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.
(CHINA) — Chinese health officials are reportedly monitoring an increase in cases of human metapneumovirus (HMPV).
There is currently no evidence that the outbreak is out of the ordinary or that a new respiratory virus or illness has emerged in China.
A spokesperson for the World Health Organization (WHO) said data from China indicates “there has been a recent rise in acute respiratory infections” but that “the overall scale and intensity of respiratory infectious diseases in China this year are lower than last year.”
Cases of HMPV have been steadily increasing in the U.S. since November 2024 with 1.94% of weekly tests positive for HMPV as of Dec. 28, 2024, according to data from the Centers for Disease Control and Prevention (CDC). By comparison, 18.71% of weekly tests were positive for flu and 7.10% were positive for COVID during the same week, the data shows.
Public health experts told ABC News that HMPV is well-known to health care professionals and commonly circulates during respiratory virus season.
“This is that winter respiratory virus season, indeed,” Dr. William Schaffner, a professor of preventive medicine at Vanderbilt University Medical Center in Nashville, told ABC News. “So, all of these respiratory viruses — influenza, COVID, RSV, human metapneumovirus — they all increase this time of the year, in part because we get so close to each other.”
“We spend time indoors and, of course, all of this holiday traveling, family get-together, and parties have been opportunities for us to get close together and for the virus to be transmitted,” he continued.
Here’s what you need to know about HMPV, including what it is, how it spreads and how to treat it.
What is HMPV?
HMPV is a virus that can cause upper and lower respiratory disease, according to the CDC.
It was discovered in 2001 and is in the Pneumoviridae family along with respiratory syncytial virus, or RSV, the CDC said.
Over the years, there has been a better understanding and awareness of HMPV, which has led to broader testing, according to the federal health agency.
“Human metapneumovirus is another one of those respiratory viruses that we’re now appreciating more because we have the diagnostic capability to actually diagnose it more readily in hospitals, emergency rooms and even in physicians’ offices,” Schaffner said. “Now we have diagnostic panels that can tell you whether you have influenza or COVID or RSV or human metapneumovirus.”
What are the symptoms?
HMPV has an incubation period of three to six days, according to the CDC.
Symptoms include cough, nasal congestion, fever and shortness of breath, the federal health agency said.
“It’s oftentimes indistinguishable from the other respiratory viruses, because we don’t usually check for it unless somebody is really ill,” Dr. Peter Chin-Hong, a professor of medicine and an infectious diseases specialist at the University of California, San Francisco, told ABC News.
Young children and adults aged 65 and older are among those at the highest risk of HMPV progressing to bronchitis or pneumonia.
How does it spread?
HMPV can spread through secretions from coughing and sneezing, close personal contact and touching objects that have the virus and then touching the eyes, nose or mouth, according to the CDC.
In the U.S., like other respiratory viruses, HMPV cases typically rise in the winter and decrease in the spring.
Chin-Hong said most people are exposed to HMPV by the time they’re five years old. People can get reinfected, but symptoms are typically milder.
Those who are immunocompromised or are older may experience more severe symptoms if they are reinfected.
Is there treatment for HMPV?
There are no antivirals to treat HMPV, so treatment consists of providing supportive care to patients with moderate or severe symptoms, the experts said.
“If you’re wheezing, we’ll give bronchodilators,” Chin-Hong said, referencing a medication that relaxes and opens the airways and helps clear mucus from the lungs. “If you’re dehydrated, we give fluid; we reduce the fever.”
Chin-Hong said that because people may develop co-infections, including bacterial infections, antibiotics may need to be given.
How do I prevent HMPV?
There is no vaccine to prevent HMPV, so prevention includes following basic hygiene including washing hands with soap and water, covering the nose and mouth when coughing and sneezing and staying home when sick.
“People who are in this high-risk group for any of these viruses — particularly older people, people who are frail, people who are immune-compromised — if they go indoors where there are a lot of people, [they should] put their mask back on and also consider social distancing,” Schaffner said.
Chin-Hong and Schaffner added that it’s important for people to receive vaccines for other respiratory illnesses including COVID-19, flu and RSV.
Getting vaccinated against other respiratory viruses can reduce the risk of co-infection and may help health care professionals rule out certain illnesses much sooner.
“Sure, you can get serious disease from HMPV itself, but if you get HMPV plus pneumococcus or HMPV plus influenza or RSV, it could be much worse,” Chim-Hong said. “During respiratory virus season, you want to minimize the probability of co-infection.”
ABC News’ Youri Benadjaoud contributed to this report
(WASHINGTON) — President-elect Donald Trump is nominating a critic of COVID-19 lockdown policies to serve as the head of the National Institutes of Health.
In a statement, Trump said he has picked Dr. Jay Bhattacharya to serve as NIH director to work in cooperation with Robert F. Kennedy Jr. — whom Trump named as his pick for secretary of the Department of Health and Human Services — to direct the nation’s medical research.
“Together, Jay and RFK Jr. will restore the NIH to a Gold Standard of Medical Research as they examine the underlying causes of, and solutions to, America’s biggest Health challenges, including our Crisis of Chronic Illness and Disease,” Trump said in the statement. “Together, they will work hard to Make America Healthy Again!
Bhattacharya is a professor of health policy at Stanford University who gained notoriety for openly opposing COVID-19 lockdown restrictions.
In addition to a medical degree, he has a doctorate in economics.
Trump also nominated Jim O’Neil to serve as the deputy secretary of the Department of Health and Human Services to “oversee all operations and improve Management, Transparency, and Accountability,” according to a statement.
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.
