Outbreak Outlook - National - February 12
Influenza-like illness returns
Respiratory Diseases
ILI
Flu season is determined to keep us on our toes this year. Influenza-like illness rose this week, driven primarily by increases in children. This follows several weeks of declining activity in January. Test positivity for influenza is increasing, too. This pattern has definitely happened before (2018-2019 season, for example), but I still regard it as unusual.
On the bright side, influenza-associated hospitalizations are declining—perhaps because it’s mostly young people seeing increased activity right now.
By age: The poor little ones can’t catch a break. Both the 0-4 and 5-24 age groups saw increases in outpatient ILI. The school age group is seeing the most marked uptick, with ILI rising from 6.4% to 6.6% to 6.9%. I wouldn’t be surprised if we see increases in the parent age groups next, but for now all adult age groups are declining.
By region: The Southern region is again seeing high and very high levels of ILI activity. It’s been a rough season in the Sunbelt states, and the season isn’t quite over yet. The Midwest has had a light season up until this point, but now some states like Iowa and Ohio are tipping into the high category. The West is looking relatively good, with most states in the moderate category. The Northeast is quite mixed: Massachusetts, New Hampshire, New York City and New Jersey are all high or very high, but other states in the region are in better shape.
COVID-19
Hmm, the Covid-19 picture is nuanced right now. The number of new weekly hospitalizations is declining at the national level and in all four regions, and for most age groups.
However, there are some other signs that are worth noticing:
There is increased activity in the 5-24 age group, both in emergency department visits and hospitalizations.
Wastewater concentration is rising again, driven primarily by increases in the Northeast.
Certain parts of the Southern region are seeing increasing hospitalizations for older adults. Specifically, HHS region 6, which spans New Mexico, Texas, Louisiana, Arkansas and Oklahoma.
The signs are very mixed, so there is no clear trend or pattern to indicate what will come next. I don’t have any reason to believe it is a new variant. For now my working assumption is that it’s just a temporary blip, but I will keep a close eye on trends in the weeks to come.
RSV
All quiet on the RSV front. National-level test positivity is down to 5.5%, a half point decline from last week.
In other RSV news, three new RSV products entered the market this year, a vaccine for older adults, a monoclonal for infants, and a vaccine for pregnant women. The vaccine for older adults, currently approved for those 60 and older, might become available to a broader age group starting next year. European and U.S. regulators are reviewing a proposal to lower the eligible age to 50 for individuals with specific risk factors.
Stomach Bugs
PCR test positivity is now 13.4% at the national level, up from 12.4% last week.
Norovirus is a common cause of the “stomach bug” or “24 hour flu” [this nickname is a misnomer, it is not related to influenza]. It is very unpleasant and spreads easily from person to person. Also, getting norovirus once does not protect you from reinfection (at least, not for very long). The best way to prevent norovirus infection is frequent handwashing with soap and water.
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 big recall of Queso Fresco and Cotija Cheese is affecting numerous consumer products: (more info)
Trader Joe’s Chicken Enchiladas Verde, Cilantro Salad Dressing, Elote Chopped Salad Kit, Trader Joe’s Southwest Salad (more info)
Cilantro Lime Crema, Everything Sauce Fiesta, Cilantro Cotija dressing, Poblano Caesar dressing, Cilantro Dressing, Street Taco Express Meal Kit sold at Trader Joes, Don Pancho and HEB (more info)
Rojo’s Black Bean 6 Layer Dip (more info)
Cheese, Yogurt, Sour cream by Rizo Brothers California Creamery (more info)
Previously reported:
Robitussin Honey CF Max cough syrup products (more info)
Brightfarm Spinach and Salad Kits (more info)
Charcuterie meats sold by Fratelli Beretta and, newly, Busseto (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.
In other news
Rio de Janeiro has declared a health emergency to combat a surge in dengue fever, with cases in Brazil quadrupling in January compared to last year. Rio reported 10,000 cases early this year, nearing half of 2023's total. The city is opening treatment centers and emphasizes early treatment to reduce severe cases and fatalities. Efforts include distributing a newly approved dengue vaccine, promoting mosquito bite prevention, and eliminating stagnant water where dengue mosquitoes breed. Other Brazilian regions and Argentina are also facing increased dengue incidences, partly attributed to high temperatures and El Niño.
A military academy in Bogotá is reporting an outbreak of respiratory infection, leading to a quarantine. Influenza H3N2 is being evaluated as a possible cause. There have been 103 symptomatic cases and one death in a population of around 268 cadets. The academy is under strict quarantine from February 5 to 14.
Has the measurement process for Covid “hospitalizations” changed since the end of the public health emergency? Are the same hospitals and all the hospitals reporting with the same time frames as before. In other words, how comparable are recently reported numbers to those of - oh say- 2021.