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Respiratory diseases
Influenza like illness (ILI) activity continues to rise, though the increase was less prominent this week than in previous weeks. (Influenza like illness includes influenza and other viruses that cause fever and cough or sore throat.) This is not a sign that flu season is peaking—it’s normal for the data to move around a bit. I do hope we have an early peak since the season began well advance of normal, but there is no way to tell at this point.
Children caught a bit of a break for the first time in months: the proportion of visits to the doctor that are for influenza like illness remained flat in children ages 5-24, and increased only slightly (from 15.3% to 15.9%) in children ages 0-4. ILI activity continues to rise modestly in adults. Still, seven pediatric deaths from influenza have been reported this year, and we continue to see very high levels of RSV (more on that below).
For my U.S. based readers, as you prepare for the Thanksgiving holiday, please remember to take extra precautions to protect your youngest and oldest loved ones. Most respiratory viruses have a short incubation period, so if you begin to take extra precautions like wearing a mask while in public now, you’re less likely to be sick over the Thanksgiving weekend. At dinner, wash your hands regularly and attend to ventilation by opening a window or running an air purifier. Anyone who is not feeling well should stay home.
The early flu season activity is widespread. Thirty states now report very high or high levels of ILI, up from 25 states last week. The north central states and parts of New England are the only regions with minimal flu activity, but at this rate I expect they will see upticks in the coming weeks. (And remember, flu data is delayed by at least a week, so that is already in progress.)
RSV continues more or less unabated. Last week’s hospitalization rates were revised upward as more data became available, and this week’s data continues to show very high levels of activity. I do see some preliminary encouraging signs in certain state reports, so I hope to be back with better news next week.
Conveniently, I had an interview with the Washington Post this week that touched on RSV, so this week’s Force of Infection is multimedia ✨.
Covid-19 is mostly stalled, neither increasing nor decreasing with much energy. The daily average of new cases remains at about 40,000, where it has been since early October. Average daily death count is in the 280-300 range.
New Mexico, New York, Colorado and Arizona remain the most affected states for new cases and hospitalizations.
A few weeks ago I was worried about hospitalization rates in people ages 70+, which looked like they were beginning to climb. That trend has leveled out.
Stomach bugs
Norovirus (the classic “stomach flu”) is beginning to tick up in every region of the country. Norovirus season usually runs similar to respiratory virus season, with peak months from December to March.
Norovirus spreads very easily between people through the “fecal-oral” route. To stop it from spreading, wash your hands thoroughly after using the bathroom and before eating or preparing food. I also use hand sanitizer while I’m in public like after I use self-checkout at the grocery store or when I use public transportation, but you should know that hand sanitizer is not as effective against norovirus as hand washing. Be sure to wash your hands properly when you get home. Most importantly, stay home if you have vomiting or diarrhea.
If someone in your household gets the stomach flu, you can reduce the chance it will spread by keeping them out of the kitchen and disinfecting contaminated (read: bathroom) and shared surfaces. Also regard laundry like bedsheets, clothes and towels as contaminated. Use gloves when handling the items and wash them thoroughly with hot water on the longest cleaning cycle.
Food recalls
The following foods are being recalled because they are contaminated with bacteria that causes food poisoning. Please check your cupboards and throw out any of these items:
Brie, baked brie, and camembert cheese made by Old Europe Cheese, Inc. with best-by dates from September 28, 2022, to December 14, 2022. (more info)
Frozen falafel sold in Aldi stores (more info)
Nestle edible Chocolate Chip Cookie Dough tubs with best-by dates of January 28-30, 2023 (more info)
Giant Brand Wild Caught Sockeye Smoked Salmon sold in Maryland, Virginia, Washington D.C. and Delaware (more info)
Certain lettuce products, marshmallow cookies and beef dumplings that only reached a small number of consumers
There is also a multi-state outbreak of Listeria linked to deli meats and cheeses, but the specific source has not been identified. If you are pregnant, over the age of 65, or have a condition that weakens your immune system, consider avoiding meat or cheese from deli counters. (more info)
Have a safe and healthy Thanksgiving!