Outbreak Outlook - National - October 9

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Respiratory diseases

Influenza-like illness

In the week ending September 30, influenza-like illness (ILI) increased slightly to 2.1%, edging closer to the 2.5% threshold that signifies the onset of the flu season.

Once again, it’s the littlest ones who are most heavily affected. For kids aged 0-4, 7.1% of their visits to the doctor were for fever and cough or sore throat, up from 6.8% the week prior. For the 5-24 age group, the rate is lower at 3.3%, while rates for older age groups are below 2%.

Although national-level rates of ILI are low overall, some areas of the country are beginning to heat up. New York City and Washington D.C. were in the high category again this week. Georgia and New Mexico tipped over into the moderate category, and some other Southern states are heading there as well. If you’re in those areas of the country, I would get your flu shot sooner rather than later.

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Covid-19

Improvements in Covid-19 activity continued again in this week’s report. Since reaching a high of around 20,600 new hospitalizations during the week of September 9, we've seen a moderate drop to 18,100 new hospitalizations the week of September 30. (But just to keep things in perspective, our numbers are still pretty high compared to the summer months like June and July.) The percentage of these admissions coming from emergency visits has also dropped slightly, from 2.4% to 1.6% over the last month. Test positivity is falling as well.

Also, I got my free, at-home Covid-19 tests in the mail last week! One reader pointed out that the tests were not due to arrive until October 2 — and indeed they did, right on time. Order yours today! covid.gov/tests.

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RSV

RSV activity continues to pick up, reaching 4.1%, up from 1.3% in mid-July. Most of this is driven by increased activity in the South. Test positivity has been increasing for several weeks now, and indeed may continue to rise through winter. The virus usually becomes active in the autumn months, ahead of influenza, so it’s more or less on schedule. On the bright side, current activity is below what we saw this time last year during the start of the tripledemic.

This is the first year that RSV shots are available for older adults, infants, and pregnant women, so I hope the availability of these products helps reduce severe illness among these vulnerable groups.

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Others

All the other respiratory virus that I keep an eye on — seasonal coronavirus, human metapneumovirus, parainfluenza virus, and adenovirus —look good. Rhinovirus/enterovirus, one cause of the common cold, is high though, so expect stuffy noses.

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Stomach bugs

Norovirus

Norovirus activity has been fluctuating for several weeks now, with a few spikes during the summer months. Recent test positivity stands at around 6% at the national level, with a significant portion of this increase attributed to heightened activity in the Midwest. Norovirus is usually most active through the winter months, but does not peak until early spring.

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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:

• Ion and Restore brands Sinus Spray (more info)

• Organic Chicken and Beef Broth sold at Costco and Whole Foods (more info)

Previously reported:

• Whole cantaloupes sold by Eagle Produce (more info)

• Not Fried Chicken sold by Life Raft Treats (more info)

• Hillshire Brands smoked sausage (more info)

• Banquet Chicken Strips Meal (more info)

• Frozen corn and mixed vegetables from Food Lion and Kroger (more info)

• If you have food allergies, you may wish to review these FDA safety alerts and USDA alerts for foods with undeclared allergens.

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In Other News

• FDA has authorized the Novavax Covid-19 vaccine for people aged 12 and up. The rollout for the other fall vaccines has been bumpy, with reports of unavailability and insurance issues, so I hope this vaccine is on shelves for people who would like an alternative to the mRNA products.

• China has reported an additional human case of avian influenza A(H5N6) in Chongqing. The patient, a 68-year-old male who had been exposed to live poultry, died in late August. Chinese health authorities have reported 87 human cases of avian influenza A(H5N6) since 2014. Cases of highly pathogenic avian influenza in humans are concerning because they have the potential to mutate and become easily transmissible among people.

• Denmark is battling a large outbreak of whooping cough. In the week ending September 16, there were 200 cases of whooping cough reported, compared to the typical average of 20 cases per week. Whooping cough, also known as pertussis, is a respiratory infection that causes prolonged coughing fits, often accompanied by a distinctive "whooping" sound during inhalation. The infection is especially severe in infants. In the United States, the Tdap vaccine (the p stands for pertussis) is part of the childhood vaccination schedule. Doses are also recommended for pregnant women and caregivers of infants.

Photo by Joseph Gonzalez on Unsplash