Force of Infection is now on the summer schedule, meaning most national Outbreak Outlook updates are only available to paid subscribers. However, we are making today's version freely available given widespread interest in the hantavirus outbreak. The winter schedule, including the free national version, will resume in October. To continue receiving reports during the summer, please upgrade to paid.
Influenza-like illness
We are well into the off-season. Trips to the doctor for fever and cough or sore throat (known as influenza-like illness, or ILI) are at 1.8%.
At the regional level, the Midwest reports the lowest levels of ILI (down to 0.9%), while the West is also declining but remains slightly higher than the national average at 2.2%.
Severe illness is also trending down. Flu-related hospitalizations remain low at 0.3%, while emergency department (ED) visits for influenza-like illness are at 0.4%. Progress in the West is slightly slower (0.7%), primarily because ED visits in Hawaii are stuck at 2%, but still a noticeable improvement from last week (2.3%). All other states in the Western region are below 1%.
By age groups
Activity across all age groups continues to level out now that flu season is over. Infants and children 0-4 years have decreased one additional notch to 5.8%, while young people ages 5 to 24 years are flat at 2.8%. Three influenza-associated pediatric deaths were reported this week (reflecting events that happened earlier in the season) for a total of 158 deaths this season. Activity in adults is lower than 2%, with activity in the 65+ age group below 1%.
Covid-19
Covid-19 is still quiet. Wastewater concentration is low and stable across the country. The South continues to have a bit wastewater concentration compared to other regions, but it is declining. Trips to the emergency department are very low nationally.
Hospitalization rates for Covid-19 are also declining, now 0.3 per 100,000 population, down from 0.5. The Northeast had a slight uptick in hospitalizations this past week to 0.7, primarily driven by increases in Connecticut and New York. However, ED visits look fine in those states (show in plot), so I'm not reading too much into it.
RSV
RSV activity has peaked and is trending down in all regions. Emergency department visits for RSV are very low at 0.1%, with the Midwest slightly higher at 0.2%. In that region, North Dakota and South Dakota are registering slightly higher emergency department visits for RSV than other states.
Stomach Bugs
Rotavirus is a highly contagious virus that causes vomiting and diarrhea and is especially dangerous for babies and young children. Rotavirus test positivity continues to be high across the country at 5.9%. While most regions have seen a decline in test positivity over the last two weeks, the Western region continues to climb. A vaccine is available for infants, however doctors worry that declining vaccination rates could lead to more severe illness, especially in young children. The best preventive measures are handwashing, cleaning surfaces and staying home when ill.
Norovirus, another stomach bug, is also elevated in the West and South. Test positivity there is fairly high and rising. The other regions of the country are in better shape, with low and stable test positivty.
Food Recalls
The following foods are being recalled because they are contaminated and can pose a health risk to you and your family. Please check your cupboards and throw out any of these items:
New:
- Giant Eagle, Pita Chips with Parmesan, Garlic and Herbs (More info)
- John B. Sanfilippo & Son, Inc. Snack Mixed Products (More info)
- Spring & Mulberry chocolate Bars (More info)
- Allbright’s Raw Pet Food (More info)
- Wildlife Seasoning for Popcorns (More info)
- Stolzfus Family Dairy Sour Cream and Onion Cheese Curds (More info)
- Pork King Good Pork Rinds and Seasoning Bottles (More info)
- Zapp’s and Dirty Potato Chips (More info)
Previously reported
- Ghirardelli Powdered beverage mixes (more info)
- Good Brain Tonic (more info)
- USDA has retracted a recall for ready-to-eat dinosaur shaped chicken nuggets, sold under the Great Value label sold at Walmart stores. (more info)
- Raw Farm unpasteurized cheddar cheese, shredded and block (more info)
- Peeled garlic, sold under the Christopher Ranch and Garland brand names (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
- Hantavirus outbreak on MV Hondius:
- Headlines this week were dominated by a news of an outbreak of a hantavirus aboard a cruise ship that departed from Argentina on April 1, 2026. Hantaviruses are typically found in rodents; human transmission generally happens through contact with the urine, faeces, and saliva of the infected rodents or by touching contaminated surfaces. The Andes type of hantavirus is the only species known to transmit from human to human. It is endemic to South America (Argentina, Chile and Uruguay).
- Aboard the cruise ship there were 147 people, including 17 Americans. As of May 8, a total of 8 cases, including three deaths (fatality rate of 38%) were reported. WHO assesses the global risk as low, which I agree with. Given that all cases have a direct link to the cruise ship, the situation is currently stable. The incubation period of this virus is long (up to 8 weeks), so more developments may unfold.
- On May 7 we issued an advisory on the outbreak in our FOI Clinical newsletter, which is a Force of Infection publication for clinicians focused on outbreak-prone diseases. That same day, an op-ed I wrote was published in the New York Times. Here is a gift link, in case you want to read it.
- Infant formula safety: Escherichia coli (E. coli) bacteria are a major cause of serious bloodstream infections in newborn babies, especially those born prematurely. A new study looked at the health characteristics of newborns with E. coli infections, as well as how the bacteria are changing over time and becoming more resistant to commonly used antibiotics. Infant formula, particularly powdered and non-sterile formula, can be a source of infections, including E. coli. The study found that E. coli infections in newborns still have a high death rate, particularly among premature infants. They also found growing resistance to two major groups of antibiotics that are often used as first-line treatment (ampicillin and ceftriaxone). The study showed these bacteria have certain genetic features linked to more severe disease, highlighting the need for ongoing monitoring and surveillance.