Flu season is back with a vengeance
Respiratory viruses are surging in the United States once again
Flu season
An early flu season continues to pick up steam in the United States. According to weekly data released by the Centers for Disease Control and Prevention today, 4.3% of visits to a healthcare provider are for respiratory illness this week—well above the baseline of 2.5%. (These reports measure influenza like illness, which includes not just influenza but also other infections that cause fever and cough or sore throat.)
Nineteen jurisdictions are reporting very high or high levels of influenza like illness (ILI) activity, an increase of fourteen over last week. Three states and the District of Columbia earned a purple color, which I’m not sure I have seen before. States in the south, southeast, and mid-Atlantic regions are most heavily affected, but at this rate I wouldn’t take much comfort if you live in a “green” state.
The burden of ILI is highest in young children, continuing a weeks-long trend. In children ages 0-4, some 1 in 7 visits to healthcare providers are for respiratory illness. In people ages 5-24, it’s around 8%. The startling burden reflects news that children’s hospitals around the country are experiencing surges of patients needing care for respiratory infections. See, for example, reports by the New York Times, Chicago Tribune, Nature, NPR, and the Washington Post.
This wave in young children is drive at least in part by respiratory syncytial virus. Data from Chicago, for example, show an extremely high burden of RSV that exceeds previous peaks over the last three seasons. There is no vaccine for RSV, but there is a shot that can be given monthly to protect the highest risk children. Pfizer is reportedly applying for FDA approval for an RSV vaccine that would be given to pregnant women to protect their infants after birth.
If you have even a mild cold, please remain at home or at least wash your hands frequently and wear a mask while in public. Be especially vigilant when visiting with infants. Most adults get only cold-like symptoms when infected with RSV, but in young children and the elderly it can be deadly.
And it’s not just RSV. Reports of influenza positive tests are increasing, as are the number of influenza-confirmed hospitalizations. Please get your flu shot as soon as possible, if you haven’t already, and remind your family members (especially those who are elderly) to do the same. I also encourage masking (don’t @ me) and attention to ventilation and filtration. The measures that became common during Covid-19 also help with other respiratory viruses.
Covid-19
All WHO regions have seen weeks of declining Covid-19 incidence, but I am not resting easy. The United States has seen weeks of declining incidence of COVID-19, but our fortunes may soon change. Europe is recovering from a recent wave driven by yet another new variant. Their experience often foreshadows what we can expect here in the U.S.
A closer look at regional trends in the United States do show hints of an uptick in the midwest and parts of the northeast, which I’m keeping my eye on. New Jersey, New Mexico, and Michigan in particular have seen worsening trends in reported cases. However, there are no clear signs in the number of new hospitalizations or regional wastewater data that would indicate a nationwide surge, so I have low confidence in this assessment.
Ebola virus disease
Uganda continues to fight an outbreak of Ebola virus disease caused by Sudan virus, for which there are no approved vaccines or treatments. The latest situation report tallied 131 cumulative confirmed cases and 48 deaths. There are seven affected districts, which has not changed since last week. The epidemic curve hints at a slowing, but a closer look at the number of suspect cases (38 new in the previous 24 hour reporting period) gives me pause. (Suspect cases are those that have symptoms that cannot be explained by usual causes, but no lab confirmation of infection yet). Contact tracing performance remains good (most days at least 90% of contacts receive follow up) and testing is reported as adequate, so I hope to see further signs of improvement soon.
