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 acutely higher and expected to rise in the months ahead.
• Cyclospora: The cyclospora outbreak has improved.
• Salmonella: The outbreak related to Jalapeno peppers has led to 488 cases, 65 hospitalizations and continues at this time. The outbreak related to shell eggs has ended.
• Influenza: Influenza activity is increasing rapidly and is similar to rates from early December 2025. We’re currently seeing a fall surge of Influenza, COVID and Rhino/enterovirus that began in early September. Seattle Children’s Emergency Department is open and ready to care for your patients; please do not hesitate to send patients when the ED is the appropriate setting for care. 
  
  When sending patients to the ED, please call our Mission Control team at 206-987-8899 with as much notice as possible to help us plan for their arrival. Call this number also if your patient needs admission or might need admission in the next several days. Let families know that we continue to triage to see the most emergent patients first. Please continue to identify and manage lower-acuity complaints in outpatient settings, including urgent care, to help maintain ED capacity for higher-acuity concerns. 
• RSV: RSV positives remain at interseasonal lows. Numbers will likely increase over the next month. Encourage vaccination for eligible patients.
• Measles: The 2026 U.S. confirmed case count was 3,887 as of Oct. 1, and there have been five reported measles-related deaths in unvaccinated individuals in Pennsylvania. Due to increased cases in Clark County, WA, measles screening has resumed at Seattle Children’s.
• Coronaviruses: COVID activity is uptrending at this time. Vaccines are available at community pharmacies.
• Other respiratory pathogens: Rhino/enterovirus is the most common non-influenza/RSV positive.
• Mycoplasma: Empiric double coverage with a penicillin and a macrolide is not indicated at this time.
• Pertussis: Activity is down after two years of increased positivity at both the state and national level. We have averaged 0 to 2 positives per week for months. Encourage vaccination.
• Norovirus and Rotavirus: Norovirus is increasing nationally and regionally. Rotavirus activity is low.

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 Sept. 30, there were a reported 8,224 confirmed cases and 3,982 deaths with a 48% case fatality rate. The Ebola vaccine trial targeting Bundibugyo virus continues.

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  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.