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 are rising as in past years with the onset of the respiratory viral season. With international data as a guide, we anticipate RSV and influenza seasons will overlap, leading to high volumes and surges in the ED

Measles: We continue to screen for measles. The US confirmed case count is the highest since 1992. Canada recently lost its measles elimination status and measles is now considered to be endemic there. The US will find out its status in January.

Influenza: National influenza-like activity remains below the epidemic threshold, but our hospital activity suggests the beginning of the steep part of the curve, suggesting we may see high influenza activity in the next few weeks.  The UK, Canada, and Japan are seeing early, severe influenza activity linked to a new H3N2 Subclade K virus that emerged after this year’s vaccine was set. In the U.S., the majority of typed influenza viruses are also Subclade K. While this doesn’t guarantee a severe local season, it’s a strong signal to prepare for a higher-than-usual surge. The first human case of H5N5 avian influenza, a Washington state resident, died on Friday. The potential exposure was backyard poultry. Bird flu cases are rising across the U.S.

RSV: RSV positives are at moderate levels and are continuing to slowly climb. We would expect things to start to increase significantly in the next few weeks. Continue to encourage immunization and prophylaxis.

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

Mpox: WHO has ended the mpox emergency, but cases continue – King County is seeing its highest levels in three years. 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. This channel represents multiple virus strains and does not include all enteroviruses. Seasonal coronaviruses and HMPV are low. Parainfluenza is having its usual fall increase. We will be seeing more croup.

Mycoplasma: Activity is still low: we are currently seeing a 1% positivity rate, which is common for Fall.

Pertussis: There has been an increase in pertussis activity state and nation-wide over the course of the past two years, with the current U.S. case count on track to double last year’s numbers. We have had 0-2 positives per week for months. Continue to encourage vaccination.

Norovirus and Rotavirus: Updated national data shows that norovirus activity is increasing. Rotavirus activity is low but increasing.

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 virus disease patient in the Democratic Republic of the Congo was discharged. If there are no new cases for 42 days, the outbreak will be declared over.

Ethiopia is seeing its first outbreak of Marburg Virus, another viral hemorrhagic fever. Nine cases have been identified thus far.

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 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 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.