Outbreak Outlook - National - Dec 9
Respiratory Diseases
Influenza-like illness
Influenza like illness (ILI) is rising, as expected this time of year. Approximately 3.5% of visits to the doctor were for fever and cough or sore throat during the week ending November 30th, up from 3.0% the week prior.
As always, children ages 0 to 4 are most heavily affected. In the 0-4 age group, outpatient ILI has now risen a full point to 10.4%, up from 9.4% last week. The 5 to 24 year old age group is also seeing an uptick, now at 5.2%. Older age groups are rising as well, but at much lower levels.
Most of the Southern region is now experiencing moderate levels of activity. Some parts of the region are worse off, with Louisiana, the District of Columbia, and Georgia all have high or very high levels of activity. This increase is evident in both emergency department visits and outpatient visits.
The Western region is also seeing an increase, notably Arizona and California. In fact, in particular may soon be seeing intensifying activity as wastewater levels of wastewater concentration are higher there than in other parts of the country.
The Midwest is doing fine, with most states still reporting low or minimal levels of ILI. And in the Northeast, the more populous states are beginning to see significant increases, including New Jersey and New York City, both at moderate.
COVID-19
Wastewater activity remains low nationally. Things have now been fairly stable at this low level for about a month.
Trips to the emergency department for Covid-19 made up just 0.6% of all ED visits in the past week., which is much lower than past winters. Hospitalizations have further decreased to 0.8 hospitalizations per 100,000 population, which is the lowest it has been in the past year.
However, there are indications that this prolonged quiet period may be coming to an end soon, including increasing wastewater activity in a few states, including parts of the Western and New England regions.
RSV & Other Bugs
RSV: Activity is beginning to rise, though we are off to a slower start than years prior. Emergency department visits for RSV remain relatively low, about on par with Covid-19 right now. One major exception is the Southern region, which is definitely seeing an increase in both wastewater concentration and hospitalization rates. Caution is warranted for residents of the region.
Other bugs:
Adenovirus transmission has continued to rise, but it remains within the normal/moderate range.
Human coronaviruses continue their slow and steady rise, and are at elevated levels.
Parainfluenza appears to be cresting after several weeks of increases. It has held steady at an elevated level for a few weeks; hopefully we will start to see the drop-off soon.
Similarly, rhinoviruses/enteroviruses appear to be slowly coming down from a couple months of high rates, dipping to 24% test positivity this past week.
Stomach Bugs
Norovirus is very high right now - test positivity is up to 17%, which is higher than it has been in the past year. Just two weeks ago, it was at 11.4%. Rates are highest in the West, followed by the Midwest and South. The Northeast continues to have rates that are less than half the national average, but rates are rising here too. Keep washing those hands!
Food recalls
The following foods are being recalled because they are contaminated. Please check your cupboards and throw out any of these items:
New:
A large-scale cucumber recall is affecting both whole cucumbers and prepared foods with cucumbers
Fresh Creative Foods Beef & Lamb Gyro Sandwich Express Meal Kit sold at Sam’s Club (related to the cucumber recall) (more info)
F&S Fresh Foods Mediterranean Inspired Party Tray (related to the cucumber recall) (more info)
Yummi Sushi (related to the cucumber recall) (more info)
Multiple vegetable trays, salads, and sliced cucumbers sold under the Supreme Produce (related to the cucumber recall) (more info)
Multiple vegetable trays, salads and sliced cucumbers sold under the Snowfruit and Snowfox brands (more info)
Fresh cut cucumber slices at Walmart (more info)
Cucumbers and salad kits (more info)
Blue Ridge Beef log Puppy Mix [for Dogs]. While not for human consumption, humans may be infected by Salmonella if they do not adequately wash their hands or contaminated surfaces after handling the product. (more info)
Curly mustard greens under the Baker Farmers brand (more info)
Previously reported:
SunFed whole cucumbers (more info)
Kirkland Signature Organic Eggs (more info)
If you have food allergies, you may wish to review these FDA safety alerts and USDA alerts for foods with undeclared allergens.
In other news
Health officials in the Democratic Republic of Congo are investigating a mysterious influenza-like illness in Kwango province that has sickened approximately 376 people and caused around 79 deaths, with symptoms including fever, headache, cough, difficulty breathing, and anemia. Initial tests will screen for common diseases like influenza or malaria, with genetic sequencing as a next step if results are negative. The WHO, CDC, and international teams are assisting with sample collection, contact tracing, and risk assessment to identify the pathogen causing this outbreak. As of Sunday evening, results have not yet been returned.
The USDA’s Animal and Plant Health Inspection Service has issued a federal order establishing a national strategy for testing raw milk in response to ongoing H5N1 avian flu outbreaks on dairy farms. Expanding existing state-level bulk milk tank testing policies, the order mandates the collection and testing of raw unpasteurized milk samples, sharing of epidemiological data from affected herds, and mandatory reporting of positive results by veterinary labs. The initiative aims to create a uniform testing system to rapidly identify infected herds and better understand the virus's spread.
A study published in JAMA Network Open analyzed flu transmission in 699 influenza-positive individuals and their 1,581 household members over three respiratory seasons (2017-2020). The study found a household secondary infection risk of 18.8%, with the highest risk among children under 5 years. The flu vaccine showed an estimated 15-2% effectiveness in preventing secondary infections, with significantly higher effectiveness against influenza B strains (56.4% overall, up to 88.4% in children aged 5-17).
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