MMWR

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In puzzling outbreak, officials look to cold beer, gross ice, and ChatGPT

An AI assist?

The author of the MMWR report, county health official Katherine Houser, noted that the beer-tent workers were hesitant to give details because they didn’t want to get any of their community members in trouble. But one let slip that someone had put leftover food in the cooler overnight at the start of the fair.

The county health officials hypothesized that the cooler had become contaminated with Salmonella that spread to beer cans from which people then drank, allowing for infection. But with the makeshift cooler gone, it would remain only a hypothesis. So, the health investigators then turned to ChatGPT for assurances.

After providing the chatbot with details of the outbreak, health investigators asked it several questions, including: “Will S. Agbeni grow in an improperly drained cooler?”; “Are any other sources, other than ice, likely if only canned beverages and no foods were available at this location?’ ; and “What examples of similar outbreaks have been documented in scientific literature?”

Some of the questions are easy enough to answer without a chatbot. A simple search on PubMed, a federal database of scientific literature, quickly pulls up examples of Salmonella being found in ice, for example. But, the chatbot assured the officials that the cooler was a “credible and likely” source of the outbreak and they stuck with the hypothesis.

In the end, the officials required new cooler sanitation protocols—and concluded that the AI assistance was helpful. “AI was effective in this rural setting for rapid situational awareness,” Houser wrote. However, she also acknowledged the potential concerns of using AI for outbreak investigations: “Given the inherent limitations of generative AI tools, including potential inaccuracies and lack of source transparency, all AI-generated summaries were critically reviewed and validated against primary literature before incorporation,” she wrote.

Overall, the case report has a murky ending. It’s unclear how helpful the chatbot actually was in this case. Critically reviewing AI-generated answers can easily take as much time as simply researching the answer on one’s own. And of course, we’ll never know for certain what was really going on in that makeshift beer cooler—though the new cooler sanitation protocols seem like a good idea, regardless.

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Doctors report upticks in severe brain dysfunction among kids with flu

Doctors around the US have anecdotally reported an uptick of children critically ill with the flu developing severe, life-threatening neurological complications, which can be marked by seizures, delirium, hallucinations, decreased consciousness, lethargy, personality changes, and abnormalities in brain imaging.

It’s long been known that the seasonal flu can cause such devastating complications in some children, many with no underlying medical conditions. But doctors have begun to suspect that this year’s flu season—the most severe in over 15 years—has taken a yet darker turn for children. On February 14, for instance, health officials in Massachusetts released an advisory for clinicians to be on alert for neurological complications in pediatric flu patients after detecting a “possible increase.”

With the anecdata coming in, the Centers for Disease Control and Prevention analyzed all the data it has on neurological complications from flu this year and seasons dating back to 2010. Unfortunately, existing surveillance systems for flu do not capture neurological complications in pediatric cases overall—but they do capture such detailed clinical data when a child dies of flu.

An analysis of that data, published today in the CDC’s Morbidity and Mortality Weekly Report, can’t definitively say that this year is out of the norm. For one thing, the flu season is not yet over. But the data so far does suggest it may be one of the more severe seasons in the last 15 years.

Specifically, the CDC received reports of a severe neurological complication called influenza-associated acute necrotizing encephalopathy (ANE). ANE is a severe form of the more general category of influenza-associated encephalopathy or encephalitis (IAE), meaning brain dysfunction or inflammation from the flu.

When a child dies of the flu, clinicians are required to fill out a standardized case report form from the CDC, which collects a large variety of data, including complications. Encephalopathy or encephalitis are included as a checkbox on the form.

Between 2010 and February 8, 2025, 1,840 children died of the flu. Of those, 166 had IAE checked off as a complication. IAE was most prevalent in children aged 2 to 4 but affected children in all age groups under 18. More than half of the cases (54 percent) had no underlying medical conditions, and most (80 percent) were unvaccinated against the flu.

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