***All questions or comments regarding this alert should be directed or sent to LDH Dept of Public Health.***

Cychlorphine: Emerging, Highly-Potent Synthetic Opioid

The Louisiana Department of Health (LDH) is alerting healthcare and laboratory providers to the detection of 

cychlorphine (N-propionitrile chlorphine)

, an emerging synthetic opioid identified in Louisiana and other states.

Cychlorphine is an emerging synthetic opioid identified in the illicit drug supply across the United States, including in counterfeit pills and drug mixtures. Because routine toxicology testing may not detect cychlorphine, clinicians should 

not use a negative routine opioid or fentanyl screen to exclude opioid poisoning

The priority remains rapid recognition and treatment of opioid toxicity, including 

support of ventilation and administration of naloxone

 when clinically indicated, even when routine drug screening is negative. Because cychlorphine can be more potent than fentanyl, 

overdoses may require multiple doses of naloxone

Office of National Drug Control Policy (ONDCP)

 at the White House reported 106 drug-supply reports across 10 states in 2025, with detections in all four U.S. Census regions. Cychlorphine has been linked to at least 55 deaths nationally from 2025 to 2026, with the highest prevalence in Ohio, Texas, and Tennessee. These data are evolving as surveillance and toxicology testing expand.

There has been evidence of exposure to cychlorphine in Louisiana, and at least two opioid-related deaths involved cychlorphine since December 2025.

Key Clinical Messages in Managing Suspected Opioid Overdose

1. Suspect opioid poisoning based on the clinical presentation, not the toxicology screen.

Patients with depressed consciousness, respiratory depression, or hypoventilation 

should be treated for suspected opioid poisoning when clinically appropriate

, even when routine drug testing is negative.

Routine fentanyl screens may also be negative.

Standard fentanyl and nitazene test strips do not reliably identify cychlorphine.

A positive fentanyl or other opioid result does not exclude co-exposure to cychlorphine.

·A negative screen does not rule out cychlorphine or another opioid exposure. 

Identification generally requires an expanded laboratory method, such as mass spectrometry, that specifically includes cychlorphine.

2. Support ventilation AND administer naloxone.

For a patient with suspected opioid toxicity:

Immediately assess and support airway and breathing.

Provide assisted ventilation, oxygen, and other airway support as clinically indicated.

Administer naloxone when opioid toxicity is suspected.

, rather than requiring complete reversal of sedation.

·Reassess frequently for recurrent respiratory depression.

3. Be alert for recurrent or persistent toxicity.

Patients with suspected cychlorphine or other synthetic opioid exposure may require 

Repeated naloxone dosing or a naloxone infusion may be appropriate when clinically indicated.

 including other central nervous system depressants like benzodiazepines.

Repeatedly escalating naloxone is not a substitute for adequate airway and ventilatory support.

·Disposition should be based on the patient's clinical course and response to treatment rather than an assumed duration of cychlorphine effect.

Routine testing may not detect cychlorphine.

1.  Determine whether cychlorphine/N-propionitrile chlorphine is included in their current testing panels.

Identify whether testing is performed in-house or through a reference laboratory.

Determine whether previously collected or retained specimens can be evaluated using an expanded toxicology panel.

4. Establish a clear specimen-referral pathway for suspected cases.

Preserve appropriate residual specimens from unusual cases.

When clinically and operationally appropriate, clinicians and laboratories should 

preserve residual specimens from unusual or unexplained suspected opioid poisonings

 under laboratory guidance so that additional testing can be considered.

A clinical opioid toxidrome but a negative routine opioid/fentanyl screen;

Unexpected or unusually severe respiratory depression;

Recurrent respiratory depression after initial treatment;

Suspected exposure to counterfeit pills or an unknown drug;

An unusual cluster of suspected opioid poisonings; or

·A toxicology result that does not adequately explain the patient's clinical presentation.

Do not delay clinical treatment while arranging additional testing.

Specimen collection, storage, handling, and referral should follow the submitting laboratory's requirements and applicable clinical, legal, and institutional policies.

Louisiana’s opioid-related surveillance relies on accurate data from clinicians. The 

Louisiana Opioid Data and Surveillance System (LODSS)

 is an interactive, public-facing online dashboard utilizing aggregate critical health data including opioid-related deaths, emergency department overdose visits, inpatient hospitals admissions, and localized opioid prescription rates. Please ensure you're appropriately coding data submitted in the EHR using specific ICD-10 codes so that we have the most detailed data possible.

Coding for cychlorphine is not currently possible because there are no cychlorphine-specific ICD-10 codes. Depending on the diagnosis code documented in the medical record, LDH may capture these cases as opioid overdoses. However, the more specific and accurate the diagnosis coding, the better we can identify and categorize these cases.

https://www.dea.gov/press-releases/2026/05/12/public-safety-advisory

https://ndews.org/wordpress/files/2026/05/ONDCP-Drug-Threat-Notice-Cychlorohine_Final.pdf

·Novel Opioid Cychlorphine Linked to Non-Fatal Overdose in First Direct Evidence of Patient Exposure: 

https://www.acmt.net/news/novel-opioid-cychlorphine-linked-to-non-fatal-overdose-in-first-direct-evidence-of-patient-exposure/

·Novel Synthetic Opioid Cychlorphine: What Doctors Should Know: 

https://www.medpagetoday.com/publichealthpolicy/opioids/122919

https://www.cdc.gov/overdose-prevention/prevention/index.html

·Increase in Fatal Overdoses Linked to Novel Synthetic Opioid N-Propionitrile Chlorphine (Cychlorphine): 

https://www.cfsre.org/nps-discovery/public-alerts/increase-in-fatal-overdoses-linked-to-novel-synthetic-opioid-n-propionitrile-chlorphine-cychlorphine

***All questions or comments should be directed or sent to LDH Dept of Public Health.***

, pursuant to LSA-R.S. 42:19(A), that the Louisiana State Board of Medical Examiners (the "Board"), within the Louisiana Department of Health, State of Louisiana, shall convene a Regular

R.S. 42:17.3 and Act 408 of the 2022 Regular Session, the advisory committee will participate via live- streaming video and teleconference for the public session and via non-streaming video and teleconference during the executive session.

 Click the appropriate committee’s name then “Live Stream Here” next to the date. The YouTube link will be posted immediately prior to

Camp Street, New Orleans, Louisiana, or remotely.

Individuals who wish to make a public comment before or during the meeting, may do so by

Members of the public may give verbal comment on any agenda item when the matter comes up for discussion.

Individuals wishing to make verbal comment must email 

“ZOOM LINK REQUEST” to request a link to the videoconference, identifying themselves by name and relevant affiliation, if any, and the agenda item about which they wish to make verbal comment. 

This request should be made as far in advance of the meeting as possible so that the request can be processed. 

The committee will make reasonable efforts to accommodate requests made while the meeting is in progress but cannot guarantee that such requests can be honored. The committee reserves the right to limit or prohibit participation in order to maintain orderly conduct of the meeting in accordance with La. R.S. 42:17(C). Members of the public who choose to view the video meeting at the anchor location may give verbal comments by notifying the presiding officer at the anchor location.

Regular Meeting held and noticed pursuant to La. Rev. Stat. §42:17A(1), (2), (4), (5) and (10), R.S. 42:17.3 and Act 408 of the 2022 Regular Session. Further, agenda items may be taken out of order and/or in executive session pursuant to R.S 42:17A. La. R.S. 42:17A states “A public body may hold an executive session pursuant to La. R.S. 42:16 for one or more of the following reasons: (1) Discussion of the character, professional competence, or physical or mental health of a person, provided that such person is notified in writing at least twenty-four hours, exclusive of Saturdays, Sundays, and legal holidays, before the scheduled time contained in the notice of the meeting at which such executive session is to take place and that such person may require that such discussion be held at an open meeting.….In cases of extraordinary emergency, written notice to such person shall not be required; however, the public body shall give such notice as it deems appropriate and circumstances permit; (2) Strategy sessions or negotiations with respect to collective bargaining, prospective litigation after formal written demand, or litigation when an open meeting would have a detrimental effect on the bargaining or litigating position of the public body;….(4) Investigative proceedings regarding allegations of misconduct; (5) Cases of extraordinary emergency, which shall be limited to natural disaster, threat of epidemic, civil disturbances, suppression of insurrections, the repelling of invasions, or other matters of similar magnitude; and,….(10) Or any other matters now provided for or as may be provided for by the legislature.”

Respiratory Therapy Advisory Committee Meeting

and teleconference for the public session and via non-streaming video and teleconference during the executive 

. Click the appropriate committee’s name then “Live Stream Here” next to the date. The YouTube link will be posted immediately prior to

Occupational Therapy Advisory Committee Meeting

Any questions/concerns regarding this alert are to be directed to the Louisiana Department of Health.

The Louisiana Department of Health is reporting a confirmed 

infection in a Louisiana resident. The resident most likely acquired the infection while swimming in Lake Claiborne, located in Claiborne Parish, shortly before illness.

, often referred to as a brain-eating amoeba, is commonly found in warm freshwater lakes, rivers, canals, ponds, and hot springs throughout the United States. It can cause primary amebic meningoencephalitis (PAM), a brain infection that may result when water containing the amoeba rushes up the nose and reaches the brain. PAM cannot occur from swallowing water containing 

 and it cannot be transmitted person-to-person.

The infection is extremely rare, but nearly always fatal. Only 180 cases of PAM are known to have occurred in the in the U.S. (between zero and eight cases annually) from 1937 through 2025. Louisiana had three

Early symptoms of PAM can include: headache, fever, nausea, and vomiting. These symptoms typically start about 5 days after someone is exposed to 

 but can occur anywhere between 1 and 12 days after exposure.

Once symptoms occur, PAM progresses quickly. As it does, additional symptoms can include: stiff neck, lethargy, confusion, disorientation, photophobia, hallucinations, seizures, and cranial nerve abnormalities.

Signs and symptoms mimic those of bacterial meningitis, especially in the early stages. Findings on an exam may include meningeal signs and focal neurologic deficits. 

 infections destroy brain tissue and cause cerebral edema, which is often the cause of the patient’s death.  

Recommendations for Healthcare Professionals

Diagnosis, Testing, and Clinical Management

Clinicians should consult with CDC for the diagnosis and treatment of PAM by contacting the CDC Emergency Operations Center at 

Amoeba (free living) infection (including 

, and others) is a Class A reportable condition in Louisiana, which requires public health reporting within 24 hours. Confirmed or suspected cases should be reported by phone by contacting the Infectious Disease Epidemiology 24/7 clinician hotline at 

 Naegleria Fowleri Infection

R.S. 42:17.3 and Act 408 of the 2022 Regular Session, the advisory committee will participate via live- streaming

teleconference for the public session and via non-streaming video and teleconference during the executive session.

 Click the appropriate committee’s name then “Live Stream Here” next to the date. The YouTube link will be posted immediately prior to the meeting.

Members of the public may view the video meeting at the anchor location at 630 Camp Street, New Orleans, Louisiana, or remotely.

to no more than 3 minutes length and the email size must be less than 10 megabytes.

will be identified and acknowledged during the meeting and maintained in the meeting minutes.

Athletic Trainer Advisory Committee Meeting

All questions or comments should be directed or sent to LDH Dept of Public Health.

Domestically Acquired Cyclosporiasis Cases, 2026

Multiple states are investigating cases of domestically acquired cyclosporiasis. Since May 1, 2026, the Centers for Disease Control and Prevention (CDC) has received reports of 1,645 confirmed domestic cases of cyclosporiasis and is aware of more than 5,100 cases that require further analysis to confirm the illness as domestically acquired cyclosporiasis. This is substantially higher than the 249 cases reported nationally by this same time last year. Of the 1,645 case-patients with available information, 141 (9%) were hospitalized, and none have died. CDC, the 

, and state and local health departments are working together to investigate multistate outbreaks of Cyclospora infections and to identify the sources of illness. Because cyclosporiasis is often underdiagnosed and underreported, the true number of illnesses is likely higher than what has been reported to CDC. This Health Advisory provides background information about cyclosporiasis, current U.S. surveillance data, and recommendations for clinicians, laboratorians, and public health departments to support recognition, diagnosis, and reporting.

Cyclosporiasis is a gastrointestinal illness caused by the microscopic parasite Cyclospora. People can become infected by consuming food or water contaminated with the parasite. This illness is not usually spread directly from person to person. Case counts typically rise during spring and summer months, and CDC considers May 1-August 31 the annual cyclosporiasis season. Previous outbreaks have been linked to consuming contaminated fresh produce.

Symptoms of cyclosporiasis typically begin about 1 week after exposure. Onset of symptoms can occur 2-14 days after being exposed. The most common symptoms include watery diarrhea, which can be frequent, along with loss of appetite, weight loss, bloating, nausea, and fatigue. Less common symptoms include low-grade fever and vomiting. Without treatment, symptoms can follow a remitting-relapsing course that can last from a few days to a month or longer. Illness can be severe, but is not usually life-threatening. Complications can include malabsorption, cholecystitis, and reactive arthritis.

As of July 14, 43 cases of cyclosporiasis have been reported in Louisiana during 2026. By comparison, over the past five years, Louisiana confirmed an average of 30 cases during the same time period.

Cyclosporiasis cases have been reported among Louisiana residents in nearly every region of the state. The parishes with the highest number of reported cases are East Baton Rouge and Lafayette. Five patients have been hospitalized, and none have died. Eighty percent of the cases were domestically acquired.

Consider cyclosporiasis in patients presenting with prolonged or relapsing watery diarrhea, particularly during the May–August cyclosporiasis season, even without a history of international travel.

Ask patients with suspected or confirmed cyclosporiasis about their recent food and travel history to assist local investigations.

Laboratory detection of Cyclospora in stool can be challenging even in symptomatic patients, and standard ova and parasite exams might not detect it reliably. Clinicians should specifically request diagnostic testing for Cyclospora when it is clinically suspected. Consider molecular (PCR-based) diagnostic testing where available, because it can improve detection.

Treat confirmed cases of cyclosporiasis with 7-10 days of trimethoprim-sulfamethoxazole (TMP-SMX) for immunocompetent adults and children over age 2 months; consider longer courses for patients with immunocompromising conditions. Consult current 

Advise patients to stay well hydrated, especially if diarrhea is frequent or severe.

Cyclosporiasis is a Class B reportable condition in Louisiana, which requires public health reporting within one business day. Cases can be reported electronically, via fax (504-568-8290), or reported to the respective LDH 

. To reach LDH’s on-call epidemiologist, call 800-256-2748. Cyclosporiasis cases can sometimes be identified in clusters due to common exposures.  Outbreaks or clusters of any infectious disease are considered Class A Conditions in the State Sanitary Code, which require immediate reporting by phone to LDH’s clinician hotline: 800-256-2748.

Recommendations for Disinfecting Cyclospora in Healthcare Settings

Given the typical lifecycle of Cyclospora, person-to-person transmission is unlikely, even within healthcare settings. If an affected patient is continent of stool, the level of environmental contamination is probably small.

Cyclospora is unlikely to be killed or inactivated by routine chemical disinfection. No EPA-registered disinfectant products have been demonstrated to be effective against Cyclospora. When affected patients are incontinent or diapered, the risk of contamination of healthcare surfaces might be higher. Facilities should clean surfaces initially with a detergent to remove any visible soil and scrub the surfaces thoroughly. After this cleaning, an EPA-registered hospital disinfectant should be used. Immediately after cleaning, healthcare personnel (HCP) should remove gloves used during cleaning and clean their hands.

HCP should always use Standard Precautions, including wearing gloves when there might be direct contact with feces. A gown, facemask, and eye protection, or face shield should be used if splashing might occur. Hand hygiene should be performed before and after every patient contact. If hands are visibly soiled, HCP should wash them with soap and water, scrubbing vigorously for 15-20 seconds. If hands are not visibly soiled, alcohol-based hand sanitizer may be used. For patients with gastroenteritis who are diapered or incontinent of stool, HCP should use Contact Precautions when providing direct patient care in healthcare settings.

, pursuant to LSA-R.S. 42:19(A), that the Louisiana State Board of Medical Examiners (the "Board"), within the Louisiana Department of Health, State of Louisiana, shall convene a Regular Call meeting of the Clinical Laboratory Personnel Advisory Committee starting at 3:00 P.M., Tuesday,

live- streaming video and teleconference for the public session and via non-streaming video and teleconference during the executive session.

Clinical Laboratory Personnel Advisory Committee Meeting

Although the risk of Louisiana and the rest of the United States is considered low at this time, the Louisiana Department of Health (LDH) is issuing this Health Alert Network (HAN) Health Advisory to raise awareness about an outbreak of Ebola disease in the Democratic Republic of the Congo (DRC) and Uganda. The HAN also provides recommendations for healthcare workers about potential Ebola disease case identification and testing.

The outbreak of Ebola disease was confirmed by the Ministry of Health of the Democratic Republic of Congo (DRC) on May 15, 2026, and CDC issued 

 for people traveling to DRC and Uganda. On May 17, the World Health Organization (WHO) determined this outbreak to be a 

public health emergency of international concern

. As of June 17, DRC and Uganda have reported 856 confirmed cases and 198 confirmed deaths with many more suspected cases and deaths. No suspected, probable, or confirmed Ebola cases related to this outbreak have been reported in the United States.

The U.S. Centers for Disease Control and Prevention (CDC) redirects U.S.-bound travelers coming from Ebola-affected regions to designated airports for enhanced entry screenings. After screening, CDC is providing contact information for low-risk travelers arriving from an affected country to states and local jurisdictions so that health monitoring can be performed for the duration of the 21-day incubation period.

Again, the risk of spread to Louisiana and the rest of the United States is considered low at this time

, but it is possible for travelers from affected areas in DRC or Uganda to enter the United States. Therefore, as an additional precaution, LDH is working to raise awareness of this outbreak among Louisiana healthcare providers.

Ebola disease is a viral hemorrhagic fever (VHF) caused by a group of viruses known as orthoebolaviruses. Ebola disease most commonly affects humans and nonhuman primates, such as monkeys, chimpanzees, and gorillas. Four orthoebolaviruses cause illness in people, presenting as clinically similar disease. The current outbreak is caused by Bundibugyo virus (species Orthoebolavirus budibugyoense). There are currently no FDA-approved or authorized treatments or vaccines for this species of orthoebolavirus.

Early “dry” symptoms include fever, aches and pains in the muscles and joints, severe headache, sore throat, and fatigue. Later “wet” symptoms include loss of appetite, diarrhea, vomiting, abdominal pain, and unexplained bleeding.

Ebola disease is spread through direct contact (through broken skin or mucous membranes) with the body fluids (e.g., blood, urine, feces, saliva, semen, or other secretions) of a person who is sick with or has died from Ebola disease. It can also be transmitted through contact with objects like needles that are contaminated with the virus. 

Ebola virus is not spread through airborne transmission.

The incubation period ranges from 2 to 21 days after exposures. A person infected with Ebola virus is not considered contagious until after symptoms appear.

Ebola Outbreak

, pursuant to LSA-R.S. 42:19(A), that the Louisiana State Board of Medical Examiners (the "Board"), within the Louisiana Department of Health, State of Louisiana, shall convene a Regular Call meeting of the Medical Psychology Advisory Committee starting at 1:00 P.M, Friday, June 12, 2026, at the offices of the Board, 630 Camp Street, New Orleans, Louisiana. Pursuant to La. R.S. 42:17.3 and Act 408 of the 2022 Regular Session, the advisory committee will participate via live-streaming video and teleconference for the public session and via non-streaming video and teleconference during the executive session.

. Click the appropriate committee’s name then “Live Stream Here” next to the date. The YouTube link will be posted immediately prior to the meeting.  Members of the public may view the video meeting at the anchor location at 630 Camp Street, New Orleans, Louisiana, or remotely.

. Public comments comprised of videos and/or audio content must be limited to no more than 3 minutes length and the email size must be less than 10 megabytes.

Both requirements must be met, or the content will be refused by our system. All comments received prior to or during the meeting will be identified and acknowledged during the meeting and maintained in the meeting 

The committee will make reasonable efforts to accommodate requests made while the meeting is in progress but cannot guarantee that such requests can be honored. The committee reserves the right to limit or prohibit participation in order to maintain orderly conduct of the meeting in accordance with La. R.S. 42:17(C).  Members of the public who choose to view the video meeting at the anchor location may give verbal comments by notifying the presiding officer at the anchor location.

. Click the appropriate committee’s name then “AGENDA” next to the date.

 Regular Meeting held and noticed pursuant to La. Rev. Stat. §42:17A(1), (2), (4), (5) and (10), R.S. 42:17.3 and Act 408 of the 2022 Regular Session. Further, agenda items may be taken out of order and/or in executive session pursuant to R.S 42:17A. La. R.S. 42:17A states “A public body may hold an executive session pursuant to La. R.S. 42:16 for one or more of the following reasons: (1) Discussion of the character, professional competence, or physical or mental health of a person, provided that such person is notified in writing at least twenty-four hours, exclusive of Saturdays, Sundays, and legal holidays, before the scheduled time contained in the notice of the meeting at which such executive session is to take place and that such person may require that such discussion be held at an open meeting.….In cases of extraordinary emergency, written notice to such person shall not be required; however, the public body shall give such notice as it deems appropriate and circumstances permit; (2) Strategy sessions or negotiations with respect to collective bargaining, prospective litigation after formal written demand, or litigation when an open meeting would have a detrimental effect on the bargaining or litigating position of the public body;….(4) Investigative proceedings regarding allegations of misconduct; (5) Cases of extraordinary emergency, which shall be limited to natural disaster, threat of epidemic, civil disturbances, suppression of insurrections, the repelling of invasions, or other matters of similar magnitude; and,….(10) Or any other matters now provided for or as may be provided for by the legislature.”

Medical Psychology Advisory Committee Meeting

, pursuant to LSA-R.S. 42:19(A), that the Louisiana State Board of Medical Examiners (the "Board"), within the Louisiana Department of Health, State of Louisiana, shall convene a Regular Call meeting of the Medical Psychology Advisory Committee starting at 1:00 P.M, Friday, March 20, 2026, at the offices of the Board, 630 Camp Street, New Orleans, Louisiana. Pursuant to La. R.S. 42:17.3 and Act 408 of the 2022 Regular Session, the advisory committee will participate via live-streaming video and teleconference for the public session and via non-streaming video and teleconference during the executive session.

The committee will make reasonable efforts to accommodate requests made while the meeting is in progress but cannot guarantee

to limit or prohibit participation in order to maintain orderly conduct of the meeting in accordance with La. R.S. 

42:17(C).  Members of the public who choose to view the video meeting at the anchor location may give verbal comments by notifying the presiding officer at the anchor location.

Regular Meeting held and noticed pursuant to La.Rev.Stat.§42:17A(1), (2), (4), (5) and(10), R.S. 42:17.3and Act 408 of the 2022 Regular Session. Further, agenda items may be taken out of order and/or in executive session pursuant to R.S 42:17A. La. R.S. 42:17A states “A public body may hold an executive session pursuant to La. R.S. 42:16 for one or more of the following reasons: (1) Discussion of the character, professional competence, or physical or mental health of a person, provided that such person is notified in writing at least twenty-four hours, exclusive of Saturdays, Sundays, and legal holidays, before the scheduled time contained in the notice of the meeting at which such executive session is to take place and that such person may require that such discussion be held at an open meeting.….In cases of extraordinary emergency, written notice to such person shall not be required; however, the public body shall give such notice as it deems appropriate and circumstances permit; (2) Strategy sessions or negotiations with respect to collective bargaining, prospective litigation after formal written demand, or litigation when an open meeting would have a detrimental effect on the bargaining or litigating position of the public body;….(4) Investigative proceedings regarding allegations of misconduct; (5) Cases of extraordinary emergency, which shall be limited to natural disaster, threat of epidemic, civil disturbances, suppression of insurrections, the repelling of invasions, or other matters of similar magnitude; and,….(10) Or any other matters now provided for or as may be provided for by the legislature.”

The committee will make reasonable efforts to accommodate requests made while the meeting is in progress

to limit or prohibit participation in order to maintain orderly conduct of the meeting in accordance with La. R.S. 42:17(C).

verbal comments by notifying the presiding officer at the

, pursuant to LSA-R.S. 42:19(A), that the Louisiana State Board of Medical Examiners (the "Board"), within the Louisiana Department of Health, State of Louisiana, shall convene a Regular Call meeting of the Clinical Laboratory Personnel Advisory Committee starting at 3:00 P.M., Wednesday,

Multi-State Outbreak of Infant Botulism Linked to ByHeart Infant Formula 

The Louisiana Department of Health (LDH) is issuing this health advisory to alert clinicians about a 

 and assist in identification and management of suspected cases. 

To date, no cases have been identified in Louisiana.

 has been identified in the United States. As of November 14, 2025, this outbreak includes 23 infants with suspected or confirmed infant botulism from 13 states (

). All 23 infants were hospitalized and treated with BabyBIG® (Botulism Immune Globulin Intravenous medication). No deaths have been reported.

The CDC National Botulism Surveillance System records approximately 150-180 infant botulism cases each year. In 2024, over half of infants with infant botulism were exclusively breastfed and 43% were receiving powdered infant formula before becoming ill.  According to information shared by the 

Infant Botulism Treatment and Prevention Program (IBTPP)

, since August 1, 2025, through November 10, 2025, 84 infants nationwide have received BabyBIG® treatment.

Data from IBTPP have demonstrated a concerning association between consumption of ByHeart infant formula and botulism. Among the 84 infants recently receiving BabyBIG® treatment, 36 (43%) had any powdered infant formula exposure. Notably, more than 40% (15) consumed ByHeart Whole Nutrition infant formula.  This information shows that ByHeart brand formula is disproportionately represented among sick infants in this outbreak, especially given Food and Drug Administration’s (FDA) data that ByHeart represents an estimated 1% of all infant formula sales in the United States. Investigations are ongoing but have not identified any other infant formula brands or shared exposures that pose a risk to infants at this time.

 that parents and caregivers immediately stop use of all ByHeart Whole Nutrition infant formula, including cans and single serve packets.

 On November 11, ByHeart Inc. recalled all ByHeart Whole Nutrition infant formula products. FDA does not anticipate any formula shortages as a result of this outbreak.

Infant botulism occurs when an infant ingests spores from a type of bacteria called 

, which then grows in the large intestine and produces toxin that blocks the neuromuscular junction by inhibiting the release of acetylcholine. Initial signs and symptoms often include constipation, difficulty feeding (difficulty sucking or swallowing), loss of head control, weak facial expression, and reduced muscle tone. Without prompt recognition and treatment, descending paralysis may progress and involve the respiratory muscles, potentially leading to life-threatening respiratory failure. The time from ingestion to symptom presentation can be up to 30 days.

Consider infant botulism a clinical diagnosis

 in any infant presenting with unexplained weakness, poor feeding, decreased head control, or difficulty swallowing — especially if the infant has consumed ByHeart formula.

Immediate actions when suspecting a case:

Caregiver guidance when ByHeart formula was used:

Multi-State Outbreak of Infant Botulism Linked to ByHeart Infant Formula

 pursuant to LSA-R.S. 42:19(A), that the Louisiana State Board of Medical Examiners (the "Board"), within the Louisiana Department of Health, State of Louisiana, shall convene a Regular Call meeting of the Occupational Therapy Advisory Committee starting at 10:00 AM., November 14, 2025, at the offices of the Board, 630 Camp Street, New Orleans, Louisiana. Pursuant to La. R.S. 42:17.3 and Act 408 of the 2022 Regular Session, the advisory committee will participate via live-streaming video and teleconference for the public session and via non-streaming video and teleconference during the executive session. 

. Click the appropriate committee’s name then “Live Stream Here” next to the date. The YouTube link will be posted immediately prior to the meeting. Members of the public may view the video meeting at the anchor location at 630 Camp Street, New Orleans, Louisiana, or remotely. 

Individuals who wish to make a public comment before or during the meeting, may do so by emailing: 

. Public comments comprised of videos and/or audio content must be limited to no more than 3 minutes length and the email size must be less than 10 megabytes. Both requirements must be met, or the content will be refused by our system. All comments received prior to or during the meeting will be identified and acknowledged during the meeting and maintained in the meeting minutes. 

Members of the public may give verbal comment on any agenda item when the matter comes up for discussion. Individuals wishing to make verbal comment must email 

with the subject line “ZOOM LINK REQUEST” to request a link to the videoconference, identifying themselves by name and relevant affiliation, if any, and the agenda item about which they wish to make verbal comment. This request should be made as far in advance of the meeting as possible so that the request can be processed. The committee will make reasonable efforts to accommodate requests made while the meeting is in progress but cannot guarantee that such requests can be honored. The committee reserves the right to limit or prohibit participation in order to maintain orderly conduct of the meeting in accordance with La. R.S. 42:17(C). Members of the public who choose to view the video meeting at the anchor location may give verbal comments by notifying the presiding officer at the anchor location. 

. Click the appropriate committee’s name then “AGENDA” next to the date. 

Note: Regular Meeting held and noticed pursuant to La. Rev. Stat. §42:17A(1), (2), (4), (5) and (10), R.S. 42:17.3 and Act 408 of the 2022 Regular Session. Further, agenda items may be taken out of order and/or in executive session pursuant to R.S 42:17A. La. R.S. 42:17A states “A public body may hold an executive session pursuant to La. R.S. 42:16 for one or more of the following reasons: (1) Discussion of the character, professional competence, or physical or mental health of a person, provided that such person is notified in writing at least twenty-four hours, exclusive of Saturdays, Sundays, and legal holidays, before the scheduled time contained in the notice of the meeting at which such executive session is to take place and that such person may require that such discussion be held at an open meeting.….In cases of extraordinary emergency, written notice to such person shall not be required; however, the public body shall give such notice as it deems appropriate and circumstances permit; (2) Strategy sessions or negotiations with respect to collective bargaining, prospective litigation after formal written demand, or litigation when an open meeting would have a detrimental effect on the bargaining or litigating position of the public body;….(4) Investigative proceedings regarding allegations of misconduct; (5) Cases of extraordinary emergency, which shall be limited to natural disaster, threat of epidemic, civil disturbances, suppression of insurrections, the repelling of invasions, or other matters of similar magnitude; and,….(10) Or any other matters now provided for or as may be provided for by the legislature.”

Guidance for evaluating suspected measles cases

The Louisiana Department of Health (LDH) has confirmed 

one case of measles in an adult resident of Region 9

 (comprised of Livingston, St. Helena, St. Tammany, Tangipahoa, Washington parishes). The patient was exposed to measles during 

. The patient was not hospitalized and will remain in isolation until no longer infectious. This patient’s vaccination status is unknown. 

The Department's epidemiologic investigation identified the following public exposure:

This is the third measles case reported in Louisiana in 2025. 

In 2024, three confirmed measles cases were reported in Louisiana, all five prior cases from 2024-2025 were travel-associated and in the greater New Orleans area.

Healthcare providers should proactively identify and update the immunity status of their patients and be 

vigilant for the possibility of additional cases of measles.

Importations of measles into communities with unvaccinated persons can lead to measles cases and outbreaks in the United States. Maintenance of 

are key factors to limit importations and the spread of disease.

●      Consider measles in patients who:

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