Provider News

Viral Season Update: Illness and Volume Trends, and Helpful Resources for Our Community

February 5, 2025

As with past viral seasons, our goal is to share information and resources with our larger community as we all work together to care for patients during this busy time.

Viral Trends and Hospital Volumes

  • ED Volumes: Our ED volumes have been increasing resulting in volume surges that have led to long wait times for patients and families.
  • Influenza: In our ED, influenza A has rebounded and is likely near peak. We have seen a slight increase in influenza B activity, but it is too early to say if this represents the start of a second influenza wave. We continue to monitor the Highly Pathogenic Avian Influenza A(H5N1) news. Recently, the CDC issued a health advisory that recommended accelerated subtyping of influenza A in hospitalized patients to identify H5N1 cases. To identify patients with influenza A who test negative for H1 and H3 subtypes (currently circulating subtypes) we are now ordering extended upper respiratory panels for all symptomatic patients who are being admitted.
  • RSV: RSV positives continue to be at high levels but continues to decline. Hopefully, this relatively short season is the result of immunization and prophylaxis.
  • SARS-CoV-2: We continue to see a very low positivity rate at Seattle Children’s. This may be due a combination of a relatively large summer wave and the fact that the virus has not had a major shift since then.
  • Mpox: The ongoing outbreak in Central and East Africa continues. It is caused by the more virulent Clade Ia subvariant. Clade II mpox is still being diagnosed weekly in WA, although rates are much lower than 2022. Mpox testing is available at Seattle Children’s – if you feel your patient may have Mpox and want them tested, please call Mission Control at 206-987-8899.
  • Other Respiratory Viruses: Rhino/enterovirus positives are the most common non-flu/non-RSV positives at Seattle Children’s. Traditionally, ED census remains elevated into May due to a combination of hMPV, seasonal coronavirus, influenza B and parainfluenza 3. Although none of these typically cause large waves individually, combined, they drive the latter half of our busy season.
  • Measles: Measles remains active nationally and internationally, including a confirmed case at SeaTac Airport on January 10. Because measles is so contagious, potential measles patients can easily expose everyone in the ED. At Seattle Children’s we have patients who may have measles enter the ED by an alternate route to avoid exposing other patients. If you are considering sending a patient for evaluation or treatment of measles, please call Mission Control at 206-987-8899 before sending the patient – they will work with our teams to facilitate evaluation while reducing exposure. See helpful resources below as we remain vigilant around infection prevention.
  • Mycoplasma: Activity has been slightly elevated since late summer. It is too early to say for sure, but the wave may be passing.
  • Pertussis: There has been an increase in pertussis activity state and nation-wide over the course of the year. Continue to encourage vaccination.
  • Norovirus and Rotavirus: Norovirus positivity is very high and rising, possibly because of a new circulating strain that we may be less immune to. Rotavirus activity is low.
  • Human metapneumovirus (HMPV): You may have read or heard about elevated rates of HMPV in China. As many in pediatrics are aware, this virus circulates across the world every year and causes upper and lower respiratory infections, much like RSV and other respiratory viruses. In our part of the world, HMPV rates currently remain low, but we expect HMPV activity to increase later this season.

Special Pathogens Team Update

Seattle Children’s has a special pathogens team that is continuously monitoring worldwide outbreaks to keep our staff, patients and community providers informed. There is currently a new alert for Ebola in the Democratic Republic of Congo and we are tracking a Marburg outbreak in Tanzania. If you are referring an ill patient with recent (within the last month) travel to the DRC or Tanzania, please call Mission Control at 206-987-8899 before sending the patient.

Measles Resources

How You Can Help

  • As ED volumes increase, encourage families to review our ED vs. Urgent Care guide to find the most appropriate care setting – we have options for in-person and virtual urgent care, orthopedic urgent care, and psychiatric urgent care.
  • Families should be prepared that, if viral testing is deemed clinically appropriate, it will typically be performed using a panel that identifies only influenza, RSV, and COVID-19.
  • Before sending your patient to the ED, contact our Mission Control team with as much notice as possible at 206-987-8899. This helps us plan for your patient’s arrival. In appropriate instances, we may be able to directly admit your patient to the hospital or arrange an urgent ambulatory clinic visit in lieu of an ED visit.

Additional Resources