Active Public Health Outbreaks in North Carolina
Report generated: November 30, 2025 | Focus: Active Surveillance & Emerging Threats
?? Critical Foodborne Alerts (November 2025)
Two major multistate outbreaks are currently affecting North Carolina residents, involving severe risks to infants and immunocompromised individuals.
Infant Botulism (ByHeart Formula)
Status: Active Investigation
NC Impact: 2 confirmed cases (37 nationally).
Risk: Clostridium botulinum contamination in "Whole Nutrition" powdered formula. All affected infants nationally have been hospitalized.
Listeriosis (Pre-made Pasta Meals)
Status: Active Recall
NC Impact: Confirmed cases reported in state.
Source: Nate's Fine Foods (distributed via major grocers).
Severity: 6 deaths and 25 hospitalizations reported nationally.
The 2025 Pertussis (Whooping Cough) Surge
North Carolina is experiencing its most significant Pertussis outbreak in nearly 70 years. As of late November 2025, case numbers have skyrocketed compared to the previous year, driven by waning immunity and gaps in vaccination coverage. Western North Carolina, particularly Henderson, Transylvania, and Buncombe counties, has been identified as a primary hotspot.
NC Pertussis Cases: Year-over-Year Comparison (Jan - Nov)
*Data reflects reported cases through week ending Nov 23, 2025.
Respiratory Virus Season (2025-26)
The winter respiratory season has officially begun with rising activity across all major indicators.
- FLU: First Death Confirmed. An adult in Western NC died from complications in Oct 2025. Activity is currently moderate but rising.
- RSV: High Activity. Positive test rates have reached ~13%, exceeding the regional baseline. Infants are at highest risk.
- COVID: Elevated. Wastewater surveillance indicates high viral loads in Buncombe and Henderson counties.
The Silent Epidemic: Syphilis
While acute outbreaks grab headlines, North Carolina faces a sustained epidemic of Syphilis, with congenital cases (mother-to-child transmission) remaining a critical concern.
National Ranking: NC cities Greensboro (#30) and Charlotte (#37) rank in the top 40 US metro areas for STD rates.
Congenital Syphilis: Cases continue to rise, though the rate of acceleration has slowed compared to 2023. 41 cases were reported in the first 5 months of 2024 alone.
Providers are mandated to screen pregnant women three times during pregnancy (1st visit, 28-30 weeks, and delivery) to prevent neonatal deaths.
Data Contrast & Analysis
Public Perception vs. Data: While public attention in Western NC remains focused on the long-term recovery from Hurricane Helene (2024), the immediate infectious disease threat has shifted. The Pertussis outbreak is currently the most statistically anomalous event, with rates 6.4x higher than the previous year.
Vaccine Hesitancy: Health officials note a discrepancy between the availability of Tdap vaccines and uptake rates. The surge in Pertussis is being attributed not just to cyclical bacterial trends, but to a "post-pandemic immunity gap" and declining vaccination coverage in school-aged children.