Viral Update: Illness and Volume Trends and Helpful Resources for the Community

The goal is to share information and resources with the larger healthcare community working together to care for patients facing viral illnesses.

Viral Trends and Hospital Volumes

• ED volumes: ED volumes continue to be strong, with expectations to start dropping this month.
• Influenza: We are past peak, but influenza B activity stubbornly hangs on. The Seattle/King County tracker for COVID, RSV and influenza-related ED visits is here. Highly pathogenic avian influenza A(H5N1) updates can be found here.
• RSV: RSV positives are now at interseasonal lows.
• Measles: The 2026 U.S. confirmed case count is 2,132 (source: Pandemic Center). After less than five months, we have now surpassed last year’s numbers, which were the highest since 1991. After an extremely busy start of the year, new national measles cases are slowing. Maintain a high degree of suspicion and follow standard process for isolation, evaluation and testing. Please call Mission Control at 206-987-8899 in advance. Mission Control is provider-to-provider only; families should not call. If you need a resource for measles postexposure prophylaxis (PEP), please contact your local health department.
• Coronaviruses: Wastewater and our local ED data show that SARS-CoV-2 activity remains low. National COVID metrics (ED visits, cases) are at the lowest rate in 12 months. Seasonal coronaviruses have dropped and are at moderate levels. We are past peak.
• Hantavirus: As of May 22, there were 12 confirmed or suspected cases and three deaths. All of these cases are limited to passengers and crew on the MV Hondius.
• Other respiratory viruses: Rhino/enterovirus is the most common non-influenza/RSV positive. This represents multiple virus strains and does not include all enteroviruses. HMPV and parainfluenza activity remain low. We are likely past peak for HMPV after a relatively mild season. We usually have a spring rise in parainfluenza activity, PIV3 can cause a mixed picture of both upper and lower respiratory illness.
• Mycoplasma: Mycoplasma activity remains low with a 1% positivity rate.
• Pertussis: Activity is down after two years of increased positivity at both the state and national level. Continue to encourage vaccination.
• Norovirus and Rotavirus: Norovirus and rotavirus activity remains high.

Special Pathogens Team Update

Seattle Children’s has a special pathogens team that is continuously monitoring worldwide outbreaks to keep staff, patients and community providers informed.

There is an outbreak of Ebola in the Democratic Republic of Congo. The outbreak is expanding and affecting surrounding areas of Sudan and Uganda. Risk of a global pandemic is extremely low, but the risk of a severe regional outbreak is very high.

This outbreak is caused by the Bundibugyo strain of Ebola virus, which has no approved vaccine or treatment. Incubation is 2-21 days and the case fatality rates range from 30-50%. There are currently estimated to be over 1,000 cases.

There continue to be new cases of Crimean-Congo hemorrhagic fever in Iraq and increasing suspected cases in Afghanistan.

The Lassa fever case fatality rate in Nigeria has exceeded prior seasonal peaks with 190 deaths reported this year.

Multiple King County residents are being monitored for Andes virus, the type of hantavirus that is transmissible from person to person and recently made headlines for the cruise ship outbreak. The risk to the public remains low.

If you are treating a patient with recent (within the last month) travel to areas 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 the ED vs. Urgent Care guide to find the most appropriate care setting. Seattle Children’s has 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.
• Before sending your patient to the ED, contact the Mission Control team with as much notice as possible at 206-987-8899. This helps with planning 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.