Outbreak Outlook - National - New Year!

Gather round for an important update on peak season

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Respiratory diseases

Influenza-like illness

Phew, we’re in the thick of it now. The percentage of doctors visits that were for influenza-like illness (ILI) symptoms jumped to 6.1%, up from 5.2% the week prior. The season peaked in the 7-8% range the last two years, to give you a sense of scale. Sometimes there is a single week of peak activity, and sometimes it bounces around high season for a while. January is often, but not always, the worst month for ILI.

By region: Lots of purple on the map this week, which indicates very high levels of activity. In fact, 23 states have activity that ranks as high or very high.The South is still most affected, with a big block of purple stretching from Tennessee to Georgia and over to Louisiana. I have my eye on that region as a bellwether for peak season; the South often sends the trend first. The Midwest is currently least affected, with a few states hanging on to the green (low) category. I don’t expect that to last though.

By age: As usual, the little ones are most affected, with 14.1% of doctors visits for fever and cough or sore throat. The 5-24 age group saw a huge jump this week, up to 10.3%. The older groups are in the 3-5% range. If you have kids at home, expect some sick days as we head back to work and school. 

By severity: Emergency department visits for influenza are way up, too. Around 5% of visits to the ER are for the flu. The proportion is highest for 5-17 year olds, at 13%, followed by kids 0-4. The proportion is higher in older adults, but that perhaps reflects the fact that older adults are more likely to need ER care in general, so the share that is for ILI will be lower. And indeed, the rate of hospitalization for flu is highest for adults ages 65+.

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Covid-19

Covid-19 activity is still rising, as expected. The number of new hospitalizations jumped to 29,000 last week, which is the 7th week of increase in a row. January is usually the worst month for Covid-19, so I would not be surprised if activity continues to increase for the next few weeks. Wastewater concentration is also high in every region of the country; it’s about on par with last winter’s peak. 

By region: All four regions of the country saw increases in hospitalizations. The Northeast saw a particularly large jump, with a 25% increase in hospitalizations during the week of December 23. The Midwest is the most affected region overall. The South and Western regions are in comparatively better shape, but both are still clearly seeing increasing activity.

Other notes: Hospitalization rates for Covid-19 are higher than for influenza, in case you are wondering how the two compare. Covid-19 continues to be most dangerous for older adults.

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RSV

It is still peak RSV season. The data are a bit unstable right now, I think due to the holidays, but there are no clear signs of improvement in most regions of the country. One exception is the Southern region, which is improving after an early and significant season.

By age: One thing that is important to know is that although RSV hospitalizations have peaked in infants, they are still rising in adults ages 65+. Everyone should continue to be careful given that activity is still quite elevated, but older adults should be especially cautious.

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Others

I’m monitoring several other respiratory viruses. 

• Big spikes in seasonal coronaviruses, a cause of the common cold. Stuffy noses are going around!

• Not much going on with human metapneumovirus. 

• Parainfluenza and adenovirus look ok.

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Stomach Bugs (Norovirus)

Norovirus activity is rising, and will likely continue to do so through spring. Test positivity at the National level is nearing 13%. This is higher than where we were at this time last year.

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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 this week:

• Pet food sold by Blue Ridge Beef (more info). Pet food can pose a risk to humans through cross contamination.

Previously reported:

• 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

• Over 700 staff from Airbus Atlantic in France suffered from food poisoning after a Christmas dinner held on December 14 at a restaurant. Symptoms included severe vomiting and diarrhea, with one employee comparing the pain to being worse than childbirth. 

• In Gaza, the World Health Organization has raised concerns over soaring rates of infectious diseases, which now pose a greater threat than direct military action. Despite a previously effective health system, the recent conflict has severely damaged Gaza's medical infrastructure, with only a quarter of hospitals partially functional. This deterioration has led to widespread infectious diseases, including over 100,000 severe cases of diarrhea and respiratory illnesses, exacerbated by overcrowding, poor sanitation, and limited medical resources. Global health groups are urgently working to enhance disease surveillance and prevention efforts.

• If you find this newsletter helpful, please consider sharing it. I wish everyone had easy access to updates on what’s going around. And if you want more detailed information about what is happening in your area, check out regional editions, which are available to paid subscribers.

Photo by Ian Schneider on Unsplash