The CDC's measles dashboard reported 1,814 confirmed cases as of April 30, across 24 outbreaks, with 93% of cases outbreak-associated. [1] The wastewater-detection map still shows two metro signals — Newark and Atlanta — with Houston, Phoenix, and Detroit on watch but no new positive sewershed sample posted Friday. [1] Brenner's second MMWR Friday, Volume 75 Number 16, shipped routine influenza and tobacco surveillance content; the unpublished Covid-vaccine report and the hep-B birth-dose operational guidance remain in the queue. [2]

The neighborhood-warning frame the paper installed at the end of April is now a stable shape rather than a moving one. Newark and Atlanta hold for a second weekend; the third metro is still pending. The Pan American Health Organization's November elimination-status review is the clock — the United States's elimination status, secured in 2000, is at risk of formal redesignation if outbreaks remain endemic through the summer. [3]

What is not in motion this week is also part of the picture. The case count is rising on a curve that two MMWR Fridays under new principal-deputy line authority have not formally addressed. The dashboard updates; the guidance does not.

PAHO's deadline does not require action from anyone. It only arrives.

-- KENJI NAKAMURA, Atlanta