Flu activity is increasing slightly among children while RSV activity is elevated in the southern, central and eastern U.S., according to data updated Monday from the Centers for Disease Control and Prevention.
As of the week ending Nov. 23, the latest date for which data is available, 0.6% of emergency department visits were for flu and 0.4% were for RSV. While the overall percentages are low, they are higher than the percentages at the beginning of October, CDC data shows.
Meanwhile, about 5.6% of weekly tests are coming back positive for RSV and 2.5% are coming back positive for flu, according to CDC data.
Currently 14 states are experiencing moderate levels of overall respiratory illness: Arizona, Connecticut, Delaware, Georgia, Indiana, Kansas, Kentucky, Louisiana, Maryland, Ohio, Pennsylvania, Texas, Virginia and Wisconsin. The remaining states are seeing low levels.
Dr. John Brownstein, an epidemiologist and chief innovation officer for Boston Children’s Hospital and an ABC News contributor, said the current season is trending similarly to pre-pandemic seasons.
“Compared to the pandemic years, we’re witnessing a return to more traditional seasonal patterns of respiratory illnesses,” he said. “During the pandemic, measures like masking and social distancing significantly reduced the spread of viruses like flu and RSV. Now, with those measures relaxed, the circulation of these viruses resembles pre-pandemic seasons.”
He added, “These are typical seasonal increases. Every cold and flu season is different in terms of start, end and severity but, like clockwork, we see a rise in respiratory viruses during the fall and winter months.”
Brownstein said it is unsurprising that young children are currently the most impacted by these respiratory viruses.
CDC data shows that children aged 4 and under accounted for 6.7% of emergency department visits for COVID-19, flu and RSV compared to 1.1% among those aged 65 and older during the week of Nov. 23. Children aged 4 and under also had the highest rate of hospitalizations over the same period.
“Managing capacity is going to be on the minds of every pediatric hospital for the next few months,” Brownstein said.
The CDC also noted that cases of so-called “walking pneumonia” among young children remain high. The illness is due to a respiratory tract infection caused by the bacteria Mycoplasma pneumoniae.
Brownstein said the best way for Americans to stay protected is to stay up-to-date with their vaccinations.
To prevent RSV, there are three vaccines approved for adults ages 60 and older as well as some adults between the ages 50 and 59 who are at higher risk. There is also a vaccine available for pregnant women between 32 weeks and 36 weeks of pregnancy.
For babies under eight months, there are two monoclonal antibody products available. Monoclonal antibodies are proteins manufactured in a lab that mimic the antibodies the body naturally creates when fighting an infection.
“Additionally, practicing good hygiene — like frequent hand washing, covering coughs and sneezes, and staying home when feeling unwell — can significantly reduce the spread of these viruses,” Brownstein said.
(SILVER SPRING, Md.) — The U.S. Food and Drug Administration (FDA) on Thursday approved the first new drug to treat people with schizophrenia in more than 30 years.
Cobenfy, manufactured by Bristol Myers Squibb, combines two drugs, xanomeline and trospium chloride, and is taken as a twice-daily pill. In clinical trials, this combination helped manage symptoms such as hallucinations, delusions, and disorganized thinking, which are common in schizophrenia.
“Schizophrenia is a leading cause of disability worldwide. It is a severe, chronic mental illness that is often damaging to a person’s quality of life,” Tiffany Farchione, M.D., director of the Division of Psychiatry, Office of Neuroscience in the FDA’s Center for Drug Evaluation and Research, said in the approval announcement.
“This drug takes the first new approach to schizophrenia treatment in decades,” Farchione continued. “This approval offers a new alternative to the antipsychotic medications people with schizophrenia have previously been prescribed.”
Cobenfy offers new hope for people with schizophrenia, providing an innovative treatment option that could change how this condition is managed, according to Jelena Kunovac, MD, a board-certified psychiatrist and adjunct assistant professor at the University of Nevada, Las Vegas, in the Department of Psychiatry.
“We are overdue for a medication that targets schizophrenia with a different mechanism of action,” Kunovac told ABC News.
The first drugs for schizophrenia, including chlorpromazine and haloperidol – also known by the brand names Thorazine and Haldol, respectively – were introduced in the 1950s and revolutionized treatment of the disease. However, there have been very few new medications since then, with most subsequent FDA approvals being for variations of these older drugs.
Most schizophrenia medications, broadly known as antipsychotics, work by changing dopamine levels, a brain chemical that affects mood, motivation, and thinking, Kunovac explained. Cobenfy takes a different approach by adjusting acetylcholine, another brain chemical that aids memory, learning and attention, she said.
By focusing on acetylcholine instead of dopamine, Cobenfy may reduce schizophrenia symptoms while avoiding common side effects like weight gain, drowsiness and movement disorders, clinical trials suggest. These side effects often become so severe and unpleasant that, in some studies mirroring real-world challenges, many patients stopped treatment within 18 months of starting it.
In clinical trials, only 6% of patients stopped taking Cobenfy due to side effects, noted Dr. Samit Hirawat, chief medical officer at Bristol Myers Squibb. “That’s a significant improvement over the 20-30% seen with older antipsychotic drugs,” he added.
The most common side effects of Cobenfy are nausea, indigestion, constipation, vomiting, hypertension, abdominal pain, diarrhea, increased heart rate, dizziness and gastroesophageal reflux disease, according to the FDA announcement.
“It may prove advantageous to those who don’t tolerate what has been available,” Dr. Leslie Citrome, a clinical professor of psychiatry and expert in psychopharmacology at New York Medical College, told ABC News regarding Cobenfy. “This will provide a new approach that may work out quite nicely.”
Citrome emphasized that patients who have trouble tolerating the side effects of traditional schizophrenia medications may benefit most from Cobenfy, and that a different mechanism of action holds hope for those who have not responded adequately to existing treatments.
Schizophrenia is a mental health disorder that affects about 24 million people worldwide, or roughly one in 300 people, according to the World Health Organization (WHO). It often leads to significant challenges in daily functioning, work, and relationships, impacting both patients and their families.
The disorder typically begins in late adolescence or early adulthood and can lead to lifelong disability if not properly managed, according to the WHO, further highlighting the need for effective treatment options.
Following approval, doctors could start prescribing Cobenfy by the end of October, according to Adam Lenkowsky, executive vice president and chief commercialization officer at Bristol Myers Squibb.
Experts hope that the drug’s unique mechanism and reduced side effects will help set a new standard of care for schizophrenia patients. Studies for additional therapeutic uses, including the treatment of Alzheimer’s disease and bipolar disorder, are also underway.
Jake Goodman, MD, MBA is a psychiatry resident physician and a member of the ABC News Medical Unit.
Three influenza A (H5N1/bird flu) virus particles (rod-shaped). Note: Layout incorporates two CDC transmission electron micrographs that have been inverted, repositioned, and colorized by NIAID. Scale has been modified. Image via CDC and NIAID.
(NEW YORK) — As seasonal influenza ramps up, and with bird flu continuing to circulate, some public health experts are worried there may be a strain on the public health system.
Since the bird flu outbreak began earlier this year connected to dairy cows and poultry, there have been 55 human cases reported in the U.S., according to the Centers for Disease Control and Prevention (CDC). This includes a child in California, who was confirmed on Friday by the agency to be the first pediatric case linked to the outbreak.
There is currently no evidence of person-to-person transmission of bird flu and the risk to the general public is low, federal health officials say. But with millions of seasonal flu infections around the corner, there is some concern about additional stress on how public health surveillance systems will track the virus.
“I think it does add a layer of stress, at least in the public health planning part of things, because we have to think about what resources would be necessary were we to have a significant outbreak of bird flu,” Dr. Tony Moody, a professor of pediatrics and infectious diseases specialist at Duke University, told ABC News.
Bird flu and seasonal flu at the same time
Currently, respiratory virus activity is low in the U.S., but the country is on the brink of entering traditional flu season.
Dr. Otto Yang, a professor of medicine and microbiology, immunology and molecular genetics at the David Geffen School of Medicine at the University of California, Los Angeles, said the flu season earlier this year in the Southern Hemisphere looked typical so the same can be expected for the Northern Hemisphere.
Countries in the Southern Hemisphere experience their flu season before countries in the Northern Hemisphere. This often provides a glimpse as to what the upcoming flu season may potentially look like for the Northern Hemisphere, though it is not fully predictive of what may occur in each individual country.
“It looks like everything so far points to a fairly typical flu season in terms of the numbers, not [an] especially severe flu season, but not one especially mild either,” he told ABC News.
So far, all bird flu cases in humans in the U.S. have been mild and patients have all recovered after receiving antiviral medication. Almost all confirmed cases have had direct contact with infected livestock.
Yang said he doesn’t see bird flu putting a major strain on the health system right now, but there are unknown factors such as whether COVID-19 or RSV will lead to a higher number of cases than normal.
Moody added that health systems have conversations every year about respiratory virus season regarding whether there are enough beds, enough staff and enough equipment to treat sick patients, and that unknown factors always present a threat.
“That’s what we would be thinking about, is, what can we do to try to blunt that as much as possible, because it’s not so much that the public health system can’t absorb it,” he said. “They just can’t absorb everything all at once.”
Testing for bird flu
With flu season expected to start ramping up in the coming weeks, it may be increasingly difficult to differentiate bird flu from seasonal flu without more extensive testing, experts say.
“The reality is, we want to be ahead of a problem. There’s a surveillance challenge that was easier in the summer because we didn’t have seasonal flu cycling,” said Dr. John Brownstein, an epidemiologist and chief innovation officer at Boston Children’s Hospital and an ABC News medical contributor. “As we enter flu season, we’re going to have a respiratory mix that includes flu and may include cases of avian, and it’ll be an even greater needle in the haystack.”
Right now, a PCR test, which checks for genetic material, is needed to detect a novel flu virus in a patient. More than 60,000 tests have been completed by public health labs to detect any presence of bird flu since February of this year, according to the CDC.
Tests are sent to public health labs if there is suspicion of bird flu exposure from a clinician or a sample was submitted for surveillance purposes. Health care systems send in a quantity of flu samples to public health labs for additional testing to help detect any new bird flu cases, which is how a case in Missouri was initially identified.
“We’re doing some opportunistic sampling of cases that would get additional sequencing. [Our hospital] is sending five samples per week to state labs that would ultimately get deeper identification for bird flu,” Brownstein said.
The nation’s flu surveillance systems “are built to be able to detect novel flu infections even during peak flu season” the CDC told ABC News in a statement in part. “The level of testing performed is designed to scale with increases in seasonal flu activity so that we’re casting a wider net and maintaining the ability to detect rare infections with novel influenza viruses.”
Other surveillance methods like emergency department trends and wastewater data may become less reliable as seasonal flu ramps up, Brownstein said.
“Patients that have access to rapid tests at home also aren’t necessarily collected and connected to surveillance systems” he added.
Risk of recombination
Questions have swirled about whether or not bird flu and seasonal influenza could form a recombinant virus, meaning a combination of the two.
There is currently no evidence that this has happened and, although it is possible for either virus to mutate with each new case, experts believe this is unlikely considering bird flu is not yet showing evidence of person-to-person transmission.
“It certainly is possible, but generally you get recombination when you have hosts where both strains can get in easily, and at the moment the bird flu strain is not traveling human to human, and so very, very few humans are infected with it,” Yang said. “It’s been a handful of cases, so the risk is really tiny.”
Moody said so-called “recombination events” do happen, with people becoming infected with multiple viruses at the same time or multiple strains of a virus. However, most of the time, they are “failures,” he said.
“That’s an important thing to understand, these recombination events are happening all the time and, most of the time, it doesn’t go anywhere,” Moody said. “Very, very rarely it does, and then that becomes a possibility for transmission”
How to best protect yourself
Moody and Yang say they both recommend that people receive the flu shot. Flu vaccines are currently available for everyone six months and older, according to the CDC.
In the last flu season prior to the COVID-19 pandemic, flu vaccination prevented an estimated 7 million illnesses, 3 million medical visits, 100,000 hospitalizations, and 7,000 deaths in the U.S., the CDC said.
The seasonal flu vaccine does not protect against bird flu, but it can reduce the risk of human influenza viruses, and therefore lower the risk of co-infection.
“Is there the potential for some cross-benefit for the avian flu? There may be. It’s hard to say, because, of course, these viruses are distinct from one another,” Moody said.
(NEW YORK) — With autumn in full swing, flu season is ramping up as well.
According to the Centers for Disease Control and Prevention, flu season in the U.S. typically picks up in the fall and winter months and children, especially, are the most likely to get sick from influenza, a type of respiratory virus.
Here’s how to prepare for the season ahead:
What causes influenza (flu)?
The flu is caused by various influenza viruses that impact the respiratory system. For the 2024-2025 flu season, the CDC expects the dominant influenza viruses in the U.S. to be an A(H1N1) virus, an A(H3N2) virus, and a B/Victoria virus.
What are common flu symptoms?
Symptoms of the flu can vary but per the CDC, they may include fever or chills, a cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, fatigue, vomiting or diarrhea. The latter two symptoms are more common among children with the flu.
What is the flu incubation period and when are you most contagious?
Individuals with the flu can spread the virus to others, and according to the CDC, the incubation period can last between one and four days. The first three days of an infection tend to be the most contagious period.
The CDC recommends a flu vaccine for nearly everyone six months and older in the U.S. every flu season, except for anyone younger than six months or anyone with a severe, life-threatening allergy to any ingredient in a vaccine or the flu vaccine specifically.
What months are considered flu season?
The flu is most active between the fall and winter months. During the 2023 to 2024 flu season, CDC reports showed that national flu activity started to increase in October 2023 and didn’t start to decline until mid-April 2024.
How can you prepare for flu season?
Dr. Meghan Martin, a pediatric emergency medicine physician and a mom, shared in a TikTok post what she keeps on hand at home to stay prepared for flu season.
Her top items include:
Disposable vomit bags
Acetaminophen/Ibuprofen in multiple forms, including chewable tablets, liquid form or suppositories
Digital Thermometer
Zyrtec or a similar second-generation histamine for allergic reactions or hives
A portable pulse oximeter to measure heart rate and oxygenation
Packs of electrolyte powder
Cough suppresants and oral anesthetics including those in lollipop forms
Saline nasal mist
A squeeze bottle kit for over-the-counter saline solutions
