Outbreak Outlook - Dec 2

An abbreviated look at what's going around

Happy December, everyone! I hope you had a nice Thanksgiving holiday.

Most of the epidemiological data sources I use for this newsletter were not updated last week due to the holiday, so today I'm sharing a few quick insights instead. There will be no regional editions this week for the same reason.

As expected, influenza-like illness rose again from 2.7% to 3%. At a national level, we are now right at the threshold that marks the beginning of flu season. Children ages 0-4 again (always) have the highest level of activity at 8.8%. The 5-24 age group is also high, at 4.4%. Regionally, the South leads the country in ILI activity. Washington D.C. jumped to very high levels of activity, and Louisiana is at high. Georgia, Arizona, New Jersey, and Texas are all in the moderate category.

Most of the country continues to enjoy a relative respite from Covid-19. Hospitalizations are low and falling, and wastewater concentration of SARS-CoV-2 is quite low as well. There are a few wastewater hotspots (shown below), but based on the limited data that is available right now, it’s not necessarily translating into clinical illness. ED visits have drifted up slightly in some of the states in the high category (e.g., New Mexico, Arizona) but still remain low compared to previous winters.

Moving on to food recalls, organic carrot recall continues to expand, now to include carrots in bags of mixed vegetables. Whole cucumbers from the SunFed brand are also recalled. Perhaps most significantly, Kirkland Signature Organic Pasture Raised 24-Count Eggs sold at Costcos in the Southern region have been recalled.

In other news, President-elect Trump has announced nominees to several key health positions in his new administration. In addition to nominating Robert F. Kennedy Jr. to serve as Secretary of Health and Human Services, he has also named surgeon Marty Makary to FDA Commissioner, former Congressman Dave Weldon to CDC Director, Mehmet Oz to CMS Administrator, and Jay Bhattacharya to NIH Director. All will need to undergo Senate confirmation before taking up their posts. Unfilled top positions include the leader of the Administration for Strategic Preparedness and Response and director of the White House Office of Pandemic Preparedness and Response.

Finally, Canadian health officials have closed the epidemiological investigation into a teenager hospitalized with H5N1. The source of their infection was not found. The official update reads, “all tests on humans, animals and environmental samples related to this investigation have been negative for influenza H5. While it is reassuring that no further cases have been identified, officials have been unable to definitively identify the source of the young person’s infection.” This is the second recent case of H5 where the infection source was not clear. The first was identified in Missouri earlier this fall.

I continue to be unsettled by the situation, especially as we head into flu season. We are coming up on the one year mark since the virus began circulating in dairy cattle, and we are no closer to bringing the outbreak under control. If you have been following H5N1, you may be interested in the risk assessments that my academic group at Johns Hopkins publishes regularly. Our work was mentioned in the New York Times last week, which was a fun surprise.