Public Health Division

• Hard or no bowel movements (constipation)
• Poor feeding/Not eating well
• Trouble swallowing
• Weak or different sounding cry
• Droopy eyelids
• Loss of head control/Unable to hold head up
• Trouble breathing
• Respiratory arrest (stopping breathing)

• Monitor infants who consumed Nara Organics infant formula and seek medical care immediately if signs or symptoms of infant botulism develop.
• Do not use recalled Nara Organics formula. Thoroughly wash and sanitize bottles and kitchenware that came into contact with the formula.
• Throw away or return any unopened containers of Nara Organics formula.
• Save any opened containers of any Nara Organics formula, record the lot information, and label it “DO NOT USE.”  After 30 days, if no symptoms have developed, discard the product unless otherwise directed by DPH.
• Follow safe infant formula preparation and storage steps from CDC: Infant Formula Preparation and Storage.

• All recalled Nara Organics formula products are removed from shelves.
• Returned Nara Organics formula products are also removed from inventory and not resold.
• Staff are informed about the recall and instructed not to restock affected products.
• Wash and sanitize items and surfaces that may have touched the recalled formula.

• CDC outbreak advisory: Infant Botulism Outbreak Linked to Powdered Infant Formula, June 2026
• FDA public health advisory: Outbreak Investigation of Infant Botulism: Powdered Infant Formula (June 2026)
• FDA company recall announcement: Nara Organics Recalls All Lots of Nara Infant Formula Because of Possible Health Risk
• CDC: Infant Formula Preparation and Storage
• Information on the Prevention and Treatment of Infant Botulism from the California Department of Public Health
• Consumers can report a complaint or adverse event to FDA through the FDA Safety Reporting Portal or by calling 1-888-INFO-FDA.

• CDC is responding to a deadly outbreak of Andes virus, a type of hantavirus, among passengers and crew of a cruise ship in the Atlantic Ocean.
• CDC is working with the U.S. State Department and other U.S. government partners to get Americans on the ship home as quickly and as safely as possible.
• To date, no cases of Andes virus have been reported in the United States as a result of this outbreak.
• At this time, the overall risk to travelers and the American public remains extremely low. Routine travel can continue as normal.
• Andes virus, the type of hantavirus involved in these infections, can cause hantavirus pulmonary syndrome (HPS), a severe and potentially deadly disease that affects the lungs.

The Massachusetts Department of Public Health (DPH) confirmed today that two cases of measles have been diagnosed in Massachusetts residents.

• The first case was reported in a school-aged Massachusetts resident who was exposed and diagnosed out of state and remains out of state during the infectious period. There are no known exposures to others in Massachusetts.
   
• The second case was diagnosed in an adult who lives in Greater Boston. The individual recently returned from international travel and had an uncertain vaccination history. During their infectious period, the individual visited several locations where exposures to others likely occurred. State and local public health officials are working with these locations to identify and notify those who were potentially exposed.

These two cases of measles in Massachusetts have occurred in the context of a large national outbreak of measles and a very large international outbreak. Although there is no evidence of the spread of measles within Massachusetts at this time, additional cases could occur. View a 10-year table of vaccine-preventable disease reports in Massachusetts.

“Our first two measles cases in 2026 demonstrate the impact that the measles outbreaks, nationally and internationally, can have here at home. Fortunately, thanks to high vaccination rates, the risk to most Massachusetts residents remains low,” said Public Health Commissioner Robbie Goldstein, MD, PhD. “Measles is the most contagious respiratory virus and can cause life-threatening illness. These cases are a reminder of the need for health care providers and local health departments to remain vigilant for cases so that appropriate public health measures can be rapidly employed to prevent spread in the state. This is also a reminder that getting vaccinated is the best way for people to protect themselves from this disease.” 

Early symptoms of measles occur 10 days to 2 weeks after exposure and may resemble a cold (cough, runny nose, and red eyes), usually with fever. A rash occurs 2-4 days after the initial symptoms develop. The rash usually appears first on the head and then moves downward. The rash typically lasts a few days and then disappears in the same order.  People with measles may be contagious up to four days before the rash appears and four days after the day the rash appears. Measles is a potentially serious illness, with complications occurring in approximately 30 percent of infected individuals, including immune suppression, pneumonia, diarrhea, and encephalitis, which may be life-threatening.

Those who were exposed to measles and develop symptoms should call their health care provider before visiting an office, clinic, or emergency department. Visiting a health care facility without calling in advance may put others at risk and should be avoided. Anyone who has had measles in the past or has received two doses of the vaccine is unlikely to develop measles, even if exposed.

People who have had measles, or who have been vaccinated against measles per the DPH Guidance for Vaccines are considered immune. The Measles-Mumps-Rubella (MMR) vaccine offers the best protection against measles and the serious complications associated with infection. The DPH recommendations for the MMR vaccination are:

• Children: Children should receive their first dose of the MMR vaccine at 12-15 months. School-aged children need two doses of the MMR vaccine.
   
• Adults: Adults should have at least one dose of the MMR vaccine. Certain groups at high risk need two doses of the MMR vaccine, such as international travelers, health care workers, and college students. Adults born in the U.S. before 1957 are considered immune to measles from past exposures. 

People who are exposed to measles and have not been vaccinated are at risk for developing measles and will need to avoid all public activities until they are no longer at risk of developing disease. This means that unvaccinated, exposed people will need to miss daycare, school, work, and other activities. Anyone concerned about measles is advised to contact their health care provider to confirm their immunization status and get vaccinated, if needed.

For additional information, contact your local health department or DPH at 617-983-6800. To learn more about measles, visit the DPH website.   

The Massachusetts Department of Public Health (DPH) is issuing this notification to inform clinicians of a change in recommended reference materials for pediatric immunization schedules. 

DPH has a longstanding and ongoing commitment to promoting evidence-based immunization practices that protect communities from vaccine preventable illnesses. Following a review of recent changes to the Centers for Disease Control and Prevention (CDC) pediatric immunization schedule, DPH now recommends that clinicians in Massachusetts use the American Academy of Pediatrics (AAP) Recommended Child and Adolescent Immunization Schedule as the primary reference for the routine immunization of infants, children, and adolescents. 

DPH recognizes the importance of clear, consistent, and evidence-based guidance to facilitate safe and effective vaccination practices. AAP is a national professional organization representing pediatric physicians, and its immunization schedule is developed by pediatric experts and updated regularly to reflect current evidence and clinical best practices for immunizing children and adolescents. The AAP immunization schedule aligns with science-backed pediatric standards of care and provides detailed guidance that supports clinical decision-making in pediatric settings. 

Clinicians should continue to follow all applicable state requirements, including the immunization requirements for school and camp entry (aligned with AAP recommendations), and reporting obligations, including documentation of administered immunizations in the Massachusetts Immunization Information System (MIIS). 

DPH will continue to monitor national immunization policy updates and will communicate any additional guidance as needed. Thank you for your continued commitment to protecting the health of Massachusetts children and families. 

Resources 

• The American Academy of Pediatrics Recommended Child and Adolescent Immunization Schedule 
• Massachusetts Immunization Requirements for School and Camp Entry 
• Massachusetts Immunization Information System (MIIS) 
• AAP Communicating with Families and Promoting Vaccine Confidence 
• DPH recommended guidance for vaccines 

The Massachusetts Department of Public Health (DPH) is reporting very high and rising levels of influenza activity statewide as the Commonwealth moves through peak flu season. Thousands of residents have become ill, forcing them to miss work, school, and other activities. Many are experiencing serious complications, leading to increased visits to urgent care centers and emergency departments, and high levels of hospitalization.  

The current widespread burden of illness underscores the importance of taking preventive measures, especially vaccination, to reduce severe disease and protect individuals, families, and communities. 

Tragically, influenza has already been reported to be associated with the deaths of three pediatric patients in Massachusetts during recent weeks. In addition, there have been 29 adult influenza deaths reported so far this season. While COVID-19 and respiratory syncytial virus (RSV) rates currently remain low, cases of both illnesses are beginning to rise. DPH is reviewing two possible COVID-19-associated deaths and one RSV-associated death in individuals younger than 18 years.  

“This is a moment for clarity, urgency, and action,” said Public Health Commissioner Robbie Goldstein, MD, PhD. “These viruses are serious, dangerous, and life-threatening. We are seeing children who are seriously ill, families grieving devastating losses, and hospitals under capacity strain. There is a simple, effective, and available way to address these concerns: vaccines. They can prevent serious illness and hospitalization. And they save lives. If you have not yet been vaccinated against flu or COVID-19 this season, now is the time. It is not too late. Choosing vaccination is choosing to protect yourself, your family, your friends, your colleagues, and your community.” 

Hospitals across Massachusetts are continuing to see high numbers of patients seeking care for respiratory illness. Each day last week, there were nearly 9,000 emergency department visits statewide, with approximately one-quarter of those related to acute respiratory illness, including flu, COVID-19, and RSV. Some regions in the state reported challenging hospital capacity levels exceeding 90% in medical-surgical units, largely related to influenza.  

DPH urges everyone 6 months of age and older to stay up to date on flu and COVID-19 vaccinations. These annual shots can be given at the same visit and are available from local boards of health, community health centers, pharmacies, and many health care providers.

Vaccination is especially important for people at higher risk of severe disease, including adults age 65 years and older, children between 6 months and 2 years old, people with chronic respiratory conditions or heart disease, individuals who are immunocompromised, and people who are pregnant. Vaccination also helps protect family members, coworkers, and others in the community who may be more vulnerable to serious illness.  

For RSV, one-time immunization is recommended for adults age 75 and older, those aged 50-74 who have conditions that put them at increased risk, and people who are pregnant. For infants and children, parents should talk with their child’s health care provider about RSV immunization. It is recommended that infants younger than 8 months be immunized if the birth parent did not receive the RSV shot during pregnancy. Children between 8 and 19 months who are at increased risk because of certain pulmonary or immune system disorders should also be immunized.  

In Massachusetts, vaccines are covered by insurance and are available at no cost for almost all adults. All vaccines for individuals younger than 18 years are supplied free of charge to health care providers through the state’s universal childhood immunization program.  

For those who begin to experience flu symptoms – which include high fever, chills, muscle aches, headache, extreme fatigue, cough, sore throat, and congestion – antiviral medications, such as oseltamivir (Tamiflu), are available by prescription. When started early, these medications can significantly reduce the severity of illness. Parents are encouraged to seek medical advice promptly if they or their children develop flu-like symptoms. 

Spending time indoors and around larger groups increases the likelihood of exposure to respiratory viruses. The following everyday measures can help prevent illness: 

• Stay up to date on flu and COVID-19 vaccinations 
• Wash hands frequently with soap and water 
• Stay home when sick 
• Cover coughs and sneezes 
• Consider wearing a mask in crowded indoor settings, especially if you or a loved one is at higher risk.

DPH continues to closely monitor respiratory activity and hospital capacity across Massachusetts. Up-to-date data are available on the DPH respiratory virus dashboard.  

Despite some improvements, drought conditions have continued in most of Massachusetts. The Cape and Islands Regions and Millers Basin are at Level 2-Significant Drought, while the Connecticut River Valley, Central and Northeast Regions are at Level 1–Mild Drought. The Western and Southeast Regions are at normal condition.

How can the general public help?

• Conserve overall water use, especially indoors
• Shut off/winterize sprinkler systems, disconnect hoses, and wrap spigots/backflows
• Limit any remaining watering to one day a week
• Identify and stop any water leaks inside your home
• Avoid removing outlet boards/stop logs that manage pond and lake levels

Silicosis is an incurable and potentially fatal, but preventable, lung disease associated with working in the stone countertop industry

BOSTON – The Massachusetts Department of Public Health (DPH) today issued a safety alert urging employers in the stone countertop fabrication industry to protect workers from silica dust exposure, following the first confirmed case of silicosis among this workforce in Massachusetts.

Silicosis is a preventable, yet incurable and progressive lung disease caused by inhaling crystalline silica, which is found naturally in granite and other stones. The state’s first confirmed case associated with occupational exposure in this industry was recently diagnosed in a Hispanic man in his 40s who, for the past 14 years, worked for stone countertop fabrication and installation companies in Massachusetts.

Processes like cutting, polishing, or grinding stone can generate silica dust, which can cause silicosis if breathed into the lungs. Historically, silicosis was associated with mining and construction, but in recent years, the disease has become more prevalent among stone fabrication workers due to the rise in popularity of countertops made from engineered stone (also known as quartz or artificial stone), which contains significantly more silica than other types of stone – over 90 percent compared to less than 45 percent in granite.

While this is the state’s first confirmed case of silicosis among this workforce, the growing number of cases recently reported in other states and countries linked to this industry suggests that additional, unconfirmed cases could exist in Massachusetts.

There is a long latency period between silica exposure and the development of silicosis. Silicosis is an often disabling and sometimes fatal disease that is characterized by scarring of the lungs. Early symptoms include an irritating cough, mucus, and shortness of breath. As the disease progresses, people may have difficulty breathing and can experience fatigue, chest pain, leg swelling, and blueish lips. Silicosis increases the risk for other lung diseases, such as lung cancer and tuberculosis.

Most engineered stone workers with silicosis in the U.S. were exposed to silica at their jobs for over ten years, although some were exposed for less time. There is no cure for silicosis, but exposure to silica dust can be minimized through proper workplace controls.

“Silicosis is a devastating, life-altering disease – and one that is also absolutely preventable,” said Public Health Commissioner Robbie Goldstein, MD, PhD. “Massachusetts employers in industries where workers are exposed to silica dust have a responsibility to protect their workforce, including from harmful airborne dust. No worker should have to suffer from a chronic and insidious lung disease or possibly die because of a preventable exposure at work.”

“The confirmation of this case in Massachusetts is a tragic reminder that silicosis is not just a distant threat – it is here, and it is seriously impacting the health of workers in Massachusetts,” said Emily H. Sparer-Fine, Director of DPH’s Occupational Health Surveillance Program. “Beyond the critical role employers play, everyone involved in the supply chain – from consumers and designers to contractors – can help reduce the danger by opting for materials that contain less silica and pose fewer health hazards.”

Most cases of silicosis are work-related – it is very rare for silicosis to occur outside of workplace exposure. The first reported case of silicosis in the U.S. associated with exposure to silica dust from engineering stone was identified in Texas in 2014. Since then, other states have reported hundreds of cases, and dozens of deaths, particularly in California. Cases have also been reported globally, with Australia going as far as banning the use and manufacture of engineered stone last year.

In the U.S., most engineered stone workers with silicosis are relatively young, male, and Hispanic/Latino. This largely reflects the demographic composition of this industry’s workforce. In 2023, over half of workers in this industry were under 45 years old, nearly three-quarters were men, and more than 1 in 3 were Hispanic/Latino, according to the U.S. Census Bureau.

Workers in other industries, such as construction and masonry, might also be at risk of exposure to silica dust when working with silica-containing construction materials, such as sand, stone, concrete, brick, or mortar.

By issuing this safety alert, DPH’s Occupational Health Surveillance Program is sounding the alarm to raise awareness among employers in Massachusetts about the hazards of silica and how to protect their workers’ health and safety. The program has also issued a hazard alert for countertop industry workers in English, Spanish, and Portuguese with information about silica dust, silicosis, and employees’ rights to a safe workplace. Preventing this disease is dependent on employers putting effective workplace controls in place.

In 2016, the U.S. Occupational Safety and Health Administration (OSHA) updated relevant rules to help keep stone countertop fabrication workers safer – for example, by requiring ventilation and other methods to limit exposure to respirable silica dust.

Other key workplace controls recommendations:

• Use effective dust control methods, such as wet cutting or proper dust collection systems.
• Make sure fabrication work takes place in well-ventilated areas.
• Follow housekeeping practices that minimize dust in the air, such as wet sweeping or using a HEPA-filtered vacuum (instead of dry sweeping).
• Periodically assess the levels of silica dust in the workplace.
• Enroll workers in a medical surveillance program that includes periodic exams by a qualified health care provider.
• Develop and implement a written exposure control plan.
• Train employees in their preferred languages on the health effects associated with silica dust and related control methods as part of a hazard communication program.
• Provide workers with appropriate respirators based on the task and ensure they are used correctly with an accompanying respiratory protection program.

Employers are also encouraged to utilize the state’s Department of Labor Standards’ On-Site Consultation Program, a free and confidential service designed to help them recognize and control possible safety and health hazards at their worksites and establish and improve safety and health programs. The goal of the service is to prevent injuries and illnesses that are the result of hazardous workplace conditions and practices. 

Health care providers also play an important role in active surveillance of silicosis by being vigilant about asking their adult patients about their work, particularly if they have respiratory symptoms. Because symptoms can take years to appear, silicosis diagnosis is often delayed. Early diagnosis and timely intervention can help slow down the progression of the disease.  Silicosis is a reportable condition in Massachusetts, and providers are mandated to report suspected cases to DPH.

Between the long latency period before symptoms show and the current demand for engineered stone products, additional cases of engineered stone-associated silicosis are, unfortunately, expected to emerge in the future. This is a growing occupational health concern that emphasizes the importance of coordinated efforts among public health, health care providers, employers, and regulatory agencies to prevent further cases and protect worker health.

The North Suffolk Public Health Collaborative conducts a Community Health Needs Assessment (CHNA) for the communities of Revere, Chelsea, and Winthrop.

BOSTON (November 11, 2025) — The Massachusetts Department of Public Health (DPH) is advising parents, caregivers, and health care providers that ByHeart Inc. is recalling its infant formula because it may be contaminated with the bacteria Clostridium botulinum that can make infants sick.  No cases of infant botulism have been identified in Massachusetts.
 
On November 8, 2025, the Centers for Disease Control and Prevention (CDC) and U.S. Food and Drug Administration (FDA) posted that they were investigating an outbreak of infant botulism linked to ByHeart powdered infant formula.  As a result of the investigation, ByHeart Inc. on November 11 voluntarily recalled all lots of powdered Whole Nutrition Infant Formula.  ByHeart products are distributed online and nationwide. Caregivers are advised not to use ByHeart formula.
 
Formula from ByHeart Whole Nutrition Infant Formula should be thrown away immediately or returned to the store where they were purchased. Before disposing of any ByHeart formula, write down or take pictures of the lot numbers, which can be found on the bottom of the cans. Check for any formula you may have removed from the original can and placed in another container. Wash all items and surfaces that may have touched the recalled formula using hot soapy water or a dishwasher.
 
Infant botulism is a rare and serious illness that is caused when infants inhale or swallow the spores produced by Clostridium botulinum bacteria.  Under certain conditions, the spores can grow inside the infant and produce toxins that can make infants very sick.  Symptoms can take anywhere from several days to several weeks to appear.
 
Most infants with infant botulism may develop constipation, poor feeding (sucking and swallowing), loss of head control, and difficulty swallowing.  Other symptoms may include decreased facial expression, a weak or altered cry, or other signs of muscle weakness.  Infants with botulism must be treated quickly to stop symptoms from progressing to flaccid (floppy) paralysis and breathing difficulties.  
 
Caregivers should seek immediate medical care for their infant if they consumed ByHeart Whole Nutrition Infant Formula and develop any symptoms of infant botulism. Health care providers should immediately report any cases of suspected infant botulism to their local health department or DPH 24/7 at (617) 983-6800.   
 
Infants who consumed the recalled infant formula should be monitored for symptoms for 30 days after their last exposure to the formula.  There is no testing or treatment recommended for infants who consumed the recalled formula but who do not have symptoms of infant botulism.
 
Caregivers should contact their infant’s pediatrician or health care provider if they have any questions about their infant’s health.  Individuals with questions about the recall may contact FDA at the link below or the DPH Division of Food Protection at fpp.dph@mass.gov or (617) 983-6712. Updates to the national investigation are expected to be posted on the CDC’s and FDA’s webpages as they become available:
 
Infant Botulism Outbreak Linked to Infant Formula, November 2025 | CDC
Outbreak Investigation of Infant Botulism: Infant Formula (November 2025) | FDA
In Response to a Broader FDA Investigation, ByHeart Initiates a Voluntary Recall of Two Batches of Infant Formula | FDA  Includes pictures of the recalled product and how to find lot code information.
 
According to FDA, ByHeart Whole Nutrition Infant Formula makes up an estimated less than 1% of all infant formula sold in the United States, and this outbreak does not currently create any concerns of a possible shortage in infant formula. 

The Revere Fire Department and Revere Emergency Preparedness Manager are teaming up with the National Fire Protection Association (NFPA) - the official sponsor of Fire Prevention Week (FPW) for more than 100 years - to promote this years' FPW campaign, "Charge into Fire Safety: Lithium-Ion Batteries in Your Home."  It highlights how important it is to buy, charge, and recycle lithium-ion batteries safely.

Most of the electronics we use in our homes every day - smartphones, tablets, power and lawn tools, laptops, e-cigarettes, headphones, and toys - are powered by lithium-ion batteries.  In fact, most everything that's rechargeable uses this type of battery.  

If not used correctly or if damaged, lithium-ion batteries can overheat, start a fire, or even explode.  To reduce these risks, look around your home - it's important to know which devices are powered by them.

Buy only listed products.

• When buying a product that uses a lithium-ion battery, take time to research it. Look for a stamp from a nationally recognized testing lab on the packaging and product, which means that it meets important safety standards.
• Many products sold online and in stores may not meet safety standards and could increase the risk of fire.

Charge devices safely.

• Always use the cords that came with the product to charge it. Follow the instructions from the manufacturer.
• If you need a new charger, buy one from the manufacturer or one that the manufacturer has approved.
• Charge your device on a hard surface. Don’t charge it under a pillow, on a bed, or on a couch. This could cause a fire.
• Don’t overcharge your device. Unplug it or remove the battery when it’s fully charged.

Recycle batteries responsibly.

• Don’t throw lithium-ion batteries in the trash or regular recycling bins because they could catch fire.
• Recycling your device or battery at a safe battery recycling location is the best way to dispose of them. Visit call2recycle.org to find a recycling spot near you.

Come to Revere's Fire Prevention Open House on Saturday, October 11, 2025 from 11:00 AM - 2:00PM at Revere Central Fire Station on 400 Broadway.  Free Pizza and Giveaways.  Touch-A-Truck with Water Spray will happen at 11:30 and A Ladder Truck demonstration will happen at 12:30. All are welcome!