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Respiratory Diseases

Influenza

Overall

Flu is increasing rapidly across the Midwest, with high or very activity in about half the states in the region. ED visits for the region are at about 4%, and hospitalizations are increasing. Outpatient influenza like illness is around 4.5% in the region, which is lower than in many parts of the country but still significant. For context, last year was a bad year and the regional peak was around 7-8%.

We are at levels where avoiding large crowds and masking up makes a lot of sense. Metrics of serious illness are also rising, with nearly all states in the region reporting an increase in emergency department (ED) visits this past week, along with increases in hospitalizations.

What’s ahead

Personally, I am not really seeing signs of peaking yet, but the Center for Forecasting and Outbreak Analytics estimates that growth has stopped in Illinois, Indiana and Kansas, which suggests those states may have peaked. If so, the other states are not far behind.

And going by the calendar, peak week could happen any time now. We typically hit peak week either during or soon after the holidays. Last year we had an uncommon double peak, which prolonged the season by quite a bit, which just goes to show that flu loves to surprise.

State details

Activity is very high in Michigan, Ohio, Missouri, and Minnesota, and high in Indiana. In Minnesota, ED visits are at 8.4% — higher, by far, than anywhere else in the region. Hospitalizations in the state are also very high, at 11.4 hospitalizations per 100,000 people. In Michigan, outpatient ILI is up to 7.8%, and hospitalizations are increasing (though they remain fairly low at 2.8).

Activity is moderate in Nebraska and Iowa; ED visits in both states increased this past week (to 1.9% and 2.4%, respectively). Outpatient ILI activity remains low in Wisconsin, Illinois, and North and South Dakota. However, ED visits have doubled or more in the past week in Illinois (4.8%), Wisconsin (4.8%), and North Dakota (4%).

COVID-19

Covid-19 activity has shot up: wastewater activity jumped from low to high activity for the region. Most states in the region are reporting elevated wastewater activity, and every state reported an increase in ED visits this past week.

Indiana has the greatest spread right now, with the highest rate of both wastewater activity and ED visits in the region. Wastewater activity in the state is very high and rising rapidly. ED visits, while still fairly low, increased to 1.4% this past week.

In Nebraska, wastewater activity is also very high and increasing, but ED visits are the lowest in the region at 0.6%. However, ED visits increased this week and I expect their rise to continue.

Wastewater activity is high and increasing in Ohio, South Dakota, Michigan, and all states reported notable increases in ED visits this past week. In Michigan, hospitalizations remain very low, but also increased slightly this past week to 1.7.

In Minnesota, wastewater activity held roughly steady at high levels after a few weeks of increases. It is not clear if it peaking or just pausing before rising again. ED visits rose to just under 1%. However, hospitalizations are very low and decreased a bit this past week (to 1.0 hospitalizations per 100,000 people).

Wastewater activity is moderate and increasing in Illinois and Missouri, and ED visits rose in Illinois to 1.1% (Missouri does not report ED data).

There is no where in the region where activity is fully quiet. Although wastewater activity held steady at moderate levels in Kansas, ED visits increased to 0.9%. ED visits are roughly equivalent in Wisconsin and Iowa, though in both these states wastewater activity remains very low.

RSV

RSV is now classified at moderate activity nationally and is growing in nearly all states. ED visits have increased to 0.4% for all age groups, and to 3.6% for children aged 0 to 4 years. For children 0-4, hospitalizations are elevated at 8 hospitalizations per 100,000 people.

Despite increases in ED visits in most states in the Midwest this past week, rates remain pretty low in the region. The highest ED rate is 0.4% in Illinois.

Hospitalizations increased in both Minnesota and Michigan this past week, to 0.8 hospitalizations per 100,000 people.

Other Bugs

• Adenovirus is high right now,
• Parainfluenza is past peak, but still elevated. Similarly, rhinoviruses/enteroviruses continue their slow decline but are still at moderate levels.
• Human coronaviruses and human metapneumovirus, while low, are on the rise.

Stomach Bugs

Norovirus is high nationally, at 12.1% test positivity. Test positivity rebounded in the South up to 15%. In the West and Midwest, test positivity is high and increasing at 11.2% and 12.2%, respectively. In the Northeast, test positivity increased to 8.8%. Norovirus loves the type of close contact and shared food plates that occur over the holidays, so I expect these rates to be even higher by next week.

Food recalls

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

New:

• 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)
• Country Vet Biscuits & Heartland Harvest Dog Biscuits [for dogs] are being recalled for potential contamination with Salmonella. Salmonella can sicken both pets who consume the treats, and humans who handle the products (or who touch surfaces the items touched). (more info)
• Forward Farms Grass-Fed Ground Beef (more info)

Previously Reported:

• Frozen raw shrimp sold under the Market 32 and Waterfront Bistro brand names, due to possible cesium-137 contamination (more info)
• Mild Cheddar Cheese under the Charlevoix Cheese Company label, sold in Michigan (more info)
• Tamales, various flavors, in 4 count packs, sold by Primavera Nueva Inc. (more info)
• Salted Caramel Cluster Non-Dairy Frozen Dessert sold under the So Delicious label (more info)
• Town Food Service Equipment Co. Aluminum Saucepans, due to potential lead contamination (more info)
• Lucky Foods cinnamon powder, due to potential lead contamination (more info)
• ByHeart Infant Formula due to potential botulism contamination (more info)

In other news

• I couldn’t find anything this week! Happy New Year, thank you for trusting me with some of your health information needs this year. Here’s to many more!