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Respiratory Diseases

Influenza

I am happy to report that the Northeast saw substantial improvement in influenza activity this week. Every state in the region saw declines in emergency department visits, many of them quite steep.

New Hampshire reported the highest ED visits at 6.2%, down from 8.4% the week prior. Massachusetts and New Jersey followed at ED visits of 5.3% and 5.1% respectively, both down sharply from the prior week (8.7% and 8.4%). None of these states reported outpatient ILI this week.

New York saw a dramatic drop in outpatient ILI, falling from 10.9% to 6.6%, the highest in the region. Interestingly, ED visits there are now among the lowest at 3.2% (down a lot from 6.5%). New York City also reported hefty declines in ED visits, now at 2.5%. This aligns with were the city was around Thanksgiving time.

Connecticut and Rhode Island both improved too, with ED visits falling to 4.4% and 4.1% respectively. Connecticut dropped from 8.5%, one of the steepest declines in the region. Neither state reports outpatient ILI.

Pennsylvania and Maine both came in at 4.1% for ED visits, each down from the prior week. Both states also report outpatient ILI: Pennsylvania at 4.0% (down from 5.1%) and Maine at 4.9% (down from 7.6%).

Northeast: ED visits for influenza (%)

% of visits to the emergency department that are for influenza

Vermont had the lowest ED visits in the region at 3.3%, down from 6.4%. No outpatient ILI data is available.

The Center for Forecasting and Outbreak Analytics is also estimating robust declines in all states in the region. I think we may be past peak!

COVID-19

Covid-19 activity is moderate, but trends are mixed, depending on which metric you look at. ED visits for Covid-19 are declining, but wastewater tells a more complicated story.

Maine had the highest ED visits in the region at 1.3%, down from 1.8%. However, wastewater there to very high levels. Pennsylvania is in a similar spot, with ED visits at 1.2% (down from 1.4%) but wastewater rising into the very high category.

New Hampshire reported 1.2% ED visits (down from 1.5%) with high wastewater that increased slightly. Massachusetts, Vermont, and Connecticut all have high wastewater levels, though all three saw concentrations decline this week. ED visits in those states ranged from 1.0% to 1.1%, all improving.

Northeast: Covid-19 wastewater concentration

Wastewater concentration of SARS-CoV-2

Rhode Island saw a sharp drop in wastewater, now at low levels, with ED visits holding steady at 1.2%.

New Jersey and New York are in the best shape in the region. New Jersey has low wastewater (flat at 3.0) and ED visits at 0.7%. New York saw wastewater plummet from to very low levels, with ED visits at 0.6%. In New York City, ED visits held flat at a comfortably low 0.3%.

The divergence between declining ED visits and rising wastewater in Maine and Pennsylvania suggests that some states in the region are in a plateau, but the overall picture in the Northeast is one of moderate activity and improvement.

Northeast: ED visits for Covid-19 (%)

% of visits to the emergency department that are for Covid-19

RSV

RSV continued to decline across the Northeast, with every state below 0.6% of ED visits. New Jersey was highest at 0.5%, down from 0.7%. Rhode Island saw a notable drop from 0.7% to 0.4%. Hospitalization data is limited, but New York saw a slight increase while Connecticut declined.

Northeast: ED visits for RSV (%)

% of visits to the emergency department that are for RSV

Stomach Bugs

Norovirus is moderate in the Northeast, with test positivity around 9.4%. This is higher than the summertime lows of below 5%, but well below the 20%+ peaks we sometimes see. Noro season lasts into springtime, so I expect activity to remain elevated in the weeks ahead.

Food recalls

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

New:

• Super Greens supplement powder (more info)
• Spring & Mulberry chocolate bars (more info)
• Pecorino cheese from various brands, including Boar’s Head and Members Mark (more info)
• Sea Moss Gel Superfood (more info)

Previously Reported:

• Klong Kone Shrimp Paste, sold exclusively at Golden Land in Des Moines, Iowa and Terri Lee Oriental Groceries in Maywood, New Jersey (more info)

• Primavera Nuevo tamales, various flavors (more info)
• There is a big recall of hundreds of products — from Airhead candies to meat to Splenda packets — that passed through a single distributor and were sold to over 50 stores, primarily in Minnesota and Indiana. I strongly urge you to check out the list of stores (here) and if you’ve shopped at one of them recently, check out the much longer list of items that are being recalled (here)
• ByHeart Infant Formula due to potential botulism contamination (more info)

In other news

• Norovirus in Connecticut. Webster Hill Elementary School in West Hartford, Connecticut closed on January 16 due to a norovirus outbreak affecting a significant number of students. Norovirus spreads quickly and remain on surfaces for extended periods, with symptoms including vomiting, diarrhea, nausea, and stomach cramps. Patients continuing to shed the virus even after symptoms resolve.