Active Public Health Outbreaks in Tennessee: Comprehensive Surveillance Report
Current Status (November 30, 2025): Tennessee is currently transitioning into the respiratory virus season, with RSV activity showing a marked increase across the Southern United States, including Tennessee. While Influenza and COVID-19 levels remain relatively low nationally, early indicators suggest an upward trend for flu. Throughout 2025, the state has managed significant outbreaks of Measles, Pertussis (Whooping Cough), and West Nile Virus, alongside a persistent rise in Candida auris cases in healthcare settings.
1. Respiratory Virus Surveillance (November 2025)
Data reflects the latest surveillance reports from the CDC and Tennessee Department of Health (TDH) as of late November 2025.
Activity is rising in the South. Emergency department visits for RSV are trending upward.
Activity remains low nationally but is beginning to increase. Early season indicators are present.
Hospitalizations and wastewater viral activity levels remain low or very low across the state.
2. Vector-Borne Diseases: West Nile Virus (2025 Season)
The 2025 mosquito season saw significant West Nile Virus (WNV) activity in Tennessee. While activity typically declines by November, the cumulative data for the year highlights specific hotspots. As of November 18, 2025, Tennessee reported 16 human cases.
| Region / County | Reported Activity | Notes |
|---|---|---|
| Shelby County | 2+ Human Cases | Early season hotspot; multiple positive mosquito pools. |
| Knox County | 1 Human Case | Confirmed in June 2025. |
| Carroll County | 1 Human Case | West Tennessee region. |
| Statewide Total | 16 Cases | Data as of Nov 18, 2025 (CDC). |
3. Urgent Threat: Candida auris
Candida auris, a multidrug-resistant fungus, continues to be a critical public health threat in Tennessee healthcare facilities. The CDC classifies this as an "Urgent Threat."
- Total Cases (YTD Nov 2025): ~226 (Combined Clinical & Screening)
- Clinical Cases: 55 confirmed infections.
- Screening Cases: 171 colonization cases (patient carries the fungus but is not sick).
- Primary Hotspots: Mid-Cumberland Region (Nashville area) and West Tennessee Region.
2025 Candida auris Distribution (YTD)
Source: TN Dept. of Health Weekly Report (Nov 8, 2025)
4. 2025 Outbreak Archive (Year-to-Date Context)
While currently contained or seasonal, the following outbreaks defined the public health landscape of Tennessee earlier in 2025.
Measles Outbreak
March - April 2025
Tennessee confirmed its first measles case of the year on March 21, 2025. The cluster grew to 6 confirmed cases by late April, part of a larger national resurgence involving over 800 cases.
Pertussis (Whooping Cough)
Peak: Spring 2025
Cases surged significantly in 2025. By late April, TDH reported 235 confirmed cases, nearly matching the total for the entire previous year within just four months.
Foodborne Illnesses (E. coli & Listeria)
Various Incidents
- Venison E. coli Outbreak (May 2025): Linked to a processing facility; resulted in the death of a 4-year-old in Henry County.
- Listeria (Jan 2025): Linked to Yu Shang Food Inc. meat products; one infant death reported in Tennessee.
- General Status: Tennessee maintains a high rate of Shiga toxin-producing E. coli (STEC) compared to national averages, despite low overall foodborne illness rates.
Emerging Policy: Alpha-gal Syndrome
New Reporting Requirement: Following the passage of House Bill 383, Alpha-gal syndrome (a red meat allergy caused by tick bites) became a reportable condition in Tennessee as of July 1, 2025.
Impact: Estimates suggest 35,000 to 70,000 Tennesseans may be affected, with rural areas being disproportionately impacted. This new data stream will help quantify the burden of tick-borne illnesses beyond Lyme and Rocky Mountain Spotted Fever.