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

Our goal is to share information and resources with our larger community as we all work together to care for patients facing viral illnesses.

Combating Measles Outbreaks

Measles cases continue to increase both nationally and locally, driven by lower vaccination rates. Seattle Children’s is dedicated to helping reduce the spread of preventable outbreaks of this highly contagious disease. To help ensure patients, families and the community are healthy, watch this webinar on how the community can prepare and limit exposures to measles. For additional information, review the measles resources listed below.

Viral Trends and Hospital Volumes

ED Volumes: ED volumes are currently stable. We are prepared for anticipated high(er) volumes perhaps into mid-May. 

Measles: The 2026 US confirmed case count is 416 as of January 23. 2025 was the worst measles year since 1991 and 2026 is off to an even worse start. Multiple outbreaks are ongoing, driven by lower vaccination rates.

Influenza: Influenza activity varies nationally with local cases remaining steady. This season remains dominated by influenza A (H3N2) Subclade K.

RSV: RSV positives may be declining.

SARS-CoV-2: Local wastewater and ED data show COVID-19 activity remains low.

Mpox: Additional cases have been reported in Madagascar and Israel. King County is reporting its highest levels in three years. 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 remains the most common non-influenza/RSV positive. This channel represents multiple virus strains and does not include all enteroviruses. Seasonal coronaviruses and HMPV remain low. These viruses usually contribute to our late winter/early spring respiratory season.

Mycoplasma: Mycoplasma activity remains low, with a 3% positivity rate last week.

Pertussis: Pertussis activity continues to increase statewide and nationally. Locally, we continue to see 0 to 2 positives per week. Continue to encourage vaccination.

Norovirus and Rotavirus: Norovirus and rotavirus activity remain at moderate levels and are rising.

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.

The Marburg outbreak in Ethiopia is now up to 14 cases and 9 deaths. No new cases have been reported since mid-December. Ethiopia is close to declaring this outbreak over. South Sudan and Somaliland are reporting possible new Marburg outbreaks.

There is a new outbreak of Nipah virus disease in India. Current information is limited but we will continue to monitor. A little information about Nipah virus:

• The virus: Nipah is a paramyxovirus that causes severe encephalitis and pneumonia.
• Incubation period: typically 4-14 days.
• The illness: sometimes classified with viral hemorrhagic fevers due to its severe, systemic. nature and potential for hemorrhage.
• Transmission: Spread via fruit bats, pigs, or human-to-human contact.
• Fatality Rate: estimated between 40 and 75%.
• Symptoms: Fever, headaches, vomiting, sore throat, and rapidly progressing encephalitis.

If you are treating a patient with recent (within the last month) travel to areas in Africa affected by hemorrhagic fevers and suspect a related illness, please contact your local public health department immediately.

If you are referring an ill patient that needs urgent evaluation to Seattle Children’s, please call Mission Control at 206-987-8899 before sending the patient.

Measles Resources

• Webinar Recording: Measles Community Response
• 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)
• Recognizing Measles in Your Patients (Pediatric Pandemic Network)
• Vitamin A and Measles Vaccine Talking Point (Pediatric Pandemic Network)
• Measles FAQ for Families & Caregivers (Pediatric Pandemic Network)

How You Can Help

• To help maintain ED volumes, 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

• View the respiratory virus data dashboard for the latest Seattle/King County trends for COVID, RSV and influenza-related ED visits.
• Read the situational summary on H5 Bird Flu to stay updated on the current Highly Pathogenic Avian Influenza A(H5N1) outbreak.
• View these resources on vaccine guidance for the most current COVID vaccination recommendations.
• Review the latest viral activity on the National Respiratory and Enteric Virus Surveillance System dashboard.