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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 Diseases
ILI
Flu activity is up, up, up. Activity is widespread across the region, with no signs of slowing yet.
Massachusetts leads the Northeast region with outpatient ILI at 10.5% and ED visits at 8.6%, up from 7.7% last week. New Hampshire is also up there, with outpatient ILI at 10.4% with ED visits at 8.9%, up from 7.3% last week, and very high wastewater levels. New Jersey shows outpatient ILI at 10.3% with ED visits at 9.5%, maintaining high wastewater concentrations.
Rhode Island reports outpatient ILI at 7.1% with ED visits at 5.3%, and high wastewater levels. Connecticut has outpatient ILI at 6.5% with ED visits at 8.4%, up from 7.5% last week, maintaining very high wastewater concentrations.
New York reports outpatient ILI at 6.1% with ED visits at 5.9%, showing high wastewater levels. However, New York City has super high outpatient ILI at nearly 13%.
The remaining Northeast states have varying activity levels. Maine reports outpatient ILI at 5.8% though ED visits are lower at 3.9%, showing high wastewater levels. Pennsylvania shows the region’s lowest outpatient ILI at 4.5% with ED visits at 7.0%, maintaining high wastewater concentrations. Vermont, while not reporting outpatient ILI, shows ED visits at 7.1% and very high wastewater levels.
COVID-19
Unfortunately, Covid-19 also appears to be worsening in the Northeast. Wastewater activity is high and has spiked in the past week, nearly doubling. Concentration is back up to where it was at the beginning of January. The Northeast has now surpassed the Midwest as the region with the highest activity.
However, severe illness is stable or declining in most states in the region. I’ll be watching to see if that changes, since wastewater is typically a leading indicator.
At the state level, wastewater activity is high or very high across the region, with the sole exception of Pennsylvania, where activity is moderate.
Activity is very high in Connecticut, having nearly rebounded to the peak it reached at the beginning of this year. Similarly, activity is high and increasing in Vermont and New Jersey.
However, despite the high levels of activity, things appear to be improving in several states. Activity dropped from very high to high levels in Maine, Massachusetts, Rhode Island. And in New Hampshire, following a very large spike at the beginning of January, activity has decreased in the past few weeks more than 5-fold.
Demonstrating just how high activity was, even with this dramatic decline, it is still at high levels, though activity remained stable this past week. Unfortunately, there was only limited data coverage of New York for this week, so it is hard to get a sense of what is going on there.
ED visits are low (<1.5%) across the Northeast. ED visits are stable in New York, Pennsylvania, New Jersey, Connecticut. ED visits have come down substantially in the past month in Maine, Vermont, Rhode Island, New Hampshire, and Massachusetts, and they continued that downward trend this week as well.
Hospitalizations in most states are moderately elevated levels – between 3-6 hospitalizations per 100,000. In Connecticut, hospitalizations are increasing, and in Vermont, Rhode Island, New York, and New Jersey, rates are holding steady. Hospitalizations are coming down in New Hampshire (3.4), Massachusetts (5.0), and Maine (3.3). The outlier is Pennsylvania – where hospitalizations are at a high 11.6 and increasing.
RSV
RSV activity is generally low across the region, with all states reporting less than 1% of visits to the emergency department for RSV.
New Hampshire and Vermont are outliers with comparatively high activity and stable or rising indicators. I assume this is a temporary blip, both because the rest of the states in the region look find and because we are moving out of the season. I will keep an eye on it.
Stomach Bugs
The worst may be over, but norovirus isn’t going away anytime soon. Norovirus data are often quite jagged (rising and falling), but it looks like we may be on the other side of the peak. Nevertheless, rates remain very high: test positivity is 14.5%.
Norovirus rates tend to remain elevated for several months in the winter. As such, even if the peak is in fact behind us, I don’t expect rates to return to low levels any time soon.
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Source: CDC
Other Bugs
- Human coronaviruses (a common cause of colds) are peaking for a second time this winter. They had peaked at the beginning of January, and now are back up again to the same level.
- Human metapneumovirus is low, but seems to be ticking up.
- Other causes of cold- and flu-like symptoms, like adenovirus and rhinovirus/enterovirus, are fairy low right now.
Food recalls
The following foods are being recalled because they are contaminated. Please check your cupboards and throw out any of these items:
New:
- Alfalfa sprouts sold under the Jack and the Green Sprouts brand name (more info)
- Aleppo Tahini Sesame Paste (more info)
- DJ’s Boudain sausage links (more info)
Previously reported:
- Blue Ridge Beef Natural Mix [for dogs] (more info). While not for human consumption, humans may be infected with Salmonella if they do not adequately wash their hands or contaminated surfaces after handling the product.
- Wegman’s fully cooked breaded chicken nuggets (more info)
- Casa Mamita frozen chicken and cheese taquitos (more info)
- If you have food allergies, you may wish to review these FDA safety alerts and USDA alerts for foods with undeclared allergens.
In other news
- Live bird markets in New York City, Long Island, and Westchester County will close for a week following the detection of avian flu in seven poultry flocks at markets in Brooklyn, the Bronx, and Queens. The cases were identified during routine inspections, and all infected birds will be culled. The closure order requires markets to sell remaining inventory, undergo deep cleaning and disinfection, and stay closed for five days post-cleaning. Meanwhile, bird flu infections among animals, including dairy cows, poultry, wild birds, and pet cats, have been rising, with millions of birds affected in recent months.
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