Respiratory Diseases

Influenza-like illness

Flu just will not quit. Test positivity remains quite high, and increased this past week, to 18.6%. Outpatient influenza-like illness (ILI) is at 4.6% and also increased a touch this past week from 4.4%. We have been bouncing around this zone for four weeks now, with a long way to go until we reach the 3.1% that marks the end of flu season. This isn’t hugely uncommon, we saw high activity through February the last two seasons, but it’s still an unwelcome development.

The littlest kids (0-4) are going to the doctor the most with ILI, with fever and cough or sore throat accounting for 11.6% of visits. Rates are also high for those 5-24, at 8.2%. Older age groups remain elevated compared to the off season, but fairly stable.

However, severe illness is slowly improving. Emergency department (ED) visits are moderate, at 3.2%, and stable in most regions. Hospitalizations decreased slightly this past week to a moderately elevated 3.3 hospitalizations per 100,000 people.

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COVID-19

Covid-19 wastewater activity is moderate and declining nationally. In the Midwest, wastewater is high, but is declining again after a second peak last week. Most states with very high activity are clustered in the Midwest or neighboring states. In the Northeast, activity is moderate and declining, and in the South, activity is low and, despite some oscillations, is on a week-over-week declining trend. In the West, wastewater is steady at low levels.

Severe illness is quite low. ED visits for Covid-19 are down to 0.6% of all ED visits and hospitalizations have declined to 1.1 hospitalizations per 100,000 people.

RSV & Other Bugs

RSV activity is still elevated as well. Most of the growth in rates right now is in the West and Midwest. RSV test positivity is higher than it has been all season, at 7.6%, though still below last season’s peak of 11.0%. ED visits are moderate and held this steady this past week, at 0.5%. ED visits are particularly elevated for babies under 1 year of age at 4.5%, and children from 1-4 years of age at 4.0%.

Hospitalizations for RSV have increased to an elevated 2.4 hospitalizations per 100,000 people for the entire population. Hospitalizations are very high for infants under the age of 1, at 25.3. They are also quite high for children aged 1-4, at 12.9.

Norovirus

CDC norovirus data, after returning last week briefly, has not been updated again. My alternate data source for norovirus wastewater activity shows high activity nationally. In the Midwest, activity is high and has spiked even higher in the past week. It is high and has held (roughly) steady this past week in the West and Northeast, and has increased a bit in the South.

Food recalls

The following foods are being recalled because they are contaminated. Please check your cupboards and throw out any of these items:

New:

• Rosabella Moringa capsules (more info)
• Tippy Toes brand Apple Pear Banana Fruit puree (for babies) due to elevated levels of patulin, which is a mycotoxin produced by molds that sometimes grow on fruit, including apples. Ingestion can cause gastrointestinal upset in the short-term; long-term exposure can cause a range of problems, including immune suppression (more info).
• Farm-raised Atlantic Salmon, under the brand name Wellsley Farms sold at BJ’s Wholesale Club stores (more info)
• Ground beef, sold in bulk to foodservice locations (more info)

Previously Reported:

• Dried Croaker Fish (more info)
• Gerber Arrowroot biscuits (more info)
• IKM cookware products (primarily sold in California grocery stores) due to potential lead contamination (more info)
• Organic chia seeds sold by Navitas Organics (more info)
• Live it Up Super Greens powders and packets in Original and Wild Berry flavors (more info)
• Canned yellowfin tuna in olive oil under the Genova brand name (more info)
• Suzanna’s Kitchen Recalls Ready-To-Eat Grilled Chicken Breast Fillet (more info)
• Super Greens supplement powder (more info)

In other news

• Norovirus detected in Swiss hockey team at the Olympics. Last week, one player with the Swiss women’s hockey team tested positive for norovirus, and the entire Swiss hockey team is in isolation. This comes after several cases were detected among the Finnish women’s hockey team. Norovirus spreads fast and easily, and is very hard to contain in close quarters.
• Second Salmonella outbreak linked to moringa leaf powder this year. The CDC is investigating an extensively drug resistant outbreak of Salmonella, which has affected at least 7 individuals (in 7 states) and led to 3 hospitalizations to date. It has been tied to Rosabella brand moringa powder capsules. This outbreak is unrelated to an outbreak reported in January linking other supplements containing moringa leaf powder to Salmonella. Notably, the strain in this outbreak is resistant to all first-line and alternative antibiotics that are typically used to treat more severe Salmonella infections. If you have any of the affected lots, throw them away and wash anything that may have come in contact with the capsules using hot, soapy water or in a dishwasher. Severe Salmonella symptoms that require medical attention include bloody diarrhea, diarrhea lasting more than 3 days that is not improving, and an inability to keep liquids down or signs of dehydration.
• Listeria outbreak linked to pasta has concluded. A Listeria outbreak that was traced to prepared pasta meals, including those sold by FreshRealm, has ended. The CDC’s investigation into the outbreak identified 28 cases, 27 of whom were hospitalized and 7 of whom died, across 19 states. The true total number of affected individuals is almost certainly substantially higher, since many people who become infected do not become seriously ill and seek medical care. However, for certain groups, Listeria infection is quite risky, including for pregnant individuals (and fetuses), newborns, people over the age of 65, and those who are immunocompromised.
• Opportunities with FOI. I am hiring a part-time writer and I’m also looking for freelancers for individual assignments for the Force of Infection family of reports. Learn more over at FOI Clinical.