It's that time of year again. The fourth annual regional editions of Outbreak Outlook launch October 18.
Respiratory virus activity varies a lot from place to place. Already this fall, flu activity is increasing in the West while most of the country remains low. The regional editions track and report these differences state by state, so you can make more tailored decisions based on local trends.
Here is what you need to know about opting in:
What is Outbreak Outlook? I send out a weekly report on infectious disease activity, including respiratory viruses, plus food recalls. These updates are useful for older adults, parents, people with weakened immune systems, and anyone looking to stay well.
During the winter months, the national weekly update is free for everyone. Paid subscribers have the option to receive more detailed updates tailored to the Northeast, Midwest, South, and West regions (links go to examples from last season).
Paid subscribers get weekly state-level updates for any or all regions. $5 per month or $60 per year.
Format: Each regional edition contains state-level data on respiratory illnesses like Covid-19, influenza, and RSV, as well as stomach bugs and food recalls.
Schedule: Both the free national version and the paid regional versions will be published weekly throughout the winter months. I usually move back to my summer publishing schedule in late spring, when viral activity dies down.
Cost: Paid subscriptions are $5 per month or $60 per year. You can cancel at any time. Gift subscriptions are also available.
Reminder: Last spring, I moved from Substack to an independent platform. You will not be able to access regional editions or manage your account through Substack. Instead, visit forceofinfection.com.
Picking a region: The options are Northeast, Midwest, South, and West, as defined by the Census Bureau. Paid subscriptions include all regions, so you can sign up for as many as you like. The state groupings are shown in the map below, and there is a text list at the bottom of this post.

How to sign up to receive regional editions
- Become a paid subscriber. If you are already a paid subscriber, go to step 2.
- Log in by clicking Account on forceofinfection.com.
- Under Emails, click Manage. In the window that appears, select as many regions as you want. Paid subscriptions are all-access. You can change your selections at any time.

Once you've done this, you'll receive an email with my updates each week, beginning October 18. If you need help, you can reach me at support@forceofinfection.com.
Please bear with me as I roll this out; there are always a few hiccups at the start of the season. Thank you for reading!
-Caitlin
List of states in each region:
- The Northeast region includes Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont, New Jersey, New York and Pennsylvania
- The Midwest region includes Illinois, Indiana, Michigan, Ohio, Wisconsin, Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota and South Dakota
- The South region includes Delaware, District of Columbia, Florida, Georgia, Maryland, North Carolina, South Carolina, Virginia, West Virginia, Alabama, Kentucky, Mississippi, Tennessee, Arkansas, Louisiana, Oklahoma and Texas
- The West region includes Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Utah, Wyoming, Alaska, California, Hawaii, Oregon and Washington