Respiratory Diseases

Influenza-like illness

Outpatient visits for influenza-like illness increased again this week, which is expected this time of year now that we’re deep into flu season. During the week ending December 16, 3.8% of doctor visits were for fever and cough or sore throat, up from 3.4% the week before.

For reference, peak flu activity typically falls in the 7-8% range, though of course this can vary. If previous seasons are any guide, we likely have a few weeks more of high activity before we start to see relief.

After a brief dip in outpatient activity during the last report, young children once again saw an increase, with rates rising from 10.1% to 11%. The slightly older 5-year-old age group also experienced a notable jump, from 5% to 6%. Older age groups remain under 3%.

Emergency room visits for influenza show similar trends, particularly with a marked increase in the 5 to 17-year-old age group. Overall, this suggests that both school-aged children and younger kids are seeing significant increases in flu activity. However, it’s the older age groups who are at the highest risk for hospitalization.

Among adults, those aged 75 and older face hospitalization rates more than double that of the 65 to 74-year-old group. As we head into the holidays, where younger and older age groups are likely to mix, I encourage everyone to take precautions—like improving ventilation and staying home if you’re feeling unwell.

COVID-19

Last week, I reported that COVID-19 appeared to be on the rise after months of relative quiet. Unfortunately, that trend has intensified, with wastewater concentrations of SARS-CoV-2 increasing again.

The highest concentrations are in the Midwest, suggesting that this region may be an emerging hotspot.

Moreover, all indicators are pointing in the same direction. Test positivity rates are climbing, and emergency department visits for COVID-19 are also on the rise.

Together, these trends suggest that the period of relative quiet may be coming to an end. However, with only two weeks of increases and starting from very low levels, we’re still in a good place overall.

RSV

RSV activity is increasing as well with wastewater concentration, test positivity, and emergency department visits all rising, though this is a somewhat light year compared to previous seasons. The South is particularly affected. Infants and older adults are at highest risk of severe RSV, so please be cautious as you head into intergenerational holiday gatherings.

Food recalls

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

New:

• None

Previously reported:

• Connie’s Thin Crust Cheese Frozen Pizzas (more info)
• Daily Veggies Enoki Mushrooms (more info)
• Sprouts Markers Market Gyro Family Kit (more info)
• MadeGood Granola Bars (various flavors and varieties) (more info)
• Blue Ridge Beef log Puppy Mix [for Dogs]. While not for human consumption, humans may be infected by Salmonella if they do not adequately wash their hands or contaminated surfaces after handling the product. (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

• Programming note: I will be off next week for the holidays. Be well!

• I’m in the New York Times today with pitch for…this newsletter, basically! I argue that “public health professionals should take a page from meteorologists and broadcast virus reports like weather reports.”

  • Thank you all for joining me on this journey, now 2.5 years in the making, to bring news of what’s going around to more people. If you find this newsletter useful, please do share.

  • And as a reminder, if you are interested in my perspective about how epidemiology works—or should work!—you’ll probably like my book, Crisis Averted. I wrote it for people who enjoy story-driven nonfiction, so I hope you will check it out.

• California Governor Gavin Newsom declared a state of emergency on Wednesday due to the spread of H5N1 bird flu among the state’s dairy cattle.

• Germany has reported four new clade 1b mpox cases, including two in school-aged children, in a family from the Rheinisch-Bergischer district near Cologne. The infections are linked to recent travel to Africa, where one family member likely contracted the virus and spread it to the others. Health officials are contacting the family’s schools and workplaces and monitoring close contacts for symptoms.

• The Democratic Republic of Congo's health ministry has identified a previously unknown disease in the Panzi health zone as a severe form of malaria, complicated by respiratory symptoms and malnutrition. The illness caused 143 deaths in Kwango province in November and has affected 592 people since October, with a fatality rate of 6.2%.

• One pro tip for parents: restock your children’s Tylenol (or whatever you use) and rehydration fluid today. We are in peak flu season, which unhappily coincides with plenty of days when pharmacies and doctors’ offices are closed. Don’t be caught without!

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