Welcome to this week’s Northeastern regional 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 DiseasesInfluenzaFlu activity is still underway in the Northeast, as in the rest of the country. The region has not yet shown a clear, consistent sign of peak. New Jersey leads the region in outpatient influenza-like illness (ILI) at 4.8%, essentially flat from last week. Emergency department (ED) visits there rose to 2.3%, one of the larger week-over-week ED increases in the region. New Hampshire saw a meaningful jump in ILI, rising to 4.0% from 3.3% last week, making it the second most active state. ED visits there held roughly flat at 2.7%. Northeast: Outpatient influenza-like illness (%)
% of visits to the doctor that are for fever and cough or sore throat
 Massachusetts ticked up to 3.6% ILI and 1.7% for ED visits. New York also climbed modestly, with ILI at 3.2% and ED visits at 1.0%. Hospitalization rates in New York held flat at 1.7 per 100,000. Vermont is showing some improvement, with ILI falling to 3.1% and ED visits declining to 3.7%, though ED visits there remain the highest in the region. Maine also eased slightly on both ILI and ED visits. Rhode Island saw ILI drop notably, from 3.2% to 2.4%, though ED visits paradoxically rose from 0.9% to 1.5%, a divergence worth watching. Pennsylvania continued to climb on both measures, with ILI up to 2.3% and ED visits to 2.1%. Connecticut does not have ILI data this week. ED visits rose to 1.9% and hospitalization rates ticked up to 1.6 per 100,000, up from 1.3 last week. Northeast: ED visits for influenza (%)
% of visits to the emergency department that are for influenza
 COVID-19Covid-19 activity in the Northeast is fine but not great. ED visits are low and broadly flat/slowly declining, but wastewater signals are still a bit all over the place, making it hard to assess trends. I’m including wastewater here as I know many readers rely on it, but I encourage you to put more weight on the ED numbers and trends. New Hampshire is seeing clear improvement, with ED visits falling to 1.0% and wastewater declining significantly. Maine also improved on both ED visits, which dropped from 1.2% to 0.7%, and wastewater. Massachusetts eased on both measures as well. Northeast: Covid-19 wastewater concentration
Wastewater concentration of SARS-CoV-2
 Vermont saw ED visits rise to 0.8% and wastewater tick up. New Jersey saw modest increases in both ED visits and wastewater. Pennsylvania ED visits edged up slightly despite declining wastewater. Rhode Island saw ED visits fall but wastewater rose sharply. Most notably, New York saw wastewater rise considerably this week, even as ED visits held essentially flat at 0.5%. Hospitalization rates there eased slightly to 2.9 per 100,000, the highest in the region among states with available data. Connecticut ED visits declined slightly to 0.8% but wastewater was essentially flat and hospitalizations held at 2.5 per 100,000. Northeast: ED visits for Covid-19 (%)
% of visits to the emergency department that are for Covid-19
 RSVRSV activity is rising across much of the Northeast, with ED visits up in most states and wastewater signals elevated in several. Vermont and New Hampshire lead the region in ED visits at 1.1% and 1.0% respectively, both up from last week. Massachusetts rose to 0.9% for ED visits. Connecticut, Rhode Island, and New Jersey are all around 0.6%, with Connecticut hospitalizations declining slightly to 3.5 per 100,000. New York ED visits held essentially flat but hospitalizations rose to 3.2 per 100,000, up from 2.6 last week. Pennsylvania and Maine are at the lower end of the region for ED visits. Northeast: ED visits for RSV (%)
% of visits to the emergency department that are for RSV
 NorovirusNorovirus activity is still rising in the Northeast, with test positivity nearing 16%. This is typically peak or just past peak season, so I’m hoping we’ll see improvements soon. Norovirus weekly percent positive tests (%)
Data reported to NREVSS
 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:
In other news
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THE WORLD READS WHITE PLAINS CITIZENETREPORTER — 8,324,077 VISITS IN ONE YEAR
2,905,611 VISITORS VISIT 8,324,077 TIMES 3 TIMES EVERY DAY IN ONE YEAR. HIGHEST ACTIVITY IN WPCNR HISTORY.White PlainsCitizeNetReporter lifted its worldwide visits from unique visitors to wpcnr.com to 8,324,077,a 1,306,419 increase in visits in one year from 7,017,658 visits to the site last year which covers White Plains and Westchester County. The 8,324,077 visits were made by 2,005,611 unique visitors who visited wpcnr an average of 3 visits a day. ON JULY 20- -2026 visitors have accessed wpcnr and made 3,072 visits an average of 1.6 visits. In the last week 33,495 individual vistors made 54,458 visits, averaging 1.6 visits. In the last month, 152,940 visitors recorded 229,338 visits (1.5 visits)
