Summer Plans: As summer approaches and data on respiratory diseases dwindles, I am moving to my off-season schedule. For the summer months, I’ll be combining weekly updates into a single report for paid subscribers. Expect these updates to be less detailed until the fall, at which point I will return to my normal publishing schedule, including a free national version. Free subscribers will continue to receive other essays and posts during the summer months, but I won’t be posting as often.
ILI
As expected for the summer months, influenza activity is very low across the country. Outpatient visits for influenza-like illness remain low - with nearly every state reporting percentages that reflect off-season expectations.
As noted last week, hospitalization data are now coming from a subset of 14 states. The story looks pretty similar across all of them - very few people (<0.8 per 100,000 population) are being hospitalized for influenza. Several states - Ohio, North Carolina, New Mexico, and Connecticut - report a rate of 0. This, of course, does not necessarily mean that there were not any hospitalizations for influenza but that it is such a small number that, when put into a rate of per 100,000 population it appears as 0.
COVID-19
Covid-19 activity remains minimal across the country, with no notable variations across regions.
Wastewater data continues to show minimal activity nationally, and within each of the four regions. There was a very small uptick in the West this past week - here’s hoping that doesn’t turn into a trend.
Emergency department visits are very low across the United States - with all states reporting that fewer than 1.5% of visits to the ED were for Covid-19 (note: Oklahoma, Minnesota and Missouri had insufficient data). As noted last week, Covid-19 hospitalization data are now coming from a subset of 13 states. In the South, hospitalization rates for Covid-19 are very low, with 0.8 or fewer hospitalizations per 100,000 population. This sample suggests that very few people are being hospitalized for Covid-19, with most reporting fewer than 1 hospitalization per 100,000 population. It ranges from 0.2 in Colorado and Tennessee to 1.4 in Connecticut.
Stomach Bugs
Norovirus activity is finally coming down, though CDC changed its noro dashboard so I’m a little turned around. Test positivity at the national level is setting at 8%, down from a recent high of 13-14%. Activity should continue to fall through the summertime, but I’d still put it in the moderate category for now. Test positivity is highest in the Midwest, at around 9%. The other three regions are all around 7%.
Food recalls
The following foods are being recalled because they are contaminated. Please check your cupboards and throw out any of these items:
New
- Great Value chia seeds (more info)
Previously reported:
- Yogurt covered pretzels by Western Mixers Produce & Nuts, Inc. (more info)
- White-coated candy sold by Palmer Candy Company of Sioux City, Iowa (more info)
- HyVee Cream Cheese (more info)
- Planters Honey Roasted Peanuts and Deluxe Lightly Salted Mixed Nuts (more info)
- California Shelled Walnuts, Organic Light Halves and Pieces (more info)
- Trader Joe’s 50% Less Salt Roasted & Salted Whole Cashews (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
- West: Los Angeles County health officials are investigating five hepatitis A cases among the homeless since mid-March 2024. Although specifics on patient locations were not disclosed, the risk to the public is deemed low. The hepatitis A virus, primarily found in stool, poses a higher risk to homeless individuals due to limited access to hygiene facilities. Free vaccines are being offered to the homeless in encampments and interim housing sites. Health officials urge residents to check their vaccination status and practice good hand hygiene. Symptoms of hepatitis A include fever, nausea, and jaundice, and it can be fatal.
- West: Health officials have declared a pertussis outbreak in Lane County with at least 40 suspected or confirmed cases, primarily in the greater Eugene-Springfield area and one in Junction City. Infants are at the highest risk, and residents are urged to vaccinate themselves and anyone in contact with infants. The outbreak, initially detected in schools, is now spreading in the community. Pertussis is highly contagious and causes a severe, prolonged cough. There have been 120 cases in Oregon this year compared to 17 last year.
- Midwest: The Chicago Department of Public Health has warned of an increase in invasive meningococcal disease cases, with eight reported in 2024, compared to seven in 2023 and only one to three annually from 2017 to 2022. This serious bacterial infection affects the brain, spinal cord, and bloodstream and can be deadly. Most recent cases in Chicago involve adults aged 30-60, with a significant number of Black patients. Meningococcal disease spreads through saliva and close contact. Symptoms resemble the flu but worsen quickly and can be fatal within hours.
- Midwest: The Champaign-Urbana Public Health District (CUPHD) has confirmed a case of Rocky Mountain spotted fever (RMSF) in Champaign County, transmitted by the American dog tick. RMSF, caused by the bacterium _Rickettsia rickettsii_, can be fatal if untreated, even in healthy individuals. Symptoms, appearing one to four days after exposure, include high fever, severe headache, muscle soreness, gastrointestinal distress, and eye and hand swelling. A distinctive rash may develop on the wrists, forearms, ankles, and sometimes the trunk, palms, and soles. RMSF is not contagious between people.
- Northeast: A Stamford, CT resident unknowingly contracted Rocky Mountain spotted fever (RMSF) and was admitted to Stamford Health's emergency department after mistaking the symptoms for the flu. In mid-February 2024, the 42-year-old experienced a slight fever and body aches, which escalated to a 104°F fever, severe aches, chills, and a rash resembling mosquito bites. After several days of extensive testing, he was diagnosed with RMSF, a rare and potentially fatal tickborne disease caused by Rickettsia rickettsii. RMSF, spread by the American dog tick in Connecticut, requires prompt treatment with doxycycline to prevent fatality. The patient was hospitalized for nine days.
