Outbreak Outlook - National - November 13

Covid-19 rising in some parts of the country, and RSV activity remains high

Nov 13, 2023

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Respiratory diseases

Influenza-like illness

No new data was released this week due to the Veteran’s Day holiday.

Covid-19

The Covid-19 picture is mixed across the country, but the overall trend suggests an increase in activity as we approach the holiday season.

The number of new weekly hospital admissions for Covid-19 remained flat nationally for the week ending October 28, with 15,745 people admitted. The percentage of emergency department visits for Covid-19 also remained mostly unchanged for the third week in a row across the country. National test positivity was flat as well, with 9% of PCR tests coming back positive.

Regionally, New England, the Mid-Atlantic, the Southeast, the Southwest, and the Northwest saw slight decreases in hospitalizations, emergency department visits, and test positivity.

However, the South Central region saw increases in all three metrics, suggesting rising Covid-19 activity there. The Great Lakes and Central Plains regions also saw notable increases in hospitalizations and test positivity, indicating increasing spread there. The South Central region has now seen multiple consecutive weeks of rising indicators, reflecting sustained growth in Covid-19 activity.

Uptake of the annual Covid-19 vaccine is quite low, so if you haven’t gotten yours yet, I would recommend doing so soon.

RSV

We may be nearing peak RSV season. After a lag in reporting, the new numbers are in and unfortunately show that RSV continues to rise. PCR test positivity has bounced upward to 10.3% nationally, up from a little over 6% two weeks ago. This remains lower than last year at this time, but is still not great.

All regions of the country are seeing increases in RSV, though the South is the most heavily affected. There have also been notable increases in cases in the Northeast (up to 8.4%).

Others

Human metapneumovirus and adenovirus activity are holding steady at a low level.
Seasonal coronavirus and parainfluenza remains low nationally, although both appear to be increasing slightly.

Norovirus

Ugh. It’s stomach bug season for some parts of the country. Norovirus is trending upward, with PCR test positivity at 7.9% - a noticeable increase from last week (6.2%).

Cases in most regions of the country remain below this level—the increase is driven primarily by a surge in the Midwest, where PCR test positivity is up to 13%.

Norovirus is notorious for its easy of spread. Washing your hands with soap and water is the best defense.

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:

Tyson chicken nuggets (more info)
Fresh cantaloupes sold under Malichita label (more info)
Multiple brands of dog and cat food (more info) (Note: this poses a risk to pets and to the people that care for them, since Salmonella can be acquired via handling of the pet food and/or contact with infected animals.)

Previously reported:

Multiple brands of eye drops, including some new brands added since last week (more info)
Multiple brands of Apple Cinnamon Fruit Puree, including some new brands added since last week (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

There has been an alarming increase in infants born in the US with congenital syphilis, a condition that is preventable with adequate maternal testing and treatment. In 2022, more than 3,700 cases of congenital syphilis were reported, roughly 11 times more than were reported in 2012. The vast majority (88%) of the pregnant individuals who tested positive received inadequate, undocumented or no treatment; 40% of people who delivered babies with congenital syphilis received no prenatal care. Two decades ago, syphilis was nearly eliminated from the US; experts say that substantial cutbacks to public health services have contributed to the increase.
I remain worried about H5N1. Highly pathogenic avian influenza A(H5N1) continues to circulate widely in bird populations around the globe, sometimes resulting in spillover into other wild and domesticated mammalian species. A mass die-off of more than 5,000 sea lions in Peru in early 2023, for example, was attributed to H5N1. Surveillance of fur farms (foxes and raccoon dogs) detected H5N1 in ten fur farms in Finland; previously, 32 fur farms in the country had had detections. H5N1 has been reported in numerous other mammalian species, including mink, harbor seals, and cats.
The FDA has approved the first vaccine against chikungunya, a mosquito-borne illness that causes severe joint pains that can last for months or years after the initial infection. Affected individuals may also experience rashes, headaches and muscle pain. Between January and September of this year, over 440,000 cases have been reported globally, including 350 deaths. Chikungunya is rare in the United States, but it may become more common due to the effects of climate change.
The Major League Baseball general managers meetings in Scottsdale, Arizona, were abruptly cut short due to an outbreak of (what is likely) norovirus. Over 30 of the 300 attendees fell ill. Almost every team had at least one person affected, including eight officials from the league office. The outbreak led to the cancellation of the remainder of the meetings, with subsequent agent meetings moved to a virtual format.

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