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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 DiseasesInfluenzaThe Northeast is the last region in the country to transition to low levels of influenza-like illness (ILI) activity. Many states in the region are still reporting moderate and high levels of ILI. However, I do think that relief is coming soon, as all indicators look good. Influenza Emergency Department Visits (%)
% of visits to the ED that are for influenza
 At the state level, New Jersey leads the Northeast in flu activity with outpatient ILI at 4.7% (down from 5.4%). The proportion of ED visits that are for influenza is 2.1%, a moderate decrease of 0.6% from the previous week. For reference, I’d like to see the ED metric get to below 1%. New York state also reports outpatient ILI at 4.7% (down from 5.2%) with lower ED visits at 1.8%. In New York City, outpatient ILI is 6%, which is an improvement from previous weeks but is still quite high. A huge proportion (73%) of specimens in NYC is flu B, which is quite anomalous compared to the national picture. Northeast: Outpatient influenza-like illness
% of visits to the doctor that are for fever and either cough or sore throat
 Maine is also still working to turn the corner, with outpatient ILI at 4.0% (down from 4.5%), and the highest ED visit percentage in the region at 3.0%. However, this is a substantial decrease of 1.2% from the previous week. Connecticut reports outpatient ILI at 3.2% (down from 3.6%) with ED visits at 2.8%. Massachusetts shows similar outpatient ILI at 3.1% (down from 4.0%) but with lower ED visits at 1.7%. New Hampshire reports outpatient ILI at 3.0% (down from 4.1%) with ED visits at 3.0%, nearly matching Maine for the highest ED visit percentage. Rhode Island shows outpatient ILI at 2.7% (down from 3.1%) with the region’s lowest ED visits at 1.1%. Pennsylvania reports the lowest activity in the region with outpatient ILI at 1.9% (down from 2.3%) and ED visits at 1.7%. Vermont has no reported outpatient ILI data. ED visits for influenza there is 2.6%. Northeast: ED visits for influenza (%)
% of visits to the emergency department that are for influenza
 COVID-19Things are quiet—with a few exceptions. Wastewater activity remains low at the regional level. Severe illness is low and decreasing in most places. In most of the region, wastewater activity is low or very low. Activity is low and declining in New Hampshire and Massachusetts, and is very low in New York and Maine. Despite slight increases this past week, activity remains low in Vermont and Rhode Island. In contrast, in New Jersey, wastewater activity is high and increasing. In Connecticut, activity is also high but is on the decline. (Incomplete data for Pennsylvania). Northeast: Covid-19 wastewater
Wastewater concentration of SARS-CoV-2concentration
 Trips to the emergency department were minimal (<1.5%) and held steady or declined in most states in the region. ED visits did increase in New Hampshire but only to 0.5%, which is far, far lower than where they were in January (3.0%). Hospitalizations remain low-to-moderate across most of the region. Even Pennsylvania, which for so long has had particularly high rates, has dropped down to 4.6 hospitalizations per 100,000 people. Most states reported stable or decreasing rates, but two (Vermont (2.2) and Rhode Island (2.6)) reported increases. I’ll be watching to see if these increases continue in the coming weeks, but for now the rates remain low. Northeast: ED visits for Covid-19 (%)
% of visits to the emergency department that are for Covid-19
 RSVRSV activity is very low in the Northeast and will likely continue to remain out of season until autumn. Northeast: ED visits for RSV (%)
% of visits to the emergency department that are for RSV
 Other BugsA bunch of those pesky bugs that cause cold- and flu-like symptoms are spreading widely or picking up steam right now.
Stomach BugsNorovirus dropped a bit this past week, down to 12.7% test positivity. This is still high, but marks the lowest rate in the Northeast since November. Norovirus tends to persist into the spring – and to jump around a bit – so I wouldn’t get too excited just yet. I expect several more weeks of elevated levels.
Source: CDC Food recallsThe following foods are being recalled because they are contaminated. Please check your cupboards and throw out any of these items: New:
Previously reported:
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