The Link - September 2026

When a pediatrician thinks about ethics, the uncommon cases often come to mind: disagreements over life-sustaining treatment, conflict between parents and clinicians, questions about consent and assent, or the challenge of making a decision in a child’s best interest when all options are bad. These are the sort of situations that warrant a call to the ethics committee. Much of medical education focuses on these types of situations, which are clearly important. In reality, though, these cases are relatively rare. Most pediatric clinicians will not face a headline-making ethical dilemma this week.

Childhood diarrhea is a leading cause of morbidity and mortality worldwide and is associated with substantial health care utilization, including outpatient visits and hospitalizations, and subsequent socioeconomic burden. Although acute diarrhea typically has an infectious etiology, chronic or persistent diarrhea, defined as loose or watery stools persisting beyond 14 days, spans an etiologic spectrum from benign, self-limited conditions to more serious inflammatory and malabsorptive diseases. Due to the broad differential diagnosis, a stepwise, evidence-based evaluation for chronic diarrhea is essential to limit unnecessary testing and promptly identify serious disease requiring specialist consultation.

Over the last several years, there has been a lot of discussion surrounding measles, a virus that infected as many as 400,000 people annually in the U.S. during the pre-vaccine era.¹ In the year 2000, measles was declared eliminated from the U.S. largely because of coordinated vaccine efforts and sustained uptake of the vaccine. That status is unfortunately being reviewed by the Pan American Health Organization this winter.² We all remember the outbreak of measles that started in Gaines County, Texas, in 2025, and the conversation has continued since. In 2025, there were 2,289 cases of measles and three deaths.¹ As of Sept. 17, 2026, between 3,387 and 3,471 cases of measles were reported nationally, with two infant and two adult deaths reported by the Commonwealth of Pennsylvania.^1,3,4,5 On Sept. 4, the Missouri Department of Health & Senior Services issued a Health Alert about rising cases in the Midwest to increase vigilance for this infection and encourage vaccination efforts.⁶ This alert was followed by an announcement from the Missouri Department of Health & Senior Services about a possible measles exposure at a Sedalia train station.⁷ While there is no current measles outbreak in Kansas or Missouri there have been two confirmed cases in Kansas and 10 confirmed cases in Missouri as of Sept. 18, 2026.^1,8 These events are a reminder of how quickly the situation can change within our community. Let’s discuss clinical presentation and resources for measles diagnosis.