Outbreak Outlook - National - Nov 4
Covid and ILI remain low, but norovirus is going around.
Respiratory Diseases
Influenza-like illness
Outpatient visits for influenza-like illness remain quite low at 2.2%. However, numbers are creeping up. The flu season threshold is 3%, which is likely still several weeks away. For comparison, at this time last year, rates were at 2.7% and we were just a week away from crossing the threshold.
Parents, beware. Last week, doctor visits for fever, cough, or sore throat spiked among kids 0-4, jumping from 6.6% to 7.1%. Kids aged 5-24 also saw an increase, from 3.5% to 3.9%. All older age groups remain under 2%.
All states report minimal or low outpatient activity, with the exception of Washington, D.C. at moderate. The Southern region will likely be the first to tip over into flu season, as activity is highest there right now (but still low).
I got my flu shot last week. If you haven’t gotten yours yet, now is a good time.
COVID-19
The lull in Covid-19 cases continues. Wastewater activity is low nationally, with all four regions of the country reporting minimal or low activity. The Midwest has seen a slight rebound lately, but it’s too soon to call it a trend, as numbers do jump around.
Visits to the emergency department due to Covid-19 are minimal at 0.6% of all ED visits nationally, with no significant changes in the past week. Hospitalizations also declined again, to a low 1.4 hospitalizations per 100,000 population. This is close to the lowest it has been all year.
RSV & Other Bugs
RSV: Wastewater concentration is minimal. Not much activity happening yet — I hope it stays like this.
Other bugs: Some common causes of respiratory illness, with cold and flu-like symptoms, continue to rise.
Parainfluenza viruses in particular has increased rapidly, and is up to about 5% test positivity, which is higher than it reached at any point last fall, but remains lower than its peak from this May (of 8%).
After decreasing slightly a couple weeks ago, rhinoviruses/enteroviruses have also increased again in the past week, and remain quite elevated at 28% test positivity.
Adenovirus has been slowly increasing for the past few weeks, as have human coronaviruses, though neither are at particularly high levels at the moment.
Stomach Bugs
Norovirus is high and increasing right now. Nationally, test positivity is at nearly 12%. To put this in context, the peak last year was 13.6%. Rates are particularly high in the Southern region.
A reminder as cases increase: norovirus causes stomach pains, diarrhea, and vomiting. It is extremely transmissible via bodily fluids and through contaminated surfaces, food, and water.
To reduce your odds of getting sick, remember to wash your hands frequently with soap and water for at least 30 seconds (norovirus is able to withstand hand sanitizer).
If you or someone in your household becomes sick, wash hard surfaces with soap and water or a diluted bleach mixture, and wash soiled clothing and linens in hot water and then dry on high heat.
Norovirus is still highly transmissible for several days after symptoms improve or go away. As such, insofar as is possible, avoid preparing food for others for at least 72 hours after symptoms end. Longer is better: it can spread up to two weeks after symptoms end, though it is most transmissible during those first few days of illness and after symptoms resolve.
Food recalls
The following foods are being recalled because they are contaminated. Please check your cupboards and throw out any of these items:
New:
Enoki mushrooms sold by HH Fresh Trading Corp (more info)
Kirkland Signature Smoked Salmon (more info)
Gourmet Cafe Chicken Caesar Salad Bowls sold by Fresh Express (more info)
Previously reported:
Waffles and pancakes - many flavors and styles - sold under a very large variety of brand names, including numerous store brands, including 365 Organic, Best Choice, Good & Gather, Harris Teeter, H-E-B, Nature’s Promise, Publix, Trader Joe’s and Wegmans.
Given the size of this recall, if you have any variety of frozen/toaster waffles, Belgian waffles or pancakes in your freezer that you bought in the US or Canada, check this list. (more info)
Prepackaged Chicken Street Taco Meal Kit produced by Sprouts Farmers Market (more info)
Ready to eat meals and store-made deli items including chicken from a variety of grocery chains, including Albertsons, Safeway, Star Market, and others. (more info)
Green onions sold under Church Brothers, Trader Joe’s and Imperial Fresh brand names (more info)
Prepackaged sandwiches - Pepperjack Cheeseburger, Bacon Cheeseburger and The Gambler sold under the Dakota Tom’s brand name (more info)
Large variety of ready-to-eat meat and poultry products under different brand names, including Rao’s chicken alfredo and Michael Angelo’s grilled chicken piccata with penne pasta (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
Big week for my new book, CRISIS AVERTED! Got a fantastic review in Science: “Remarkably, perhaps, after the damage of the COVID-19 pandemic, Rivers manages to convey a sense of hope, courage, and desire to fortify public systems for the next big challenge.” I also had a great book event at local bookstore Politics and Prose (standing room only!), and my book is now on shelves in Barnes & Noble stores. If you need a diversion from election stress, give it a look.
The CDC has lowered the recommended age for adult pneumococcal vaccination from 65 to 50, aiming to boost protection among adults at increased risk.
For ages 50–64, any of the three available pneumococcal vaccines (PCV15, PCV20, or PCV21) can be used, though a second dose with PPSV23 is needed if PCV15 is chosen.
Adults 19–49 with specific risk conditions (e.g., cigarette smoking, diabetes, chronic heart, liver or lung disease, sickle cell disease, and immunocompromising conditions) should continue to receive pneumococcal vaccination.
The USDA and Oregon veterinary officials are investigating H5N1 detected in a backyard farm in Crook County, Oregon, where poultry and swine were infected. This marks the first confirmed H5N1 case in U.S. swine. The mixed-species farm, which shares water and equipment among animals, has been quarantined, and further testing is underway. The farm’s animals were not intended for the commercial food supply.
In a recent interview, former President Donald Trump indicated that Robert F. Kennedy Jr. could play a “big role” in a potential second Trump administration. Trump suggested he would consider Kennedy’s stance against vaccines and water fluoridation. Kennedy, a vocal critic of childhood vaccines and fluoridation, stated that Trump had assured him of a significant position in public health oversight. Trump’s remarks follow Kennedy’s claim that a second Trump administration would advise U.S. water systems to halt fluoridation, despite evidence supporting its dental health benefits. Needless to say, both of these proposed policies would seriously erode long-standing public health measures.
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I got my latest Covid shot on Friday which was delayed as I found this time that I had to wait at least two weeks after anything that had cortisone in it to have one according to the protocols at my primary care provider.
So over three weeks ending two weeks ago I had three othovisic injections in my right knee for multiple fractures that has had four surgeries, a cortisone shot for a long ago fractured right hip and a fractured left shoulder. Not to overlook a spinal epidural. It’s a complicated story.
So now I’ve had all eight available vaccines if I’m counting correctly.