State of Affairs: Feb 22
Respiratory activity and... measles? And... raw milk?
Slowly but surely we’re moving through the 2023-2024 respiratory season. I’m also adding a measles section to the State of Affairs because… well… here we are in the 21st century.
Let’s dig in.
Influenza-like illnesses: Moderately stubborn
The rate at which people are going to the doctor with a fever, cough, or sore throat is stubborn—stalling at a very inconvenient rate. But a two- or three-hump season is very normal (i.e., in pre-pandemic times). This could stretch out to April or May.
Increased activity is driven by our kiddos. Outpatient visits among 0-24 year olds continue to increase, while visits among other age groups are receding.
Covid-19: High
Covid-19 wastewater levels are high nationally. And, in fact, higher than they were this time last year. Although national rates are declining, the South has a very weird pattern. We don’t know why.
Covid-19 hospitalization admissions are stalling after a nice decline. We remain at fewer hospitalizations than last year.
CDC and WHO are paying attention to another highly mutated variant in South Africa. However, there have only been 9 cases, with no impact on wastewater or hospitalization trends. This seems like a dud, which is great news. No other huge variants are on the horizon; JN continues to be king.
Flu: Still high and stabilizing
The rate of hospitalizations due to flu remained stable compared to last week. Flu can stretch out, sometimes to even May, so this is unsurprising. It’s not too late to get your flu shot!
RSV: Plummeting
RSV continues to go down nationally. It’s clear we’ve hit our season’s peak.
More good news with RSV: many babies (40%) got monoclonal antibodies this winter. This could certainly be improved, but given the rough access issues, it is a decent start.
Measles: More outbreaks
This may be a bad year for measles (see why in my previous post), so many epidemiologists are carefully watching the data.
So far, in 2024, we’ve had 20 cases across 11 states. This is about twice as many cases as this time last year.
Data is delayed, so this doesn’t include a few recent cases making the news:
Ohio reported its second case of the year, which exposed a number of people at a grocery store.
Washington also reported a case, which is likely from international travel.
An elementary school outbreak in Florida has infected six so far. Florida allows non-medical vaccine exemptions, which has increased since 2021. And Florida is below the herd immunity threshold, with ~90% vaccination rate (we need 95%). The worst part is the Florida Surgeon General’s letter to parents ignoring standards of practice and suggesting schools and parents should “choose their own adventure” with measles containment. It is egregious. Expect a full YLE post on this soon, but here is my initial reaction. I wasn’t happy.
Other things I’m paying attention to:
E. coli outbreak linked to raw milk cheese.
At least 10 cases across 4 states, with 4 people hospitalized and one developing a serious kidney condition.
There is a reason we pasteurize dairy, people. This method was developed 160 years ago to reduce the risk of bacterial contamination and foodborne illnesses. Please don’t fall for wellness misinformation. Raw milk has zero additional health benefits.
Next week, ACIP—CDC’s external scientific advisory board—is meeting to discuss all vaccines. I will report back on Covid-19 and RSV. I have two big questions:
What is the spring plan for Covid-19 vaccines? U.K. (and local U.S. jurisdictions like Los Angeles) have announced that older people can get a spring Covid-19 vaccine. I assume this is coming for the U.S.
What does the safety profile look like for the older adult RSV vaccine? Some questions were brought up during clinical trials. We really need real-world data.
Bottom line
This respiratory season continues to march on with few surprises. Unfortunately, it’s happening amidst a backdrop of misinformation, which will increasingly cause a mess, like measles and e-coli outbreaks.
Vaccines. Masks. Ventilation. Tests. Treatment. Isolation. We can do things to keep ourselves healthy. For high-risk folks, this may also mean changing Spring Break plans to avoid a measles outbreak or two.
Love, YLE
“Your Local Epidemiologist (YLE)” is written by Dr. Katelyn Jetelina, M.P.H. Ph.D.—an epidemiologist, wife, and mom of two little girls. During the day, she is a senior scientific consultant to several organizations, including CDC. At night, she writes this newsletter. Her main goal is to “translate” the ever-evolving public health world so that people will be well-equipped to make evidence-based decisions. This newsletter is free, thanks to the generous support of fellow YLE community members. To support this effort, subscribe below:
I’m seeing a good amount of flu in my practice still, so appreciate the national validation chart.
Having milked a cow, and seen the udders up close, pasteurize my milk, please.
I’ll break this rule for some high end cheese from DiBrunos in the Italian Market down the street every once in a while…😋
Measles, Covid, Ladapo, seniors, Florida make for a perfect storm. If I make it to retirement I’m absolutely headed north instead! Hygge over humid, community over hyper-individualism, embryos are not people deserving more protection under the constitution than women.
We are in Florida and have COVID in our household for the first time (that we know). It came home with the 10-yo from school. They are usually the only one masking at school and have no option for outdoor (safe) eating. They are still testing positive on RAT's on day 7. Their school said they could come back on day 5 regardless of test results as long as they didn't have a fever. They never had a fever. Public health as a whole is completely broken, and is essentially nonexistent in Florida.
Thankfully, we are not willfully/maliciously ignorant and our family's COVID mitigations (isolating the infected child in a separate room, high quality masking indoors, open windows, tons of HEPA filters/CR boxes in every room, outdoor dining, serial testing, Betadine Cold Defense nasal spray, CPC mouthwash, as-up-to-date-as-possible vaccinations, etc.) have prevented spread to any of the other 5 members of the household (so far), including high-risk members. However, we also know that we are very privileged to be able to do these things, but so very frustrated that we have had to do them completely on our own with absolutely no support from supposed experts and officials. I honestly know more about COVID than any of our medical doctors where we live which is apparent by the fact that NONE of them mask at all. We live in the dumbest of times and there is absolutely no excuse for it.