Outbreak Outlook - National - Feb 17

Checking in on a particularly severe flu season

Feb 17, 2025

Influenza-like illness

As I reported on Friday, flu season continues to hit hard across the country.

Outpatient visits for influenza-like illness (the percentage of visits to the doctor for fever plus either cough or sore throat, also known as ILI) have climbed to 7.8%, up from last week's already high 7.7%. This is among the worst seasons in two decades.

As always, young children are most heavily affected with the 0-4 age group seeing particularly intense activity. In that group, outpatient ILI rose from 17% to 18% in the most recent report. That means that nearly 1 in 20 visits to the doctor are for flu symptoms. School-aged children are also heavily affected, with outpatient ILI now at 13%. Older age groups are more stable but still elevated compared to what we saw earlier in the season.

The South has been experiencing the most intense activity, and we see that in emergency department visits as well. The region has the highest percent of visits to the emergency department that are for influenza at 9.2%. The Midwest is not far behind at 8.7%, and I'm seeing some signs that the Midwest will see continued intensification and acceleration in the weeks ahead. I'll be keeping a close eye on activity in that region.

As a reminder, state-level updates are available to paid subscribers. Regional editions go out each Monday and contain comprehensive local coverage for every state, organized by Census region.

COVID-19

Covid-19 is elevated compared to the off season, but it’s lower than both influenza and past winter Covid-19 seasons.

Wastewater activity held roughly steady this past week at high levels. The national average has been sitting right around the threshold between moderate and high for the past month. Activity is quite a bit higher in the Midwest than anywhere else, and is lowest in the Northeast.

Trips to the emergency department for Covid-19 remain stable at 1.0% of all ED visits this past week. The Midwestern region has the highest percent of visits to the emergency department that are for Covid-19 at 1.2%, but that number is slowly coming down. The Western region is in the best shape, and activity there is stable.

Hospitalizations decreased slightly this past week, to a fairly low 3.5 hospitalizations per 100,000 people. The Northeast has the highest hospitalization rates, though the region is seeing general improvements.

RSV & Other Bugs

Data were not updated this week.

Norovirus

Data were not updated this week.

Food recalls

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

New:

Menma Ajitsuke Prepared Bamboo Shoots sold under Choshiya brand name (more info)
Canned Tuna sold under Genova, Van Camp’s, H-E-B, and Trader Joe’s brand names (more info)

Previously reported:

Alfalfa sprouts sold under the Jack and the Green Sprouts brand name (more info)
Aleppo Tahini Sesame Paste (more info)
DJ's Boudain sausage links (more info)
Blue Ridge Beef Natural Mix [for dogs] (more info). While not for human consumption, humans may be infected with Salmonella if they do not adequately wash their hands or contaminated surfaces after handling the product.
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

The Central Nevada Health District has reported the state's first human case of avian influenza A (H5N1) strain D1.1 in a dairy worker who was exposed to infected cattle in Churchill County. The individual is experiencing only mild conjunctivitis symptoms and is recovering. This case is notable because it involves the D1.1 strain, which is distinct from the B3.13 variant that has infected at least 40 other U.S. dairy workers. The D1.1 strain was previously linked to 15 human cases from bird exposure in 2023, including one fatal case in Louisiana.
A recently published MMWR report, which was withheld from publication for several weeks, reveals that a serosurvey (or blood test looking for evidence of past infection) conducted in September 2024 among 150 bovine veterinary practitioners found three asymptomatic cases of H5N1 avian influenza exposure. Notably, one of these cases was in a veterinarian who only practiced in Georgia and South Carolina, which are states where no H5N1 infections in dairy cattle had been previously reported. The findings suggest H5N1 may have spread more widely in U.S. dairy herds than initially known. None of the three practitioners who tested positive for H5N1 antibodies reported symptoms or knew they had worked with infected animals, indicating that surveillance of only symptomatic workers may underestimate human infections.
Robert F. Kennedy Jr. has been confirmed as Secretary of Health and Human Services by a vote of 52-48, with all Democrats and independents opposing and all Republicans except Sen. Mitch McConnell supporting his nomination. Kennedy, a lawyer and activist known for his vaccine skepticism and criticism of healthcare and pharmaceutical industries, will now oversee 13 health-related divisions including the CDC, NIH, and FDA, with a $1.8 trillion budget. While Kennedy has expressed plans to address what he terms America's "chronic disease epidemic," public health experts have voiced serious concerns about his two decades of anti-vaccine advocacy.
A measles outbreak in Texas's Gaines County has rapidly expanded to 48 confirmed cases since late January, with the majority concentrated in Gaines County (42 cases) and several cases reported in neighboring counties. All affected individuals are either unvaccinated or have unknown vaccination status, with most cases occurring in children aged 5-17 years old who developed symptoms within the past three weeks. The outbreak has resulted in 13 hospitalizations, and health officials anticipate more cases.