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Respiratory Diseases

ILI

This is a big flu season in the South. All indicators (outpatient activity and severe illness) increased this week, rising to very high levels.

South Carolina leads the Southern region with outpatient ILI at 17.0% and ED visits at 12.6%, though ED visits decreased slightly from 13.1% last week. These are very big numbers—it means that nearly 1 in 5 visits to the doctor are for fever and cough or sore throat.

The mid-South also reports intense activity. Tennessee reports outpatient ILI at 12.6% with ED visits at 8.0%, up from 6.0% last week, and very high wastewater levels. Texas reports outpatient ILI at 11.1% with ED visits at 11.7%, up from 10.2%, maintaining very high wastewater concentrations. District of Columbia reports outpatient ILI at 9.9% with ED visits at 7.1%, showing high wastewater levels.

Georgia reports outpatient ILI at 8.5% with ED visits at 6.8%, and very high wastewater levels. Mississippi has outpatient ILI at 8.4% with ED visits at 9.6%, maintaining very high wastewater concentrations. Louisiana reports outpatient ILI at 8.2% though ED visits are lower at 5.3%, showing high wastewater levels. Arkansas shows outpatient ILI at 7.9% with ED visits at 9.2%, and very high wastewater concentrations.

The remaining Southern states show varying activity levels. Virginia reports outpatient ILI at 7.9% with ED visits at 9.4%, and very high wastewater levels. Florida shows outpatient ILI at 7.7% with ED visits at 7.9%, maintaining very high wastewater concentrations. North Carolina reports outpatient ILI at 7.5% though ED visits are higher at 12.0%, with very high wastewater levels. Alabama shows outpatient ILI at 7.4% with ED visits at 7.3%, and very high wastewater concentrations.

Oklahoma reports outpatient ILI at 6.7% but leads the region in ED visits at 14.0%, up sharply from 10.5% last week, maintaining high wastewater levels. Maryland has outpatient ILI at 6.9% with ED visits at 9.3%, showing very high wastewater concentrations. Kentucky reports outpatient ILI at 4.3% though ED visits are notably higher at 10.8%, showing very high wastewater levels. Delaware shows outpatient ILI at 3.6% with ED visits at 10.1%, maintaining very high wastewater concentrations. West Virginia reports the region's lowest outpatient ILI at 3.2% with ED visits at 6.0%, showing high wastewater levels.

COVID-19

Covid-19 is picking up in parts of the South. Wastewater activity is high and increasing, though severe illness remains fairly moderate.

At the state level, most states in the South are reporting high wastewater activity, roughly split between those where activity is increasing again: Maryland, Washington, DC, North Carolina, and Arkansas, and those where activity is decreasing: Delaware, Kentucky, Tennessee, and Louisiana. Although wastewater activity is very high in South Carolina, it did dip slightly this past week.

Activity is moderate in Texas, Florida, Virginia, and Georgia. It is low in just two states: West Virginia and Oklahoma. (Insufficient data for Mississippi).

ED visits are low (<1.5%) in all Southern states. Most states reported stable rates, but West Virginia and North Carolina reported decreases. The rate of ED visits increased a bit in Arkansas, Tennessee, Texas, and Virginia, but remain far below the levels they reached during the late summer wave or in last winter’s wave in any of these states.

Hospitalizations are at fairly low to moderate levels across much of the South, ranging from 2.4 in Texas to 5.1 in West Virginia. While they remain moderate, hospitalizations are picking up in Virginia, Tennessee, Georgia, Delaware, Alabama, and South Carolina.

RSV

RSV activity is low across the region with the exceptions of Oklahoma, West Virginia, and North Carolina where ED visits are a little higher.

Most states, again with the exception of Oklahoma, are seeing declining levels of activity as we head out of the season.

Stomach Bugs

Norovirus remains stubbornly high. Test positivity decreased this past week to 13.8%. Rates are oscillating a bit right now: the last couple months, rates have oscillated in a band between ~12-18 test positivity. As such, despite the decrease this week, I expect it to go back up again.

Other Bugs

• Human coronaviruses - a common cause of colds - are peaking for a second time this winter. They had peaked at the beginning of January, and now are back up again to the same level.
• Human metapneumovirus is low, but seems to be ticking up.
• Other causes of cold- and flu-like symptoms - like adenovirus and rhinovirus/enterovirus are fairy low right now.

Food recalls

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

New:

• Alfalfa sprouts sold under the Jack and the Green Sprouts brand name (more info)
• Aleppo Tahini Sesame Paste (more info)
• DJ's Boudain sausage links (more info)

Previously reported:

• Blue Ridge Beef Natural Mix [for dogs] (more info). While not for human consumption, humans may be infected with Salmonella if they do not adequately wash their hands or contaminated surfaces after handling the product.
• Wegman’s fully cooked breaded chicken nuggets (more info)
• Casa Mamita frozen chicken and cheese taquitos (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

• Lynn County, Texas, confirmed a measles case in its emergency room on February 5, marking the third reported case in West Texas within a week. This case is separate from the ongoing outbreak in Gaines County. The Lynn County Healthcare System is urging parents to monitor children for symptoms and seek medical advice if needed. Both Texas and New Mexico have issued health advisories in response.
• Meanwhile, the measles outbreak in Gaines County has grown to 12 confirmed cases, with health officials anticipating at least six more. The outbreak is linked to low vaccination rates, with some schools reporting less than 50% of kindergartners immunized against measles, mumps, and rubella. Public health officials are working to track transmission and provide care.
• A surge in flu cases has led to school closures in multiple North Texas districts, including Comanche ISD, Morgan ISD, and Godley ISD, where 650 students were out sick earlier this week. The outbreak has also strained pharmacy supplies, with some locations running out of Tamiflu.
• Polk County School District in Georgia is closing all schools and facilities on January 31 due to an outbreak of flu and norovirus. The district reports nearly 800 students and over 60 staff members affected. Administrators say the closure will allow for deep cleaning and additional recovery time for those impacted.