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We have vaccines, antibiotics, sophisticated tests, and intensive care. Apparently, the microbes didn’t get the memo.
Some familiar infections are making a comeback. Others never left. A few newcomers have learned to shrug off our medicines. They can turn up in a waiting room, on vacation, or in someone who insists, “It’s probably nothing.”
This countdown isn’t a scientific ranking. Your risk depends on your health, vaccinations, travel, and exposures. But each infection deserves attention—and a few practical precautions.
This article is educational. For symptoms, exposures, or questions about prevention, consult your clinician.
#10: Whooping Cough
“It’s only a cold.” Famous last words.
Whooping cough, or pertussis, has been causing trouble for centuries. It often starts with a runny nose and an ordinary cough, making it easy to spread before anyone realizes what’s happening.
Then come the coughing fits: exhausting, sometimes violent, and occasionally followed by vomiting. Recovery can take weeks. The signature “whoop” isn’t required, and babies may stop breathing without much coughing at all.
The practical move: Keep vaccinations current. Children receive DTaP; adults need Tdap if they haven’t received it, followed by Td or Tdap boosters every ten years. Tdap during each pregnancy, preferably at 27–36 weeks, helps protect the newborn.
#9: Mpox
“Could you take a look at this bump?”
Mpox, formerly called monkeypox, was identified in research monkeys in 1958 and spread internationally in 2022.
It spreads mainly through close contact with infected skin, including during sex, or through contaminated materials such as bedding. Lesions can be painful, firm, centrally dimpled, and eventually scabbed. Sometimes there are only a few, particularly around the genitals or anus.
Mpox can resemble herpes, syphilis, or other skin conditions. A new bump may even be mistaken for a wart. Appearance alone isn’t enough; a lesion swab for PCR can establish the diagnosis.
Most patients recover, but severe illness can occur, especially in people with weakened immune systems.
The practical move: Have suspicious lesions evaluated, avoid close contact and shared towels or bedding, and ask about vaccination if you’re eligible. After an exposure, seek advice promptly: vaccination works best within four days.
#8: Candida auris
An unwelcome hospital guest.
Candida auris is a yeast identified in 2009. It’s the newcomer on this list, and it has made itself far too comfortable in healthcare facilities.
It can live quietly on someone’s skin, then spread through hands, surfaces, and shared equipment. In seriously ill patients—particularly those with invasive devices—it can cause dangerous bloodstream infections. Many strains resist common antifungal medicines, and some resist multiple drug classes.
Deaths are frequent among patients with invasive infection, although many are already critically ill. Carrying the organism on the skin is different from having an infection.
Older laboratory systems can also mistake it for another yeast, delaying recognition.
The practical move: Healthcare facilities need accurate testing, hand hygiene, appropriate precautions, and disinfectants effective against C. auris. Healthy household members generally face low risk.
#7: Dengue
The mosquito wasn’t included in the resort brochure.
A Caribbean vacation. A trip to coastal Mexico. An afternoon in Florida. Lovely—until an infected mosquito joins the itinerary.
Dengue, pronounced DENG-ee, can cause fever, headache, rash, and the punishing aches behind its nickname, “breakbone fever.” I contracted it in Grenada in 1995. Mine was considered mild. I would have chosen another adjective.
Severe dengue can cause bleeding, shock, and organ damage. A subsequent infection can increase that risk, although severe illness can happen with a first infection, too.
The nasty twist: warning signs may appear as the fever goes away. A better thermometer reading isn’t always an all-clear. Local transmission has also occurred in several U.S. states, and Tampa’s Hillsborough County recently declared an emergency.
The practical move: Use repellent, screens, and protective clothing. These mosquitoes often bite during the day. Seek immediate care for severe abdominal pain, persistent vomiting, bleeding, or marked weakness. If dengue is suspected, avoid aspirin and ibuprofen because they can increase bleeding risk.
#6: Syphilis
“It went away, so I’m fine.” Not necessarily.
Syphilis has been around for centuries. Penicillin made it curable in the 1940s, but the infection still exploits missed testing, delayed treatment, and untreated partners.
It often begins with a painless sore. The sore heals, which sounds reassuring—except the infection can remain. A rash may follow, or syphilis may go silent for years while remaining capable of causing serious damage.
Untreated infection can affect the brain, nerves, eyes, and cardiovascular system. During pregnancy, it can cause miscarriage, stillbirth, or severe illness in the baby. U.S. congenital syphilis cases increased for the twelfth consecutive year in 2024, even as some adult infection rates declined.
The practical move: Don’t diagnose a sore by optimism. Get tested, complete treatment, make sure partners are evaluated, and return for recommended follow-up blood tests. Condoms reduce risk but may not cover every infectious lesion. Prenatal screening is essential.
#5: Polio
The “iron lungs” weren’t museum pieces when our parents were young.
Before vaccines, polio left thousands of children paralyzed and some dependent on machines to breathe.
Most infections cause no symptoms or only a mild illness. A small proportion attack the nervous system, causing meningitis or paralysis. When breathing muscles are affected, the consequences can be fatal. There is no cure for paralytic polio.
The virus spreads mainly through fecal contamination of hands, food, or water. People without symptoms can pass it along, allowing circulation before a case of paralysis reveals the danger.
Vaccination eliminated wild poliovirus in the United States. Worldwide eradication remains unfinished.
The practical move: Complete the recommended vaccine series. The inactivated vaccine used in the U.S. cannot cause polio. If you missed doses—or plan to visit an area where poliovirus circulates—review your protection with a clinician.
#4: Tuberculosis
“Consumption” sounds old-fashioned. TB isn’t.
Tuberculosis once filled sanatoriums. It still fills hospital beds.
After infection, TB bacteria may remain dormant for years. This latent infection causes no symptoms and cannot spread. Active TB in the lungs or throat, however, can spread through shared air.
Symptoms may include a persistent cough, fever, night sweats, and unexplained weight loss. Coughing up blood is a warning sign, but you shouldn’t wait for it.
U.S. cases increased for four consecutive years through 2024. Worldwide that year, an estimated 10.7 million people became ill and 1.23 million died. Drug resistance makes some infections harder to treat.
The practical move: Have a persistent cough or known exposure evaluated. Testing and treatment for latent infection can prevent future disease. If treatment is prescribed, finish it—even when you feel better. Your local health department can help.
#3: Cholera
The water looks clear. That tells you very little.
Cholera caused devastating nineteenth-century pandemics and still produces major outbreaks where safe water and sanitation are lacking.
The bacteria travel through contaminated food or water. Many infections cause little illness, but severe cholera produces profuse watery diarrhea and vomiting. Dehydration can become fatal within hours.
Fortunately, prompt replacement of fluids and salts can save lives. Severe cases require intravenous fluids; antibiotics help selected patients.
Cholera is rare in the U.S. because of modern water and sewage systems. Most cases involve international travel, although contaminated seafood—including, very rarely, raw or undercooked Gulf Coast shellfish—can be a source.
The practical move: In affected areas, use safe water, eat thoroughly cooked food, and choose fruit you can peel yourself. Wash your hands. An oral vaccine is available for eligible travelers, but it doesn’t replace food and water precautions.
#2: Measles
By the time the spots appear, the virus has had a head start.
By the time I earned my degree, measles had become so uncommon that many clinicians had never seen it. Declining vaccine coverage has given it another opening.
WHO calls it “one of the world’s most contagious diseases.” About nine in ten susceptible close contacts can become infected. The virus can remain infectious in the air for up to two hours after the infected person leaves.
That means sharing a room can be enough—even without sharing it at the same time.
Measles can cause pneumonia, brain inflammation, pregnancy complications, and death. Large outbreaks have returned across the Americas and Europe.
The practical move: Check your immunity. Two MMR doses are about 97% effective at preventing measles. If you suspect exposure or illness, call before entering a clinic so staff can arrange care without exposing everyone in the waiting room. We appreciate the heads-up.
#1: Influenza
“Familiar” doesn’t mean harmless.
Flu gets the top spot because it returns so reliably—and we so reliably underestimate it.
The Great Influenza pandemic of 1918–1919 killed an estimated 50 million people worldwide. Today’s seasonal flu causes roughly three to five million severe illnesses and 290,000–650,000 respiratory deaths each year.
For some, it means fever, aches, and several miserable days. For others, it brings pneumonia, worsened heart or lung disease, hospitalization, or death. Older adults, young children, pregnant patients, and people with weakened immune systems face greater risk.
“Just the flu” can do a lot of damage.
The practical move: Get your annual flu vaccine. Protection varies by season, but vaccination can reduce serious illness and hospitalization. Improve indoor air, wash your hands, and stay home when sick. Masks add protection in crowded settings. If you’re at higher risk and develop symptoms, contact your clinician promptly; early antiviral treatment can help prevent complications.
Fear Is Useful—Panic Isn’t
Fear is useful when it gets a vaccine booked, a test taken, a mosquito bite prevented, or urgent care sought early. Panic begins when facts leave the building and rumors take the elevator down.
The goal is not to treat every cough as a plot twist. It is to recognize when the plot twist needs a clinician.
Concerned you might have the flu?
Next time: “Ten Symptoms You Should Never Google at 2:00 a.m.”
