Respiratory Diseases
Influenza-like illness
Influenza-like illness continues to recede as we head out of flu season. At last report, 4.3% of visits to the doctor were for fever and cough or sore throat, down from 4.9% the week prior.
We are inching closer to the 3% threshold that marks the end of flu season. I think there are at least 2-4 weeks left until we reach that threshold.
All age groups saw declines in outpatient influenza-like illness, though improvements have slowed in the youngest age groups. Outpatient influenza-like illness in children 0-4 was 11.7%, down from 12.4% the week prior. ILI in school-age kids fell slightly to 7.0%, down from 7.3%. All older age groups are below 4% and falling.
As you would expect from falling outpatient numbers, emergency visits for influenza are falling as well. Most regions are seeing similar levels of ED visits, though the Northeast remains most affected and the West remains in best shape.
Influenza B activity is creeping up, now about 5-6% of cases. Flu B is usually more active in the springtime, and current trends fit this pattern. Still, flu A is predominating.
COVID-19
Things are fairly quiet in broad swaths of the country, with high wastewater activity clustered in about a dozen states. Severe illness is low and stable.
Covid-19 wastewater activity is low nationwide, though it just squeaked through to that designation and is sitting only a tenth of a point below the moderate category. That being said, activity is trending downward, and I expect it to keep going in that direction.
The highest wastewater activity is primarily clustered in the South and Midwest, with significantly lower rates in the West and Northeast.
Not much movement with severe illness: ED visits are minimal at 0.7%, and hospitalizations held steady at 2.8 hospitalizations per 100,000 people.
RSV & Other Bugs
Data on other respiratory pathogens was not updated this week.
Norovirus
Norovirus data was not updated this week, but I think it is a safe bet that rates are still very high.
Food recalls
The following foods are being recalled because they are contaminated. Please check your cupboards and throw out any of these items:
New:
- Enoki mushrooms sold under Daily Veggies brand (more info)
- Hot pot sauce sold under Wangshihe brand (more info)
Previously reported:
- Prepared vegetables sold at Tokyo Central/Marukai stores in California (more info)
- Wild Coast Raw Chicken Formula [for cats] due to potential contamination with avian influenza H5N1 (more info). This poses a risk to cats who ingest the product, as well as to humans handling the product.
- Lyons ReadyCare and Sysco Imperial Frozen Supplemental Shakes in various flavors (more info)
- Canned Tuna sold under Genova, Van Camp’s, H-E-B, and Trader Joe’s 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
Beginning in April, I'm transitioning to my summer publication schedule since flu, Covid-19, and RSV are winding down. Summer schedule includes:
Weekly national edition for paid subscribers only
No regional editions (unless disease activity warrants additional coverage)
My wintertime schedule will resume in October when flu season begins again
The FDA has announced its recommendations for influenza vaccine strains for the 2025-2026 U.S. flu season. Notably, the FDA's Vaccines and Related Biological Products Advisory Committee (VRBPAC) was not consulted in this decision-making process. Instead, the FDA convened experts from the CDC and Department of Defense to evaluate circulating flu viruses, mid-season vaccine effectiveness data, and candidate vaccine strains. The FDA says they anticipate no impact on timing or availability of vaccines and expects an adequate supply for the upcoming flu season.
For egg-based vaccines, the FDA recommends using A/Victoria/4897/2022 (H1N1)pdm09-like, A/Croatia/10136RV/2023 (H3N2)-like, and B/Austria/1359417/2021 (B/Victoria lineage)-like viruses.
Cell- or recombinant-based vaccines should contain A/Wisconsin/67/2022 (H1N1)pdm09-like, A/District of Columbia/27/2023 (H3N2)-like, and B/Austria/1359417/2021 (B/Victoria lineage)-like viruses.
The measles outbreak in west Texas has grown to 259 cases since it was first identified in late January. The outbreak includes 34 hospitalizations and one death of an unvaccinated school-aged child. Gaines County has the highest concentration with 174 cases. The outbreak has also spread to neighboring New Mexico, where the Department of Health reports 35 cases in Lea County (33 cases) and Eddy County (2 cases), including 2 hospitalizations and no deaths. Among New Mexico cases, 22 individuals were unvaccinated, 8 had received at least one dose, and 5 had unknown vaccination status.
The combined outbreak affects predominantly children, with 115 cases in ages 5-17 and 86 cases in children under 5 in Texas, and 10 cases in ages 5-17 and 5 cases in children under 4 in New Mexico.
By my unofficial count, 10 states reported measles cases or exposures this past week.
