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Respiratory Diseases
Influenza-like illness
Influenza still remains elevated across most of the country, with outpatient influenza-like illness (ILI) at 4.5%, down from this season’s high of 8.3% but disappointingly stable. It’s not unheard of for activity to stay high this late into the season, but that’s cold comfort as we head into March.
The South and Midwest are continuing to drive activity. The West is the most improved region this week, with broad declines across most states. The Northeast remains the least affected region, though activity is ticking up in a few states.
Children aged 0 to 4 continue to have by far the highest outpatient ILI rates of any age group at 11.7%, essentially unchanged from last week. ILI among those aged 5 to 24 rose slightly to 8.6%. Activity was also up modestly across adult age groups: 3.7% for those aged 25 to 49, 2.4% for those 50 to 64, and 1.8% for adults 65 and older. Recall that although older adults have the lowest outpatient rates, they remain at highest risk for severe disease.
Severe illness indicators are mixed. Emergency department visits ticked up to 3.5% nationally, with children ages 5-17 seeing continued increases. Hospitalization data, which lags by about two weeks, show a rate of 2.2 per 100,000, a sharp decline from the peak of 13.1 per 100,000 at the end of December.
Flu B continues to rise, as flu A wanes. Flu B now accounts for 45.4% of clinical lab samples, and 18.5% of public health lab samples.
COVID-19
Covid-19 activity nationally remains relatively low, with emergency department visits holding essentially flat at 0.6% this week. Wastewater concentration increased slightly nationally, but I am increasingly finding that wastewater data is divorced from clinical indicators, which has led me to rely on it less for clues about trends.
The Midwest continues with the highest levels of activity, with emergency department visits right around 1.1%. The Northeast is in better shape at 0.7%. The other regions of the country are lower and stable.
Severe illness indicators are encouraging nationally. Hospitalizations, which lag by about two weeks, have fallen to 0.8 per 100,000, down from the prior week and well below the levels seen earlier this season. Infants under the age of 1 and older adults 65+ have the highest rates of hospitalization for Covid-19.
RSV & Other Bugs
RSV activity nationally is holding essentially flat, with ED visits at 0.5% this week, nearly unchanged from last week. Hospitalization rates, which lag by about two weeks, have declined to 1.6 per 100,000 nationally.
Norovirus
Norovirus continues its march upward, reaching the highest levels seen so far this season: 15.4% test positivity nationally. This national pattern is repeated in the Midwest (17.6%), and the Northeast (14.6%).
In the South, rates are very high, at 13.8%, but remain lower than the mid-November peak of 18%. And in the West, rates are high at 10.9%, but have been declining for the past few weeks.
Food recalls
The following foods are being recalled because they are contaminated. Please check your cupboards and throw out any of these items:
New:
- Multiple flavors of cream cheese under the Made Fresh Salads, Inc. label (more info)
- Frozen chicken fried rice products, sold under Trader Joe’s and Ajinomoto labels due to possible glass shards (more info)
Previously Reported:
- Gerber Arrowroot biscuits (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)
- Suzanna’s Kitchen Recalls Ready-To-Eat Grilled Chicken Breast Fillet (more info)
- Super Greens supplement powder (more info)
- Spring & Mulberry chocolate bars (more info)
- Pecorino cheese from various brands, including Boar’s Head and Members Mark (more info)
- Sea Moss Gel Superfood (more info)
- Primavera Nuevo tamales, various flavors (more info)
- There is a big recall of hundreds of products — from Airhead candies to meat to Splenda packets — that passed through a single distributor and were sold to over 50 stores, primarily in Minnesota and Indiana. I strongly urge you to check out the list of stores (here) and if you’ve shopped at one of them recently, check out the much longer list of items that are being recalled (here)
In other news
- Large avian flu outbreak in Pennsylvania poultry farms.Over the past month, 7.3 million birds have been affected by highly pathogenic avian influenza (HPAI) in Pennsylvania, across 11 commercial flocks and 8 backyard flocks. Pennsylvania has become the epicenter of highly pathogenic avian flu in poultry in the country, accounting for roughly 80% of the total known cases in the past 30 days. These are rates far above what Pennsylvania has reported for the past several years. Just in the past 30 days, roughly as many birds in the state have been affected as were affected across the entirety of the past four years (7,210,220 from Feb. 2022-Jan. 2026). The outbreak has affected both commercial egg layers and turkeys being raised for their meat. There are concerns both about the economic impact of these losses, but also about spillovers to dairy farms in the region. The more HPAI spreads on commercial farms, the greater the chance of spillovers to humans as well.
- Measles very high, fueled by outbreak in South Carolina. According to the CDC, as of February 20, 982 measles cases have been confirmed in the US so far this year. Less than 2 months into 2026, we are at 43% of last year’s high numbers. South Carolina’s outbreak accounts for a majority of these cases (64.3%, 632), but there are also substantial outbreaks in Utah (117), Florida (64). 26 states in total have reported measles cases so far this year. These outbreaks are occurring because of inadequate vaccination levels — measles outbreaks can be prevented through high levels of vaccination.
- If you are curious about FOI Clinical the first weekly report and the first health alert are now free to read. FOI Clinical is a new resource from Force of Infection that publishes weekly outbreak briefings focused on reportable diseases plus real-time health alerts for fast moving events.
