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

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.

Update: a patient with measles is being treated at Seattle Children’s. Read more about potential community exposures and post-exposure prophylaxis. To support healthcare providers in our community we have scheduled a webinar for Friday, Mar. 14  at 7:30 a.m. – Measles Community Response: Preparing Your Office and Hospital. Learn more and register here.

Viral Trends and Hospital Volumes

• ED Volumes: Our ED volumes remain elevated, resulting in surges that have sometimes led to longer wait times for patients and families. Please do not hesitate to send patients to the ED when you have emergent concerns.
• Influenza: Influenza activity is very high, driven by both A H1N1 and A H3N2, though local and national data is indicating we may be starting to see a slight decline. We are tracking reports of an increase in influenza A-associated acute necrotizing encephalitis this year. Cases have been associated with both H1 and H3, and morbidity and mortality are high. We continue to monitor national Highly Pathogenic Avian Influenza A (H5N1) news.
• RSV: RSV positives remain above inter-seasonal baselines but continue 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. Hopefully, the lack of significant genetic shifts and our combined immunity will continue to make this a relatively light winter. Researchers recently published details about a new coronavirus found in Pipistrellus bats. Like SARS-CoV-1, SARS-CoV-2, and HCoV-NL63 (one of our existing seasonal coronaviruses), the new coronavirus lineage (HKU5-CoV-2) uses the human ACE2 receptor to enter cells. This deserves watching but should not make people jump to conclusions that another pandemic will result.
• 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 locally, nationally, and internationally. 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 but is waning and near baseline levels.
• 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. Rotavirus activity is low.

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. There is also an ongoing outbreak of Lassa Fever in Nigeria. If you are referring an ill patient with recent (within the last month) travel to the DRC, Tanzania, or Nigeria, please call Mission Control at 206-987-8899 before sending the patient.

Additionally, multiple outbreaks of viral hemorrhagic fever continue to be monitored and managed in Central and East Africa.  

Measles Resources

• Measles One-Pager for Healthcare Providers (AAP)
• Measles - For Healthcare Professionals (CDC)
• Measles Specimen Collection Instructions for RT-PCR (DOH)
• Measles Specimen Collection Instructions for Serology (DOH)
• Immunization Schedules (CDC)
• Safety Information for Measles, Mumps, Rubella (MMR) Vaccines (CDC)

How You Can Help

• As ED volumes remain high, consider reminding families of your clinic’s resources and procedures for urgent and after-hours patient needs to help direct them to the most appropriate site of care.
• 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, especially if there are concerns for communicable diseases.

Additional Resources

Advise patient families to utilize our library of Barton Schmitt patient education handouts on hundreds of conditions including COVID-19, influenza and RSV.