Flu season continues to heat up
Updates for the week ending November 19
Respiratory diseases
Flu season continues to heat up.
The cumulative hospitalization rate for influenza is already on par with where we would expect to be in December or January. More than 11,000 people with flu were hospitalized the week ending November 19, up from 8,800 new admissions the week before.
On the bright side, the trajectory of “influenza like illness” activity has slowed somewhat. Influenza like illness (ILI) is a term that includes influenza and other causes of fever and sore throat or cough. Two weeks ago, 5.5% of visits to the doctor were for ILI. In the data reported this week, it’s 6%. The baseline is 2.5%, so 6% is not exactly comforting, but at least we aren’t seeing big jumps like in previous weeks.
The big caveat is that the Thanksgiving holiday may have both disrupted disease surveillance and given viruses new opportunities to spread, so we’ll have to see how things unfold in the weeks to come.
Thankfully, ILI activity seems to have slowed among children. For the week ending Nov 19, 15.4% of visits to the doctor were for ILI in kids ages 0-4, down from 15.8% the week before. In people ages 5-24, ILI visits have remained stable for the last three weeks at about 10%.
I was struck by this graph of ILI outbreaks in Minnesota schools. Over 560 schools have registered an outbreak during this school year, far more than in previous seasons. I would like to see this reported from more jurisdictions because it gives a more concrete picture of the impact of outbreaks on schools and workplaces than other indicators. Ventilation, filtration, masking and hand washing can help to keep kids healthy and in school during flu season.
As expected, the whole country is now in the thick of flu season, with 35 jurisdictions reporting high or very high levels of ILI activity.
For RSV, a respiratory virus that is particularly dangerous for infants and older adults, the hospitalization rate is way down this week—but these numbers get revised quite a bit as data backlogs are resolved, so I am not making a call that RSV has peaked yet. RSV activity (either hospitalizations or test positivity) is still rising according to data from Oregon and California, but it’s down in Minnesota, Georgia, New York and Chicago. These last few months have been very hard on young children, so I’m hoping to see the peak soon.
At the national level, COVID-19 activity remains mostly stable—though hospitalizations in people ages 70+ are rising, likely due to low booster coverage. Just 31% of people 65 and older have received an updated bivalent booster. In some states, primarily in the south, coverage in older adults is under 25%. Please get your bivalent booster if you haven’t already, and remind the older adults in your life to do so as well.
Stomach bugs
Norovirus (the “stomach flu”) is likely still rising, though there are not as many good data sources for enteric viruses as there are for respiratory viruses. Norovirus usually peaks in winter, similar to flu season.
Norovirus spreads very easily between people through the “fecal-oral” route. To stop it from spreading, wash your hands thoroughly after using the bathroom and before eating or preparing food. I also use hand sanitizer while I’m in public like after I use self-checkout at the grocery store or when I use public transportation, but you should know that hand sanitizer is not as effective against norovirus as hand washing. Be sure to wash your hands properly when you get home. Most importantly, stay home if you have vomiting or diarrhea.
If someone in your household gets the stomach flu, you can reduce the chance it will spread by keeping them out of the kitchen and disinfecting contaminated (read: bathroom) and shared surfaces. Also regard laundry like bedsheets, clothes and towels as contaminated. Use gloves when handling the items and wash them thoroughly with hot water on the longest cleaning cycle.
Food recalls
The following foods are being recalled because they are contaminated with bacteria that causes food poisoning. Please check your cupboards and throw out any of these items:
New this week:
Enoki mushrooms by Green Day Produce. (more info)
Previously reported:
Brie, baked brie, and camembert cheese made by Old Europe Cheese, Inc. with best-by dates from September 28, 2022, to December 14, 2022. (more info)
Frozen falafel sold in Aldi stores (more info)
Nestle edible Chocolate Chip Cookie Dough tubs with best-by dates of January 28-30, 2023 (more info)
Giant Brand Wild Caught Sockeye Smoked Salmon sold in Maryland, Virginia, Washington D.C. and Delaware (more info)
Certain lettuce products, marshmallow cookies and beef dumplings that only reached a small number of consumers
There is also a multi-state outbreak of Listeria linked to deli meats and cheeses, but the specific source has not been identified. If you are pregnant, over the age of 65, or have a condition that weakens your immune system, consider avoiding meat or cheese from deli counters. (more info)
If you have food allergies, you may wish to review these FDA safety alerts for foods with undeclared allergens.
Thanks for the updates. I'm resorting to scanning information like yours, YLE, Eric Topol, and CIDRAP, JHU newsleters, and UColo updates... plus info from colleagues via various routes as opposed to pulling the data and creating my own native updates. Your efforts, and especially your explanations make my work easier, as I can refer to what you've done, and the explanations are better received than what I've been known to write. Again: Thanks for all your efforts!