Norovirus (stomach bug) surges, respiratory diseases hold steady
Outbreaks this week
Respiratory diseases
Influenza-like illness (ILI) remained just above baseline during the week ending February 4, 2023, again thwarting my hopes that it would fall below the national baseline of 2.5%. Instead, 2.6% of visits to the doctor were for ILI, similar to the previous two weeks. Visits in the 0-4 and 5-24 age groups actually increased slightly, to 8.1% and 4.2%, respectively. Trends in older age groups remained stable.
Oklahoma moved on from whatever anomaly launched it into the very high category last week. It’s now in the low ILI category. New York City, however, continues to experience high levels of activity, with 5% of doctor visits attributed to ILI. Although this metric is drifting downward, the pace of improvement is slow. Two other jurisdictions, New Mexico and Puerto Rico, also remain in the high ILI category, though the situation is improving in those regions as well. Canada remains in the low ILI category with just 1.4% of doctor visits attributed to ILI.
COVID-19 activity has picked up again in some places, at least according to one indicator. National case counts and hospitalizations are still falling, but the rate of hospitalizations in older adults has begun to tick up a bit. It’s a subtle shift in trends and it’s only evident in the mid-Atlantic and Great Lakes regions. Data on the viral concentration in wastewater shows an uptick in the Midwestern region. (The geographies of these various data streams don’t line up well.) I’ll keep a close eye on trends and let you know next week what develops.
Seasonal coronaviruses continue their months-long ascent. All regions of the country are seeing increased activity, but the trajectory in the Western region is especially striking. Seasonal coronaviruses cause cold-like symptoms, including runny nose, sore throat, and headache. Prevention measures are the same as for Covid: wear a mask, attend to ventilation, avoid crowded indoor areas, and so on.
RSV activity is still falling.
Stomach bug
My suspicion from last week is correct — norovirus is surging, at least in England. The UK Health Security Agency announced that laboratory reports of norovirus are 66% higher than normal during this time of year (“but within the historical range reported in the decade before the COVID-19 pandemic”). Norovirus activity in people ages 65+ are at levels that “haven’t been seen in over a decade” — yikes.
The U.S. often experiences similar trends as the UK, so I feel this supports my concern that the U.S. also has a lot of norovirus going around. Norovirus causes the classic “stomach bug,” with vomiting and diarrhea that usually resolves in a couple of days.
The biggest concern with norovirus is preventing dehydration. This is especially important in children and older adults, who dehydrate quickly. I keep Pedialyte powder packets in the pantry, because they take up less space and have a longer shelf life than bottles of liquid rehydration products. Water, broth, popsicles, diluted juice, sports drinks, etc. are also good options. Don’t fall behind by waiting until dehydration sets in. Encourage frequent sips from the onset of illness.
More on preventing the stomach bug: 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 norovirus, 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 (and eye drops)
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:
EzriCare Artificial Tears Lubricant Eye Drops. The product is also distributed by Delsam Pharma. I reported on this last week, but it’s an especially important recall because the adverse events are very serious. Please check that you do not have any Ezricare or Delsam Artificial Tears drops in your cabinet (more info).
Reported in the last month:
Ready-to-eat sausage and charcuterie products sold by Daniele International, LLC (more info).
Two recalls of alfalfa sprouts, sold by Fullei Fresh and SunSprout Enterprises. The sprouts were sold to retailers and distributors in Florida, Nebraska, Kansas and Iowa. (more info, more info)
A recall of Enoki mushrooms sold by Utopia Foods Inc has been expanded to include packages with best by dates of 03/02/2023 and 03.09.23. The mushrooms were sold to wholesale companies in NY, NJ and CT. (more info)
Frozen manicotti by Caesar’s Pasta, sold to restaurant distributors in Pennsylvania, New York and Puerto Rico (more info)
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.
Other news
Avian influenza H5N1, also known as “bird flu,” continues to circulate globally. The virus is widespread among wild birds, commercial poultry, and backyard flocks. It has also been found in all kinds of other animals, including bears, sea lions, a lion, and more. Very occasionally, it spills over into humans. The epidemic has been underway for most of a year now, but reports of large outbreaks in farmed mink and now sea lions in Peru have heightened concerns that the virus could become human-to-human transmissible.
Health officials in Equatorial Guinea are investigating reports of 20 deaths from an unknown illness resembling a viral hemorrhagic fever (VHF). Examples of VHF include Ebola, Lassa, and Marburg. The victims reportedly all attended a funeral before falling ill, which also fits with concerns that the outbreak is caused by a VHF. Around 200 people have been quarantined as officials await the results of diagnostic tests. Neighboring Cameroon has implemented border controls over concern about the outbreak.