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Respiratory Diseases

Influenza

Flu remains low, but is increasing, particularly in New York.

In New York, influenza-like illness is at 2.3% of all outpatient visits, and emergency department visits have risen sharply to 1.2%, more than doubling from 0.5%. Hospitalizations for flu have increased as well, to 0.8 hospitalizations per 100,000 people, from 0.5.

In New York City, flu ED visits increased 142% last week, jumping from 0.6% of ED visits to 1.6% of ED visits. Hospitalizations show a similar spike, more than doubling to 0.7% of hospitalizations.

Northeast: Outpatient influenza-like illness (%)

% of visits to the doctor that are for fever and cough or sore throat

Pennsylvania reports 1.5% of outpatient visits for ILI, essentially unchanged from the week prior. ED visits climbed to 0.5% from 0.3%.

New Jersey and Connecticut are also showing clear increases: ED visits increased substantially over the past week, to 0.9% and 0.8%, respectively. Hospitalizations more than doubled in Connecticut, but remain low overall (at 0.5).

Several more states are showing slow and steady increases: ED visits are hovering around 0.4% in Massachusetts, Rhode Island, and New Hampshire.

Things are still really quiet in Maine, which had a stable outpatient ILI of 0.9%, and ED visits at a low 0.2%. Similarly, Vermont is in good shape, with ED visits down to 0.1%, from 0.4% a week ago.

Northeast: ED visits for influenza (%)

% of visits to the emergency department that are for influenza

Note: Data on outpatient ILI was not available for Vermont, New Hampshire, Connecticut, Rhode Island, Massachusetts, and New Jersey.

COVID-19

Things are still in pretty good shape across the Northeast, though Covid-19 is starting to pick up in a few places. Wastewater activity is low and increasing at the regional level. In Vermont, wastewater activity is high, with viral concentrations more than doubling in the past week, and ED visits rising from 0.5 to 0.8%.

Wastewater activity is low and increasing in Massachusetts, Pennsylvania, and Maine. ED visits have crept up as well in Massachusetts and Pennsylvania to 0.5% and 0.4%, respectively. In Maine, ED visits held steady at 0.3%.

Northeast: ED visits for Covid-19 (%)

% of visits to the emergency department that are for Covid-19

Wastewater activity is low but decreasing in New Hampshire; ED visits in the state also held roughly steady (at 0.5%). In the rest of the region (Connecticut, New York, Rhode Island, and New Jersey) wastewater activity is very low, and ED visits range from 0.2-0.4%, mostly stable or declining.

Severe illness (hospitalization) is improving in both Connecticut (at 1.6 per 100,000, down from 2.0) and New York (at 1.2, down from 1.4).

Northeast: Covid-19 wastewater concentration

Wastewater concentration of SARS-CoV-2

RSV

RSV remains very low across the region.

ED visits range from 0% in Maine to 0.2% in Rhode Island. In Rhode Island, New Jersey, and New Hampshire, ED visits increased this past week.

Massachusetts, New York, Pennsylvania, Connecticut, Vermont, and Maine report fairly stable and very low rates of ED visits (<0.1%). Nevertheless, hospitalizations are increasing in both New York and Connecticut (though they remain low at 0.3 and 0.2 per 100,000 people).

Northeast: ED visits for RSV (%)

% of visits to the emergency department that are for RSV

Other Bugs

Many other causes of cold- and flu-like illnesses are spreading widely right now. Sniffles abound.

• Adenovirus has increased rapidly in the past week, and is now higher than it has been in the past year.
• Parainfluenza is nearing its second peak of the year.
• Rhinoviruses/enteroviruses are still quite elevated, but are gently declining from their peak in September.
• Human coronaviruses are low, but increasing.

Stomach Bugs

Norovirus test positivity decreased slightly this past week, but is an overall increasing trend. Test positivity is currently at 12% nationally. The Northeast is doing quite well: norovirus held roughly stable at 6.4%.

Norovirus weekly percent positive tests (%)

Data reported to NREVSS

Food recalls

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

New:

• Grated Pecorino Romano cheese, sold under various labels, including Boar’s Head, Locatelli, Member’s Mark, Ambriola, and Pinna at major retailers, including Wegman’s (more info)
• Prairie Farms Gallon Fat Free Milk (more info)
• Dried Whole Smelts Salted (Korushka) (more info)

Previously Reported:

• Vampire Slayer Garlic Cheddar, sold by Face Rock Creamery exclusively at the Face Rock Flagship store in Oregon (more info)
• Organic Supergreens Powder Mix and Organic Moringa Leaf Powder sold under Food to Live label (more info)
• Organic Moringa Leaf Powder sold under Africa Imports label (more info)
• ByHeart Infant Formula recall reported last week has expanded to include more batches due to potential botulism contamination (more info).
• Peach salsa sold under the Snowfruit label (more info)
• First and Last tomato sauces, distributed in Connecticut and Massachusetts (more info)
• Oven Dried Fish distributed to customers of African Food on Wheels in the Bronx, NY only (more info)

In other news

• Suspected botulism cases following DIY injections. According to a note published in the CDC’s MMWR journal, over the summer, 3 individuals in the U.S. (in New York, Texas, and Wisconsin) experienced severe illness from suspected botulism, after self-injecting botulinum toxin purchased online (for cosmetic purposes).
• The New York State Department of Health and the NYC Health Department have issued a joint statement warning healthcare providers about these cases, and also stating that the number of affected people is 10. It is not clear if the discrepancy in totals is an accident or if additional cases have been identified by the Health Department. Botulinum toxin should only be purchased from a licensed seller, and injected by a licensed and trained medical professional.
• My Northeast subscribers received the Southern edition by accident last week. My mistake!