Health awareness

HIV community advocates spark a global conversation

Meet three HIV advocates who are using their stories to uplift, spark change, and create spaces of healing and hope across continents

October 7, 2025

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Around the world, HIV advocates are working tirelessly to confront stigma, alleviate loneliness and empower people living with HIV through education, community building and storytelling.

Isaac Ogunkola, Erika Castellanos and Nesrine Rizk exemplify how compassionate advocacy can transform lives. Their work reminds us that even the smallest action — whether it’s sharing a story, offering support or educating just one person — can spark meaningful change.

Above, watch them reflect on their work and read on to learn more about each advocate.

Isaac Ogunkola: Empowering the next generation of HIV advocates

Isaac Ogunkola didn’t set out to be a voice for the HIV community. When he began working with young refugees and local children in Nigeria, the goal was to teach reading and writing. After learning some of them were living with HIV, he reflected on the experience of watching family members die from preventable diseases and decided he would pursue public health.

Ogunkola’s organization connects youth to clinics for testing and treatment of HIV, preventive education and harm reduction services. “People living with HIV face many challenges, and my work is about connecting them to medical services and fostering environments where they can live safely and with dignity,” Ogunkola said.

His biggest impact has been through the development of a peer education program for refugee settlements in West Africa. By training 35 young refugees as educators and advocates, they’ve been able to reach 2,000 other refugees with testing and prevention services. These peer advocates help combat stigma by creating a safe space to discuss topics related to HIV transmission, like sex and drug use, that are often stigmatized.

“The peer educators can continue the training while I’m no longer in the settlements. Seeing that the project is self-sustaining, that is success for me.”

  • Isaac Ogunkola

Although Ogunkola’s advocacy journey has expanded beyond the grassroots level to working with governments and policymakers, he’s still passionate about the power of individuals to make a difference, especially young people.

“We can tap into the strength of young people,” he said. “We can push young people to be stakeholders in the implementation of these projects right from the beginning and throughout the life of the projects.”

Erika Castellanos: The joyful warrior

Erika Castellanos first encountered the devastation of the HIV epidemic while volunteering at a hospice in Mexico in the early 1990s. As a transgender woman from a small town in Belize, Castellanos understood what it felt like to be stigmatized by her community. So, when she noticed hospice patients with HIV who had been abandoned by their relatives, she stepped in to hold their hands and read them books, making sure they knew they weren’t alone.

In 1995, Castellanos contracted HIV and was told she’d have just six months to live. She’s grateful to have survived that moment, and it was an unexpected encounter with another woman living with HIV at that time that inspired Castellanos to become an advocate herself. This other woman was always cheerful and good-humored about her condition despite her difficult prognosis, which puzzled Castellanos — until she decided to try and do the same. She realized that by embracing her own diagnosis and speaking openly about living with HIV, she could empower others. 

“It felt good to be able to laugh again, even about the things we were struggling with. If I want to do anything in life, I want to make someone else smile.”

  • Erika Castellanos

Over the past three decades, Castellanos has advocated for a better quality of life for people living with HIV and the LGBTQ+ community worldwide. She now lives in the Netherlands with her husband and two children, where she runs an organization that advances equality for the transgender and gender diverse communities.  

Even as the challenges facing these communities have changed, the most important part of her advocacy work has always been sharing positivity with others. 

“Living with HIV is not just about managing the virus, but also about managing the judgment and prejudice that comes with it,” she said. 

Castellanos emphasizes the importance of sharing stories to combat loneliness and stigma. “Don’t be shy,” she urges. “Speak out. Share your stories. Someone else will hear your message and no longer feel alone.”

Nesrine Rizk: Bridging medicine and social science in HIV care 

Dr. Nesrine Rizk believes medicine is not just a science, but also a social discipline, especially when treating people with infectious diseases like HIV.

“Because of its history and transmission route, HIV is deeply intertwined with cultural norms, stigma and how people live and interact,” said Rizk, who practices in Lebanon.

Rizk advocates for comprehensive education of health care providers and the public, policy reform and community engagement to dismantle stigma.

“Stigma will impact the ability of a person to access prevention methods, stigma will impact an individual’s access to HIV health care, and stigma will affect treatment and adherence to therapy,” she said. “Stigma creates barriers to accessing prevention, care and treatment, and can lead to late diagnosis and increased mortality. It impacts their quality of life profoundly.”

In Rizk’s region, access to condoms can be limited, at-home testing is often unavailable and patients sometimes feel compelled to hide their medication from loved ones. These additional barriers to care have, in part, contributed to the region’s steep rise in new infections.

Rizk believes physicians should normalize discussions about sexual health and HIV in primary care settings, just as providers would address cholesterol or blood pressure.

“The bond between providers and people living with HIV is unique,” she said. “Being present to support patients throughout their life journey is essential.”

  • Nesrine Rizk

These stories are a powerful reminder that HIV advocacy is not just about HIV — it’s about humanity. Through empathy, courage and connection, individuals like Ogunkola, Castellanos and Rizk show us that change often begins with one person making the effort to care. Whether by listening, sharing or simply standing beside someone on their journey, we all have the power to make a difference.

Health awareness

Debunking 6 common myths about pneumonia in adults

Don't underestimate the severity of this infection of the lungs

October 1, 2025

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What is pneumonia?

Pneumonia is an infection of one or both lungs that can make it difficult to breathe and limit your ability to get enough oxygen.

Some common myths about pneumonia in adults, explained:

01.

Myth: Pneumonia is only viral.


Fact: Viral and bacterial pneumonia are the most common types of pneumonia.

Viral pneumonia is typically caused by respiratory viruses like the flu, SARS-CoV-2 (the virus that causes COVID-19), respiratory syncytial virus (RSV) or human metapneumovirus (HMPV). If you have viral pneumonia, you’re also at risk for developing bacterial pneumonia as a complication.

The most common type of bacterial pneumonia is called pneumococcal pneumonia, which occurs when the bacteria Streptococcus pneumoniae causes a lung infection. Pneumococcal pneumonia can be a serious illness.

02.

Myth: Cold weather causes pneumonia.

Fact: Cold weather doesn’t cause pneumonia — viruses and bacteria do. Pneumonia can be a concern year round, especially for those at increased risk.

03.

Myth: Only elderly people get pneumonia.

Fact: It’s true that adults 50 years of age and older are particularly at risk, but people of all ages can get pneumonia.

Pneumonia risk factors for people of all ages include medical conditions such as diabetes, heart disease, lung disease and HIV.

04.

Myth: Pneumonia isn’t contagious.

Fact: The viruses and bacteria that cause pneumonia are contagious. People who are infected can spread the virus or bacteria through the air when they cough, sneeze or talk. People who have the virus or the bacteria in their respiratory tract, but have no symptoms, can pass it on to others.

People can occasionally catch pneumonia by touching something that has the virus or bacteria on it and then touching their noses or mouths.

05.

Myth: Pneumonia’s only symptom is a cough.

Fact: Cough is a common symptom, but pneumonia can present differently in people based on a variety of factors. Other symptoms include:

  • Fever
  • Difficulty breathing
  • Shortness of breath
  • Chills
  • Rapid breathing
  • Chest pains
  • Confusion
  • Loss of appetite

Older adults with pneumonia may even have a lower-than-normal temperature and, at times, sudden changes in mental awareness. For those with chronic lung conditions, pneumonia may exacerbate existing symptoms. Sometimes, pneumonia symptoms can be mild, making it more difficult to diagnose.

06.

Myth: Pneumonia isn’t serious.

Fact: Pneumonia can cause serious illness, such as respiratory failure, fluid or pus in or around the lungs and sepsis. These complications can be life-threatening.

As you grow older, your risk for pneumonia increases. Speak with your health care provider to learn more about the disease and the actions you can take to help reduce your risk.

Health awareness

From awareness to action: understanding triple negative breast cancer (TNBC)

Early detection is important for this aggressive type of breast cancer. Learn more about the risk factors, signs and symptoms of TNBC.

September 29, 2025

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Breast cancer is the most commonly diagnosed cancer among women in the U.S. There are many different types and subtypes of breast cancer — defined by where it starts in the breast, how much it has grown or spread, and how it behaves. One of the more aggressive and difficult-to-treat types is triple-negative breast cancer (TNBC), and knowing the facts is one of the most important steps in a patient’s cancer journey. 

What is TNBC? 

Breast cancer tumors may be tested for three receptors, or proteins, that make cancer grow. A TNBC diagnosis is made when the tumor tests negative for estrogen and progesterone receptors and does not over express HER2. 

TNBC differs from other types of invasive breast cancer, as it tends to grow and spread faster, with a worse prognosis for patients. It also has a high likelihood of recurrence.   

Approximately 1 in 8 women in the U.S. will be diagnosed with breast cancer. Approximately 10-15% of these diagnoses are TNBC. 

Who’s at risk of developing TNBC? 

While TNBC can affect anyone, some people may be at higher risk. Factors that make someone more likely to be diagnosed with TNBC include: 

  • Sex: People assigned female at birth are at higher risk for TNBC compared to people assigned male at birth.
  • Race/ethnicity: TNBC disproportionately affects Black women. Nearly 20% of breast cancers diagnosed in Black women are TNBC.
  • Age: TNBC is more common in women younger than 40.
  • Genetic mutations: Mutations in certain genes are associated with TNBC.

What are the signs and symptoms of TNBC?

TNBC may have the same signs and symptoms as other common types of breast cancer, though most breast cancers are detected before any symptoms appear through regular screenings.

Possible signs and symptoms of breast cancer may include:

  • A new breast lump or mass
  • Swelling of all or part of a breast
  • Skin dimpling
  • Breast or nipple pain
  • Nipple retraction
  • Nipple or breast skin that’s red, dry, flaking or thickened
  • Nipple discharge
  • Swollen lymph nodes, under the arm or near the collar bone
Health practitioner explaining medical test to female patient in hospital room

Our commitment to access to health  

We recognize that barriers like limited access to screening and quality care, differences in potential risks and other factors continue to fuel disparities among those disproportionately affected by breast cancer. That’s why it’s critical to ensure those who need it have access to care and support early enough in their journey to benefit them. Through a combination of digital support tools and resources, we’re closing care gaps and helping patients overcome barriers to care, no matter where they are in their journey.

Josette Gbemudu

Early detection of breast cancer isn't just important — it could be life-saving. That’s why we’re focused on helping women get the care they need.

— Josette Gbemudu

AVP, patient health innovation 

Navigating breast cancer, especially aggressive types like TNBC, can be daunting and for some — overwhelming. However, access to information and the right tools and resources can contribute to a more equitable patient journey for those impacted. By equipping patients to make better informed decisions, we can help them to advocate and determine the best path forward.  

”We focus our work on making the most impact for patients — from advancing science to help patients living with this condition to creating patient-friendly education materials. We’re committed to improving outcomes for breast cancer patients, globally,” said Dr. Karen Lisa Smith, senior principal scientist.   

Learn more about our commitment to expanding access to health.

Health awareness

Finding joy after surviving cervical cancer twice

How one woman embraced life, marriage and motherhood despite her cervical cancer diagnosis

September 25, 2025

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Chrstine Granado and her family

Several years ago, Christine Granado was living happily in New Jersey with her fiancé and then-9-year-old son, but she felt something wasn’t right.

In the span of a year, she lost three pregnancies. The first miscarriage came as a total shock. With the second, she felt confused. After the third, she was afraid something was terribly wrong. She decided to go for a routine checkup. While undergoing a series of tests ordered by her OB-GYN, she got surprising news: she was diagnosed with stage IIB squamous cell cervical cancer that had spread to her lymph nodes. At just 28, Christine said she felt disbelief.

“How can I have cancer at this age?” she asked herself. “I remember peeking through my bangs, feeling like I was trying to hide behind them.”

Young women are at risk for cervical cancer, too

Granado wasn’t alone in asking herself that question. Cervical cancer is most often diagnosed between the ages of 35 and 44. In 2022, over 660,000 people around the world were diagnosed with cervical cancer. In 2025, it’s estimated that around 13,000 people will be diagnosed with cervical cancer in the U.S.

Regular screenings can catch early changes in the cervix before they turn into cancer, but not everyone has the same access or risk factors for cervical cancer. That’s why it’s so important to make sure everyone gets the care they need.

Beginning her cancer treatment journey

Granado started treatment as soon as possible. She was prepared for physical side effects but was overwhelmed by the other changes that soon followed, including how she felt about losing her fertility. She and her partner discussed preserving her eggs but decided against it as doing so would have delayed her treatment.

Granado’s cancer went into remission for three years, and she found joy again: She and her fiancé got married and decided to have a baby via surrogate.

The shock of a recurring cancer diagnosis

Then, soon before her son was born, Granado started having unexplained chest pains. A CT scan found enlarged lymph nodes. She was diagnosed with metastatic cancer.

“When I got the recurrence diagnosis, I was devastated. It was hard to hear, but it motivated me to finish things, to contact a lawyer and get things in my kids’ names — to think about life after me,” she said. 

It also motivated her to continue with more treatments. During her second round of treatment, Granado was able to welcome her new son. When she saw him, she took him in her arms: “I bawled my eyes out.” 

A focus on mental health 

In addition to her son’s arrival, Granado said a focus on herself has sharpened her resolve to live her best life. When the cancer came back, she grieved for her life. She would cry and sleep all day. Her depression stopped her from enjoying precious time with her family.

“The most disabling thing I dealt with was the depression,” she said. “There were days when I would feel physically OK, but I’d still stay in bed all day.” Thankfully, Granado had the support of a psychologist and a psychiatrist who helped her feel well again. 

little boy laying with a dog

Cervical cancer won’t stop her from living her best life 

Granado has been able to complete a master’s degree in health leadership, and her family has a new border collie named Harry. Even everyday activities like going to the hardware store and winding down with a book mean so much more now. She appreciates the small details, like watching TV with her son on the couch.

“Life has been amazingly boring,” she says. “In a good way.” 

Granado said she hopes her story will inspire others and give them hope in the face of a cancer diagnosis.

Health awareness

Measles: signs and symptoms

Learn more about what the measles virus is and how measles spreads

September 17, 2025

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Illustration of a person holding a child. A circular inset on the left side of the image contains various virus-like particles, indicating an infection or illness.

What is measles?

Measles is a highly contagious viral disease that can affect people of all ages but is most common in children. The virus lives in the mucus of the nose and throat of an infected person.

Measles spreads through the air when an infected person coughs or sneezes. Symptoms appear 7 to 14 days after contact with the virus.

Common measles symptoms include:

High fever

(may spike to more than 104°F)

Cough

Runny nose

Red watery eyes

(7-14 days after contact with the virus)

Tiny white spots in mouth

(2-3 days after symptoms begin)

Rash

(3-5 days after symptoms begin)

How measles spreads

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Is measles airborne?

The measles virus can live for up to two hours in an airspace after an infected person leaves an area.

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How contagious is measles?

If one person has measles, up to 90% of unvaccinated people close to that person will also become infected.

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How long is measles contagious for?

Infected people can spread measles to others four days before through four days after the rash appears.

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How long is the measles incubation period?

After being exposed to the measles virus, it can incubate for up to 21 days. An incubation period is how long it takes for you to develop symptoms after exposure to an infectious disease.

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Does measles cause complications?

Measles can cause health complications. Common complications include ear infections and diarrhea. Serious complications include pneumonia and encephalitis (an inflammation of the brain). Measles may impact the daily lives of patients and their caretakers (e.g., can result in lost work time or missed school days).

Measles can be serious and lead to complications 

  • About 1 in 5 unvaccinated people in the U.S. who get measles are hospitalized.
  • As many as 1 out of every 20 children with measles get pneumonia, the most common cause of death from measles in young children.
  • Approximately 1 to 3 of every 1,000 children who become infected with measles will die from respiratory and neurologic complications.

Understanding measles outbreaks

Before the vaccine became available in 1963, an estimated 3 to 4 million Americans contracted measles each year; an estimated 48,000 people in the U.S. were hospitalized and there were approximately 400 to 500 deaths annually.

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Endemic (regularly occurring within an area or community) measles was declared eliminated in the U.S. in 2000.

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2025 saw the greatest number of measles cases reported in the U.S. since 1992.

When you’re contagious with measles, up to 90% of the people around you who are not vaccinated will also become infected.

In the U.S., measles cases can originate from international travel as the disease remains common in many parts of the world. Typically, 2 out of 3 of travelers with measles are unvaccinated Americans re-entering the country.

As seen by the recent outbreaks across the country, measles can spread rapidly, and infected individuals can spread measles to other people who are not immune.

Health awareness

Helping protect against vaccine-preventable diseases

Vaccination is one of the many ways you can help protect your loved ones against certain vaccine-preventable diseases

September 10, 2025

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Vaccines are one of the greatest public health success stories in history

Vaccines help protect against more than 30 potentially life-threatening diseases and are one of the greatest public health achievements of our time.

We recognize and support many global health stakeholders for their efforts in raising awareness about the importance of vaccination and helping prevent infectious diseases around the world.

Broader vaccination coverage along with other public health measures have contributed to the eradication of smallpox and significantly decreased the incidence of other vaccine-preventable diseases.

Declining immunization rates persist

Childhood immunization rates have been declining in recent years, with the global population facing the largest sustained decline in approximately 30 years.

mother laying down in bed with her newborn

A downward trend in global immunization persists, with immunization coverage stalling in 2023, leaving 2.7 million more children un- or under-vaccinated compared to 2019.

baby sitting down on table with band aid on right arm

Research shows that routine childhood vaccinations for people in the U.S. born from 1994-2023 have contributed to helping prevent about 508 million illnesses and 32 million hospitalizations.

family being consulted by doctor wearing white coat

In 2024, it’s estimated that more than 14.3 million infants around the world did not receive some routinely recommended vaccines.

Recovering immunization rates together

Now, more than ever, we have an opportunity to reimagine the role we all can play.

At Merck, our broad portfolio of vaccines helps protect against certain infectious diseases affecting individuals around the world and across all stages of life from infancy through older adulthood. Through our work in vaccines, we’re committed to helping protect people from vaccine-preventable diseases today and for generations to come.

But we can’t be successful alone. That’s why we’re working with a variety of stakeholders to help increase vaccination rates, build trust and enable access to vaccination services for everyone who can benefit from them.

We’re also encouraging individuals to speak with their health care providers about vaccines that may be recommended for them or their families.

older person with pink shirt smiling outstretching her arms to hug a younger person with braids.

Merck and its legacy companies have a 100+ year history of innovation and commitment to helping prevent disease by discovering, developing, supplying and delivering vaccines.

To keep pace with the ever-evolving disease landscape, we go where the need is to find new ways to address complex public health problems. We continue to invest in groundbreaking research and breakthrough technologies to help protect against potentially life-altering vaccine-preventable diseases.

Health awareness

Is your child up to date on their vaccines? Make a plan today

Keeping kids’ vaccinations current can help protect them against vaccine-preventable diseases

August 18, 2025

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One of the many ways parents can help protect their kids from certain infectious diseases is by keeping them up to date on their recommended vaccines.

“Vaccines are powerful tools that can help protect against certain diseases. Making sure your kids are up to date on their vaccines is one way you can help protect them,” said Andrew “Drew” Otoo, PharmD, president of global vaccines from 2022-2025 and current regional president, Merck. “Speak with your child’s health care provider and ask about vaccines that may be recommended.”

In addition to scheduling vaccinations, child well-visits are essential for discussing concerns about children’s health and tracking growth and developmental milestones.

Dr. Andrew Otoo
Dr. Andrew “Drew” Otoo

“For all of us, let’s get creative. We’ve seen what our communities can do when it comes to new and effective ways to reach populations for vaccination.”

Even small actions can have an impact. Parents and community members can make a point to talk about routine and recommended vaccinations. Health care providers can use electronic health records and immunization registries to remind parents to schedule well-child visits for children who may be overdue for a check-up.

It’s critical to improve and maintain high vaccination rates

In 2023:

~21M

~21 million children around the world were either unvaccinated or undervaccinated in 2023. 14.5 million children did not receive any vaccines, almost 2 million more than in 2019, according to UNICEF.

40%

40% of adults in the U.S. feel it is “extremely important” for parents to have their children vaccinated, down from 58% in 2019 and 64% in 2001. (Gallup, July 1-21, 2024).

Persisting challenges around vaccination equity and confidence can lead to drops in vaccination coverage rates, putting children and individuals of all ages at risk of potentially serious, yet vaccine-preventable, diseases.

“Our purpose is clear: How can we continue to increase vaccination rates for all recommended vaccines for all populations, including underserved communities, to help protect public health? There is an urgency to this work,” said Otoo.

Health literacy is also key in these efforts. When you understand health information, you can make make informed health decisions.

“We’re surrounded by so much information coming at us from so many directions, and it can be hard to make sense of where to go for guidance or answers,” said Otoo. “It’s so important to make sure that we’re providing information that parents can understand to help them make informed decisions about vaccination for their families, as well as overall health care.”

For more than 100 years, Merck has been a pioneer in the fight against vaccine-preventable diseases. But the burden is still too high, and new threats to global health will emerge. That’s why we are continuing to invest in groundbreaking research and breakthrough technologies to help protect against a variety of potentially serious infectious diseases. We’re also collaborating globally, nationally and locally to build trust, enable access and improve vaccination rates.

We remain focused on helping to protect people around the world and across all stages of life.

Health awareness

Navigating RSV disease: one family’s journey

As the leading cause of hospitalization for infants in the U.S., respiratory syncytial virus (RSV) can progress to severe illness for some babies

June 11, 2025

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Mom holding Charlotte

Caring for a child with respiratory syncytial virus (RSV) can be challenging. New parents Amanda and Jeremy thought they were as prepared as possible for any illness for their daughter Charlotte.

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Charlotte’s first night in the pediatric ICU.

They had an established pediatrician, supportive family and friends and a variety of resources and supplies on hand to help manage symptoms. But they weren’t prepared for Charlotte to progress from having what they initially thought was a cold, with a cough and runny nose, to being admitted to the pediatric intensive care unit for RSV at only 7 months old.

RSV is a contagious, widespread seasonal infection and the leading cause of hospitalization for infants under a year old in the U.S. Infants are among the populations most at risk of contracting the severe virus during their first RSV season, which typically starts in the fall and peaks in the winter in most regions of the U.S.

Charlotte’s experience with RSV

“Charlotte was a happy, chill baby. When she wasn’t happy, it was usually a sign that she was about to get sick,” said Amanda, who as a first-time parent hadn’t thought much about RSV up until that point.

On the day Charlotte was cleared to go home.

As Charlotte’s symptoms worsened, their doctor told Amanda and Jeremy what to look out for, mainly retracting or pulling in between and under the ribs, which was a sign of her struggling to breathe.

Amanda and Jeremy were surprised when Charlotte was admitted for difficulty breathing due to RSV and stayed in the pediatric ICU for a week.

Fortunately, she recovered and Amanda and Jeremy were so appreciative of her medical care. Today, Charlotte is a healthy and happy 3-year-old who loves spending time with her parents and younger brother.

Amanda understands that her family’s experience is unfortunately not unique.

"I urge all parents to understand the signs and symptoms of RSV so you can be prepared."

— Amanda

The impact of RSV on infants

RSV is a common seasonal respiratory infection that can be spread through virus droplets when an infected person coughs or sneezes, or through direct contact with the virus, like kissing the face of a child with RSV.

It’s the most common cause of hospitalization in infants under one year old in the U.S.

Common symptoms include a runny nose, fever, coughing and wheezing. While RSV doesn’t usually cause severe illness, healthy and at-risk infants can develop more severe cases that may lead to illnesses such as bronchiolitis (inflammation in the small airways of the lungs) or pneumonia (infection of the lungs) and may require hospitalization.

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It’s important for caregivers to speak with a health care provider to learn more about RSV and its symptoms.

Health awareness

Infectious disease detection and prevention

Learn more about how to detect and help prevent many infectious diseases

June 2, 2025

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Infectious diseases are illnesses caused by pathogenic microorganisms such as bacteria, viruses, fungi and parasites that can spread directly or indirectly from one person to another. These diseases can range from mild to severe and can affect various bodily systems, potentially leading to significant health complications and, in some cases, death.

Vaccination is one way we can help protect against certain infectious diseases. However, in recent years, vaccination rates have been declining, which has contributed to outbreaks of some infectious diseases. For example, measles was declared eliminated; yet in 2019, there was a large measles outbreak in the U.S. with 1,274 cases reported across 31 states, which was the greatest number of cases reported in the country since 1992. And as recently as 2025, outbreaks continue to appear in parts of the U.S.

Outbreaks like these are a worrying sign of a heightened risk for the spread of vaccine-preventable diseases.

Information about certain infectious diseases 


Hepatitis A    |    Hepatitis B     |     Measles     |     Mumps   I    Rotavirus   I    I Rubella

Hepatitis A

Hepatitis A is a disease of the liver caused by the hepatitis A virus, which spreads when someone ingests the virus, usually through person-to-person contact or by consuming contaminated food or drink. Those infected may feel sick for a few weeks or several months.

Signs and symptoms of hepatitis A

  • Dark urine or clay-colored stools
  • Feeling tired
  • Diarrhea
  • Fever
  • Joint pain
  • Loss of appetite
  • Nausea
  • Yellow skin or eyes (jaundice)

Potential risks and complications

In rare cases, hepatitis A can cause liver failure and death.

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Hepatitis B

Hepatitis B is a disease of the liver that’s transmitted when blood, semen or another body fluid from a person infected with the hepatitis B virus enters the body of someone who is uninfected (e.g., during sexual contact or childbirth). The disease can range from a mild, acute illness lasting a few weeks to a serious long-term, chronic infection.

Illustration of young girl

Signs and symptoms of hepatitis B

  • Dark urine or clay-colored stools
  • Feeling tired
  • Fever
  • Joint pain
  • Nausea, stomach pain or vomiting
  • Yellow skin or eyes (jaundice)

Potential risks and complications

Approximately 15%-25% of people with chronic infection develop chronic liver disease, including cirrhosis, liver failure or liver cancer.

About 9 in 10 infants infected with hepatitis B ultimately develop a chronic infection, with the risk of chronic infection decreasing as the child gets older.

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Measles

Measles is highly contagious and can cause serious health complications, especially in children younger than 5 years old. The disease spreads through the air when an infected person coughs or sneezes, with symptoms appearing seven to 14 days after contact with the virus.

By 2000, due to effective use of vaccines along with collaborative efforts with public health organizations and health care professionals, measles was declared eliminated from the U.S. However, outbreaks continue to occur.

Learn more about measles.

Illustration of small boy with red spots on his arm

Signs and symptoms of measles

  • Fever
  • Cough
  • Runny nose
  • Red, watery eyes
  • Spots in mouth
  • Rash

Potential risks and complications

Complications from measles include ear infections in about 1 in 10 children and diarrhea in fewer than 1 in 10 cases. Some children may suffer from severe complications, such as pneumonia (infection of the lungs) and encephalitis (infection of the brain).

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Mumps

Mumps is caused by a virus that affects the salivary glands. The disease spreads through direct contact with saliva or respiratory droplets from the mouth, nose or throat. It can take two to four weeks for signs of infection to show.

At one time, mumps was the most common cause of acquired deafness in the U.S.

Illustration of boy

Signs and symptoms of mumps

  • Puffy cheeks and a tender, swollen jaw
  • Fever
  • Headache
  • Muscle aches
  • Tiredness
  • Loss of appetite

Potential risks and complications

Although rare, mumps can cause serious complications, which include inflammation of the testicles (a condition known as orchitis).

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Rotavirus

Rotavirus commonly spreads in families, hospitals and child care centers with symptoms usually starting about two days after a person is exposed to the virus. Some symptoms can last three to eight days.

Illustration of baby

Signs and symptoms of rotavirus

  • Severe watery diarrhea
  • Vomiting
  • Fever
  • Stomach pain
  • Dehydration
  • Loss of appetite

Potential risks and complications

Although usually self-limiting, severe illness can result in dehydration with shock leading to hospitalization or, on rare occasions, even death

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Rubella

Rubella, also known as German measles, spreads when an infected person coughs or sneezes. The disease is usually mild with few noticeable symptoms.

About 25 to 50% of people infected with rubella will not experience symptoms but will still be at risk of spreading the infection to others.

Illustration of girl

Signs and symptoms of rubella

  • Fever
  • Headache
  • Mild pink eye (redness or swelling of the white of the eye)
  • General discomfort
  • Swollen and enlarged lymph nodes
  • Cough
  • Runny nose

Potential risks and complications

Rubella is especially dangerous to developing babies during pregnancy. If you’re pregnant and become infected with rubella, there’s an increased risk of having a miscarriage or the baby dying just after birth. The virus can also be passed on to the baby, who may develop congenital rubella syndrome, which includes birth defects such as heart problems, hearing and/or vision problems or developmental delays.

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Understanding disease prevention 

Illustration of doctor and patients

It’s important to learn about the potential risks of these diseases.

Talk to your health care provider about ways to help prevent infectious diseases including appropriate vaccines for you and your family.

Band aid applied to arm

Vaccines: Our history, our legacy

We’ve spent more than a century working to discover and develop vaccines.

Health awareness

Addressing the global shortage of TICE BCG

A new facility will triple our manufacturing capacity and address anticipated global demand for TICE BCG for the foreseeable future

May 30, 2025

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Since 2012, when Merck became the sole manufacturer of TICE® BCG BCG LIVE (for intravesical use) in many locations around the world, increasing global demand has outpaced our current maximum manufacturing capabilities. Committed to producing TICE BCG, in 2021 we announced our plans to construct a new manufacturing facility to significantly expand our production capacity for TICE BCG.

Once fully operational, the new facility will triple our current manufacturing capacity, with supply gradually increasing over time, and address global demand for TICE BCG. We’re investing more than $650 million in the new manufacturing facility, which is expected to be fully operational by late 2026 following inspection, regulatory review and approval.

Warehouse used to maintain inventory of materials used for TICE BCG production

This medicine has a lengthy and complex manufacturing process. Each batch takes more than three months to make, 30 days of which are spent waiting for the growth of a bacteria used to make the medicine.

This investment reaffirms Merck’s longstanding commitment to producing this medicine, and all our medicines, for patients who need them. We recognize the impact supply shortages can have on patients when they can’t receive the medicines they need. Until the new facility is complete, we’ll continue to use a system to proportionally allocate TICE BCG to minimize disruption to patient care as much as possible.

If patients have questions regarding TICE BCG, they should speak with their physicians. Additional information related to the shortage, current allocation practices and our efforts to increase supply, including construction of a new manufacturing site, is below.

What caused the TICE BCG shortages and backorders?

Since 2012, when Merck became the sole manufacturer of TICE® BCG BCG LIVE (for intravesical use) in many locations around the world, increasing global demand has outpaced our current maximum manufacturing capabilities. While we have many years of experience producing TICE BCG, this medicine has a lengthy and inherently complex manufacturing process.

Prior to 2012, additional manufacturers supplied the U.S. market with TICE  BCG, with Merck providing 30-40% of the U.S. supply. As other manufacturers exited the U.S. market in 2012, Merck increased production of TICE BCG to the full extent allowed by our current manufacturing capacity, which effectively doubled our supply of TICE BCG to the U.S. market.


What’s the latest update on the new TICE BCG facility?

Merck is investing more than $650 million to construct a new manufacturing facility to significantly expand production capacity for TICE BCG (first announced in 2021). We expect the facility to be fully operational by late 2026, following inspection, regulatory review and approval, and will address the anticipated demand for TICE BCG.

Once operational, our manufacturing capacity of TICE BCG will triple, and we expect supply to gradually increase over time following local market review and approvals.


How does the TICE BCG allocation process work?

To minimize disruption to patient care as much as possible until the new facility is complete, we’ll continue to use a system to proportionally allocate TICE BCG based on historical demand or in accordance with existing contractual obligations.

Merck allocates available supply among its network of wholesalers and distributors based on historical purchasing patterns or in accordance with existing contractual obligations. In turn, wholesalers and distributors allocate their inventory of TICE BCG to their own customers. End customers, including hospitals or private physician practices, cannot order product directly from Merck. This process is designed to proportionally allocate TICE BCG to minimize disruption to patient care as much as possible.


Where can I find more information about the availability of TICE BCG?

Patients:
Patients should reach out to their physician, as they are in the best position to answer questions about the availability of the medicine in their practice and can inquire about the quantity and timing of product availability with their supplier.

Health care professionals:
Health care professionals with questions regarding allocation should contact their wholesaler or distributor.