Outbreak Outlook - National - April 8

Seasonal viruses retreating, but mpox and H5N1 remain concerns

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Respiratory Diseases

ILI

Influenza-like illness (ILI) declined again this week, now at 3% of visits to the doctor for fever and cough or sore throat. This is just above the national baseline of 2.9%. Half of specimens tested  were influenza B, which is typical this time of year.

This has been an uncommonly long season. ILI activity has been above baseline since October. With any luck, next week we will finally officially exit the flu season—but we haven't gotten there yet. 

By age: The 0-4 age group saw a decrease in activity again this week, with ILI now at 8.7%. The 5 to 24-year-old age group also saw a modest decline, now at 4.8%. Older age groups are all below 3% and holding more or less steady.

By region: Most of the country is now enjoying low levels of flu activity, with 44 states reporting low or minimal levels of activity. There are six exceptions: North Dakota, Michigan, the District of Columbia, Nebraska, Wyoming, and New Mexico are all still reporting high levels of activity.  The remaining five states, mostly in the Midwest and Northeast, are reporting moderate levels.

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COVID-19

Covid-19 activity is on the decline nationwide, marked by a consistent decrease in both hospitalizations and visits to emergency departments over the past several weeks.

This week saw just over 8,000 new Covid-19 hospitalizations, the lowest since July. Although Covid-19 deaths are decreasing, the latest full week of data reports still over 1,000 weekly deaths.

Wastewater for SARS-CoV-2 is steadily decreasing in all four regions of the country, which gives me additional confidence that we will continue to see declining activity in the weeks ahead. With any luck, we will not face any new Covid-19 waves until mid-summer, which is when the earliest indicators of the summer wave begin to appear.

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Stomach Bugs

No rest for the weary. Norovirus activity rose by over a point this week, hitting 13.3% on the national level. Last year peaked at 16.5%, for reference. Even the Northeast, which I thought for sure had peaked, saw a slight rebound this week. Stay vigilant by washing those hands!

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Food recalls

The following foods are being recalled because they are contaminated. Please check your cupboards and throw out any of these items:

New

• None

Previously reported:

• Helados Mexico mango bars (more info)

• Trader Joe’s 50% Less Salt Roasted & Salted Whole Cashews (more info)

• Multiple brands of cinnamon sold at discount stores, for lead contamination. The best resource I found to quickly survey affected products is here.

• Robitussin Honey CF Max cough syrup products (more info)

• Tons of different granola and oatmeal products from Quaker (more info).

• If you have food allergies, you may wish to review these FDA safety alerts and USDA alerts for foods with undeclared allergens.

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In other news

• A human case of H5N1 bird flu in Texas has been confirmed in an individual who was presumably exposed to infected dairy cattle. The only symptom was conjunctivitis. This marks the second instance of such an infection in the U.S.; a previous case was diagnosed in Colorado in 2022. CDC maintains that the risk to the general public remains low, with increased risk limited to those with significant exposure to infected animals or environments. H5N1 has been found in wild birds, poultry, and sporadically in mammals. More recently, fifteen farms in six states have reported outbreaks in dairy cows.

• The Democratic Republic of the Congo (DRC) is experiencing a severe mpox outbreak. There have been over 4,500 cases and nearly 300 deaths this year. Reported cases in the first quarter of 2024 are three times higher than the previous year, according to WHO Director-General Tedros Adhanom Ghebreyesus.

  • According to Tedros, “Nineteen of DRC’s 26 provinces have reported cases, and 70% of cases and 87% of deaths are in children under 15 years of age. While mpox is spread among children by close contact, there is also a concerning outbreak among adults due to sexual transmission in previously unaffected areas.”

  • Unlike the clade IIb variant that circulated globally in 2022 (and through today), the DRC is battling the more virulent clade I virus, which now shows unusual patterns of transmission, including a significant impact on children.

  • The United States is also seeing a substantial increase in mpox cases this year compared to last year — 664 through March 30, compared to 307 last year. I could not find any useful information on clade testing.

Photo by Libby Penner on Unsplash