Welcome to the Northeastern edition of Outbreak Outlook! It is only available to paid subscribers. If you wish to become a paid subscriber and access region-specific information, please click the Subscribe now button below. Thanks for reading! -Caitlin

Respiratory Diseases

ILI

Influenza-like illness is minimal across most of the Northeast. The bottom line is that very little influenza is circulating, but if you want the details:

Connecticut and New Jersey report outpatient activity at a “low” level, but wastewater concentration remains minimal in these states, so not much is happening.

Similarly, Pennsylvania and Massachusetts have low wastewater concentration but show minimal outpatient illness.

Rhode Island has moderate levels of wastewater concentration but minimal outpatient visits.

Activity in New York City is minimal.

P.S. New to the regional editions? This information will get more detailed when activity picks up later in the season.

COVID-19

Things are quiet with Covid-19. Covid-19 wastewater activity is minimal across the region. That increase I reported last week appears to have been a blip; rates are now lower than they were before that transient increase. Severe illness is low and declining, with minimal visits to the emergency department for Covid-19.

Source: CDC

Only one state in the region is reporting high wastewater activity: New Hampshire (limited coverage), but it appears to be declining there. In addition, wastewater activity has declined from high to moderate in Maine and Vermont.

These states have similarly seen a drop-off in ED visits over the past month. In Maine, ED visits declined substantially this past week to 0.9%, down from 2.6% of all ED visits a month ago. And in Vermont, rates have fallen from 3% a month ago to 1% this past week.

Source: CDC

Wastewater activity is low in Pennsylvania (limited coverage), and minimal in Rhode Island and New Jersey.

The exceptions to these improving trends are Connecticut and Massachusetts where wastewater activity is moderate and increasing. However, in both of these states, ED visits declined (in the case of Massachusetts) or held steady (Connecticut) at minimal levels this past week, and hospitalizations decreased in Connecticut. (Massachusetts did not report Covid-19 hospitalizations).

Last week I reported that it looked like there might be a notable increase in wastewater activity in New York, but that there were lags in reporting, so this increase was based on data from <5% of the state’s population. The data caught up and fortunately that increase was just sampling error: activity remains minimal for the state. Further supporting that rates are low, ED visits in the state were minimal (0.5% all ED visits were for Covid-19) and hospitalizations decreased (to 4.0 per 100,000).

In New York City, the number of Covid-19 hospitalizations has declined steadily, now averaging less than 20 city-wide. Still, the City reports an average of one death per day.

RSV

As noted last week, test positivity is increasing, but continues to be very low. One curious data point is that wastewater concentration in Connecticut is coming in as “very high,” but again test positivity in the state is very low so I am not too concerned right now.

Other Bugs

Common causes of cold- and flu-like symptoms are picking up steam. Parainfluenza has increased rapidly the past few weeks, and is now at a moderately high level. Adenovirus activity has also increased moderately. Human coronaviruses have started increasing as well, but remain at low levels.

Stomach Bugs

No updates this week; there were reporting delays.

Food recalls

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

New:

• Waffles and pancakes – many flavors and styles – sold under a very large variety of brand names, including numerous store brands, including 365 Organic, Best Choice, Good & Gather, Harris Teeter, H-E-B, Nature’s Promise, Publix, Trader Joe’s and Wegmans.
  • Given the size of this recall, if you have any variety of frozen/toaster waffles, Belgian waffles or pancakes in your freezer that you bought in the US or Canada, check this list. (more info)
• Prepackaged Chicken Street Taco Meal Kit produced by Sprouts Farmers Market (more info)
• Ready to eat meals and store-made deli items including chicken from a variety of grocery chains, including Albertsons, Safeway, Star Market, and others. (more info)
• Green onions sold under Church Brothers, Trader Joe’s and Imperial Fresh brand names (more info)
• Prepackaged sandwiches – Pepperjack Cheeseburger, Bacon Cheeseburger and The Gambler sold under the Dakota Tom’s brand name (more info)

Previously reported:

• Large variety of ready-to-eat meat and poultry products under different brand names, including Rao’s chicken alfredo and Michael Angelo’s grilled chicken piccata with penne pasta (more info)
• Enoki Mushrooms (more info)
• Bistro28 and Don Pancho Meal Kits containing chicken (more info)
• Happy Moose Tropical Roots and Strawberry Fields juice (more info)
• L&B Lone Star Dip (more info)
• Eggs under labels “Milo’s Poultry Farms” and “Tony’s Fresh Market” (more info)
• Don’t forget to throw out Boar’s Head deli meats (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

• Whooping cough cases in New Jersey have surged, reaching 423 confirmed cases by mid-October 2024, more than double last year’s count. This uptick coincides with a relatively mild start to flu and COVID season, unlike the intense start seen in 2022. Nationally, whooping cough cases also rose significantly, with nearby states like Pennsylvania seeing particularly sharp increases. New Jersey health officials urge vaccinations to curb the spread, especially in schools where outbreaks have occurred.