The US Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) said there are now four cases of infant botulism illnesses from three states, up from three last month. The new case is in California.

California now has two cases, while Pennsylvania and Washington state each have one.

All cases have been linked to Nara Organics Whole Milk Organic powdered formula, which was recalled last month. According to the FDA, Nara Organics Powdered Infant Formula was distributed nationally across Target retail stores, Target.com, and Nara.com from July 2025 to June 2026.

Nara Organics, Inc, is headquartered in New York City.

“Parents and Caregivers should stop using Nara Organics Whole Milk Organic Infant Formula immediately,” the FDA said yesterday. “If your child is experiencing symptoms after consuming Nara Organics Whole Milk Organic Infant Formula seek immediate health care.”

Rare but serious illness

According to the CDC, infant botulism is a rare but serious illness, which occurs when a baby swallows spores of Clostridium botulinum bacteria. The first symptoms are typically poor feeding, and symptoms can take several days and weeks to develop.

Hong Kong’s Centre for Health Protection (CHP) is reporting a new case of variant H9N2 avian flu H9N2 in a 1-year-old girl from Guangdong province. The girl first had symptoms on June 12. There is no further information provided on her current status.

There have been 16 known human infections of H9N2 over the past six months, including 12 on mainland China, one each in Hong Kong and Taiwan, and one case in Italy. Twelve of the 16 cases reported in recent months have occurred in children 10 years or younger.

Since 2015, a total of 164 cases of human infection with H9N2 avian flu, including two deaths (both in people with underlying conditions), have been reported to the World Health Organization in the Western Pacific, the organization said.

Of the 164 cases, 160 were in China.

An investigational vaccine candidate for Shigella provided high-level protection in a phase 2 clinical trial, researchers reported last week in The Lancet Infectious Diseases.

In a challenge trial conducted at two US sites, 73 healthy adults aged 18 to 49 were randomly assigned to receive WRS2, a live-attenuated oral vaccine targeting Shigella sonnei, or placebo. S sonnei is one of four species of the highly contagious bacteria, which infects tens of millions around the world, causing mild to severe diarrhea and vomiting. There are no licensed vaccines for any of the Shigella species, two of which—S sonnei and S flexneri—are becoming increasingly resistant to first-line antibiotics.

The primary end point of the trial was occurrence of shigellosis following an oral challenge with S sonnei, assessed from day 57 to day 63 after the challenge in participants who received two doses with two different dose levels and the placebo recipients. Investigators also assessed systemic adverse events.

89% estimated vaccine efficacy

Among the 34 participants given the pooled two-dose vaccine, three (9%) were diagnosed as having shigellosis, compared with 21 (81%) of 26 placebo recipients, yielding an estimated vaccine efficacy of 89%. Participants in both two-dose groups elicited strong antibody response. Although most adverse events were mild, six vaccine recipients experienced grade 3–level adverse events, which prompted a review by the data safety monitoring board and a reduction of the vaccine dose.

The investigators say the next step will be to optimize the dose level and conduct larger trials in endemic settings that include children, who are among the most affected by shigellosis in high-burden settings like sub-Saharan Africa. 

“This study represents an important step forward in developing a safe and effective vaccine against Shigella,” senior study author Robert W. Frenck, Jr., MD, director of the Vaccine Research Center at Cincinnati Children’s Hospital, said in a news release. “With continued research, we have the potential to significantly reduce the global burden of this disease, particularly among children.”