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: ED volumes have been stable over the past few weeks. Overall, viral activity is increasing, and we expect volumes to increase soon.

Measles: There has been a local confirmed case of measles in an unvaccinated adult who traveled through SeaTac Airport on October 13.  A secondary case was identified on October 26. Secondary cases would most likely occur between October 29 and November 17. The U.S.-confirmed case count is up to 1,625, the highest since 1992. There are ongoing outbreaks in Arizona, South Carolina and Utah. Canada and the United States are on track to lose their measles elimination status. See additional information and helpful resources below as we remain vigilant about infection prevention.

Influenza: Influenza activity remains low locally, but there are suggestions that we are starting to see the early part of the season.

RSV: Respiratory syncytial virus (RSV) positives remain low but are starting to slowly climb.

SARS-CoV-2: Wastewater and our local ED data show that COVID is down trending and near baseline levels.

Mpox: The mpox outbreak in Central and East Africa has been downgraded by the World Health Organization (WHO) and is no longer considered an international health emergency. The California Department of Public Health recently confirmed three unrelated mpox cases, which have been identified as clade I, the more virulent strain of the virus. The strain that affected the United States during the 2022 outbreak was from clade II, which has a relatively low mortality rate. All three recent California cases required hospitalization. According to the California Department of Public Health, these cases indicate that, like the outbreak in 2022, the virus may be spreading through the communities of men who have sex with men. 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 is the most common positive. 

Mycoplasma: Mycoplasma activity is low. 

Pertussis: There has been an increase in pertussis activity both state- and nation-wide over the course of the year.  

Norovirus and Rotavirus: It has been two months since the last data release, so we don’t have a great understanding of where we are with acute gastroenteritis pathogens on a national level. Locally, our rate of norovirus detections remains low, while we had an uptick in rotavirus cases in mid-October.  

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.

As of October 19, the last Ebola patient in the Democratic Republic of the Congo (DRC) was discharged. If there are no new cases for 42 days, the outbreak will be declared over. Containment of this outbreak within six weeks of the start is a remarkable achievement of the DRC Ministry of Health, WHO and partners. There have been 64 cases and 45 deaths during the outbreak. This is a confirmed case fatality rate of 70%. 

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 who needs urgent evaluation to Seattle Children’s, please call Mission Control at 206-987-8899 before sending the patient.

Measles Resources

• Track local exposure locations with the King County chart. (Public Health) 
• 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-19, 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-19 vaccination recommendations.
• Review the latest viral activity on the National Respiratory and Enteric Virus Surveillance System dashboard.