CDC is working with state and local health departments to investigate reports of serious adverse events, including deaths, following administration of injectable ceftriaxone. So far, no single manufacturer or lot has been linked to these events, and ceftriaxone has not been confirmed as the cause. Most cases have been reported in the southeastern U.S. Reports show that reactions happened when ceftriaxone was given intramuscularly, by an IV push, or an IV piggyback. Events have been reported from inpatient and outpatient settings. 

CDC is requesting reports of serious adverse events following the administration of ceftriaxone to assist with the ongoing investigation. Report adverse events to VDH that meet the following criteria, occurring after September 1, 2024: 

1. Occurred within 6 hours after receipt of injectable* ceftriaxone in a non-ICU setting, and
2. Resulted in death or required cardiopulmonary resuscitation**, and
3. Not attributed by the treating provider(s) to a cause other than ceftriaxone administration***  

*Including both intramuscular and intravenous routes of administration  

**Cardiopulmonary resuscitation defined as the use of chest compressions and mechanical ventilation or provision of rescue breaths to maintain circulatory flow and oxygenation during cardiac arrest  

***Such as known infection, other underlying medical condition, or exposure to a medication or medical product other than ceftriaxone  

As federal, state, and local public health agencies work together to understand the epidemiology of these adverse events and determine the etiology, healthcare providers and healthcare facility administrators are recommended to:  

• Use clinical judgment when administering ceftriaxone. At this time, there is no recommendation to withhold ceftriaxone if it is the best agent for a patient’s bacterial infection. 
• Limit use of any unnecessary antibiotics, including ceftriaxone, to decrease the likelihood of adverse events. 
• Review post-injection monitoring protocols in your setting to verify adverse events are promptly detected and reported. 
• Should an event be detected in real time, please keep open ceftriaxone product administered to the patient, if possible. Further instruction may be given by CDC. At this time, there is no recommendation to sequester unused product. 
• Report serious adverse events that might be associated with a medical product to FDA’s MedWatch Program and to the product manufacturer. 

If practitioners suspect a related case in Virginia, please notify a member of the VDH HAI/AR Program (804-864-8141 or hai@vdh.virginia.gov) for coordination and follow-up. 

💡Avian Influenza (Bird Flu) 

💡Ebola in Uganda

• New: VDH reported a person returning from international travel was in Dulles International Airport (IAD) on March 5, 2025, while infectious with measles. Maryland Department of Health reported additional potential locations of exposure in Maryland. Anyone who might have been exposed and is at risk of developing measles is asked to watch for symptoms until March 26, 2025. 
  • Clinicians are advised to stay alert for measles given this exposure event and other ongoing measles outbreaks in the U.S. 

• VDH Recommendations: 
  • Summarized in a VDH Clinician Letter (3/12/2025) 
  • Make sure patients are up to date on measles vaccine, especially before international travel, regardless of destination. 
  • If you suspect measles: 
    • Follow CDC guidance for preventing and controlling measles in healthcare settings. 
    • Immediately notify your local health department to ensure rapid testing and investigation. 

• Additional Information: 
  • CDC Health Advisory (3/7/25): Expanding Measles Outbreak in the United States and Guidance for the Upcoming Travel Season 
  • VDH Measles Information for Healthcare Providers webpage 
  • Association for Professionals in Infection Control and Epidemiology (APIC) measles webpage – updated measles playbook. 

✴️ Cuppa Tea with an IP. A weekly live chat with VDH infection preventionists (IPs) and experts to address your infection prevention and control questions. Register once to attend any session as needed.

✴️ Vitamin IPC. Subscribe to the monthly Vitamin IPC bulletin by VIPTA for essential resources and access to events to enhance frontline healthcare personnel’s infection prevention and control training. 

✴️ Clinician Letter. This letter is emailed to all currently licensed healthcare professionals in the Commonwealth to communicate important updates. Access archived letters at Clinician Letters - Clinicians (virginia.gov) 

✴️ Healthcare Professional Newsletter. Subscribe to HCP monthly newsletter for updates on therapeutics, COVID-19, and upcoming activities. Access it and archives at Healthcare Professional Newsletter - Clinicians (virginia.gov).