Respiratory illness levels continue to climb ahead of holidays

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Levels of three main respiratory viruses—SARS-CoV-2, flu, and respiratory syncytial virus (RSV)—remain elevated or are rising, but so far hospital occupancy remains stable, the US Centers for Disease Control and Prevention (CDC) said today in its latest data updates.

Though levels this year are tracking behind last year at the same time, the CDC—expecting further impact from the viruses—yesterday sent an alert to health providers that underscored an urgent need to vaccinate more people against the three diseases to reduce severity and the potential impact on healthcare systems.

In a respiratory virus snapshot today, the CDC said COVID-19 indicators remain elevated and are increasing in some regions, such as the Midwest. The CDC said it expects the proportion of JN.1 viruses, part of the BA.2.86 family, to continue to increase. Scientists and CDC officials are closely watching JN.1, because of mounting evidence of its immune-evasive potential.

Meanwhile, flu activity is increasing in most parts of the country. And though RSV activity declined a bit in southeastern states, levels remain high nationally, with trends still rising in other parts of the country as hospitalizations continue to increase in older adults and young children.

Wastewater COVID levels rise; Midwest a hot spot

In its COVID data updates today, the CDC reported another rise in hospitalizations, which is one of its main severity markers. The level was up 3.1% compared to the previous week, with higher concentrations of counties in the moderate and high range in the northern half of the country.

The other severity indicator—deaths—held stable over the past week. The highest level was reported in Kentucky, and the CDC estimates that COVID was responsible for 2.9% of deaths nationally last week.

Early indicators reflected small declines last week. Test positivity, at 11% nationally, dropped 0.4% and is highest in the central part of the country. Emergency department (ED) visits were down 2.7% from the previous week, with levels somewhat higher in parts of the Midwest.

Wastewater SARS-CoV-2 levels, another early indicator, are still listed as high nationally, with the highest levels reported from Midwestern states, according to CDC tracking.

Flu levels high in most of the country

In its latest weekly FluView update today, the CDC reported more rises in flu activity, with the highest levels in the Southeast, south-central, and western regions. All 10 regions are now above their regional baselines. Over the past week, all regions saw rises in flu markers, with region 5—which includes Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin—showing stable but increasing trends.

Though 2009 H1N1 remains the dominant strain nationally, the South and Southeast reported higher proportions of influenza B than the rest of the country.

Hospitalizations continue to rise, with the highest levels in seniors, followed by adults ages 50 to 64 and children as old as 4. The CDC's hospital surveillance shows that more than 7,000 people were admitted to the hospital for flu last week, up more than 5% from the previous week and spanning all regions of the country.

Two more pediatric flu deaths were reported last week, raising the season's total to 14. One occurred in mid November and was due to influenza B. The other fatality occurred last week and involved the H3N2 strain.

ECDC urges stepped up vaccination

The European Centre for Disease Prevention and Control (ECDC) today urged its member countries to ramp up their vaccination efforts against respiratory viruses as community transmission of those viruses increases. It also urged countries to increase ED and intensive care unit capacity.

Currently, COVID is predominant, with RSV, flu, and other viruses cocirculating with an increasing trend.

The ECDC noted that severe COVID cases are mainly affecting seniors and that RSV is fueling higher hospitalization levels, especially in young children. Officials added that seasonal outbreaks of other respiratory pathogens, such as Mycoplasma pneumoniae, are also contributing to more patients seeking care at clinics and hospitals.

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