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 and expected to rise with the start of the school season.
• Cyclospora: The majority (80%) of Washington cases are in returning travelers – particularly from Mexico and Michigan. Heating food to 158 degrees kills cyclospora. There is ongoing work to identify the causes of the outbreak.
• Salmonella: There is a recall on products containing jalapeno (salsa, guacamole, meat) by Coast Citrus Distributors and Taylor Farms sold at Target, Whole Foods, Chipotle, Qdoba, Trader Joe’s and Hannaford supermarkets. There has been one case so far 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 2,961, the highest number since 1991, with more cases reported recently. Maintain a high degree of suspicion and follow standard processes 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 resources for measles postexposure prophylaxis (PEP), please contact your local health department.
• Coronaviruses: COVID activity remains low but is up trending at this time.
• 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 had 0-2 positives per week for months. Washington is number two on the case count list in the U.S. so far this year with 520 cases. Encourage vaccination.
• Norovirus and Rotavirus: Norovirus is stable and 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 Aug. 20 there were over 5,100 confirmed cases and 2,420 deaths with a 47% case fatality rate. 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 declared the outbreak over in the country. There was a recorded 20 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 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.