Welcome to the Northeastern 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 season looks fine so far in the Northeast, with all states reporting low or minimal levels of activity.

New York City is one exception, with outpatient ILI at 4.3%. This is nearly unchanged from last week’s 4.4%. However, wastewater concentration looks fine, and NYC often has a baseline level of ILI than surrounding states.

New Jersey is also on the high side with 3.8% ILI visits (a slight decrease from 4.2% the previous week), alongside a modest uptick in wastewater signals—but still in the minimal category.

The rest of New York State shows lower activity than NYC, with ILI visits decreasing slightly from 2.2% to 1.9%, while maintaining low wastewater concentration.

Connecticut has seen a slight dip in clinical visits from 2.4% to 2.3% ILI.

A cluster of states including Massachusetts (holding steady at 1.8% ILI), Maine (up from 1.6% to 1.7%), and Rhode Island (1.4% both weeks) all have low levels of activity,

Similarly, Vermont and New Hampshire continue to report the region’s lowest clinical activity (both around 1.0% ILI).

Pennsylvania has seen a modest increase from 1.5% to 1.6% ILI visits, while maintaining minimal but steady wastewater signals.

COVID-19

Covid-19 is quiet: wastewater activity is minimal and stable, ED visits are minimal, and hospitalizations are fairly low and declining.

Source: CDC

Wastewater activity is minimal in New York, New Jersey, and Rhode Island. It is low in Vermont, Connecticut, Pennsylvania (limited data), and New Hampshire (limited data). However, activity is moderate in Massachusetts and high and in Maine, and both states reported increases this past week.

ED visits are minimal (<1.5%) and decreasing or stable across the region, ranging from 0.4% in New Jersey to 0.8% in Maine, Connecticut, and Vermont.

Hospitalizations are fairly low and declining in the two states in the region that are reporting: New York (3.2 hospitalizations per 100,000) and Connecticut (2.3).

Source: CDC

RSV

Not too much happening yet, but that may change soon.

Massachusetts and Rhode Island are showing early warning signs through wastewater surveillance, though hospitalization rates remain very low at 0.7 and 0.0 per 100,000.

Connecticut is also seeing activity begin to stir as measured by wastewater concentration, though hospitalizations remain very low. Neighboring New York shows declining wastewater activity and low hospitalizations (0.6 per 100,000).

The rest of the states in the region look fine.

Other Bugs

Several causes of colds and flu-like symptoms are showing signs of increased activity:

• Parainfluenza continues to rise, though the rate of increase is slowing, suggesting we may be nearing a peak.
• Both adenoviruses and human coronaviruses are showing small but steady week-over-week increases.
• Rhinoviruses/enteroviruses are holding steady at a high ~28% test positivity.

Stomach Bugs

Norovirus rates remain very low in the Northeast, with 2.4% test positivity. This is much, much lower than other areas of the country.

Food recalls

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

New:

• Soft ripened cheeses, including brie, sold under multiple brand names, including Aldi, La Bonne Vie, and Glenview Farms (more info)
  • Prepackaged turkey sandwiches with spreadable brie sold under multiple brand names (more info)
• Ready-to-eat poultry and meat products sold by Yu Shang Food, including pork belly, beef shank, and whole chicken (more info)

Previously reported:

• Enoki mushrooms sold by HH Fresh Trading Corp (more info)
• Kirkland Signature Smoked Salmon (more info)
• Gourmet Cafe Chicken Caesar Salad Bowls sold by Fresh Express (more info)
• Waffles and pancakes – many flavors and styles – sold under a very large variety of brand names, including numerous store brands, including 365 Organic, Best Choice, Good & Gather, Harris Teeter, H-E-B, Nature’s Promise, Publix, Trader Joe’s and Wegmans.
  • Given the size of this recall, if you have any variety of frozen/toaster waffles, Belgian waffles or pancakes in your freezer that you bought in the US or Canada, check this list. (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

• The Maine CDC reported the state’s first case of locally acquired Eastern Equine Encephalitis (EEE) in a resident. The affected person is an adult in Penobscot County who fell severely ill in early October 2024 and remains hospitalized. EEE is a mosquito-borne disease that can cause severe symptoms including encephalitis and meningitis, potentially leading to death. We are nearing the end of mosquito season in the region, so the risk of EEE and related infections is decreasing.
• Erie County, Pennsylvania, is experiencing a pertussis (whooping cough) outbreak, with 15 confirmed cases reported as of November 8, 2024. A majority of these cases are affiliated with a particular church. This surge is part of a broader trend across the country, which has recorded over 2,000 cases this year, marking a tenfold increase from the previous year.