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

Review current viral trends at the hospital and explore resources to support the community of healthcare professionals working together to care for patients facing viral illnesses.

Viral Trends and Hospital Volumes 

• ED volumes: ED volumes are approaching seasonal norms and expected to continue to slowly fall, reaching the nadir in August. 
• Influenza: Influenza activity is finally down to interseasonal activity. Sporadic cases will continue, but test percent positivity is low enough to stop routine testing.
• Botulism: There is a new U.S. outbreak of infant botulism which has been epidemiologically linked to Nara Organics formula. Three infants were diagnosed and treated in April and May, including one patient in Washington. 
• COVID: Since omicron took over in 2022, we have had a summer wave of COVID. We will be watching COVID activity closely in the coming weeks. 
• RSV: RSV positives remain at interseasonal lows. Sporadic positives will continue through the summer. 
• Measles: The 2026 US confirmed case count is 2,343 (source Pandemic Center). We have surpassed last year’s volume, which was 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 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. Activity is past peak. 
• Other respiratory pathogens: Rhino/enterovirus is the most common non-influenza/RSV positive. This channel represents multiple virus strains and does not include all enteroviruses. HMPV and Parainfluenza activity remain low. There is a bump in adenovirus positivity. It is too early to tell if this is common cause variation or represents the beginning of a trend. 
• Mycoplasma: Mycoplasma activity remains low with a 3% 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 remain high but may be past peak.

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. There are now over 1,000 confirmed cases and 254 deaths. The case fatality rate (CFR) is 26%. In two previous Bundibugyo outbreaks reported in Uganda and the DRC in 2007 and 2012, the CFRs were 30% and 50%, respectively.

Travelers returning to Washington State from DRC, Sudan or Uganda are being symptom-monitored by the Department of Health for 21 days.

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 208 deaths reported this year. The CFR remains elevated at 25%. The number of new weekly cases is declining.

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.