Welcome to the Northeast 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

ILI activity is up, up, up, with all states reporting increases in outpatient ILI visits. On the bright side, activity remains lower in the Northeast than in other regions of the country. (The plot below shows ED visits.) We are likely at or near peak season.

New Jersey leads the Northeast with 8.7% of outpatient visits due to ILI in the last week of the year, increasing from 6.7% the week prior. ED visits are elevated at 4.9%. Massachusetts follows with 5.2% outpatient visits, up from 3.5% the previous week. New Hampshire shows similar activity levels with 4.9% outpatient visits, nearly doubling from 2.5% the week prior.

New York reports 4.2% ILI visits (up from 3.7%) and maintains the region’s highest hospitalization rate at 4.5 per 100,000 population. Connecticut is coming in at 3.9% ILI visits (up from 3.3%) with a hospitalization rate of 3.3 per 100,000. Pennsylvania reports 3.6% ILI visits, increasing from 2.3% the previous week.

The northern New England states continue to show the region’s lowest activity levels. Maine reports 2.7% ILI visits (up from 1.5%), Rhode Island shows 2.5% ILI visits (up from 1.8%), and Vermont reports the region’s lowest activity at 1.4% ILI visits, though this represents an increase from 1.0% in week 51.

COVID-19

Covid-19 is also picking up once again. Wastewater activity is now moderate, having increased sharply over the past week, and severe illness has increased in most states in the region.

Wastewater activity is very high and increasing in New Hampshire (off the chart!), Maine, Rhode Island, and Pennsylvania.

It is high and increasing in Vermont and Connecticut. In Massachusetts, activity remains high, but decreased slightly this past week. It remains low in New Jersey and minimal in New York and remained stable in both states this past week.

This increased wastewater activity is translating to increases in severe illness. The rate of ED visits has increased substantially (>20%) this past week in nearly all Northeastern states. These increases have pushed the rates from minimal to low (1.5-2.9%) in about half the states in the region, roughly mirroring the states with spiking wastewater activity: Maine, New Hampshire, Massachusetts, and Connecticut.

Hospitalizations are also up, with most states reporting increases. The highest hospitalization rate in the region is in Pennsylvania, where the rate doubled this past week to 8.7. In Vermont, hospitalizations more than tripled in the past week, up to 4.8 hospitalizations per 100,000 population.

RSV

Mixed picture here, with some states showing elevated emergency department visits and others reporting relatively low levels. Still, these rates are really quite low compared to what other regions are seeing right now.

New Hampshire leads the Northeast with 1.8% RSV emergency department visits, followed by Massachusetts at 1.3% and New Jersey at 1.1%.

Pennsylvania is reporting 1.0% ED visits. New York reports a lower ED visit percentage of 0.7% but maintains the region’s highest hospitalization rate at 4.5 per 100,000 population. Connecticut follows with a hospitalization rate of 3.3 per 100,000.

The northern New England states are showing lower activity levels, with Vermont reporting 0.6% ED visits and Maine at 0.3%, though both states show slight increases from the previous week. Both of these are very low.

Other Bugs

• Human coronaviruses – a common cause of colds – appear to be close to reaching their typical winter peak.
• Other causes of cold- and flu-like symptoms are at lower levels. Human metapneumovirus remains low but has started to slowly increase (it tends to peak around mid-spring). Adenoviruses, parainfluenza, and rhinoviruses/enteroviruses are all on the decline.

Stomach Bugs

Norovirus is very high in the Northeast – 17.2% test positivity, which while a bit lower than its peak of 19.6% two weeks ago, remains substantially higher than at any other point in the past year. I hate noro! Keep washing your hands.

Food recalls

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

New:

• Wicklow Gold Cheddar Cheeses (more info)
• Blue Ridge Beef Kitten mix [for Cats] (more info). While not for human consumption, humans may be infected with Salmonella if they do not adequately wash their hands or contaminated surfaces after handling the product.
• Marketside Broccoli Florets (more info)

Previously reported:

• Connie’s Thin Crust Cheese Frozen Pizzas (more info)
• Daily Veggies Enoki Mushrooms (more info)
• Sprouts Markers Market Gyro Family Kit (more info)
• MadeGood Granola Bars (various flavors and varieties) (more info)
• Blue Ridge Beef log Puppy Mix [for Dogs]. While not for human consumption, humans may be infected by Salmonella if they do not adequately wash their hands or contaminated surfaces after handling the product. (more info)
• If you have food allergies, you may wish to review these FDA safety alerts and USDA alerts for foods with undeclared allergens.