Outbreak Outlook - National - Jan 18
Flu activity is dropping, but remains elevated
Respiratory Diseases
Influenza-like illness
Flu remains elevated, but it appears to be declining across most of the country. Outpatient influenza-like illness (ILI) decreased two whole points from 7.2% to 5.2%, and emergency department (ED) visits for flu dropped from 6.4% to 4.1%.
All four regions of the country have seen two weeks of improvement. Rates are still highest in the Northeast at 6.4% ILI, followed by the South at 5.9%. The West and Midwest are lowest at around 4.5% to 4.7%.
Kids ages 0-4 saw ILI drop from 18.4% to 13.7%, and school-age children (5-24) down from recent highs of 19.9% and 15.1%, respectively. Big relief for kiddos and their parents! The older age groups are all at or below 5%.
Looking ahead, it is still possible for activity to rebound. We saw that just last year, when activity shot back up after two consecutive weeks of decline. But it’s more common to see a single peak, with steady declines week over week. We typically exit flu season (as measured by activity) sometime in March. (As a reminder, this newsletter publishes on a seasonal schedule.)
COVID-19
Covid-19 activity is declining this week, though wastewater remains elevated in parts of the country. Nationally, wastewater activity is at high levels (down slightly from last week), and ED visits fell from 1.0% to 0.8%.
The Midwest remains the hardest hit region. Wastewater activity there is very high and still increasing, and ED visits are substantially higher than elsewhere in the country at about 1.4%. The Northeast is also elevated, with high wastewater activity (though declining) and ED visits around 1.0%.
As with flu, we are headed in the right direction, and I hope to see continued declines through springtime.
RSV
RSV activity declined this week. Nationally, ED visits fell from 0.5% to 0.4%. The South has the highest activity, with Delaware still an outlier at 1.1% of ED visits. Most other states in the South are between 0.4% and 0.7% and declining. In the West, Hawaii bucked the trend, jumping from 0.5% to 0.7%. The Midwest and Northeast are both quiet.
Food recalls
The following foods are being recalled because they are contaminated. Please check your cupboards and throw out any of these items:
New:
Super Greens supplement powder (more info)
Spring & Mulberry chocolate bars (more info)
Pecorino cheese from various brands, including Boar’s Head and Members Mark (more info)
Sea Moss Gel Superfood (more info)
Previously Reported:
Klong Kone Shrimp Paste, sold exclusively at Golden Land in Des Moines, Iowa and Terri Lee Oriental Groceries in Maywood, New Jersey (more info)
Primavera Nuevo tamales, various flavors (more info)
There is a big recall of hundreds of products — from Airhead candies to meat to Splenda packets — that passed through a single distributor and were sold to over 50 stores, primarily in Minnesota and Indiana. I strongly urge you to check out the list of stores (here) and if you’ve shopped at one of them recently, check out the much longer list of items that are being recalled (here)
In other news
Large supplement recall. The CDC is investigating a multistate Salmonella outbreak linked to Live it Up Super Greens supplement powder, with 45 cases across 21 states and 12 hospitalizations reported as of January 15. Superfoods, Inc. recalled all Live it Up Super Greens supplement powders (Original and Wild Berry flavors, in bags and sticks) with expiration dates from August 2026 to January 2028. Discard or return all products.
New ACIP members. HHS Secretary Robert F. Kennedy Jr. appointed two obstetrician-gynecologists to the CDC’s Advisory Committee on Immunization Practices, both of whom have publicly questioned medical consensus on vaccine safety and antidepressant use during pregnancy. The appointments continue a pattern of selecting members skeptical or critical of vaccines. The committee previously voted to limit Covid vaccine recommendations to those 65+ and people with underlying conditions, reversed the decades-long recommendation for universal hepatitis B vaccination at birth, and saw Kennedy alter the childhood immunization schedule without consulting advisers, reducing universal recommendations from 18 to 11 diseases.
Wastewater surveillance for measles. A new report describes how Colorado’s wastewater surveillance program detected measles virus in Mesa County in early August, two days before cases were clinically reported. The early warning enabled public health officials to prepare staffing and coordinate a response. The subsequent investigation linked seven confirmed measles cases (six unvaccinated) to a family who had been exposed in another state in mid-July but whose testing was canceled. This is further evidence that wastewater surveillance can serve as an early alert system for infectious diseases.
More data: Many of you messaged me over the weekend to ask about specific states. I share updates about all 50 states in the regional editions, which are available to paid subscribers. You can always access previous editions via the Newsletters tab.
Get detailed, state-specific public health updates by upgrading to regional editions, available to paid subscribers. Stay informed where it matters most to you!
Thank you for your work, it is helpful. Thanks also for adding a picture of the beautiful artwork at the end of your newsletter.
Declining ILI and Covid is some good news. Thanks for all you do.