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Respiratory Diseases

Influenza

Overall

Flu is much lower in the West than in other parts of the country, but it’s rising rapidly in multiple states.

For context, current outpatient influenza like illness (ILI) in the region is around 3.4% in the southern portion of the region and 4.6% in the northern portion of the region. Last year, which was a bad year, topped out around 8.5%.

Note that there is broad variation in which states are being affected first: ED visits range from 0% in Wyoming to 7% in Colorado.

What’s next

Personally, I’m not seeing signs of peak yet. Growth seems quite strong. However, the Center for Forecasting and Outbreak Analytics estimates that flu growth has stalled in California, Arizona, New Mexico and Colorado, which suggests those locations could be at or near peak. If so, the other states are likely not far behind. Going by the calendar, we could be at or near peak any time now, too. Most years sees peak week during or just after the holidays, though you never know with flu.

State details

Where activity is high: Colorado, Alaska, Hawaii, New Mexico.

• Colorado is at the forefront, with ED visits at 7% this week. Outpatient ILI in the state — at 8.9% — is substantially higher than in any other state.
• In Alaska, Hawaii, and New Mexico, ED visits also also quite elevated, increasing to between 6 and 7% this past week. In New Mexico, hospitalizations are a bit above baseline, but are still fairly low (2.2).
• In Idaho, outpatient ILI increased sharply to 7.2% (according to state data), and ED visits are at 4.2%.

Where activity is more moderate: Nevada and Utah

• In Nevada, outpatient ILI is up to 4.7%, and ED visits in the state more than doubled this past week, to 3.5%.
• In Utah, ED visits jumped to 5.4%, and hospitalizations have risen rapidly to 4.7.

Where it is still pretty low, but increasing: California, Arizona, Oregon, Montana, and Washington.

• In Montana, ED visits increased slightly to 2.4%, but outpatient ILI is just 1.2%, which is below the state’s baseline of 2.7%.

• While California has a numerically higher outpatient ILI of 4.9%, this is only 1 point above baseline for the state, and ED visits are rising but still fairly low at 1.6%.

• In Washington and Oregon, ED visits remain low at 2% and 1.2%, respectively. Hospitalizations held low and steady at 0.8 in Washington, and low and decreasing at 0.4 in Oregon.

COVID-19

Covid-19 activity is very low but showing early indications of increasing. Wastewater activity is very low, but crept up a bit this past week. ED visits are stable at about 0.4% for the region.

Wastewater activity continues to be very low in most states in the West. Activity is low and increasing in Montana and Colorado, and low and decreasing in Alaska. In Nevada and Utah, activity is still very low, but is increasing.

New Mexico, with moderate activity, has the highest wastewater activity in the region. While wastewater activity decreased a bit this past week in the state, ED visits increased to 1.4%, which are also the highest in the region.

ED visits are very low and primarily decreasing or roughly stable in the rest of the region, ranging from 0 to 0.6%. Hospitalizations are very low and declining in California (0.2), Washington (0.3), Oregon (0.2), New Mexico (0.4), and Utah (0.5). Hospitalizations held roughly steady at 1.2 in Colorado.

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.

Nevertheless, rates still remain quite low in the Western region, with most states reporting ED rates <0.2% with tiny increases. In Washington and Alaska, rates are touch higher (0.4% and 0.3%, respectively) and increasing. In Hawaii, rates are at 0.3% and declining.

Hospitalizations are very low, under 1 hospitalization per 100,000 people. Nevertheless, hospitalizations increased notably in Utah (to 0.8), and California (to 0.7).

Other Bugs

• Adenovirus is high right now,
• Parainfluenza is past peak, but still elevated. Similarly, rhinoviruses/enteroviruses continue their slow decline but are still at moderate levels.
• Human coronaviruses and human metapneumovirus, while low, are on the rise.

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:

• (This does not directly impact the West, but I thought it was worth including.) There is a big recall of hundreds of products — from Airhead candies to meat to Splenda packets — that passed through a single distributor and were sold to over 50 stores, primarily in Minnesota and Indiana. I strongly urge you to check out the list of stores (here) and if you’ve shopped at one of them recently, check out the much longer list of items that are being recalled (here)
• Country Vet Biscuits & Heartland Harvest Dog Biscuits [for dogs] are being recalled for potential contamination with Salmonella. Salmonella can sicken both pets who consume the treats, and humans who handle the products (or who touch surfaces the items touched). (more info)
• Forward Farms Grass-Fed Ground Beef (more info)

Previously Reported:

• Frozen raw shrimp sold under the Market 32 and Waterfront Bistro brand names, due to possible cesium-137 contamination (more info)
• Mild Cheddar Cheese under the Charlevoix Cheese Company label, sold in Michigan (more info)
• Tamales, various flavors, in 4 count packs, sold by Primavera Nueva Inc. (more info)
• Salted Caramel Cluster Non-Dairy Frozen Dessert sold under the So Delicious label (more info)
• Town Food Service Equipment Co. Aluminum Saucepans, due to potential lead contamination (more info)
• Lucky Foods cinnamon powder, due to potential lead contamination (more info)
• ByHeart Infant Formula due to potential botulism contamination (more info)

In other news

• I couldn’t find anything this week. Happy New Year! Thank you for trusting me with some of your information needs this year. Here’s to many more!