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.

Viral Trends and Hospital Volumes

ED Volumes: Volumes are consistent with previous summer months. Overall viral activity is low. COVID activity remains elevated. We anticipate an increase in ED volumes once school is back in session.

Measles: The possibility of domestic and international imported cases remains. We will see more cases. The US confirmed case count is up to 1,375, the highest since measles was declared eliminated in the US in 2000 and on track to the highest since 1992. See additional information and helpful resources below as we remain vigilant about infection prevention.

Influenza: Local and national Influenza activity is low.

RSV: RSV positives remain at interseasonal baselines.

SARS-CoV-2: COVID positives are elevated, and ED data suggests that we are experiencing a summer surge. National data suggests that this will be a less severe surge than years past, and there is nothing to suggest that this variant causes more severe illness. The CDC has not released new data about COVID variants since June. At that time, the dominant variants included NB.1.8.1 (“nimbus”) and XFG (“stratus”). Both of these variants are from the JN.1 lineage. The fall COVID vaccine targets a previously dominant strain from this same lineage. However, eligibility, insurance coverage and availability of this year’s vaccine remains in flux. Due to HHS actions, it will be harder to get for most people.  

Mpox: The outbreak in Central and East Africa is still ongoing and remains a public health emergency of international concern. 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: Seasonal coronavirus, adenovirus, HMPV and parainfluenza virus detections were very low last week. Rhino/enterovirus are the most common positives. Rhinovirus positives tend to be elevated throughout the year.

Mycoplasma: Mycoplasma activity has been slightly elevated since last 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.

Norovirus and Rotavirus: Norovirus activity continues to slowly trend down after one of the worst years since before the pandemic. Rotavirus activity remains elevated but is trending down.

Special Pathogens Team Update

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. 

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 guideto 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.