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4 min read National Report

This week in outbreaks

Flu season remains in full swing, COVID-19 cases on the rise, and some good news

This week in outbreaks

According to recent data, influenza-like illness (ILI) has been on the decline for several weeks. In the week ending December 24, approximately 1 in 16 medical visits were related to ILI, compared to 1 in 13 earlier in December. Influenza-related hospitalizations and outbreaks in long-term care facilities have also decreased. These improvements are likely to be genuine and not simply a result of holiday season changes in doctor visits or reporting inconsistencies due to the holiday.

Outpatient visits for respiratory illness for week ending Dec 24, 2022. Source. Annotations mine.

Although flu activity has decreased in recent weeks, most of the country is still experiencing peak flu season. In 44 states, influenza-like illness (ILI) activity is still classified as very high or high, with only 6 states experiencing low or minimal activity. We are not out of the woods yet with flu season, but I am hopeful that the worst is behind us.

Influenza like illness activity by state for week ending Dec 24, 2022. Source.

A significant portion of the improvement in ILI activity is due to a decrease in cases among children. The proportion of medical visits for fever, cough, or sore throat among children ages 0-4 has declined from 17.5% to 14.6%, and among people ages 5-24, these numbers have fallen from 12.8% to 9.9%. While adult flu activity has not decreased as significantly, it was already at lower levels to begin with.

RSV has also continued to decline, another bit of good news.

Now for the bad news. Unfortunately, it appears that COVID-19 is increasing, likely due to the emergence of the XBB.1.5 variant (more on the variant from Eric Topol here). While the number of cases may be flat, test positivity and hospitalizations are both increasing. Case counts may be affected by the use of home antigen tests and gaps in reporting during the holidays, so hospitalizations may be the most reliable indicator of COVID-19 activity. The jurisdictions most affected by the rise in hospitalizations include Washington D.C., Delaware, North Carolina, and Connecticut.

Daily COVID-19 hospitalizations by age. Source: New York Times.

As I previously reported, the seasonal coronaviruses may be starting to tick up. There are seven known human coronaviruses, three of which can cause severe illness: Covid-19, SARS, and MERS. The other four mostly cause mild, cold-like symptoms and circulate regularly. Two of these mild, seasonal coronaviruses are currently on the rise.

Finally, there is now widespread evidence of a surge in group A streptococcus (GAS), a bacterial infection that most people know as the cause of strep throat. While strep throat is a mild illness, GAS can sometimes cause more severe diseases like scarlet fever, bacteremia and necrotizing fasciitis. Multiple European countries have reported an increase in these invasive cases, as has the United States and Uruguay. Although invasive GAS is rare, swift diagnosis and treatment is crucial, so I’m highlighting it here for your awareness. Symptoms vary depending on where the infection is in the body—I found this UKHSA summary most helpful, of the ones I reviewed. Unfortunately, there is also a shortage of amoxicillin, the antibiotic used to treat group A strep infections, so the American Academy of Pediatrics has published a list of alternative options.

Food recalls

The following foods are being recalled because they are contaminated with bacteria that causes food poisoning. Please check your cupboards and throw out any of these items:

New this week:

Previously reported:

More good news