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 at seasonal norms, increasing over the past several weeks.
• Cyclospora: As of July 17, there were 11,573 reported cases and 308 hospitalizations in 47 states, including 38 cases in Washington (most cases in Washington are associated with travel out of state). Cooking food to 158 F kills cyclospora. Consider cyclosporiasis in patients presenting with prolonged or relapsing watery diarrhea, particularly if they have traveled internationally or a U.S. state involved in the outbreak. Symptom onset can occur 2-14 days after exposure.
• Botulism: A U.S. outbreak of infant botulism was identified in June 2026 that has been epidemiologically linked to Nara Organics formula. Four infants have been diagnosed, hospitalized and treated, including one patient in Washington.
• Influenza: Influenza remains at interseasonal levels.
• RSV: RSV positives remain at interseasonal lows – sporadic positives will continue through the summer.
• Measles: The 2026 U.S. confirmed case count is 2,321. Maintain a high degree of suspicion and follow standard process for isolation, evaluation, and testing. 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. If you need a resource for measles postexposure prophylaxis (PEP), please contact your local health department.
• Coronaviruses: COVID activity remains low at this time
• Other respiratory pathogens: Rhino/enterovirus is the most common non-influenza/non-RSV positive. Parainfluenza and adenovirus remain at moderate levels, but overall viral load is low in the community.
• Mycoplasma: Two recent tests were positive. Empiric double coverage with a penicillin and a macrolide is not indicated. Testing is generally not indicated for patients well enough to be discharged.
• Pertussis: Activity is down after two years of increased positivity at both the state and national levels. Encourage vaccination.
• Norovirus and rotavirus: Norovirus and rotavirus activity is trending down.

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.

The Ebola outbreak (Bundibugyo virus) in the Democratic Republic of Congo continues. As of July 27, there were over 3,200 confirmed cases and 1,400 deaths with a 44% case fatality ratio. The first volunteer has been vaccinated in an Ebola vaccine trial targeting Bundibugyo virus.

Uganda has not had any new Bundibugyo cases since June 21 and is in the countdown to declare the outbreak over in the country. There were 20 recorded cases and two deaths with no community transmission.

Travelers returning to Washington 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 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%. While there had been a decline in new cases, a renewed transmission surge is currently occurring.

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 who 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.