Welcome to the Northeast edition of Outbreak Outlook, formerly called This Week in Outbreaks! This content is only available to paid subscribers. As I am launching the regional editions, your feedback and support is invaluable. Thanks for reading! -Caitlin

Respiratory diseases

Influenza-like illness

Influenza-like illness (ILI) has increased for several weeks now in the Northeast. It currently ranks as the second-highest region for ILI in the country, with around 2.3% of visits to the doctor for ILI symptoms. This is an increase over last week’s 1.8%, but still far below the national threshold that marks the beginning of flu season, which is 2.5%. Current levels are similar to what the Northeast region saw at this time last year.

While most states in the region fall in the “minimal” or “low” ILI activity categories, New York City was again categorized as “high.” More detailed information on influenza-like illness will become available later this month, when states begin to turn on their ILI surveillance systems and pay closer attention to what is going around.

Once again, it’s the littlest ones who are most heavily affected. For kids aged 0-4, 7.1% of their visits to the doctor were for fever and cough or sore throat, up from 6.8% the week prior. For the 5-24 age group, the rate is lower at 3.3%, while rates for older age groups are below 2%.

Covid-19

Hmm. Covid-19 trends in the Northeast are puzzling. Data from Biobot shows an unexpected rise in wastewater concentration. This surprised me, because other regions in the country are showing improvement. I had anticipated the Northeast to follow a similar trend. I’ll keep an eye on it and update you on the next developments.

In Northern New England, the number of new hospitalizations rose slightly. Interestingly, while hospitalizations increased, the test positivity rate saw a dip from 12.5% to 9.7%. I hope that foreshadows improvements in Covid-19 activity, but again, I’m uncertain.

In New York and New Jersey, the number of new hospitalizations is remaining mostly stable. The test positivity has fallen slightly. It climbed high to 16.2% on September 16, but by September 23, it had calmed down to 13.2%.

Hospitalizations in Pennsylvania are still increasing.

Also, I got my free, at-home Covid-19 tests in the mail last week! One reader pointed out that the tests were not due to arrive until October 2 — and indeed they did, right on time. Order yours today! covid.gov/tests.

RSV

RSV activity but slowly increasing in New England states. PCR test positivity is now 2%, up from a recent low of less than 1%. Still, during the height of RSV season, test positivity can reach 20%, so overall activity is low.

Not much sign of increase in New York, New Jersey or Pennsylvania.

Other Respiratory + Stomach Bugs

All the other respiratory virus that I keep an eye on — seasonal coronavirus, human metapneumovirus, parainfluenza virus, and adenovirus —look good.

Norovirus activity is low.

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 week:

• Ion and Restore brands Sinus Spray (more info)
• Organic Chicken and Beef Broth sold at Costco and Whole Foods (more info)

Previously reported:

• Whole cantaloupes sold by Eagle Produce (more info)
• Not Fried Chicken sold by Life Raft Treats (more info)
• Hillshire Brands smoked sausage (more info)
• Banquet Chicken Strips Meal (more info)
• Frozen corn and mixed vegetables from Food Lion and Kroger (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

• New Hampshire has reported the state’s first human case of Jamestown Canyon Virus (JCV) for the year. JCV, which is transmitted by mosquito bites, can lead to symptoms like flu-like illness, fever, and muscle aches It can also cause more severe illness. In addition, two cases of Powassan Virus (POWV) have been identified. POWV is transmitted by the blacklegged tick, the same tick responsible for Lyme Disease. There are no vaccines or treatments for JCV or POWV. Since 2018, New Hampshire has reported a total of 13 human cases of JCV and 8 cases of POWV since its first detection in humans in the state in 2013.