What an election week! The Democratic sweep of the U.S. Congress will likely affect health care in the Northeast, but we are also following nationwide changes.

The new Democratic majority in both the House and Senate means there is strong potential to revisit Medicaid cuts and work requirements, ACA credits, and who leads agencies that set health policies.

If you haven’t checked out our midterm issue from last week, read it here. We will continue to keep you updated every step of the way. Today we’ll focus on measles in New York State, a SNAP benefit expansion in New York City, and mosquitoes and ticks, which are still unfortunately here in Connecticut.

Disease “weather” report

The respiratory season “big three”

1. The flu continues to increase in activity, surpassing Covid levels. Test positivity in the Northeast is around 4%, which is lower than the national percentage (about 7%) but will continue to increase as we get into the winter.

2. Covid test positivity has dropped below flu in HHS Regions 1 and 2. Wastewater levels for the Northeast region are also low and decreasing.

3. RSV is low (<1% of tests coming back positive), but is starting to stir.

Respiratory grab bag: Rhinovirus and parainfluenza

We talk a lot about the “big three” respiratory viruses above because they usually cause more severe disease (including hospitalization and death) AND they’re the ones we can do something about (vaccines and medications). But many viruses circulate this time of year and can cause you to feel crummy. Two to look out for:

• Rhinovirus, aka the common cold, has the highest test positivity of any respiratory virus tracked by the CDC’s NREVSS system in most weeks of the year. Right now, it’s at 22% in HHS Region 1 and 28% in HHS Region 2.
• Parainfluenza viruses can cause upper and lower respiratory tract infections, ranging from mild colds to severe conditions like croup and pneumonia. Right now, test positivity is around the same level as flu, but there’s been a noticeable uptick since the end of September, especially in HHS Region 2.

El Niño winter is coming

We couldn’t pass up the chance to make this Game of Thrones reference, but it’s also true. Temperatures have started to drop in our area, which signals that winter is quickly approaching. You may have heard that we are entering into an El Niño season.

For the Northeast, that typically means a milder-than-average winter with more precipitation, especially near the coast. Because more of that precipitation may fall as rain or heavy, wet snow instead of light powder, things could get messier: slushy roads, overnight ice freezes, and more chances for local flooding.

State and local updates

New York City expands SNAP program with more money for fresh produce

Starting in January, SNAP shoppers in NYC can get up to $14 a day in free produce coupons at farmers markets and farm stands, up from $10. Mayor Mamdani announced the increase on October 29.

The program is called Health Bucks. For every $2 you spend with SNAP on your EBT card at a participating market or farm stand, you get a $2 Health Bucks coupon to spend on fresh fruits and vegetables. Under the new cap, spending $14 in SNAP earns $14 in coupons, so you get $28 of produce for $14.

The money comes from city funds plus $5.7 million in new federal nutrition-incentive grants (the Gus Schumacher Nutrition Incentive Program, or GusNIP). The city estimates about $2.3 million will reach SNAP shoppers in 2027.

How to tell if you have SNAP: Nearly one in five New Yorkers who are eligible for SNAP are not enrolled, so please check on your neighbors and community members. You have SNAP if:

• You have an EBT card.
• SNAP benefits are loaded each month onto an Electronic Benefit Transfer card, which works like a debit card at grocery stores and at farmers markets that accept EBT.
• You get notices from HRA, the city’s Human Resources Administration, which runs SNAP in NYC.
• They come by mail and in the “E-notices” section of your ACCESS HRA account.

If you’re not sure whether you have SNAP, log into ACCESS HRA to see your case status, or call HRA at 718-SNAP-NOW (718-762-7669).

If you are eligible, there are a few ways you can apply:

• Online. Apply through ACCESS HRA on the website or the mobile app. You can also upload documents and report changes there.
• In person. Go to an HRA SNAP Center.
• Through community groups. Look for organizations like Hunger Free America or Hunger Solutions NY, which can help with the application.

New York State reports its first measles death in 30 years

On Monday, the New York Department of Health and Lewis County announced that a child died after getting sick with measles. This is a heartbreaking outcome that shows how serious a measles infection can become.

We know that this child was seven months old, younger than the routine vaccination age. This death also offers some additional information:

Measles cases are likely undercounted. New York has reported 218 measles cases (210 in the state, eight in NYC), with the majority of cases in the central and western parts of the state. Typically we see about one to three deaths for every 1,000 measles cases.

• With 218 cases, we do not expect to see a death.
• One death suggests the actual case count is probably between 330 to 1000 cases.
• Pennsylvania is closer to what we would expect—about five reported deaths (with a sixth under investigation) among 1,433 cases.

Measles cases can escape official reporting.

One person going to seek care can lead to the discovery of a whole household of sick people. New York has requested help with investigating and controlling the outbreak from CDC “disease detectives” for the next few weeks.

People who can’t be vaccinated are at risk.

This infant  (WHO DIED IN NEW YORK STATE THIS WEEK ) was too young for the routine MMR dose (usually done at 12 to 15 months).

Infants 6 to 11 months old can safely get an early dose if they live near an outbreak. But that isn’t always widely known, as most of us have never experienced a measles outbreak.

Babies depend on those around them being immune, and they’re the most likely to have serious complications.

Measles spreads fast.

In a group with no immunity, one person can infect 12 to 18 others. As vaccine distrust grows and vaccination rates fall, the protection for those not able to get vaccinated becomes thin.

It’s been reported that this child was Amish, and Plain communities are bearing the brunt of this outbreak.

(Look for our coverage of this topic on Friday(today)  on YLE National.)

But we can’t write measles off as “their problem” since falling vaccination rates all over leave babies and medically vulnerable people at risk wherever measles spreads.

Ticks and mosquitos resurrect in Connecticut

While I intellectually recognize that mosquitoes and ticks play important roles in our ecosystem, as someone they love to bite, I am not a fan. Beyond itchy welts, both spread disease.

Connecticut recently announced that mosquitoes trapped in Colchester on October 14 tested positive for the eastern equine encephalitis (EEE) virus, the state’s first detection this year. EEE is rare but serious: about one-third of people with severe illness die, and survivors may experience lasting neurological damage.

Late to the party? Yes. But apparently, these little vampires aren’t checking the calendar.

Blacklegged ticks (Ixodes scapularis) spread several diseases, including Lyme disease, Connecticut’s most commonly reported tickborne illness. Mosquitoes transmit West Nile virus, our most common mosquito-borne virus.

But I wore a coat on Halloween—surely they’re gone for the season!

Not so fast. Blacklegged ticks can seek their next meal whenever temperatures rise above freezing, even in winter. Summer’s poppy-seed-sized nymphs are now adults, creating a fall surge—an uptick, if you will. Connecticut saw nearly 40% more ticks submitted for testing from January through July.

Mosquitoes generally stop feeding below 50°F, but warmer days can bring activity. Some overwinter as adults; others leave behind cold-resistant eggs. Bite prevention remains important until a hard freeze.

And climate change is expanding their ranges, extending active seasons, and increasing populations. Wonderful. More uninvited dinner guests, as apparently, nobody told these pests it’s time to leave.

Bottom line

Whether it’s viruses, weather, bugs, or Congress, there’s so much going on at once, and it doesn’t always happen how and when we expect. The best defense against illness usually lies in proactively preparing and watching over the people around us, especially the folks most at risk. We’ll keep tracking what’s changing so you can focus on what to do about it.

Love, YLE Northeast

Julia Tellerman, MPH, is an epidemiologist in Rochester, NY. Asuka Koda is a health journalist in New Haven, CT. Tamara Rissman, MPH, is an epidemiologist and professor in New Haven, CT.