-------------------------------------------
Up, up, and away
Respiratory State of Affairs: December 19
Welp, I’ve spent the past two days on a couch with my 4-year-old, who has the flu. Who knew a toddler could watch 10,000 Disney princess movies and still have an appetite for more? Respiratory season is here. Apparently so is our princess era.
There are many viruses circulating right now, but we aren’t at peak season yet. Here’s the State of Affairs so you feel well-equipped for the holidays.
Influenza-like illnesses: Moderate and increasing
The climate of respiratory health in the United States—which the CDC defines as “influenza-like illnesses” (ILI)—has crossed the “epidemic” threshold and is growing. The trend seems to be tracking exactly with the 2019-2020 respiratory season. I’ve started wearing my mask while traveling.
ILI has lit up in the West and South. The Midwest is still pretty quiet. Eventually this entire map will be red and purple.
Flu: Moderate and increasing
Flu is coming in hot, with an exponential spread across the United States. The spread is mainly due to Flu A strain; we typically see a Flu B peak in early spring. Nothing abnormal is jumping out about this year yet.
However, one concerning trend is flu vaccine coverage—it’s getting lower and lower every year in a step-wise fashion. This may explain last year’s high flu deaths among kids.
My daughter was vaccinated against the flu but still got infected. Unfortunately, the flu vaccine may not be a great match this year (~34% effectiveness in the Southern Hemisphere) because a specific strain is circulating. Regardless, a flu vaccine helps bring sickness from wild to mild. It’s not too late for a flu vaccine.
Also, hot tip: We used an at-home combo flu/Covid test. I wouldn’t normally care which virus infected her, but with flu, there is a specific action to take—a prescription for Tamiflu can help relieve symptoms one day earlier. This saved us a trip to the pediatrician’s office!
RSV: Peaked in some areas?
RSV may have peaked in the East/Southeast, like in Georgia, but definitely still increasing in other states, like California. This is typical of RSV—waves start in the Southeast corner and spread outward nationwide. Scientists don’t really know why.
So far, we are having a middle-of-the-road season for RSV. I’m curious if/when we will see a population-level impact from RSV vaccinations and monoclonal antibodies. It doesn’t seem like this year is the year.
Covid-19: Low but increasing
Some epidemiologists were quietly questioning whether it was possible to have a no-Covid winter, given low activity over the past month or two. Historically, Covid-19 has started increasing in November and peaked around the first week of January.
However, those rumblings were put to rest this week as Covid-19 wastewater started increasing again. Levels are still relatively low but growing.
My guess is that this winter’s Covid-19 wave has just shifted—it will peak in February. Given the relatively large summer wave, we’ll have a smaller peak than previous winters. We’ll watch to see if Covid-19 has any surprises for us.
Increasing Covid-19 (and other viruses during the winter) is largely due to three factors:
New variants. The latest Covid-19 variant is called XEC, and it has a few mutations that allow it to skip around our first line of defense, causing infections. Its growth advantage isn’t too big at 20-45%. (As a comparison, Omicron was 500%.) This signals the winter will be a wave, not a tsunami.
Cold weather leads people inside, which has poor ventilation. Also, some weather properties, like humidity, increase transmission.
Social networks. With the holidays, we see people we wouldn’t normally see, allowing viruses, like Covid-19, to transmit more.
If you’re one of those trying to time a Covid-19 vaccine before a wave to optimize protection against infection, the time to get vaccinated is now.
Other things going around
Walking pneumonia is still high but finally decreasing after a nasty year. This causes a lingering cough that is typically not severe but a nuisance.
Norovirus—think nausea, vomiting, diarrhea—is having quite the time, with the number of positive tests and outbreaks abnormally high. Norovirus spreads through contaminated surfaces, so as always, wash those hands. Unfortunately, this virus is one of the hardest viruses to kill because it doesn’t have a stable coating called a membrane. So, a quick dose of hand sanitizer doesn’t work. Bleach-based products on surfaces are the best. Read more in a previous YLE post.
Whooping cough is back to pre-pandemic levels, though it’s preventable with the Tdap/DTaP vaccine. According to a recent survey, a third of the public doesn’t know this disease is preventable. Adults need boosters—one every 10 years. Unfortunately, our second-generation vaccines are imperfect, and vaccine hesitancy is rising.
H5N1 (bird flu)— Despite all the headlines this week, nothing much has changed for the general public: The virus keep spreading, severe cases are starting to pop up (latest in Louisiana) from people with direct contact with sick animals, and, thankfully, more resources are being channeled to public health (see CA State of Emergency). It’s clear this virus isn’t going away any time soon. The biggest concern is the potential for a mutation, especially since seasonal flu is now circulating. H5N1 could swap genes with seasonal flu and become more susceptible to humans.
Bottom line
Things are heating up! Stay healthy out there— get vaccinated, get that air moving, use masks, and stay home if you’re sick. (And if you’re stuck at home watching Disney movies like me, I highly recommend starting with Encanto).
Love, YLE
Your Local Epidemiologist (YLE)
is founded and operated by Dr. Katelyn Jetelina, MPH PhD—an
epidemiologist, wife, and mom of two little girls. During the day, Dr.
Jetelina runs this newsletter and consults with several nonprofit and
federal agencies, including CDC. YLE reaches more than 290,000 people in
over 132 countries with one goal: “translate” the ever-evolving public
health science so that people feel well-equipped to make evidence-based
decisions. This newsletter is free to everyone, thanks to the generous
support of fellow YLE community members. To support the effort,
subscribe or upgrade below
.jpg)
No comments:
Post a Comment