had their babies to term. The other half had premature babies.

And "what we found was — there's this one bacterium, Prevotella [copri], which was far less in women who had delivered pre-term compared to women who delivered term," she says. "It was a eureka moment for us. We were like, oh, there is a bug, you know, which could potentially explain prematurity."

She says so far, the initial study gives them "a signal of risk and a signal of understanding, but they're by no means at a stage where we can translate it into policy."

Jehan says her team is replicating the experiment in two different ways. One draws on samples drawn from a different area; the other uses stool samples extracted in different years.

Jehan says they're also trying to cultivate the bacteria Prevotella copri in the lab. They hope to give it to at-risk pregnant women to see if it helps them get to term.

Dr. Vincent B. Young, an infectious disease physician at the University of Michigan Medical School, says Jehan's team study is "not necessarily new," but "it's confirmatory in a different population than what's been studied before. I think it adds to the idea that perhaps we can go ahead and intervene in the future."

But Young cautions, even if Jehan's team can give isolated Prevotella copri to at-risk pregnant women, it might not do anything. That's because "association is not causation, right? That just because you see A and you see B, that doesn't mean A causes B in any way, shape or form," he says. "But it's a strong association."

And even if a lack of Prevotella copri is causing premature birth in some way, giving women more of it may not help. Young explains: "Maybe the reason it's low is because something else is going on that's suppressing the level of the Prevotella copri, and just giving more of it – well, that will get suppressed too."

Young says the study may be useful in a different way — if a lack of Prevotella copri is associated with premature birth — that can be used as a way to identify at-risk women.

Jehan acknowledges there's no silver bullet to prevent premature births. She says, "if you ask me, improve education and water and sanitation and half the problems will just disappear. What we are doing is really stopgap."

But Jehan says donors are reluctant to undertake expensive, long-term work like sanitation or girls' education, when local governments are widely perceived as corrupt. She says that's why major donors would "rather fund the science" conducted in labs like hers.

A premature baby’s life

Back in Rehri Goth, it feels as if 17-year-old Mariam is fighting against the odds to keep her baby alive. Five-month-old Ladoo fusses in a hammock made from an old scarf. He was born prematurely at around 7 months, his mother says.

"The doctor told us that we should take him to the hospital because he doubted whether he would survive."

But Mariam says there was just no money. "We did not go anywhere, we returned home," she says. Ladoo has been doing poorly since. "The illness never went away."

His grandmother Hanifa lifts shirt to show us his stomach is swollen. They don't know why it's like that. Scars crisscross his bottom, from blisters that formed in the extreme heat. It was over 113 degrees here for weeks. She pulls out a tiny plastic bag of medicines they keep at the ready for Ladoo. "We are illiterate, and we don't know which medicines are for which treatment," his grandmother says.

Now, Ladoo is exposed to even more danger by another hazard many Pakistani women face: advice by health workers that is either ill-considered or so badly communicated that it becomes dangerous.

Mariam says when newborn baby Ladoo was suffering from diarrhea, "I was told not to breastfeed."

She says she was told to give him formula instead, even though the water in Rehri Goth is unsanitary and dangerous for babies — even if boiled, according to the World Health Organization.

But Mariam can't even afford formula, which sells for about $2.50 for a small packet in Rehri Goth. So "Right now, we do not have it, so he eats Cerelac."

That's a mix of rice powder, milk powder with vitamins and sugar made by the multinational Nestlé. A 25-gram packet, she says, costs the equivalent of 20 cents. The amount of sugar is not listed. It's mixed with water and given to babies like formula — in a bottle.

The World Health Organization says Cerelac is not suitable as a sole diet for a child of any age. In response to NPR questions, the organization said in a statement that Cerelac "is not formulated to meet the nutritional needs of an infant. It is not sterile and may itself be the source of food-borne illness - even if it is prepared with clean drinking water." The World Health Organization also said in the statement that the advice to withhold from breastfeeding for Ladoo was "certainly inappropriate and likely dangerous."

The statement continued, "there are vanishingly few circumstances in which breastfeeding poses a greater danger to an infant's health than replacement feeding." That's because breastmilk helps build a baby's immunity against potentially deadly diseases.

Nestlé did not respond to detailed questions from NPR about whether it knew its product was being consumed as an alternative to baby formula in a community where women were deeply poor and largely illiterate.

Ladoo's grandmother shoos away flies that have settled on his milk bottle and feeds the baby. She says, "We know this isn't good for him but what can we do?"

She says, "We will do what we can to keep this boy alive."

With additional reporting by Almas Kasmani

Copyright 2026, NPR

This summer, tiny Cyclospora parasites have wreaked havoc on the digestive systems of thousands of people in the U.S.

It's the biggest outbreak of this parasite the U.S. has ever seen. In a July 28 update, the Centers for Disease Control and Prevention counted 45 states reporting cases of cyclosporiasis — the disease caused by the parasite.

Michigan is ground zero for cyclosporiasis, where more than 10,000 people have eaten something, likely lettuce, contaminated with microscopic pods containing Cyclospora parasites.

These parasites rely on the digestive tracts of humans — and only humans — to reproduce. To get there, they've likely been hitching rides on crops from places where the parasite is relatively common, to the unwitting mouths of hungry people across the U.S. Their complex biology contributes to why they're so hard to kick, leading to infections that can last for weeks or months.

A lifecycle that requires the human gut

On the surface of an herb, vegetable or berry, Cyclospora parasites lie dormant in pods — called oocysts — that are virtually invisible to the human eye. "It would take about a hundred of them, linked end to end, to fit across the head of a pin," says Vernon Carruthers, professor of microbiology and immunology at the University of Michigan Medical School.

Once swallowed by a human, the oocysts make their way down the esophagus, to the stomach and then the intestines. "The [oocysts] respond to signals in the gut, like body temperature, probably bile, digestive enzymes. This causes the parasites to be released," Carruthers says.

The parasites go straight for the lining of the small intestine, where they burrow in, taking over the cells to make copies of themselves. "These grow from just a few of the parasites we would take in, to millions of parasites replicating inside our intestinal cells," Carruthers says.

After a while, some of those parasites begin to differentiate into egg- and sperm-like forms, which combine to form new microscopic oocysts — a process that can happen millions of times at the height of infection. "This is truly remarkable, given that the sperm must find the eggs inside infected cells that are blanketed by a mucus layer," Carruthers says.

This whole process messes with the intestinal lining. "[The parasite is] entering those host cells, replicating in those cells, producing its life cycle within those cells. And that process eventually destroys the cells," says Joel Barratt, a molecular parasitologist and associate professor at Emory University School of Medicine who used to lead a lab team at the CDC that responded to parasitic outbreaks.

Hardy pods in human excrement

As the parasites injure the cells lining the small intestine, they reduce nutrient absorption and lead to widespread damage, causing the hallmark symptoms of cyclosporiasis, such as nausea and diarrhea, Barratt says.

A single milliliter of that diarrhea can contain around a thousand of these parasitic pods, Carruthers says.

As far as scientists can tell, people only get sickened by Cyclospora when they inadvertently ingest these pods in food or water contaminated with traces of human waste.

But not when the waste is fresh. "When [the oocysts are] immediately shed, they're not infectious," Barratt says. "They have to sit out there in the environment and mature."

The science isn't clear on how long it takes for them to become infectious. It could be days or weeks; it may be affected by the seasons.

The parasite can enter the food system from tainted dirt or irrigation water, or germy hands handling the produce. It might be further spread by the industrial washing process, where many pieces of produce are rinsed in the same water.

The Cyclospora pods are hardy: They can remain viable in water or on crops, surviving chlorine, sunlight and cold temperatures.

Infections can linger

Inside the body, Cyclospora infections can last for weeks or months. "It's much more complex than the typical viral stomach bug that you can pass in a day or two," says Dr. Bobbi Pritt, a microbiologist at Mayo Clinic and director of its Clinical Parasitology Laboratory.

A combination of certain antibiotics — sold under the brand names Bactrim, Septra or Cotrim — can help by stopping the parasites from replicating and giving the immune system a better chance to clear them, Carruthers says.

Cyclosporiasis isn't typically fatal, and people's bodies seem to get better at fighting it off in places where the parasite is more common, including tropical and subtropical regions.

Where Cyclospora is endemic, studies have found that "it tends to be younger people who get the symptomatic infections; older people don't tend to get symptomatic infections," Carruthers says. "That would imply that you can build up some immunity to it, but that it may take several exposures to do that."

It’s a ‘mystery’ why this is a big outbreak year

In the U.S., Cyclospora has been causing more suffering in recent years.

Cyclosporiasis outbreaks detected in the U.S have been "up and down a little bit, kind of choppy," after large outbreaks in 2018 and 2019, Barratt says. "But this year it's just going straight through the roof."

One major reason for cyclosporiasis outbreaks in the U.S. is the imported food supply. "We're getting produce and other food materials from all around the world. Many of these are endemic countries where people don't have access to good sanitary facilities," Pritt says. Human waste containing Cyclospora "gets into the groundwater or it contaminates the plants that are being grown directly."

Still, it's a mystery why cyclosporiasis cases in the U.S. are so widespread this year. "It might just have been bad luck," Pritt says, "with a large dose that was put into products that just happened to be high consumables," destined for big chain restaurants like Taco Bell, whose shredded lettuce from Taylor Farms in central Mexico has been linked as one source of illnesses in a nine-state cluster. Taylor Farms voluntarily recalled that product on July 17.

Public health authorities are still working to figure out additional sources. In North Carolina's outbreak, parsley and cilantro may be another culprit, according to the state health department.

In the meantime, health officials recommend washing and cooking fresh vegetables to cut your risk of a gut-busting infection.

Copyright 2026, NPR

By the time summer rolls around, Minnesotans are eager to dive into their beloved lakes and ride bikes on trails. However, extreme heat, wildfire smoke and an army of mosquitoes and ticks can make summer less appealing.

This year, there is another curveball: a microscopic party crasher known as the cyclospora parasite, which is suspected of making over 18,000 people in the United States sick.

Cyclospora is typically found in contaminated produce or water and can lead to symptoms such as watery, frequent and explosive diarrhea.

While cases of gastrointestinal distress and diarrhea rise every summer in Minnesota, the likelihood that these incidents are due to the cyclospora parasite remains relatively low.

Has the national cyclospora outbreak reached Minnesota?

Minnesotans can be reassured that the large multistate outbreak of cyclosporiasis infections, a gastrointestinal illness caused by cyclospora, has not yet reached the state.

The Minnesota Department of Health has identified 98 cases of cyclosporiasis since May1, marking the beginning of what the CDC considers cyclospora season in the U.S.

“We see cyclospora every single summer in Minnesota, and what we are seeing is right on par with what we would expect to see,” said Trisha Robinson, supervisor of the waterborne diseases unit at the Minnesota Department of Health.

Robinson mentioned that cases of cyclosporiasis are expected to increase for the remainder of the summer.

The health department has not identified any cases in Minnesota linked to the outbreak and is not observing any concerning trends. Currently, there is no evidence to suggest that the contaminated food items were distributed in Minnesota.

Why is it so hard to trace the source of an outbreak?

The CDC and U.S. Food and Drug Administration have linked a subcluster of the current cyclosporiasis outbreak to iceberg lettuce. Taylor Farms, the supplier, has recalled all iceberg lettuce sourced from central Mexico that is available in the U.S. market.

A separate investigation is ongoing to identify other cyclosporiasis clusters across the country, but no specific product has yet been pinpointed as the source.

Tracking the source of a cyclosporiasis outbreak can be more challenging than other foodborne illnesses due to its long incubation period and the difficulty in obtaining samples.

Robinson emphasized that there is typically about a one-week period between when a person is exposed to when they start showing symptoms, although it can sometimes take up to a couple of weeks.

Parasites have a much longer incubation period, requiring time outside the human host to become infectious. According to Robinson, this can result in a significant delay in symptoms, making it different from viruses like the common cold or influenza.

This delay in becoming infectious can lead to contamination events occurring long before the subsequent illnesses are recognized as part of an outbreak. This situation, Robinson said, is a key reason why identifying the exact source of an outbreak can take time.

How do people get infected with cyclospora?

Unlike other foodborne pathogens, such as salmonella and E. coli, cyclospora is primarily transmitted through food or water that has come into contact with human feces. This can occur when produce is irrigated or washed with contaminated water during agricultural production.

Robinson said cyclospora is most commonly associated with environmental contamination. If the irrigation water supply on a farm comes into contact with wastewater and is not adequately filtered, it can contaminate crops intended for human consumption, and people become ill after eating food, usually fresh produce that is contaminated with the parasite.

There is no evidence that cyclospora spreads from person to person. "This is a human-only pathogen," Robinson said.

What can Minnesotans do to stay healthy?

Cyclospora can remain on certain types of produce that are hard to wash thoroughly, such as leafy greens, cilantro, and berries. Robinson mentioned that cooking fresh produce at high temperatures effectively eliminates this parasite.

The health department advises following safe food-handling practices, which include washing hands and fresh produce, to minimize the risk of illness.

If diarrhea persists for an extended period, Robinson said it's important to contact a healthcare provider for appropriate treatment.

“Even though cyclospora seems to be the hot topic of the summer, there are lots of other pathogens that are causing diarrhea that also are important,” she said. “We want to make sure that they're not being overlooked.”

Healthcare providers can test for cyclospora. Robinson noted that they previously had to order a specific test for cyclospora. However, advances in testing methods have led to an increase in the number of identified cases over the past decade. Under Minnesota’s reportable disease regulations, all laboratory-confirmed cases must be reported to the Minnesota Department of Health.

Cyclosporiasis can be treated with a seven- to ten-day course of antibiotics, and most individuals start to feel better within a few days. Additionally, public health officials recommend replenishing lost fluids by drinking water or electrolyte solutions as an essential part of successful treatment and recovery.

A play by two Minnesota writers about women’s health will make its debut at the Edinburgh Festival Fringe in August.

“Endometriosis: The Musical” is about Jane, a woman who is trying to find the answer to why she’s in chronic pain.

Turns out her ailment is in the title of the play. The musical illustrates the same challenge that many face trying to find the answer to that same question.

Maria Bartholdi and Kristin Stowell worked together to bring the play to life for the 2022 Minnesota Fringe Festival. Then in 2025, they premiered the full show at Theater in the Round in Minneapolis.

Stowell said the play comes from personal experience, even if both writers didn’t know it at the time.

“So it’s like my goal to let women see themselves in this who are dealing with this and have a question they can bring back to their doctor. Like, could it be endometriosis?” Stowell said.

For Bartholdi, she didn’t realize she may have the same disease until after they premiered the play.

“This show helped diagnose me, which I think is just one of the miraculous things that we hope this the show does for other people as well,” Bartholdi said.

Dr. Wendy VanBuren, a radiologist at Mayo Clinic in Rochester, said she’s a fan of the musical and how it spreads awareness for this common but underdiagnosed disease.

“Cells that are similar to but not identical to the cells that comprise the lining of the uterus, the inside of the uterus, are located outside the uterus,” said VanBuren. “When they’re outside the uterus, there isn’t the right environment to deal with that. So basically, what you get is bleeding, and then you get inflammation.”

Roughly one in seven people who are assigned female at birth live with the disease, and it can take nearly a decade to get a diagnosis.

Now, Bartholdi and Stowell's musical will have its international debut at the Edinburgh Festival Fringe in Edinburgh, Scotland.

“We're excited to bring it to a broader community and share it and help women with that feeling of 'it feels terrible to go to the doctor.'”

The show debuts at the festival on Aug. 5 and runs until Aug. 31.

Jacob Schlichter has been ready to open his cannabis dispensary for nearly a year.

Instead, he’s watched empty shelves collect dust.

“I get emails every day of people trying to sell me their product,” Schlichter said. “You pretty much had to be ready to operate to even pass your inspection with the OCM. So I’ve been ready to go for a year now.”

Schlichter’s business, The Smoking Tree, became the first non-tribal cannabis dispensary to receive a license from Minnesota’s Office of Cannabis Management last summer. But the city denied his registration.

After a nine-month legal battle, the Minnesota Court of Appeals ruled in May the city’s denial was arbitrary — a decision in his favor.

“Councilmembers expressed both clear understanding and dissatisfaction that their role in the cannabis registration process is limited, yet they disregarded those limitations by denying Schlichter’s application, despite city staff’s evaluation that it complied with all requirements of the city’s ordinance,” wrote Minnesota Court of Appeals Judge Lisa Beane in May.

The city is now reconsidering Schlichter’s dispensary. City manager Ian Rigg said in an emailed statement that Albert Lea is following the court ruling and sent a new application to Schlichter. Albert Lea did not file an appeal to the Minnesota Supreme Court on the court ruling.

The city currently has four registered cannabis dispensaries and Rigg said the majority of the city council supports legal cannabis businesses operating in the city.

“We have to consider his registration per the court ruling,” Rigg said. “I cannot speak as to any guaranteed result as the council will consider the facts and legal advice before making a decision.”

The dispute around Schlichter’s dispensary centered on how the city evaluated his application. During the review process, council members raised concerns about his past criminal history — in 2017 he was convicted of a misdemeanor that has since been expunged. Council members also expressed frustration about cannabis policy and a lack of local control before denying him.

The appeals court found Albert Lea did not follow its own ordinance that dispensary registrations would be handled on a first-come, first-served basis and considered issues beyond the requirements of Schlichter’s application.

Susan Burns, a Minneapolis-based cannabis attorney who’s followed the case, said state law doesn’t allow municipalities to prohibit cannabis business.

“Cities certainly can design their own registries and processes,” she said. “They're permitted to do that, but they can't use their discretion as a backdoor to deny applicants for reasons the ordinance doesn't authorize, which is what happened in the Albert Lea case.”

Cities and counties can only govern time, place and manner of cannabis businesses through zoning ordinances.

Schlichter and his attorney are now reviewing the new application the city sent him. He said Albert Lea should instead reconsider his original one, since it was already determined that it complied with local ordinances.

“The worst case scenario is that filing a new application would essentially erase all of the progress I’ve made because then they could have more discretion with how it's handled compared to my initial application, which was noted to have met all the criteria,” he said.

Rigg said in his statement the new application is needed to “satisfy requirements of the ordinance and inform the Council in order to consider the registration.”

This summer, blood donations have reached a four-year low, worsening the ongoing emergency blood shortage.

In early July, the American Red Cross declared a national "blood crisis" as the number of donations has not kept pace with hospital demand. Factors contributing to this crisis include extreme heat, poor air quality, and widespread foodborne illnesses, all of which the Red Cross said have contributed to lower donor turnout this season.

“It's the most extreme situation that we’ve found ourselves in,” said Brice Johnson, CEO of the American Red Cross for Minnesota and the Dakotas. “This is only the second blood crisis that we have declared in the Red Cross's history, so that’s significant.”

The Red Cross reported a 25 percent decrease in blood donations in June. While a drop in donations during the summer months is typically expected due to vacations and school breaks, Johnson noted that this decline is particularly concerning.

Johnson emphasized the importance of guaranteeing that blood products are available for a diverse range of patients, including those in trauma situations, undergoing surgeries, in maternity wards, and cancer patients who depend on blood transfusions.

“They all need blood to function, and so we're just encouraging people to roll up a sleeve and come out and donate that unit of blood,” he said.

Only about three percent of eligible blood donors actually donate. The Red Cross is requesting donations of all blood types, but there is an urgent need for O negative and O positive blood. According to Johnson, half of the population has one of these blood types, making them beneficial for the greatest number of patients. These blood types are also crucial during emergencies and trauma care.

Due to the recent decline in supply, the Red Cross is now limiting the distribution of type O blood products to hospitals, as their supply has fallen below a one-day reserve.

“Blood products have a shelf life. It's not something that we can manufacture or stockpile,” Johnson said. “It's not like we can collect a bunch of blood in the fall or the winter and save it for the next summer. The shelf life for platelets and plasma is even shorter, so we are only able to supply those products to hospitals in real time.”

The Red Cross is calling on community members to donate blood. Donors can schedule appointments for blood or platelet donations by visiting the Red Cross website or calling 1-800-733-2767.

Blood donors can donate every 56 days, while platelet donors can donate up to twice per month. Before donating, contact the Red Cross to confirm your eligibility.

Sam Ato Timaloa, a paroled sex offender who also served time for attempted murder, had dementia and an acute intolerance of noise — especially from roommates at Sunrise Post Acute, a nursing home in Banning, California. Over four months in 2025, a state investigative report found, Sunrise switched Timaloa's room eight times, the last into one occupied by Attilio Cecchetto, 92, a retired tile installer whose dementia led him to frequently moan, mumble, and yell.

Overnight, a nurse aide walked into their room and saw blood splattered on the floor, walls, and ceiling, according to a grand jury transcript. Cecchetto's face "looked twisted and smashed," the aide testified. A Banning city police officer testified that Timaloa, 77, told him that he had punched Cecchetto twice.

"He just kept saying that Attilio was being too loud: 'He talks too much,'" the officer said.

Cecchetto died two days later from blunt force facial trauma.

"You get placed in a facility like this to be taken care of, not to be murdered," one of his sons, Gino Cecchetto, said in an interview. "This was completely preventable at many different points."

Timaloa pleaded not guilty to assault. The charges were later upgraded to murder, and a judge ordered a mental health evaluation. The judge will rule as early as August on whether Timaloa is competent to stand trial.

PACS Group, the nursing home chain that owns Sunrise, denied negligence. "We strive to provide quality care to everyone we serve, and our hearts continue to go out to the Cecchetto family for their loss," PACS spokesman Brooks Stevenson said in an email.

In nursing homes primarily occupied by impoverished people as well as posh assisted living facilities that cost upward of $10,000 a month, agitated residents have shoved, punched, bit, and kicked others. They have wielded canes, walkers, pens, a plate, a mop stick, a shoe, a belt buckle, and even the footrests of wheelchairs as weapons, federal inspection reports show.

How often these altercations take place nationwide is unknown, but an in-depth study of 14 assisted living facilities in New York state led by Cornell University researchers estimated 1 in 7 residents experienced aggression within a month, including verbal, physical, or sexual acts. Their separate study of 10 New York state nursing homes estimated 1 in 5 residents experienced an altercation in a month. Researchers have found that these assailants are disproportionately likely to have dementia.

The diseases that cause dementia can impair brain circuits involved in impulse control and threat perception, raising the risk of aggressive behavior. Residents with Alzheimer's disease and other dementias constitute more than 900,000 of the 2.2 million people living in these settings, many of which include specialized memory care units.

Often, altercations involving a resident with dementia erupt after danger signals are missed or ineffectively addressed, according to a KFF Health News examination of court records, police reports, and state and federal inspection reports.

Since the start of 2024, the federal Centers for Medicare & Medicaid Services has faulted nursing homes at least 700 times for failing to protect residents from physical, sexual, or verbal abuse by other residents, CMS inspection reports show. The federal records do not include assisted living facilities, which are regulated by states.

In the first three months of this year, CMS cited nursing homes more often for resident-to-resident abuse than for any other type of abuse, neglect, or exploitation, including abuse by employees, the reports show.

The long-term care industry says not every clash can be averted. Presbyterian Homes & Services, a nonprofit Christian chain of senior living facilities, said in a statement: "Caring for individuals living with advanced dementia is complex, and behaviors can change in ways that are difficult to fully predict or prevent, even with clinical interventions in place."

Eilon Caspi, a dementia consultant and researcher who studies resident-on-resident altercations, said that usually there is a specific unmet need that precedes an altercation. "In the vast majority of incidents," he said, "there are warning signs in the months, weeks, days, hours, and sometimes minutes and seconds prior."

Breeding grounds

One psychological theory about Alzheimer's, the most common dementia disease, holds that as the brain's networks deteriorate, the balance shifts between the prefrontal cortex, which helps govern judgment and self-control, and limbic regions including the amygdala, which helps process fear and threat responses.

As cognition clouds, people lose the ability to understand what is happening around them and to put distress into words, researchers say. Pain, infection, medication side effects, and other physical and emotional distresses may be expressed through shouting, intimidating gestures, kicking, pushing, or punching. Long-term care facilities can be triggering environments, with intimate care often delivered by a changing stream of aides whom residents can't recognize. Amid noise, close quarters, and rigid routines, interactions become flash points.

"You don't feel safe, because you don't know these strangers who are coming in and taking off your clothes," said Al Power, a geriatrician and an advocate for alternative models of care for people with cognitive issues. "These things will be distressing to anybody."

The Cornell researchers found verbal altercations were the most common type of aggressive interaction but estimated 4% of assisted living residents and 5% of nursing home residents in their studies experienced physical assaults in a month.

Another Cornell study found that Connecticut police were called to nursing homes for resident-to-resident clashes more often than allegations of staff abuse, theft, and residents wandering away without supervision combined. A national analysis of survey data from the Centers for Disease Control and Prevention calculated nearly 8% of residents in assisted living facilities engaged in physical aggression or abuse toward other residents or staff members.

Many of the physical aggressions KFF Health News identified in CMS inspection reports were perpetrated by residents with diagnoses of dementia, schizophrenia, or other cognitive disorders. In some physical altercations, both residents were aggressors, while other fights were one-sided. Sometimes the residents were roommates.

Laura Mosqueda, a geriatrician at the University of Southern California's Keck Medicine in Los Angeles and a senior adviser to the National Center on Elder Abuse, said: "What worries me is that we just end up blaming two people who have either cognitive impairment or severe, uncontrolled mental health issues, when they're supposed to be in an environment where people are safe."

"Only a matter of time"

Gladys Lynch, a retired department store accountant, transferred into the memory care unit at Harbor Crossing in White Bear Lake, Minnesota, in September 2025. Her monthly cost was more than $10,000, according to an invoice provided by the family.

One of Lynch's daughters, Rebecca Norton, installed web cameras in her room and often saw another resident inside. "Every day I looked at it, this woman would be walking into my mom's room, harassing her, digging through her things, using her bathroom, yelling at her," Norton said in an interview. She informed Harbor Crossing's administration, and the facility said it would start locking her mother's door.

Norton emailed a Harbor Crossing administrator a list of issues with her mother's care. "My biggest concern," she wrote, was that her mother's door was not consistently locked and the webcam showed the woman had again entered, rummaged through the bathroom, and taken a couple of adult diapers.

Unknown to Norton, Harbor aides had raised concerns about the other resident, who like Lynch was new to Harbor Crossing's memory unit, according to a Minnesota Department of Health report. Diagnosed with Alzheimer's, severe dementia with agitation, depression, and anxiety, the woman was confused, had difficulty communicating her needs, and hit aides.

Aides repeatedly reported that the woman had "ongoing aggression, entered other residents' apartments, invaded others' personal space, and was difficult to redirect," the health report said. They said medications had been ineffective and pressed for new ones. The report said one nurse told the woman's doctor it was "only a matter of time before" she "hurts another resident."

Captured on camera

On the last day of September, she entered Lynch's room and resisted leaving, the state report said. The next morning, she reappeared. Video of the incident was described in the police and state reports and reviewed by KFF Health News. It shows Lynch guided the woman out and appeared to attempt to lock the door, but the woman opened it and returned once more.

The woman declared it was her house, went into Lynch's bathroom, used the toilet, and then returned to the room Lynch was in. Lynch can be seen repeatedly pressing the alert pendant around her neck to signal nurses for help.

The video shows the woman was almost out of her apartment door when she attempted to touch an object near the door. Lynch put her hands up to block her. The woman slapped at her hands and said, "I'm going to kill you if you don't quit it." She pushed Lynch, who fell, her head hitting the floor and blood seeping out.

Aides arrived 13 minutes after she had initially pressed her pendant, the state report said. Lynch suffered a brain hemorrhage and fractures to her eye socket and ribs, according to the state report. She died in the hospital five days later at age 96; the medical examiner's office declared it a homicide.

Norton said her mother was kind and pleasant and never combative. "My mom deserved better than what they gave her," she said.

Prosecutors declined to bring charges, according to the police report. The state investigation concluded Harbor Crossing was responsible for neglect because it was aware the woman "exhibited violent and aggressive behaviors" and, yet, had failed to put in place effective interventions. Harbor Crossing has requested the state reconsider its findings.

In June, Suzanne Scheller, the attorney for Lynch's family, filed a wrongful death lawsuit against Presbyterian Homes, which owns Harbor Crossing.

Presbyterian said in a statement: "We are deeply saddened by the loss of Ms. Lynch, and our thoughts remain with her family and all those impacted." It declined to comment further on the incident or the lawsuit.

Preventive tactics

Geriatricians, researchers, and resident advocates say long-term care homes should employ strategies to reduce the risk of altercations, including closer supervision of residents at high risk, relocating them closer to nursing stations, separating residents with repeated conflicts, and adjusting roommate assignments or seating in shared spaces.

Each resident should have a care plan, and homes should train staff to be alert to a resident's triggers and intervene quickly, dementia specialists say. Organized activities are essential to keep residents occupied and engaged. Antipsychotics and other psychotropic medications are often prescribed, but they can increase the risk of falls, strokes, and even death.

An aide can be assigned to watch a particularly challenging resident one-on-one, but many places lack enough staff for protracted, dedicated supervision. Some assisted living facilities will tell a resident's family they must hire a personal aide, who can cost thousands of dollars extra each month. In extreme situations, facilities might send a resident to an emergency room for evaluation or to a psychiatric hospital, or evict or discharge them.

Camille Russell, who served as Kansas' long-term care ombudsman until 2024, said she observed nurses and aides were often "woefully undertrained" in basic elements of dementia care.

"We've gotten too far away from making decisions that are caring decisions," Russell said. "There has to be a balance, and the balance has gotten too far to the profit side."

A debilitating kick

Many physical altercations between residents result in a scratch or a bruise, but nonfatal scraps can leave permanent damage on deeply frail residents.

Linda Twiddy's first weeks in a Chesapeake, Virginia, memory care unit in August 2024 were happy, her daughter, Barbara Howerin, said in a May interview. Twiddy, a former church secretary with vascular dementia, sang along with a visiting church choir, decorated pumpkins, and visited a cat cafe. The facility, The Vero at Chesapeake, charged Twiddy a one-time $6,825 move-in fee and monthly charges of $7,475, according to the lease.

Seven weeks after Twiddy started living there, a nurse called Howerin. She told her that her mother had been kicked in an altercation with another resident and was being sent to the hospital.

When Howerin arrived at the hospital, she was shocked by the extent of the injury. "It was like 10 inches long by 6 inches wide, the whole front of her shin," she said. "The calf was just like dangling down."

According to an internal facility incident report the family obtained, an aide heard Twiddy scream for help and raced over to see a male resident with dementia trying to hit Twiddy as she sat on the floor in "a pool of blood." The report said, "Linda was screaming get him away from me, he pushed and kicked me."

The man had prior episodes of aggression, according to documents Twiddy's family obtained in a lawsuit they brought against The Vero in Chesapeake Circuit Court. At his previous facility, a progress note from 2023 stated, he was "becoming very aggressive in tone and actions to residents and staff." He "grabbed another resident by the wrists and pushed her," according to the note. He was sent to an emergency room for evaluation of agitation, according to a hospital report. It did not make clear whether he was discharged back to the facility or elsewhere.

Agitation tied to pain

The male resident's medical records at The Vero said he was diagnosed with late-onset Alzheimer's disease, agitation, and anxiety, according to his doctor's deposition. He had chronic pain in his back and trouble sleeping. He could answer simple yes-or-no questions but had trouble providing more extensive answers and couldn't communicate that he was in pain, she testified. His behavioral changes usually occurred when he had a urinary tract infection, the doctor said.

When he was agitated, aides could sometimes calm him by turning on the television so he could watch his beloved New England Patriots, one aide testified in a deposition. A former aide said she tried to avoid dealing with him altogether. "If you go up to him and he was agitated, he'd reach out to try to grab you," she testified. "If he had that cane, he would swing that cane or he would punch at you."

In a court filing, The Vero denied allegations by Twiddy's family that it should have protected residents from him. The filing said The Vero complied with all standards of care and that any injuries Twiddy sustained "were caused by her own negligence" or acts of others.

In their investigation of the incident, Virginia regulators alleged The Vero had failed to assume responsibility for the health, safety, and well-being of its residents. The inspection report said The Vero pledged to appropriately staff the memory care unit based on the number of residents and to ensure someone completed rounds at least every two hours during sleeping hours.

Twiddy underwent three surgeries at the hospital for her leg, including a skin graft, then spent a month in rehabilitation. "She was never able to walk again," her son, Doug Twiddy, said in a May interview.

The family moved Linda Twiddy to a different memory care facility where the nursing station had a clear view of all the rooms. She lived there until her death earlier this year.

The lawsuit was settled on confidential terms in early June. Carlton Bennett, the family's attorney, declined to comment. In an email, Lauren Rogers, a spokesperson for Sinceri Senior Living, which operates The Vero, said the company was pleased the legal case had been resolved but could not comment further, citing confidentiality and patient privacy.

"The Vero at Chesapeake is committed to providing a caring, supportive environment where resident health, safety, and well-being remain our highest priorities," she said.

A history of violence

After Attilio Cecchetto was fatally bludgeoned at Sunrise Post Acute, his adult children and their attorney, Jody Moore, discovered disturbing details about Sam Ato Timaloa. He had been imprisoned in 1999 after being convicted of raping an underage girl and sentenced in 2008 to 24 years in prison for attempted murder involving domestic violence, according to Riverside County court records. His public defender declined to comment.

Cecchetto's sons, Moore, and her colleagues at Moore Hutchins Moore also learned more about the home's owner, PACS Group, a publicly-traded company with more than 300 long-term care facilities. Last year, PACS earned $191 million on revenue of $5.3 billion, according to its annual securities filing.

In the lawsuit the Cecchettos and their father's widow filed against PACS, they accused the company's founders, Jason Murray and Mark Hancock, of draining resources from their nursing homes to pay for the chain's expansion and swell their personal wealth.

The two had earned more than $650 million through stock sales since taking the company public and bought two private luxury jets, according to the lawsuit and securities filings. PACS has also purchased corporate sponsorships for Utah sports teams even though it owns no nursing homes in the state, the lawsuit said.

California regulators fined Sunrise $120,000 for failing to protect Cecchetto and for not taking Timaloa's articulated dislike of noise into account when assigning rooms. Medicare issued its own $62,810 fine.

In legal papers responding to the Cecchettos' lawsuit, PACS denied negligence for his death and alleged he "failed to exercise ordinary care on his own behalf for his own safety." It has sued to overturn the $120,000 state fine, saying it was issued too late and that Sunrise "did what might reasonably be expected of a long-term health care facility licensee acting under similar circumstances" to comply with state rules.

The Cecchettos' lawsuit asks for a judge to impose robust procedures PACS homes must follow for admissions, staff training, room changes, and the reporting of altercations between residents. The suit asks for a court-appointed monitor to oversee compliance. In its written statement to KFF Health News, PACS said "important context" would come out during the process and declined further comment.

In an interview, Cecchetto's three sons, Dino, Gino, and Marco, described their father's life. He spent his childhood on a farm in Italy, growing up under Benito Mussolini. After World War II he moved to Canada, where he learned to tile and lay marble and terrazzo, a decorative flooring material made of chips of stone, glass, or other materials embedded in cement or resin. He relocated to California in the early 1960s, became naturalized, and worked as a tile journeyman and a contractor for decades.

"We don't want this to happen to somebody again," Gino Cecchetto said. "With the life he led, he deserved a quiet, dignified death. Instead, he ended his life in pain and fear."

DATA METHODOLOGY

KFF Health News' analysis of federal nursing home inspection reports focused on citations for violations of Medicare and Medicaid regulations stating that each resident has the right to be free of abuse, neglect, and exploitation.

The analysis looked at the most serious levels of citations, those in which inspectors determined that one or more residents had been harmed, or that the facility's actions caused — or were likely to place residents in immediate jeopardy of — serious injury, harm, impairment, or death. We reviewed the reports since January 2024 and tallied those that explicitly described resident-to-resident altercations.

We conducted a more granular analysis of a subset of the inspection reports from January through March 2026 involving harm or immediate jeopardy. Each report was reviewed and categorized by the type of abuse, neglect, or exploitation.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.

Copyright 2026, NPR

For many people, going to the dentist is easy to put off — until something hurts.

Millions of Americans don’t get regular dental care because of cost, lack of insurance, difficulty of finding a provider or fear of the dentist.

MPR News host Angela Davis talks with two experts about why oral health matters, the barriers that keep people out of the dentist’s chair and what’s being done to make dental care more accessible.

Guests:

• Dr. Elmi Abdulkadir Elmi is a dentist and co-founder of All About Dentistry, a general dental practice with locations in Burnsville and West St. Paul. He was also selected as a 2026 Bush Fellow, recognized for his work expanding access to oral health care.

• Dr. Sheila Riggs is an associate professor of dental public health in the School of Dentistry at the University of Minnesota and chair of the Association of Critical Access Dental Providers of Minnesota.

Here are some of the resources that were discussed on the show:

• Dental Clinics and Services - Help Me Connect

• Public Resources | Minnesota Dental Association

• University of Minnesota Dental Clinics

Subscribe to the MPR News with Angela Davis podcast on: Apple Podcasts, Spotify or RSS.

Use the audio player above to listen to the full conversation. 

Anthony Fauci declined to answer any questions before a Senate committee focused on the coronavirus pandemic Wednesday morning.

"Although it pains me to do so, because of the respect I have for the legislative branch of government, and my decades-long record of cooperating with Congress, under the advice of my attorneys, I will invoke my right under the Fifth Amendment of the Constitution to refrain from answering your questions," Fauci said in front of the Homeland Security and Governmental Affairs Committee.

Fauci, who was subpoenaed to appear by Kentucky Senator and committee chair Rand Paul, has long sparred with the senator over the origins of the coronavirus that caused the pandemic. Days before Wednesdays' hearing, Paul released over 1,000 pages of Fauci's private writings, accusing him of covering up origins of COVID-19.

At the hearing, Fauci pointed out that he has responded to similar questions in previous testimony. And Fauci accused the senator of being obsessed with trying to get him behind bars.

The hearing comes days after Paul released diary entries he says were written by Dr. Anthony Fauci – the country's leading infectious disease specialist during the COVID-19 pandemic – that chronicle Fauci's daily life between December 2019 and December 2022.

The over 1,100 pages of entries span the final years of his tenure as director of the National Institute of Allergy and Infectious Diseases (NIAID). He retired in December 2022.

Sen. Rand Paul, R-Ky., posted the documents over the weekend, took them down on Monday evening and reposted them by Tuesday morning with redactions. Paul also released a 465-page "prequel," a collection of Fauci documents including records and email exchanges from 2001 to 2015.

This was all in advance of Wednesday's Senate hearing, where Fauci will testify.

Debate that won't abate

The hearing follows years of debate about the pandemic's origins, and whether the virus that causes COVID-19 emerged from a Chinese laboratory.

Paul chairs the Senate Homeland Security and Governmental Affairs Committee, and subpoenaed Fauci as the latest move in the pair's public disagreement about the origins of coronavirus.

In a thread on X over the weekend, Paul wrote that the diary entries show what Fauci "wrote privately and what he told the country are two different stories."

A spokesperson for Fauci sent a document fact-checking Paul's claims and a letter written by Fauci's legal team to Paul last month. In that letter, Fauci's lawyers wrote Paul was waging a "years-long public crusade" against Fauci.

"You are single-mindedly fixating on seeing Dr. Fauci prosecuted for imaginary crimes, and you are so invested in that outcome that you have created a personal brand around it," says the letter, which NPR reviewed.

Paul did not respond to NPR's requests for comment in time for publication. It is also unclear how Paul obtained the Fauci diary documents, though a video posted Tuesday on X by Health Secretary Robert F. Kennedy Jr. mentions digging them "out of 11 separate servers."

What Fauci's notes reveal

At first glance, Fauci's notes show him dealing with his increasing fame: including references to new security details, police guarding his home, celebrity encounters and "becoming an international celebrity" himself. The notes have the sentence fragments and typos of someone quickly recording their thoughts.

"Big front page article abut me appeared in the Washington Post," Fauci writes on May 21, 2020. "Very flattering. The situation with my national and international fame is explosive and really unimaginable. It is not hyperbole to say that today I am the most famous and talked about person in the country and one of the most recognizable peson in the world."

But the entries also show Fauci reacting with increasing alarm to case counts and the death toll and wrestling with questions about how the virus spread.

Consensus for natural origin

The current scientific consensus is that the virus is likely natural in origin. That means many scientists think the available data suggests COVID-19 started when someone in China was infected by an animal carrying the virus.

However, another theory popular with some researchers and President Donald Trump suggests SARS-CoV-2, the virus which causes COVID-19, spread from a Chinese government lab in Wuhan that was working with bat coronaviruses.

Paul alleges Fauci's notes show he covered up evidence supporting this "lab leak" theory.

On Paul's website, he points to Fauci's entry from Feb. 1, 2020, detailing a conference call between Fauci and prominent scientists.

In his notes, Fauci writes "there was not total agreement" about the virus' origins during the call.

Later in his entries, however, Fauci writes he "is almost certain that the virus evolved naturally from a species jump, even though… I keep an open mind about the possibility of a lab leak," and "that just because two alternatives are possible that does not mean that they are equally probable."

Many scientists say this thought process reflects how their consensus changed as the understanding of COVID-19 evolved.

Felicia Goodrum, a virologist at Dartmouth College who spoke to NPR on Monday from the American Society for Virology meeting in Minneapolis, says the questions in the early days of the pandemic about the lab leak were "normal scientific questioning," when scientists knew very little about how the virus spread.

"I think that's what we acknowledge that Fauci was doing, that there's of course a plethora of unanswered questions," she said of the early days of the pandemic. Now, though, she says those questions are presented as "some sort of signal of guilt that they knew that this was happening."

Gigi Gronvall, a biosecurity expert and immunologist, similarly says these kinds of questions are part of scientific exploration.

"It's not unusual that people would be entertaining a variety of opinions or thinking about a lot of different theories and holes in their theories as they go forward," she says. "That's kind of what science is all about."

The 'lab leak' theory and 'gain-of-function' controversy

The focus of the lab leak theory is the Wuhan Institute of Virology in China.

Part of the ongoing controversy has been whether a U.S. nonprofit helped the Wuhan Institute facilitate what's known as "gain-of-function" research that some believe led to the pandemic.

This kind of research involves experimenting with viruses and other pathogens in ways that give them new abilities. Often, this can help researchers better understand how the viruses work, or how they might become more dangerous or transmissible. The field has long been controversial because of the potential for dangerous pathogens to spill out of labs and cause a pandemic.

The group in question was a U.S. nonprofit called EcoHealth Alliance that researched bat coronaviruses. This included a years-long project in China, which EcoHealth ran in collaboration with the Wuhan Institute of Virology.

At the end of April 2020, the U.S. government stopped funding the project.

Many experts disagreed with the decision, saying that work was vital to preventing the next major coronavirus outbreak. The nonprofit's president at the time, Dr. Peter Daszak, said terminating coronavirus research posed a threat to national security and public health.

In January 2025, the U.S. Department of Health and Human Services (HHS) cut off all funding for EcoHealth and Daszak.

President Trump also restricted funding for gain-of-function research with an Executive Order in May 2025, and on Tuesday the U.S. Department of Health and Human Services (HHS) released a policy it says will establish more oversight for this kind of research.

What does the evidence say?

The Trump administration advanced the theory that the pandemic was caused by the virus escaping the Wuhan Institute of Virology. Leaked cables from the State Department raised concerns about safety protocols at the Wuhan lab.

But as information evolved, scientists cast doubt on what came to be known as the lab leak theory. NPR's Geoff Brumfiel and Emily Kwong spoke to 10 leading scientists in 2020 who all believed the virus spread from animals to humans. They said their analyses of the virus showed no signs of human genetic modification, and that it infected people in a way scientists had never seen before — making laboratory engineering unlikely.

The following year, in February 2021, a joint investigation between China and the World Health Organization (WHO) similarly concluded that COVID-19 likely started in bats and made its way into humans via another animal.

At the time, however, the WHO Director-General Dr. Tedros Adhanom Ghebreyesus criticized the report, saying the team hadn't done enough work to completely rule out the lab leak theory.

U.S. government agencies continued to investigate the pandemic's origins in the following years.

In August 2021, U.S. intelligence agencies failed to reach a firm conclusion — and remained divided on the origins of COVID-19.

In 2023, the U.S. Department of Energy concluded, "with low confidence," COVID-19 originated from a lab leak. This was in direct conflict with many scientists who study the origins of pandemics, who said much of the evidence still pointed to a natural origin.

A Republican-led Select Subcommittee on the Coronavirus Pandemic concluded in December 2024 that a lab leak was the most likely explanation for SARS-CoV-2. They also suggested NIH funds contributed to gain-of-function research at the Wuhan Institute of Virology.

A plea for open minds and preparation

Some scientists say there is simply not enough information to make a firm conclusion about how the outbreak began.

"In my view it's important to keep investigating this question with an open mind while also proactively taking steps to minimize the risks of both future research-related and zoonotic outbreaks," evolutionary virologist Jesse Bloom wrote in an email to NPR.

Goodrum says the focus on Fauci's stance may erode public trust in research.

"I think they're trying to sow distrust in science and scientists," she says.

She says many virologists are concerned that funding cuts and the ongoing tension regarding the pandemic's origins are already hindering research focused on preventing the next pandemic.

"We are less safe. We are less prepared for a pandemic right now than we were in 2019," says Goodrum. "And this is terrifying to all of us."

Joseph Kim contributed to this report.

Copyright 2026, NPR

Individuals and groups in Minnesota can now donate unused, unexpired veterinary drugs to benefit animals in need after a new law in effect earlier in July.

The program will reduce medical costs by reissuing donated medications for free to pet owners and animals in need. That can include individuals caring for animals or shelters, pounds and organizations such as the Animal Humane Society, according to Pamela Johnson, the executive director for the Minnesota Board of Veterinary Medicine.

Johnson said it will also reduce veterinary drug waste since medication would have otherwise been discarded.

Now, pet owners and animal organizations will “have access to donated, unused, unexpired, unadulterated veterinary medications,” Johnson said.

Minnesota is one of the first states to adopt such a program, following Rhode Island, Nevada and Colorado.

“This new law creates an important opportunity to help address one of the most important challenges many pet parents face: cost of medications,” said Graham Brayshaw, chief medical officer for the Animal Humane Society.

Johnson and Brayshaw said, for safety reasons, the program will only accept medications in pill form as it is too difficult to detect tampering or measure stability of capsule and liquid medications.

“It's up to the veterinarian who's dispensing or prescribing the medication to ensure all those safety parameters are met,” Johnson said,

Brayshaw said the greatest need is for preventive medications for issues like heartworm, flea and tickborne diseases as well as nonsteroidal anti-inflammatory drugs for pain relief.

People can donate medications right away, but Brayshaw said to check with veterinarians first to ensure they have a system in place to accept, store and reissue medications. The Animal Humane Society is still developing a process.

“We want to make sure that they are ready to receive these medications and redistribute them back out safely to the community,” Brayshaw said.

Nationwide data reports about one-third of people who have pets cannot afford regular vet care, Brayshaw said. That includes about 400,000 dogs and cats in the Twin Cities.

The new law “is not a fix, but this is a good step in the right direction for getting care for all of them,” Brayshaw said.

The veterinary drug donation law was borne out of a recent overhaul of Minnesota’s Veterinary Practice Act, the regulatory framework for the practice of veterinary medicine and technology. Johnson said it was the first update to the Veterinary Practice Act in 30 years.

A long-standing federal funding program that supports HIV prevention efforts nationwide may soon come to an end.

Last week, the Trump administration’s Office of Management and Budget informed the Centers for Disease Control and Prevention that it will not reauthorize $46 million in federal funding for HIV prevention programs.

This funding supports 96 community-based organizations that provide services such as HIV testing, referrals for pre- and post-exposure drug treatment, outbreak response and assistance for newly diagnosed HIV-positive individuals in accessing medical care and treatment.

The grants were temporarily extended through September after originally expiring on June 30. Organizations expected to learn about a new funding opportunity from the CDC before the extension ends, but they have been informed that no announcement will be made.

Instead, the money will be redirected to state and local health departments.

The shift in funding has raised concern among grantees about the continuity of financial support for their work, as the funds will no longer be allocated directly to the organizations.

The Aliveness Project, located in south Minneapolis, is one of the organizations affected by the decision. The Minneapolis-based Indigenous Peoples Task Force, which also receives direct CDC funding, is the other.

These two organizations collaborate closely, and this change could disrupt services for community members who rely on their support.

“With this work not happening in the community, the end result will be more HIV infections, and these folks won't be getting the services that they need,” said Matt Toburen, executive director of Aliveness Project. “They won't be getting the care they need. Folks won’t know that they have HIV.”

The five-year HIV community-based prevention grant provides the Aliveness Project with approximately $450,000 annually. This funding supports HIV testing and outreach efforts in high-risk communities through both clinical settings and mobile outreach.

Aliveness Project outreach workers visit shelters, bars, clubs, encampments and community events to offer rapid HIV testing, which is done with a simple finger prick. They also assist individuals in quickly accessing care, starting them on medication to prevent HIV transmission and connecting them with necessary services.

Many of the people they serve face barriers to accessing traditional healthcare. According to Toburen, these barriers often affect young queer people of color who may not regularly visit a doctor due to stigma or because they do not have a medical professional they feel comfortable discussing their sexual health with.

Toburen noted that in Minnesota, there are approximately 300 new HIV infections each year. He said if people can access care and effective medications, they can lead long and healthy lives.

“It’s an amazing public health win because that's preventing further transmission of HIV,” he said.

Over five years, Aliveness’ community-based prevention services conducted 6,297 HIV tests, identifying 56 positive results, including 51 new diagnoses. More than 96 percent of those who tested positive were connected to medical care within 30 days.

Additionally, more than 6,100 HIV-negative participants were also screened and referred for PrEP, a medication that can help prevent HIV and significantly lower an individual’s chances of contracting HIV through sex.

Aliveness Project did not receive direct communication from the CDC regarding these funding changes and has heard very little from the Minnesota Department of Health’s community-based HIV prevention programs.

Toburen mentioned that it does not seem like the health department plans to use the funds in the same way. He added that the Aliveness Project receives a small grant from the Minnesota Department of Health for HIV prevention, but it will “be a shell of itself.”

“What's so sad is we have this existing infrastructure, we have existing staff, we have the existing relationships in the community,” Toburen said. “So that just gets lost.”

The Minnesota Department of Health said in a written statement that it applied for supplemental grant funding from the CDC for HIV prevention in June but has not yet received approval or funds.

“At this time, the CDC has not given any notice to MDH that funding provided to community-based organizations would be redirected to states, nor was there any indication of that change at the time of MDH's grant application,” said a spokesperson for the health department, in a statement on Friday. “The uncertainty surrounding federal funding poses significant challenges for our public health initiatives.”

Emily Hilliard, senior press secretary for the U.S. Department of Health and Human Services, said in a statement to MPR News that the funding is being streamlined through health departments, but she emphasized the importance of local decision-making in combating HIV and using local data to guide the development of strategies and interventions.

“For the first time in 45 years, the end of this epidemic was within reach, and the federal government is choosing to drag us backward,” Toburen said. “We were born from a community that refused to be abandoned, and we will keep fighting for every person who walks through our doors.”

Eating is a fundamental part of life. So, when things aren’t going well with our digestive system, it affects not only our health but also our routines, social lives and very identity.

And these days, more people seem to be struggling with chronic gastrointestinal problems, including irritable bowel syndrome and autoimmune diseases such as Crohn's disease and ulcerative colitis.

MPR News guest host Kyra Miles talks with her guests and listeners about diagnosing and living with gut problems.

Guests:

• Dr. Justin Howard is a gastroenterologist with M Health Fairview and an associate professor at the University of Minnesota Medical School. He specializes in inflammatory bowel disease.

• Laura Van Riper is the mother of a teenager with Crohn’s disease and leads the regional parent support group for the Crohn’s & Colitis Foundation’s Minnesota and Dakotas chapter.

  

Subscribe to the MPR News with Angela Davis podcast on: Apple Podcasts, Spotify or RSS.

Use the audio player above to listen to the full conversation.    

The Brainerd-Baxter community is grieving after two middle-school students died by suicide within a few weeks.

The deaths have sparked difficult conversations about bullying and mental health, along with the roles of schools and communities in protecting young people.

Last weekend, despite scorching heat, a crowd lined a busy Brainerd street for what organizers called a peaceful assembly. They held signs reading "Stop bullying" and "Be kind. You never know who is fighting to stay."

Other posters displayed photos of two smiling girls, 11-year-old Ava Starr and 13-year-old Alexis Thornton. Both were students at Forestview Middle School in Baxter.

Ava died by suicide on June 19. Alexis took her own life just three weeks later on July 10. Both families say the girls were bullied by other students.

Chantel Smith, Alexis’s mom, described her heartbreak.

"Waking up every day and realizing she's not coming out of her room, or hearing her voice, seeing her jump around, smile, laugh, giggle … Those are the moments I'm going to miss the most,” Smith said.

Alexis's parents both wore purple shirts with their daughter's photo as they accepted hugs from friends and strangers.

“It feels amazing to see everybody wants to see change,” Smith said.

Alexis’s parents say she was bullied in and outside of school. Alexis was biracial, and her parents said some of the bullying targeted her skin color and physical features.

"It made such a beautiful girl want to change her appearance,” said her dad, Brent Willis. “She was created beautiful. There was nothing wrong with my daughter. Nothing.”

The girls' deaths have prompted calls for the Brainerd school district and the community to do more to prevent bullying and suicide.

Eleven-year-old Elizabeth Houle attends Forestview Middle School and knew Ava, who was her age.

"Bullying is not OK,” Houle said. “Some people think that everyone revolves around them, but it's not true. People have emotions."

Elizabeth’s mother, Sandy Houle, said her own children have experienced bullying at school. She said she hopes the community can find ways to better support struggling students, whether that's stronger consequences for bullies or more counseling in schools.

"We need to get to the root of why that’s what people think is the solution, and do what we can to help stop all this bullying, cyberbullying,” she said. “It's horrible. People can be anonymous and say whatever they want."

Efforts to educate on mental health, suicide

At a Brainerd school board meeting last week, Superintendent Chip Rankin said the district is offering counseling and support to students and families.

Rankin said the district will be looking at any gaps in staffing, programs or training it needs to close to support the mental health and well-being of all its students.

"Our people will return better prepared and better supported than ever to care for our kids, and that's a promise I intend to keep,” he said.

Suicide among younger children is becoming increasingly common. It’s now the second-leading cause of death in the U.S. for children and teens ages 10 to 14, said Marguerite Ohrtman, a teaching associate professor and counselor educator at the University of Minnesota.

“We're definitely seeing more and more younger students complete suicide,” Ohrtman said.

She said one contributing factor might be the increasingly young onset of puberty, during which time adolescents can struggle with emotional regulation and impulse control. Bullying, especially online through social media, also can play a role in self-harm and suicide, she said.

After such a terrible loss, people are often quick to blame and ask what they can do differently, Ohrtman said.

“Sometimes it's really hard in grief not having the answers,” she said. “And when someone commits suicide, we don't necessarily have the answers.”

Ohrtman said a key to reducing bullying and preventing suicide is educating people on how to deal with big feelings, engage civilly with people you disagree with, watch for warning signs that someone is struggling and get them help when needed.

"It comes down to parents, guardians. Everybody needs to get involved in this,” she said. “It's not just the Brainerd community. This is something as a country, as humans, we need to do better."

‘Speak up if you know of anyone who’s struggling’

People at Sunday's gathering said they'll continue pushing for change. Ava's aunt, Shannon Miller, read a statement from Ava’s family.

We want to share the message that bullying is never OK. Mental health is important to support and address.

Today is about spreading the word of kind, being kind to those around us. We miss our Ava more than words can say, and we want to do our part to make sure that this does not happen to anyone else's baby.

Love and hold your babies close, and speak up if you know of anyone who's struggling with their mental health. Call 988 if you need support, or reach out to your family and friends.

Miller said the family wants to make sure no other family has to endure the same loss.

"It doesn't cost anything to be kind,” Miller said. “Clearly, it's an issue everywhere, and we need to come together and figure out how we can break the cycle."

If you or someone you know is in crisis or needs immediate mental health support, call or text the Minnesota Lifeline at 988.

Federal officials are withholding nearly $200 million in federal Medicaid payments to Minnesota, attributing the move to suspected fraud in the state’s public health insurance programs.

The U.S. Department of Health and Human Services and the Centers for Medicare and Medicaid announced Tuesday that it is holding back millions while awaiting documentation that shows Minnesota's claims meet federal Medicaid requirements.

The deferral is part of a larger action, which also includes approximately $867 million kept from California. This brings the total to more than $1 billion in paused federal Medicaid payments to the two states.

Minnesota has taken action to respond to prior funding freezes. The amount previously withheld added up to more than $350 million. State officials called the new freeze rooted in politics while the federal government said it was safeguarding taxpayer money.

“Medicaid exists to serve vulnerable Americans, not to bankroll unsupported claims,” said HHS Secretary Robert F. Kennedy, Jr. at a news conference alongside CMS Administrator Dr. ​Mehmet Oz. "If those ​states want that money, they need to provide ​documentation that these payments are legitimate.”

Oz also cited Minnesota’s recent disenrollment of more than 3,000 Medicaid providers following an audit. He said these providers’ billing is a major driver of the $200 million deferral.

The Trump administration was already withholding $243 million from Minnesota.

Minnesota’s Department of Human Services said it has worked in good faith with the federal government to shore up program defenses and avoid misuse of health dollars. Minnesota has been in a court fight with the Trump administration over prior funding holds.

Temporary DHS Commissioner John Connolly said the federal agency hasn’t provided Minnesota with information about how it is identifying potentially fraudulent claims.

“Today’s actions show that the federal government is acting again in unprecedented and punitive ways as part of their war on Medicaid and its recipients,” Connolly said. “Partnership — not politics — is required to stop criminals and protect services for the people who need them.”

In late February, Oz and Vice President JD Vance said the federal government would freeze funds because Minnesota had not adequately addressed fraud in certain Medicaid programs, including those related to autism treatment.

The Minnesota Department of Human Services said that the corrective action plan accepted by CMS was submitted on Jan. 30.

CMS wrote a letter to the Minnesota’s Department of Human Services on March 19 informing the state that its plan to fix vulnerabilities was deemed sufficient. An additional expectation from CMS was that the state will implement a revalidation program for high-risk service providers by the end of May.

Along with the payment deferrals, HHS announced it will broaden its exclusion authority. This expansion will allow both CMS and the HHS Office of Inspector General to remove providers from federal healthcare programs. In certain instances, providers may be permanently barred from returning to these programs.

At least 930 people have died in Congo's Ebola outbreak, the country's Ministry of Health said Monday, with 37 new deaths recorded in a 24-hour span Friday into Saturday, one of the highest totals.

The deaths were recorded out of the 2,344 cases confirmed as of Saturday, the health ministry said.

The Ebola outbreak that was declared in eastern Congo on May 15 is the fastest-growing Ebola outbreak on record. The Bundibugyo virus responsible for the outbreak is less common than others that cause Ebola disease, and there is no approved vaccine or treatment.

Ebola is highly contagious and can be transmitted to people from wild animals. It spreads in the human population through contact with bodily fluids such as vomit, blood or semen, and with contaminated surfaces and materials such as bedding and clothing. The disease is rare but severe and often fatal.

The surge in deaths comes as safety fears have restricted the response in the worst-affected province of Ituri. A total of five provinces have been affected, all in the eastern region where rebel violence is rampant.

At least 12 attacks — mostly fueled by skepticism and rumors — have been recorded against health facilities and teams since the outbreak was declared in mid-May, authorities said Saturday. Many health workers meanwhile have walked off their jobs as they protest lack of payment.

At least 36 health workers infected with the virus have died.

The World Health Organization last week expressed concerns that 80 percent of new Ebola cases were emerging from unknown chains of transmission, a sign the outbreak is spreading faster than health officials can track despite an expanding response.

Congo's Health Ministry said in its latest update that 724 patients are currently in isolation and in hospitals, and that it is intensifying response efforts in affected health zones.

"Patient care and support capacities are consolidating, with 22 new recoveries recorded in 24 hours," the ministry said.

Copyright 2026, NPR