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Respiratory Diseases

ILI

Most of the country is seeing improvements in influenza-like illness.

The big exception is the Midwestern region, which is experiencing a big second bump. Moreover, despite general improvements (except the Midwest), most regions of the country are still seeing high levels of activity. We have at least a few weeks of flu season left ahead of us, and possibly a month or more.

By age: Outpatient ILI remained mostly the same across all age groups. Children ages 0-4 continue to have high rates of fever and cough or sore throat, at over 10%. The 5-24 age group is in better shape at 7%. The older age groups are all below 5%.

By region: The Midwest is still in the thick of it, with high and rising rates of ILI. The West has generally lower levels of ILI but is still taking a bit longer to turn the corner. The South and Northeast are headed in the right direction, but still well above the baseline of 2.9%.

COVID-19

Covid-19 activity is heading in the right direction, with the rate of new hospitalizations dropping to 6. This is comparable to September, of the start of the “summer wave” (which never really became a significant wave). Wastewater concentration is also improving in most areas of the country, with the exception of the Midwest, which is stable.

All four regions are seeing improvements in Covid-19 hospitalizations. This includes the South, which has faced relatively high levels of Covid-19 hospitalizations throughout the fall and winter months. Secondary indicators like emergency department visits and test positivity are improving too.

With any luck, we’ll see continued improvements until at least mid-Summer. That has been the trend for the past few years, and I don’t see a reason why we would depart from that pattern.

Stomach Bugs

As foretold, norovirus activity continues to rise. At the national level, test positivity is 12.3%, up from 11.6% the week prior. Peak norovirus season will last through perhaps April. So far, this season does not seem out of the ordinary.

Norovirus causes the classic “stomach bug,” with vomiting and diarrhea that usually resolves in a couple of days. The biggest concern is preventing dehydration. This is especially important in children and older adults, who dehydrate quickly. I keep Pedialyte powder packets in the pantry, because they take up less space and have a longer shelf life than bottles of liquid rehydration products. Water, broth, popsicles, diluted juice, sports drinks, etc. are also good options. Don’t fall behind by waiting until dehydration sets in. Encourage frequent sips from the onset of illness.

More on preventing the stomach bug: Norovirus spreads very easily between people through the “fecal-oral” route. To stop it from spreading, wash your hands thoroughly after using the bathroom and before eating or preparing food. I also use hand sanitizer while I’m in public like after I use self-checkout at the grocery store or when I use public transportation, but you should know that hand sanitizer is not as effective against norovirus as hand washing. Be sure to wash your hands properly when you get home. Most importantly, stay home if you have vomiting or diarrhea.

If someone in your household gets norovirus, you can reduce the chance it will spread by keeping them out of the kitchen and disinfecting contaminated (read: bathroom) and shared surfaces. Also regard laundry like bedsheets, clothes, and towels as contaminated. Use gloves when handling the items and wash them thoroughly with hot water on the longest cleaning cycle.

Other bugs

• Seasonal coronavirus activity is very high, likely near peak. These viruses cause cold-like symptoms, and often peak in late winter or early spring.
• Metapneumovirus, parainfluenza and adenovirus look fine, but it’s hard to tell because the surveillance data is not very good.

Food recalls

The following foods are being recalled because they are contaminated. Please check your cupboards and throw out any of these items:

New

• Roland brand Tahini (more info)
• Trader Joe’s Chicken Dumpling Soup (more info)

Previously reported:

• A big recall of Queso Fresco and Cotija Cheese is affecting numerous consumer products: (more info)
  • Trader Joe’s Chicken Enchiladas Verde, Cilantro Salad Dressing, Elote Chopped Salad Kit, Trader Joe’s Southwest Salad (more info)
  • Cilantro Lime Crema, Everything Sauce Fiesta, Cilantro Cotija dressing, Poblano Caesar dressing, Cilantro Dressing, Street Taco Express Meal Kit sold at Trader Joes, Don Pancho and HEB (more info)
  • Rojo’s Black Bean 6 Layer Dip (more info)
  • Cheese, Yogurt, Sour cream by Rizo Brothers California Creamery (more info)

• Robitussin Honey CF Max cough syrup products (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

• The Centers for Disease Control and Prevention announced new isolation guidance for Covid-19 this week. At the start of the pandemic, people were recommended to stay home for 10 days after testing positive. At the height of the Omicron wave, that was revised to 5 days. This week, isolation time was revised to 24 hours without a fever and symptoms improving, which is similar to the recommendations for other illnesses.
• In related news, adults ages 65 and older can now receive a spring booster of the Covid-19 vaccine. The CDC’s Advisory Committee on Immunization Practices approved the measure last week.
• The number of measles cases associated with a school in Broward County, Florida has grown to 10. The outbreak has drawn national attention for the decision by the state’s Surgeon General to depart from usual measures to control measles, including explicitly recommending that unvaccinated people receive the MMR vaccine and including unvaccinated children from school until the outbreak ends. At least one case is too young to be vaccinated.
  • CDC’s Advisory Committee on Immunization Practices (ACIP) recommended that adults 65 and older receive a spring Covid-19 booster. Recipients should wait at least 4 months between doses. 
• A total of 468 cases of lead poisoning linked to contaminated applesauce pouches have been reported across 44 states. This is a shocking outbreak, and I’m surprised it’s not getting more attention. Lead poisoning can cause permanent neurological damage in young children.
• I am pausing the RSV section for summertime. I will still check on the data regularly, but I won’t write about the latest happenings unless there is something you need to know. Regular reporting will resume in the autumn.