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5 min read Paid Subscriber Report: South

Outbreak Outlook - South - Dec 31

Welcome to the Southern edition of Outbreak Outlook! It is only available to paid subscribers. If you wish to become a paid subscriber and access region-specific information, please click the Subscribe now button below. Thanks for reading! -Caitlin

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Respiratory Diseases

Influenza

Overall: Flu is going up, up, up. Regionally, the percentage of visits to the doctor that are for fever and cough or throat is around 6.2% (and climbing). For context, last year was a bad year and the regional peak was around 8.8%.

Most states in the region are at high or very high levels of activity, based on outpatient influenza like illness (defined as visits to the doctor for fever and cough or sore throat).

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: I am not really seeing signs of peaking yet, but going by the calendar it 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 7 states. In Louisiana, outpatient visits for ILI are very high at 11.5%, and ED visits this past week increased to 7.8%. Similarly, in South Carolina, outpatient ILI is also very high (9.8%) and ED visits nearly tripled to 6.1%.

In North Carolina, ED visits for flu are higher than anywhere else in the region, at 10.8%. Hospitalizations in the state are also high, having doubled in the past week to 11.8 hospitalizations per 100,000 people. Activity is also very high in Tennessee, and severe illness is also picking up, with increases in ED visits and hospitalizations (3.7 per 100,000 people). Similarly, ED visits more than doubled this past week in Arkansas (to 4.4%).

Activity is high in another 5 states: Texas, Maryland, Georgia, Alabama, and Virginia. ED visits doubled or more this past week in Virginia, to 5%. In Maryland and Georgia, hospitalizations have risen to moderately elevated levels — 7.2 and 7.3, respectively — and are continuing to rise. In Washington, DC, outpatient ILI has risen to 9.2%, though ED visits remain relatively low at 3%.

Activity is moderate in just two states: Mississippi and Kentucky, with outpatient ILI at 3.9% and 2.6%, respectively. And it is low in Delaware, West Virginia, and Oklahoma. (Note: despite Kentucky and West Virginia sharing an outpatient ILI of 2.6%, the categorization of that — whether it is moderate or low — is based on the state’s historic baselines).

COVID-19

Covid-19 activity remains very low but it is increasing. ED visits range from 0.1% in Washington, DC to 1.4% in West Virginia — but increased in most states. Wastewater activity is also increasing.

In Oklahoma, wastewater activity has jumped from low to very high activity. Wastewater activity in the state are also rising, but remain low at 0.8%.

In Arkansas, wastewater activity is high and increasing, and ED visits increased notably this past week, to 0.9%. In Kentucky, ED visits similarly rose (to 1.1%) and wastewater activity held steady at high levels.

In Tennessee, ED visits increased to 0.9%, and wastewater activity is moderate and rising. However, in Alabama, despite moderate and increasing wastewater activity, ED visits remained low and stable (at 0.4%).

Wastewater is low and increasing in South Carolina and Delaware, as are ED visits (to 0.5% and 0.7%, respectively). In West Virginia, wastewater activity held roughly steady at low levels after a few weeks of increases, but ED visits continued to rise (to 1.4%).

Wastewater activity remains very low in about half the region, including in Florida, Washington, DC, Louisiana, and Virginia. ED visits held low and steady in these states as well.

Hospitalizations remain low and roughly stable in Maryland (0.0), Georgia (0.3), Tennessee (1.3) and North Carolina (1.5).

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.

These increases are apparent in the South. Nearly every state reported an increase in ED visits this past week (with the exception of Florida and Alabama, which held roughly steady). In Delaware, ED visits nearly doubled, to 0.9%. Several other states had notable increases as well, including Arkansas (0.8%), Maryland (0.7%), and Kentucky (0.6%).

Hospitalizations, however, remain low and decreased in Georgia (1.7 hospitalizations per 100,000 people), Maryland (1.7), and North Carolina (0.9). They did increase though in Tennessee (to 0.7).

Other Bugs

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:

Previously Reported:

In other news

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