Park County Wyoming Health Officer

11/10/2025

LISTERIA OUTBREAK LINKED TO PREPARED PASTA MEALS

This is an ongoing outbreak of Listeria monocytogenes in prepared pasta meals (especially those containing pasta from Nate's Fine Foods) with 27 cases (7 new), 25 hospitalizations (5 new), and 6 deaths (2 new) in 18 states (3 new).

See the following for a detailed list of the foods recalled.

https://www.fda.gov/food/outbreaks-foodborne-illness/outbreak-investigation-listeria-monocytogenes-prepared-pasta-meals-june-2025

11/10/2025

RECALL - BOTULISM POTENTIALLY IN INFANT FORMULA

The FDA has announced a voluntary recall of 2 batches of ByHeart Whole Nutrition Infant Formula sold at Amazon, Kroger, Walmart, Whole Foods, Target, and Sam's Club.

This involves contamination by spores from the bacterium Clostridium botulinum, which germinate in infants' guts, leading to toxin production that causes paralysis and respiratory difficulties. This is treatable (but can be fatal) and has led to the hospitalization of 13 infants in Arizona, California, Illinois, Minnesota, New Jersey, Oregon, Pennsylvania, Rhode Island, Texas, and Washington.

Early symptoms can include constipation, poor feeding, loss of head control, difficulty swallowing, and decreased facial expression.

See below for product images and how to identify the batches involved (as a precaution, all ByHeart Whole Nutrition Infant Formula should be disposed of). This shouldn't lead to a shortage as ByHeart produces only 1% of infant formula.

https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/response-broader-fda-investigation-byheart-initiates-voluntary-recall-two-batches-infant-formula

11/06/2025

RESPIRATORY PANEL NOW AVAILABLE AT PARK COUNTY PUBLIC HEALTH

With the respiratory illness season fast approaching, it is essential to recognize that although respiratory illnesses can be caused by viruses or bacteria, their initial symptoms can all appear similar. The diseases caused by respiratory pathogens range from the common cold to potentially life-threatening.

Park County Public Health has combined efforts with the Public Health Laboratory at the Wyoming Department of Health to offer the QIAstat respiratory panel, similar to respiratory panels available elsewhere for about $1000. This involves collecting a respiratory sample on a swab that is sent to the Public Laboratory in Cheyenne to be tested for these 22 pathogens:

Adenovirus
Coronavirus (5 varieties)
Metapneumovirus
Influenza (4 varieties)
Parainfluenza (4 varieties)
Rhinovirus
Enterovirus
Respiratory Syncytial Virus (2 varieties)
Pertussis
Chlamydia pneumonia
Mycoplasma

Park County Public Health collects the sample for a $20 fee, and the Public Health Laboratory runs the test for free. For some of these illnesses, there is no specific treatment, and they must run their course. Some should be treated with a prescription. Influenza is caused by a virus but can respond to antivirals. Pertussis, chlamydia pneumonia, and mycoplasma are caused by bacteria and respond to antibiotics. ALL of these illnesses are contagious (so stay home when you are sick).

Park County Public Health will notify your medical provider, who can help interpret the results and provide a prescription if needed. Call Park County Public Health at 307-527-8570 to schedule a time for sample collection in 1 of the following situations:

- Respiratory panel is ordered by your licensed medical provider
- Exposure to someone involved in a cluster/outbreak of significant respiratory disease (as determined by Public Health)

10/27/2025

SAFETY OF mRNA COVID-19 VACCINATIONS IN EARLY PREGNANCY

In this study of more than 500,000 live-birth infants, exposure to the mRNA COVID-19 vaccination during the 1st trimester did not change the rate of 75 different congenital malformations. This is yet another study demonstrating the safety of the mRNA COVID-19 vaccinations in early pregnancy.

This cohort study examines the association between first-trimester exposure to messenger RNA (mRNA) COVID-19 vaccines and the risk of major congenital malformations among infants in France.

10/26/2025

This mixed-methods study examines variation in US state-level policies regarding the oversight and regulation of intravenous hydration spas as well as their product offerings, claims, and practices.

10/26/2025

IV HYDRATION SPAS IN WYOMING

32 states have some form of IV hydration spa guidance. Only 4 have addressed "governance, prescriber credentials, dispensing practices, and compounding practices." This recent study in the Journal of the American Medical Association (internal medicine version) concluded "...that state-level policies governing IV hydration spas and facility practices vary widely, suggesting more stringent oversight may be necessary to protect public health."

In Wyoming IV hydration therapy must be preceded by a face-to-face or telehealth visit with a licensed healthcare provider (physician, physician assistant, or nurse practitioner) to establish a patient-provider relationship. According the Wyoming State Board of Nursing, "It is not within the scope of practice for an RN or LPN to independently engage in acts that require independent medical judgement, medical diagnosis, or the ordering, compounding, or prescribing of IV fluids, IV medications, or IV therapeutic regimens. An LPN or RN must have a provider order to administer IV medications or IV therapy/hydration, including elective services marketed as wellness promotional services at the request of a patient in any setting, such as home, mobile hydration clinic, drip bars, or other non-facility locations." (https://drive.google.com/file/d/1mGdE74LFpZs4vgaAAyxQUnIRtB7YlRWv/view)

https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2839844

This mixed-methods study examines variation in US state-level policies regarding the oversight and regulation of intravenous hydration spas as well as their product offerings, claims, and practices.

10/25/2025

EFFECTIVENESS OF THE 2020-2026 INFLUENZA VACCINE

The southern hemisphere has its winter (and influenza season) during our summer. This allows us to estimate the effectiveness of the influenza vaccine, which is available now for the northern hemisphere influenza season (which hasn't started yet).

This study found that in the southern hemisphere from March to September, the 2025-2026 influenza vaccine was:

50.4% effective against influenza-related outpatient visits
49.7% effective against hospitalization for influenza.

This report describes flu vaccine effectiveness in the Southern Hemisphere during the 2025 flu season.

10/20/2025

PERTUSIS CASES IN PARK COUNTY

Last week 2 unvaccinated children (ages 5 and 6) attending a parochial school in Cody tested positive for pertussis.

Pertussis (also known as whooping cough) is a highly contagious bacterial respiratory illness that is vaccine-preventable and treatable with antibiotics. Infants less than 6 months old are at the highest risk of severe disease and complications.

Pertussis typically has 3 stages.

1. Catarrhal Stage (1-2 weeks): Mild cough, runny nose, sneezing, and low-grade fever (resembling the virus-caused common cold).
2. Paroxysmal State (2-6 weeks): Intense coughing fits (paroxysms) followed by a "whooping" sound upon inhalation, post-tussive (after coughing) vomiting, and cyanosis (lips turning blue due to low oxygen). Infants may present with apnea (periods of no breathing) instead of the classic cough.
3. Convalescent Stage (weeks-months): Gradual reduction in cough episodes, although residual symptoms may persist.

There have been more than 115 cases of pertussis documented in Wyoming since the first of the year (there were only 17 all of 2024, and zero cases in 2023). This is the 3rd and 4th documented cases in Park County this year. Immunity to pertussis wanes with time, whether it comes through vaccination or prior infection. This is why the Tdap tetanus booster includes pertussis.

Pertussis should be considered (and tested for) in individuals with a prolonged cough (>2 weeks) or typical paroxysmal symptoms, particularly in unvaccinated children or high-risk individuals (or symptomatic individuals who are close contacts of someone diagnosed with pertussis). Both those diagnosed with pertussis and their household contacts should be treated with appropriate antibiotics. It is recommended that those diagnosed with pertussis stay home from work and school until antibiotics are completed.

Those with symptoms consistent with pertussis (or any other significant respiratory illness) should be seen by their primary medical provider for evaluation and treatment. For those for whom testing is not feasible through conventional channels, Park County Public Health can collect ($20 collection fee) and send samples to the Wyoming Public Health Laboratory (testing free of charge) in Cheyenne for respiratory panel testing. This test includes pertussis and multiple viruses (including influenza) that can cause communicable respiratory illness. Park County Public Health only serves as a collection point and will refer positive tests needing prescribed treatment (pertussis and influenza) to the primary medical provider. Please call 307-527-8570 for questions or to schedule a time for sample collection.

Brandon Koehler Park County Public Health

10/16/2025

Placebo prescriptions are common in primary care, raising ethical and clinical concerns.

In this survey study of GPs across 21 countries, essentially placebo prescriptions featured in a small minority of consultations, but they nevertheless occurred regularly for most GPs. Rates varied only slightly by GP background characteristics. This suggests that essentially placebo prescriptions w...

10/15/2025

RECENT MISLEADING COVID-19 VACCINATION STUDY

A recently published South Korean study was titled 1-YEAR RISKS OF CANCERS ASSOCIATED WITH COVID-19 VACCINATION: A LARGE POPULATION- BASED COHORT STUDY IN SOUTH KOREA (https://biomarkerres.biomedcentral.com/articles/10.1186/s40364-025-00831-w) and suggests that thyroid, gastric, colorectal, lung, breast, and prostate cancers were more commonly diagnosed in those who were vaccinated 1 year previously for COVID-19 than those who were not vaccinated. There are a few significant problems with this study and the inferences drawn from it.

1. CORRELATION DOES NOT IMPLY CAUSATION - Correlation means two variables change together, while causation means one variable directly causes the other to change. The phrase "correlation does not imply causation" is key, as variables can be correlated due to a third, confounding variable, coincidence, or reverse causation, not a direct cause-and-effect link (https://www.scribbr.com/methodology/correlation-vs-causation/ #:~:text=skewed%20sample%20data.-,Directionality%20problem,causally%20related%20in%20three%20ways). It is impossible for retrospective studies (as this one was) to prove causation. In science, the gold standard for proving causation is prospective randomized controlled trials (https://pmc.ncbi.nlm.nih.gov/articles/PMC7081045/ #:~:text=In%20clinical%20medical%20research%2C%20causality,from%20an%20observational%20study%20instead.). At best, this study suggests a correlation between 2 variables. It is not known if there is a 3rd confounding variable, coincidence, or reverse causation present. This concept is described well in this video: https://youtu.be/Tg6e2Y3IEUk.

2. CANCERS TAKE LONGER THAN A YEAR TO DEVELOP – Analysis of data from the Hiroshima and Nagasaki nuclear bombings shows us that the shortest intervals from exposure to ionizing radiation (one of the most potent carcinogens known) to the diagnosis of leukemia were 2 years and 10 years for solid cancers (https://ascopost.com/issues/may-25-2021/chernobyl-at-35-years-an-oncologist-s-perspective/). A more recent example from the World Trade Center Health Program shows that the minimum latency for solid tumors (which all of the cancers were in the above-referenced study) is 4 years (https://www.cdc.gov/wtc/pdfs/policies/WTCHP-Minimum-Cancer-Latency-Policy-040925-508.pdf).

The fact that the cancers identified in this study are cancers that are routinely screened for in South Korea should be a big red flag. If anything, this study may show that those in South Korea who are more likely to get a COVID-19 vaccination are also more likely to receive routine preventive medical care and to have their cancers diagnosed. This study is another example of the junk science that is becoming more common.

10/11/2025

https://myfox8.com/news/north-carolina/1st-flu-death-of-2025-26-reported-in-north-carolina/?fbclid=IwY2xjawNXXNJleHRuA2FlbQIxMABicmlkETE5Q1did1dwN3pzak9TNjNNAR6ysSgTndjpZjg_lqdJzA2AaMg9IiY9AteCBnBUsdcF7POr_mO604f3z2FntA_aem_wExJNgK5ew2rSVhhPqVhcQ

The first death of the 2025-26 flu season in North Carolina was announced by the Department of Health and Human Services Wednesday.

10/09/2025

PUBLIC HEALTH UPDATE

1. West Nile Virus (WNV) - Wyoming has recently had its 2nd WNV death of the 2025 mosquito season (now 1 death each in Natrona and Fremont Counties).
2. Pertussis - After a lull over the summer, pertussis cases in Wyoming are creeping up now that school is back in session. There is a good chance that we will have more pertussis cases in Wyoming this year than we have had in any year since 2003.
3. COVID-19 - The Advisory Committee on Immunization Practices (ACIP) has met and determined that a prescription will NOT be needed for COVID-19 vaccinations this virus season. Vaccinations should be covered by insurance. They also endorsed individual decision-making in COVID-19 vaccination.

https://www.hhs.gov/press-room/cdc-immunization-schedule-individual-decision-covid19-standalone-chickenpox-toddlers.html