Influenza-like illness

Last week I described flu in the Northeast as drifting up. That’s no longer the right word. Hospital admissions for influenza rose 75% in a single week, from 1.5 to 2.7 per 100,000, now above the national rate. ED visits nearly doubled, from 0.6% to 1.1%, and flu test positivity rose from 4.5% to 8.0%.

Outpatient influenza-like illness increased as well, notably in New Jersey and New York. Because ED visits and test positivity jumped along with admissions, this looks like a real trend rather than a reporting change.

COVID-19

Covid-19 hospital admissions rose from 1.4 to 1.6 per 100,000, the highest since March and a bit above this time last year. ED visits are flat at 0.4%, and wastewater levels remain moderate. CDC estimates that Covid-19 activity isn’t changing in most Northeastern states, so this may be just more of the medium-level of activity we typically see between the summer and winter waves.

RSV and other respiratory pathogens

RSV activity is starting to rise among young children. Their hospital admission rate rose from 2.0 to 3.1 per 100,000, about where it was this time last year, though ED visits for RSV are still basically zero. Looking ahead, CDC estimates that RSV activity is growing in all 7 Northeastern states with estimates. Tis the season, unfortunately.

In Other News

• New York has reported the state’s first measles-associated death in more than 30 years, a child in Lewis County. The state has counted 210 measles cases outside New York City this year through October 31, including 32 new cases in the latest week.
• Pennsylvania has confirmed its sixth measles-associated death this year, an unvaccinated resident of Jefferson County and the county’s second. The state has reported 1,467 cases so far this year. A separate death attributed to measles by the Franklin County coroner remains unconfirmed by the state.

State by State

Connecticut

Flu: Picking up quickly after last week’s dip, which looks like it was a reporting blip and not a real change.

Flu test positivity more than doubled, from 2.8% to 6.4%, and ED visits doubled, from 0.5% to 1.0%. Outpatient influenza-like illness ticked up to 1.8%. Hospital admissions nearly doubled, from 0.8 to 1.5 per 100,000.

Covid-19: Elevated. Wastewater concentration remains high, and hospital admissions are about flat at 1.6 per 100,000. ED visits ticked up to 0.5%.

RSV: Very low.

Maine

Flu: Picking up. Flu test positivity nearly doubled, from 4.9% to 9.0%, and ED visits rose from 0.6% to 1.0%. Outpatient influenza-like illness rose from 1.0% to 1.4%. Hospital admissions rose, though the numbers are small.

Covid-19: Low. Wastewater concentration fell from high to moderate, ED visits ticked up to 0.4%, and hospital admissions are low.

RSV: Very low.

Massachusetts

Flu: Picking up quickly. Flu test positivity roughly doubled, from 4.7% to 9.9%, and ED visits doubled, from 0.6% to 1.2%. Outpatient influenza-like illness rose from 2.0% to 2.3%, and wastewater concentration rose from moderate to high. Hospital admissions increased from 0.8 to 1.2 per 100,000.

Positive flu lab tests doubled in a week, according to the state health department. Nearly all of the subtyped viruses are H1N1, which matches what is being reported in other parts of the country.

Activity is highest in the Southeast region, at moderate, while most of the state is still minimal. Statewide, outpatient flu-like illness is still below the baseline that marks the start of flu season. Seven flu deaths have been reported so far this season, all in adults. Flu-like illness made up 2.3% of visits in the state’s emergency department data, the highest for this week in at least eight seasons (the previous high was 2.1% in 2022–23).

Covid-19: Rising. Wastewater concentration rose from high to very high, and hospital admissions increased from 0.8 to 1.2 per 100,000. ED visits ticked up to 0.5%.

RSV: Low but picking up. Hospital admissions rose from 0.2 to 0.4 per 100,000, nearly all young children.

New Hampshire

Flu: Rising. ED visits nearly doubled, from 0.7% to 1.3%, and outpatient influenza-like illness rose from 1.3% to 1.9%. Hospital admissions rose from 1.4 to 1.9 per 100,000, mostly among adults 75 and older. No lab data.

Covid-19: Mixed. Wastewater concentration fell from moderate to low, while ED visits rose to 0.5% and hospital admissions ticked up to 1.4 per 100,000.

RSV: Very low.

New Jersey

Flu: Still rising quickly. Outpatient influenza-like illness increased from 3.5% to 4.1%, the highest in the Northeast, and flu test positivity roughly doubled, from 6.1% to 12.5%. ED visits nearly doubled, from 0.9% to 1.7%, also the region’s highest. Hospital admissions rose from 1.7 to 2.8 per 100,000.

Covid-19: Ticking up. Hospital admissions rose from 1.5 to 1.8 per 100,000. Wastewater concentration is moderate, and ED visits are flat at 0.5%.

RSV: Low but ticking up. Hospital admissions rose from 0.3 to 0.5 per 100,000, mostly young children, and RSV accounts for 0.1% of ED visits.

New York

Flu: Taking off.

Flu test positivity rose from 3.8% to 6.5%, and ED visits nearly doubled, from 0.6% to 1.1%. Outpatient influenza-like illness rose from 2.2% to 2.8%. Hospital admissions nearly doubled, from 1.4 to 2.6 per 100,000.

Flu ED visits nearly doubled in New York City in the week ending October 31, from 0.7% to 1.3%, according to the city health department. It’s the tenth straight weekly rise and about six times the level at this point last year (0.2%). Children have the highest rates, at 3.1% of ED visits among both children under 5 and ages 5 to 17. Visits among adults 65 and older doubled to 1.0%. The Bronx (1.5%) and Queens (1.4%) are highest; Staten Island is lowest (0.6%).

Covid-19: Ticking up. Hospital admissions rose from 1.4 to 1.6 per 100,000, and ED visits ticked up to 0.4%. Wastewater concentration is very low, though as I noted last week, that reading looks out of step with New York’s neighbors.

RSV: Very low.

Pennsylvania

Flu: Rising quickly. ED visits doubled, from 0.5% to 1.0%, and flu test positivity rose from 4.2% to 7.3%. Outpatient influenza-like illness rose to 1.9%. Hospital admissions jumped from 2.5 to 4.4 per 100,000, the third highest in the country. Pennsylvania reports high flu admissions year-round, but this jump matches the rise in the other indicators so it’s credible, in my opinion.

Covid-19: Steady. Wastewater concentration rose from low to moderate, and ED visits ticked up to 0.3%. Hospital admissions are flat at 1.7 per 100,000.

RSV: Very low.

Rhode Island

Flu: Low. ED visits ticked up to 0.7%, and outpatient influenza-like illness rose from 1.3% to 1.9%. Hospital admissions fell after last week’s jump, but Rhode Island’s small numbers can swing from week to week. No lab data.

Covid-19: Mixed. Wastewater concentration fell from high to low in a single week, but hospital admissions rose from 1.6 to 2.0 per 100,000, the highest in the Northeast. ED visits are flat at 0.5%.

RSV: Very low.

Vermont

Flu: Low and steady. ED visits are flat at 0.5%, the lowest in the Northeast, and outpatient influenza-like illness is flat at 1.3%. Flu test positivity rose from 3.0% to 4.6%. Hospital admissions are low.

Vermont has reported 10 respiratory illness outbreaks this season, four of them in the week ending October 31. Seven in ten have been in long-term care facilities; the rest were in correctional facilities and child care.

Covid-19: Low. Wastewater concentration is low, and ED visits are flat at 0.3%. Hospital admissions rose, though the numbers are small.

RSV: Very low.

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