Flu season is off to its earliest start in years, and activity is very different from state to state. The regional editions cover what’s happening where you live, across flu, Covid-19, RSV and more. Try them free for 7 days, then get any or all four regions every week through the winter for $5 a month or $60 a year. Cancel online anytime. Learn more about regional editions.
Influenza
We are now about two months into this very early flu season, and activity continues to rise according to most measures.
Test positivity, which was the first indicator to suggest an early season, is still rising. The South in particular has accelerated, with test positivity increasing from 8.4% to 13.7%. The West dipped, but I'm thinking that might be a data blip. It was less than 2% during the same point last year.
Outpatient influenza-like illness (ILI), which is the percentage of visits to the doctor that are for fever and cough or sore throat, is also increasing, ahead of what we see in a typical year. At the national level, outpatient ILI increased from 2.4% to 2.8%. The South and West are in the lead at 3.3% each.
As always, young children have the highest rate of outpatient ILI. Activity in kids ages 0 to 4 increased from 7.5% to 8.7%, ahead of the 6.3% reported during the same week last year. People ages 5 to 24 saw an increase as well, now at 4.4%. Older age groups are increasing more slowly. However, do remember that older adults are at the highest risk of hospitalization.
COVID-19
Covid-19 is bouncing around. Activity is higher than what we see during the off season but well below our twice-annual peaks, and there's no clear direction yet. ED visits are flat at 0.5%, while hospital admissions ticked up this week after holding fairly steady for about two months. Wastewater levels remain moderate.
Adults 75 and older have by far the highest hospitalization rate, at 8.2 per 100,000, about three times that of adults 65 to 74. Among young children, Covid-19 accounts for 1.5% of ED visits among infants under 1 and 0.9% among children ages 1 to 4. Both are higher than at this point last year (1.0% and 0.3%).
RSV and other respiratory pathogens
RSV is still rising right on schedule. It accounts for 1.1% of ED visits among infants under 1 and 1.0% among children ages 1 to 4, about the same as this time last year. Hospital admissions have risen for eight straight weeks and are level with last year. More than half are children under 5, whose admission rate rose from 2.6 to 3.1 per 100,000. The South is furthest along, with an under-5 admission rate of 5.1 per 100,000, compared with 1.0 in the Midwest.
Rhinovirus and enterovirus, common causes of colds, remain high in several places that track them. Rhinovirus/enterovirus is the most common virus in lab testing in Wisconsin and at Nationwide Children's Hospital in Ohio, and it's elevated in Chicago, too.
Food Recalls
New:
- 365 Whole Foods Market Ashwagandha Capsules from Vitality Works (more info)
Previously Reported:
- Cold Smoked Sprats from Haifa Smoked Fish (more info)
- Raw Oysters from Little Wicomico Oyster Company (more info)
In Other News
- Measles has caused three more deaths in the United States in a single week. On November 2, New York reported the state's first measles-associated death in more than 30 years, a child in Lewis County. Two days later, Pennsylvania confirmed its sixth measles-associated death this year, an unvaccinated Jefferson County resident, as the state's count reached 1,467 cases. On November 5, Wisconsin reported that an infant had died, the state's first measles death since 1990. Nationwide, CDC has reported 5,182 cases so far this year, the most in decades. In related news, the U.S. will likely lose its measles elimination status when a PAHO committee meets later this month.
- A Yakima County, Washington, resident has died of H5N1 bird flu, the first US bird flu death this year. The Yakima Health District reported on November 1 that the person had been hospitalized with severe illness after exposure at a dairy with infected cattle, and had underlying health conditions. The district also confirmed a third human case in the county, in a resident exposed to infected cattle at a dairy who hasn't been hospitalized. Washington has had 34 infected dairy herds in the past 30 days, nearly all in Yakima County, according to CIDRAP. Separately, routine milk testing found H5N1 at a dairy in Weld County, Colorado, the state's first dairy detection since 2024.
- A new study in JAMA Internal Medicine adds good news about RSV vaccines for older adults. Researchers followed nearly 600,000 Medicare beneficiaries aged 65 and older who lived in nursing homes during the 2023–24 season, the first season the vaccines were available. Vaccinated residents were 73% less likely to be hospitalized with RSV than unvaccinated residents. Protection was 75% among residents 75 and older and 60% among those 65 to 74. Nursing home residents are among the people at highest risk of severe RSV, so this is encouraging data.
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