Flu activity continues to ebb nationwide, with rates of influenza-like illness (ILI) dropping further last week, but flu-related deaths in children climbed to 204, up 6 from the previous week, the Centers for Disease Control and Prevention (CDC) said in its weekly update today.

The percentage of outpatient visits for ILI, or respiratory illness, dipped slightly from 2.4% the previous week to 2.3% last week (see CDC graph at left). The number of patients hospitalized for flu dropped from 4,639 to 3,601.

Just one state, Rhode Island, reported high ILI activity, the same number as the previous week. In addition, one state reports moderate activity, down from two the previous week. Test positivity for flu has reached 5.6%, down from 6.7% the previous week. Hospitalizations and deaths are both down, but the cumulative hospitalization rate for this season—126.6 patients per 100,000 population—is the highest since the 2010-11 season.

The 204 pediatric deaths so far this season are just shy of the 207 deaths confirmed last season. Five of the new deaths in children were from influenza A and 1 from influenza B. All 3 deaths for which subtyping was performed were caused by the H1N1 strain.

COVID-19, RSV activity stays low

Meanwhile, COVID-19 levels remain low, according to CDC data updates today. Wastewater detections last week remained generally low except in Louisiana, which recorded high levels. The percentage of overall deaths that were caused by COVID last week stayed steady, at 0.7%, compared with 0.3% for flu.

The CDC's biweekly variant proportion update shows a slight rise in the LP.8.1 subvariant, which now causes 69% of infections. Another subvariant, LF.7.7.2, a descendent of FLiRT JN.1.16, is up a bit.

In its update on the three leading respiratory illnesses—flu, COVID, and respiratory syncytial virus (RSV)—the CDC notes that, nationally, flu (5.6%) and RSV (2.4%) test positivity declined, while COVID-19 (3.4%) stayed the same. Wastewater levels for influenza A and COVID-19 are low, while for RSV they remain very low.

Amid ongoing clade 1 mpox outbreaks in Africa, 58% of US adults say they would be willing to be vaccinated against the viral illness if their physician or health authority were to recommend it, up 12 percentage points since 2022, a University of Texas survey finds.

Published yesterday in Vaccine, the study compares the results of an online survey conducted during the 2022 global outbreak of clade 2b mpox with those of a September 2024 survey of 828 participants fielded during the African clade 1b mpox outbreaks and scattered cases reported elsewhere, including the United States. 

The surveys were designed to gauge mpox awareness, risk perception, intent to vaccinate, and trusted information sources.

"In 2022, an unprecedented global outbreak of mpox Clade IIb prompted the World Health Organization (WHO) to declare a Public Health Emergency of International Concern (PHEIC)," the investigators noted. "By 2024, cases continued to escalate significantly within the Democratic Republic of the Congo (DRC), with the Clade Ib variant spreading to neighboring countries."

Health workers still most trusted source of information

In 2024, 58% of adults were willing to receive the mpox vaccine if their doctor or health authority recommended it, up from 46% in 2022. Survey respondents from US Health and Humans Services (HHS) Region 1 (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont) were the least likely to say they would receive the mpox vaccine, even if it were recommended.

These results highlight the need for ongoing education among US adults to improve awareness of and vaccination intention for the mpox vaccine.

Self-reported knowledge of mpox (40%), as well as perceived self-efficacy (55%) and average risk perception (3.2) have also climbed since 2022. Healthcare workers remain the most trusted sources of information (73%), while trust in the federal government to provide factual information rose to 58%. 

"These results highlight the need for ongoing education among US adults to improve awareness of and vaccination intention for the mpox vaccine," the researchers wrote. "The consistently high degrees of trust placed in healthcare professionals and officials should guide future communications about mpox and other infectious diseases, and reinforce the importance of leveraging trusted sources to share essential public health information."

• Three countries reported more polio cases this week, including Afghanistan with another wild poliovirus type 1 (WPV1) case, according to the latest update from the Global Polio Eradication Initiative (GPEI). Afghanistan’s latest case was reported from Hilmand province, bringing the county’s total for the year to two. Elsewhere, two countries in Africa reported more circulating vaccine-derived poliovirus type 2 (cVDPV2) cases, including Ethiopia with three cases from two locations, bringing its total to 11, and Nigeria with one more case, which also lifts its total to 11 for 2025.
• Mali today became the 20th country in Africa to introduce the malaria vaccine into its routine immunization schedule, which comes on the annual observance of World Malaria Day. In a joint press release from Mali’s health ministry, UNICEF, Gavi, and the World Health Organization (WHO), officials said children ages 5 to 36 months will receive three doses based on age, with two more doses given ahead of high malaria season, a hybrid approach designed to maximize protection when the risk is greatest. The country has 927,800 doses of the R21/Matrix-M vaccine that it will deploy to 19 priority districts across five regions: Kayes, Koulikoro, Mopti, Segou, and Sikasso.
• If no new Ebola Sudan cases are reported today in Uganda’s Ebola Sudan outbreak, the country will declare the end of its outbreak tomorrow after passing two incubation periods with no new cases since the last patient was discharged from care on March 15, officials from the Africa Centre for Disease Control and Prevention (Africa CDC) said this week. The outbreak total remains at 14 cases, including 12 confirmed and 2 probable. Four deaths were reported, putting the case-fatality rate at 29%, lower than the 41% to 70% levels seen in other outbreaks involving Ebola Sudan. The outbreak is Uganda’s sixth Ebola Sudan event.