Feb 27

Welcome to Between 2 Graphs with Nancy Porter, your Summit County Epidemiologist. Each week I will provide my take of what is going on with respiratory diseases in the county.

In Summit County, flu cases have been decreasing since February 1st (see Flu chart below). Flu activity in Utah is low to moderate according to UDHHS’s dashboard (2). National flu trends are starting to decrease after that second flu spike we all saw in January (3).

Locally, RSV appears to be staying in a moderate zone of less than 10 cases a week (see the RSV Cases by Season graph below). In Utah, RSV activity is high (1,6). Nationally, RSV activity is slowly declining with 6.6% of tests being reported as positive for RSV (4).

Covid-19 concentrations in the wastewater (as of February 27th) are low in Coalville, very elevated and increasing in East Canyon, and elevated In Silver Creek (5). Half of the WRF sites in Utah are reporting low or very low Covid concentrations, with about 30% of sites reporting watch levels, and 17% elevated or very elevated (5). Nationally, Covid-19 wastewater concentrations are at a moderate level (high levels in the Midwest and Northeast) (6).

In Summit County (and most places), norovirus data is not as prevalent as we would like since not many people get tested for it. We have had some new cases reported in the last week, but it seems like it is slowing down (see the Norovirus tab above). In Utah, norovirus activity remains high (1). There are two wastewater districts in UT that test for norovirus (Central Salt Lake Valley and Provo WRFs), they are both reporting high concentrations of norovirus (6). In the West, norovirus is moderate, with ~18% of tests positive; Nationally, norovirus remains high with ~23% of tests positive (4).

Sources: 1) Intermountain Health GermWatch 2) Utah Department of Health & Human Services (UDHHS) Respiratory disease surveillance dashboard 3) CDC FluView 4) National Respiratory and Enteric Virus Surveillance System Dashboard 5) Utah Wastewater Surveillance System 6) WastewaterSCAN Dashboard

Feb 5

In Summit County, flu cases have continued to increase with 73 cases reported this past week (see Flu chart below). Nearly every age group is represented among these flu cases, so just stay home if you’re not feeling well, this second flu spike is not discriminating against age. In Utah, IHC is reporting high flu activity (1). The CDC’s weekly influenza surveillance report has not been updated in 12 days due to compliance with Executive Orders. Therefore, I will rely on the work of other epidemiologists who have compiled data from state health department websites. Apparently, the 2nd flu spike is not unique to us, the rest of the US is also seeing a 2nd spike in flu cases. There have been a few other years with a double peak, but not many with a 2nd peak as high as this one (3).

Locally, RSV appears to be starting to level off, with similar numbers of new cases being reported for the past few weeks (see the RSV Cases by Season graph below). In Utah, RSV activity is high (1,6). Nationally, RSV activity is slowly declining with 7.6% of tests being reported as positive for RSV (4).

Covid-19 concentrations in the wastewater (as of February 27) are low in Coalville, watch level in East Canyon, and very elevated In Silver Creek (5). Most sites in Utah are reporting low Covid concentrations, with only a couple sites reporting intermediate (watch) levels (5). Nationally, Covid-19 wastewater concentrations are high (mostly in the Midwest and the Northeast, the West and the South are reporting medium levels) (6).

In Summit County (and most places), norovirus data is not as prevalent as we would like since not many people get tested for it. We have not had any new reported cases for a few weeks. However, we know it is here and encourage the community to take proper precaution to protect yourself. In Utah, norovirus activity remains high (1). There are two wastewater districts in UT that test for norovirus (Central Salt Lake Valley and Provo WRFs), they are both reporting high concentrations of norovirus (6). In the West, norovirus is starting to trend down, with only 15% of tests positive; Nationally, norovirus remains high with 21.5% of tests positive (4).

Sources: 1) Intermountain Health GermWatch 2) Utah Department of Health & Human Services (UDHHS) Respiratory disease surveillance dashboard 3) Caitlin Rivers 4) National Respiratory and Enteric Virus Surveillance System Dashboard 5) Utah Wastewater Surveillance System 6) WastewaterSCAN Dashboard

Jan 29

In Summit County, flu cases have continued to increase with 56 cases reported this past week; about a third of those cases were among those aged 0-10 years of age, and about 40% were aged 25-64 years (check out the Flu tab to see case counts by age). Flu activity in Utah is also increasing according to UDHHS’s dashboard (1). Our neighboring counties have moderate or high influenza-like-illness (ILI) activity, however, ILI activity in Summit is minimal. Nationally, according to CDC’s FluView, seasonal influenza remains elevated and is increasing in most areas. Of those getting tested for flu, 25% of those were positive tests (2).

Locally, RSV cases have continued to increase since the beginning of January (see the RSV Cases by Season graph below). Even with this increase, RSV cases are still lower than they were at this time last year (RSV Cumulative Cases by Season graph). RSV numbers have not recently been updated at the National level, which also impacts reporting at the state level so I am unable at this time to determine the state and national RSV weekly trends.

*updated 1/30/25: Our covid-19 wastewater concentrations are low at all three Summit County WRFs, as are 69% of the WRFs in Utah (3). Nationally, covid wastewater concentrations are high (as of Jan. 11) (4).

In Summit County, norovirus is present in the community. Given the lack of testing and data, our trend analysis for norovirus is not statistically significant, even when looking at a 2-week trend. However, we know it is here and encourage the community to take proper precaution to protect yourself. I have added a graph of cumulative norovirus cases by season, check it out in the top tab. Given the low case counts/low testing, one way to use this data is that the trend may be representative of the virus in the community. In Utah, norovirus activity is high (5,6). There are two wastewater districts in UT that test for norovirus (Central Salt Lake Valley and Provo WRFs), they are both reporting high concentrations of norovirus (5). Nationally, norovirus is also high; 23% of tests were positive according to the National Respiratory and Enteric Virus Surveillance System (NREVSS) (7).

The increase in norovirus activity this year may be due to a new strain of norovirus that is circulating. The new strain isn’t making people more sick than before, just not many people have been exposed to it before so it is making more people sick. Best thing you can do is wash your hands! Soap and water is best, as hand sanitizer is not quite as effective with norovirus.

Sources: 1) Utah Department of Health & Human Services (UDHHS) Respiratory disease surveillance dashboard 2) CDC FluView 3) Utah Wastewater Surveillance System 4) CDC Covid Data Tracker 5) WastewaterSCAN Dashboard 6) Intermountain Health GermWatch 7) National Respiratory and Enteric Virus Surveillance System Dashboard

Jan 22

We had a slight dip in Flu cases two weeks ago, with cases going back up slightly this week (still slightly below our peak from early January). I think we may continue to see some ups and downs with our flu cases here in Summit for a couple more weeks. Nationally (and in the West), flu is activity is starting to drop, which is a good sign that our rates are most likely also on the decline. Across the state, flu hospitalizations are declining, as the weekly number of flu-associated hospitalizations has crossed down into the moderate level. Here in Summit County flu severity is reasonably low, with less than 11 flu-associated hospitalizations last week.

RSV cases have continued to increase since last week, indicating we may be in the middle of a seasonal spike (especially for those in the 0-4 age group). In the state & Nationally, RSV cases have declined slightly since last week. Hopefully we start to see that decrease in Summit soon.

Covid-19 wastewater concentrations have continued to decrease across the state. Here in Summit Covid-19 cases remain low. Coalville’s Covid-19 concentrations were below the reporting limit, and East Canyon and Silver Creek’s concentrations were also in the low category. Nationally, Covid-19 wastewater concentrations are high, mostly in the Midwest, with the West reporting lower rates than the rest of the country.

In addition to the respiratory viruses that I normally report on here, I wanted to add a little update about Norovirus. Norovirus is commonly referred to as the “stomach flu” even though it is not related to the flu at all. Norovirus season is typically between November and April. Norovirus is very contagious and causes vomiting and diarrhea. Anyone can get it, most people get better within 1 to 3 days, but you can still spread the virus for a few days after. Norovirus spreads through the fecal-oral route (gross, I know); which can be as simple as touching a contaminated surface and then touching your mouth or eating contaminated foods. The best thing to do to protect yourself and others is to WASH YOUR HANDS!

Nationally, norovirus rates are up and have continued to rise. We are currently in the middle of a large wave that is much higher than it has been for the past 5 years. The same is true for Summit County; reported cases are much higher at this point than they have been for over 5 years. Part of the high rates this year may be due to a new strain of norovirus that is circulating. The new strain isn’t making people more sick than before, just not many people have been exposed to it before so it is making more people sick. Best thing you can do is wash your hands! Soap and water is best, as hand sanitizer is not quite as effective with norovirus.

Jan 15

Flu cases have decreased slightly since last week, however, I don’t believe we are out of the woods just quite yet. Nationally, flu is currently in peak season, so I think we may continue to see some ups and downs with our flu cases here in Summit. Cumulatively, our flu cases are lower than this time last year, but part of that is due to our spike occurring about 2 weeks later than last year (much closer to pre-pandemic timing). Across the state, flu severity is up, as the weekly number of flu-associated hospitalizations has crossed into the high level. Here in Summit County the flu severity is not quite as high as some parts of the state and our bordering counties, so hopefully it stays that way.

In the state, RSV cases are slightly increasing, mostly in that 0-4 age group. We are also seeing that same increase here in Summit County. Our RSV cases are occurring in that 0-4 age group as well as in adults 45-84 years of age.

COVID-19 wastewater concentrations have decreased across the state. Here in Summit, Coalville’s COVID concentrations are low and decreasing, East Canyon’s concentrations are also in the low category, and Silver Creek’s concentrations are in the watch category. The 13-day trend for the WRFs in the Snyderville Basin is indeterminate, so we will have to wait and see which way they go.

In addition to the respiratory viruses that I normally report on here, I wanted to add a little update about Norovirus. Norovirus is commonly referred to as the “stomach flu” even though it is not related to the flu at all. Norovirus season is typically between November and April. Norovirus is very contagious and causes vomiting and diarrhea. Anyone can get it, most people get better within 1 to 3 days, but you can still spread the virus for a few days after. Norovirus spreads through the fecal-oral route (gross, I know); which can be as simple as touching a contaminated surface and then touching your mouth or eating contaminated foods. The best thing to do to protect yourself and others is to WASH YOUR HANDS!

Jan 2

Happy New Year! I hope everyone enjoyed their holiday and is happily welcoming 2025.

It looks like we are coming into 2025 with an increase of flu cases (as expected). This season’s flu cases started to increase around the middle of December, about a week later than last season, and are expected to continue increasing over the next few weeks. The bulk of the reported flu cases that we are seeing are in adults, especially those 45 to 84. If you’re not feeling well, just stay home.

RSV cases are seasonally low with a slight increase, but very low compared to the past three seasons.

COVID wastewater is low or in the watch category as of December 19th. This is similar for most of the state right now. On the last Between 2 graphs post, I had mentioned that there were some indicators of increases that may be soon to come. Surrounding states have been reporting some moderate to high COVID-19 wastewater concentrations. We will continue to monitor our COVID-19 wastewater levels.

Dec 18

Overall, respiratory disease activity is starting to increase just in time for the holidays.

Flu activity is starting to increase in Summit County as well as across the state. There is still time to get your flu vaccine!*

RSV cases are starting to increase; however, case counts are low. This is true for the rest of the U.S. as well. Activity is starting to increase, but it is off to a slower start than previous years.

COVID cases are starting to increase as seen by increase in wastewater concentrations in Summit County. Specifically, Silver Creek WRF reporting an increasing trend in covid concentration levels with an elevated concentration. Coalville WRF has moved into the watch category with an increasing trend as well. East Canyon WRF remains low with no discernable trend in the past 13-days. There are indicators of increases that may be soon to come. Surrounding states are reporting some moderate to high COVID-19 wastewater concentrations.

General rule of thumb, if you’re not feeling well, stay home (or put a mask on).

Dec 10

Overall, respiratory disease activity continues to remain low, so I will keep this short.

Flu activity is starting to increase (very slowly, but still an increase). Flu activity in the Mountain West is still relatively low in comparison to peak flu season. There is still time to get your flu vaccine!*

RSV cases are starting to increase; however, case counts are low. This is true for the rest of the U.S. as well. Activity is starting to increase, but it is off to a slower start than previous years.

COVID cases (reported by laboratory testing) are low. Wastewater concentrations remain low in Summit County, as well as across the state and nationally. There are indicators of increases that may be soon to come. Surrounding states are reporting some moderate to high COVID-19 wastewater concentrations.

General rule of thumb, if you’re not feeling well, stay home (or put a mask on).

Dec 2

I hope everyone had a wonderful Thanksgiving holiday! With the kick-off to the holidays officially underway, respiratory season here in Summit County is creeping up. Flu is looking very similar to last year. If it stays on track with last year, we will see slight increases over the next couple of weeks before it takes off about half-way through December. Nationwide, influenza-like illness (ILI) is starting to increase, but still below the 3% threshold that indicates the official beginning of flu season.

RSV & COVID remain low in Summit County. COVID-19 concentrations in the wastewater are low from all 3 wastewater districts and the 13-day trend is at a plateau. The most recent wastewater readings are from November 21, so we will keep an eye on those and see if the Thanksgiving holiday changes anything. Nationwide, COVID-19 wastewater concentrations are fairly low and quiet and RSV activity is also low across the country.

Nov 18

Respiratory disease season has begun. Case counts remain low. This is a good sign that we are getting back to pre-COVID seasonality. Seasonality refers to the times of year when certain respiratory diseases spread at high levels. In the United States, this is typically from October to May with peak activity between December and February. When respiratory diseases follow the “expected” patterns, it allows us to better anticipate what is coming. Since 2020, respiratory disease seasonality has been a bit out of whack, but we are slowly starting to see the expected patterns return.

We are less than 2 weeks away from Thanksgiving. There is still time to get your flu and covid shots before you gather around the table with family and friends! Respiratory diseases don’t make great side dishes.

Flu season is starting to make an appearance. We are starting to look a bit more like the 2019-2020 season, with a slow gradual increase. Hopefully it stays that way rather than the steep increase in cases we saw the past two seasons.

RSV activity is still low for the 2024-2025 season. Last year was a fairly mild RSV season, with the total number of cases being lower than the past two seasons. Part of this decrease may be due to the new RSV vaccine that came out last year. For information on who can get this, please check out the resources tab up top and chat with your primary care physician to see if its right for you. Compared to Flu, RSV season tends to start a little earlier in November. I hope with the continued uptake of the RSV vaccine, we will continue to see lower RSV rates than previous seasons.

COVID wastewater concentrations have remained low since the end of the summer. We are starting to see some increasing trends across the state as well as the Silver Creek watershed. We will keep an eye on the wastewater and see which way the trend moves.

*As always, please talk to your healthcare provider about when to get vaccinated, and which vaccinations are right for you.

Nov 14

Respiratory disease season has begun. Case counts are still very low, and lower than this time last year (and the past 3 years). This is a good sign that we are getting back to pre-COVID seasonality. Seasonality refers to the times of year when certain respiratory diseases spread at high levels. In the United States, this is typically from October to May with peak activity between December and February. When respiratory diseases follow the “expected” patterns, it allows us to better anticipate what is coming. Since 2020, respiratory disease seasonality has been a bit out of whack, but we are slowly starting to see the expected patterns return.

This weeks report is very similar to the last 2 weeks. Cases are low, there is still time to get your flu and covid shots!*

Summit County has 10 laboratory reported cases of seasonal influenza so far. Flu season is coming. It is time to go get that Flu shot before the season starts to take off! Looking back at last Flu season, it was one of the biggest we have had in the past 5 years. Last season, Flu kicked off in mid-November, a little later than the previous season (and closer to pre-pandemic timing). The past two seasons we have seen Flu cases peak around mid-December (probably because we are all gathering with family and friends to celebrate the holiday season). We will have to wait and see what this season brings, but I think that it will be similar to the past two years.

RSV activity is still low for the 2024-2025 season. Last year was a fairly mild RSV season, with the total number of cases being lower than the past two seasons. Part of this decrease may be due to the new RSV vaccine that came out last year. For information on who can get this, please check out the resources tab up top and chat with your primary care physician to see if its right for you. Compared to Flu, RSV season tends to start a little earlier in November. I hope with the continued uptake of the RSV vaccine, we will continue to see lower RSV rates than previous seasons.

In with the snow and out with the “summer wave” of COVID-19. COVID wastewater concentrations have return to low from all three watersheds after elevated levels for most of the summer. If you escaped the “summer wave” without getting COIVD, then you may want to think about getting a COVID vaccine when you go in and get your Flu shot. If you have recently gotten COVID, then you may want to wait a few months or so to get the COVID vaccine.

*As always, please talk to your healthcare provider about when to get vaccinated, and which vaccinations are right for you.

Nov 12

Respiratory disease season has begun. Case counts are still very low, and lower than this time last year (and the past 3 years). This is a good sign that we are getting back to pre-COVID seasonality. Seasonality refers to the times of year when certain respiratory diseases spread at high levels. In the United States, this is typically from October to May with peak activity between December and February. When respiratory diseases follow the “expected” patterns, it allows us to better anticipate what is coming. Since 2020, respiratory disease seasonality has been a bit out of whack, but we are slowly starting to see the expected patterns return.

This weeks report is very similar to the last 2 weeks. Cases are low, there is still time to get your flu and covid shots!*

Summit County has 10 laboratory reported cases of seasonal influenza so far. Flu season is coming. It is time to go get that Flu shot before the season starts to take off! Looking back at last Flu season, it was one of the biggest we have had in the past 5 years. Last season, Flu kicked off in mid-November, a little later than the previous season (and closer to pre-pandemic timing). The past two seasons we have seen Flu cases peak around mid-December (probably because we are all gathering with family and friends to celebrate the holiday season). We will have to wait and see what this season brings, but I think that it will be similar to the past two years.

RSV activity is still low for the 2024-2025 season. Last year was a fairly mild RSV season, with the total number of cases being lower than the past two seasons. Part of this decrease may be due to the new RSV vaccine that came out last year. For information on who can get this, please check out the resources tab up top and chat with your primary care physician to see if its right for you. Compared to Flu, RSV season tends to start a little earlier in November. I hope with the continued uptake of the RSV vaccine, we will continue to see lower RSV rates than previous seasons.

In with the snow and out with the “summer wave” of COVID-19. COVID wastewater concentrations have return to low from all three watersheds after elevated levels for most of the summer. If you escaped the “summer wave” without getting COIVD, then you may want to think about getting a COVID vaccine when you go in and get your Flu shot. If you have recently gotten COVID, then you may want to wait a few months or so to get the COVID vaccine.

*As always, please talk to your healthcare provider about when to get vaccinated, and which vaccinations are right for you.

Nov 4

Respiratory disease season has begun. Case counts are still very low, and lower than this time last year (and the past 3 years). This is a good sign that we are getting back to pre-COVID seasonality. Seasonality refers to the times of year when certain respiratory diseases spread at high levels. In the United States, this is typically from October to May with peak activity between December and February. When respiratory diseases follow the “expected” patterns, it allows us to better anticipate what is coming. Since 2020, respiratory disease seasonality has been a bit out of whack, but we are slowly starting to see the expected patterns return.

This weeks report is very similar to last week. Cases are low, there is still time to get your flu and covid shots!*

Summit County has only 2 laboratory reported cases of seasonal influenza so far. Flu season is coming. It is time to go get that Flu shot before the season starts to take off! Looking back at last Flu season, it was one of the biggest we have had in the past 5 years. Last season, Flu kicked off in mid-November, a little later than the previous season (and closer to pre-pandemic timing). The past two seasons we have seen Flu cases peak around mid-December (probably because we are all gathering with family and friends to celebrate the holiday season). We will have to wait and see what this season brings, but I think that it will be similar to the past two years.

RSV activity is still low for the 2024-2025 season. Last year was a fairly mild RSV season, with the total number of cases being lower than the past two seasons. Part of this decrease may be due to the new RSV vaccine that came out last year. For information on who can get this, please check out the resources tab up top and chat with your primary care physician to see if its right for you. Compared to Flu, RSV season tends to start a little earlier in November. I hope with the continued uptake of the RSV vaccine, we will continue to see lower RSV rates than previous seasons.

In with the snow and out with the “summer wave” of COVID-19. COVID wastewater concentrations have return to low from all three watersheds after elevated levels for most of the summer. If you escaped the “summer wave” without getting COIVD, then you may want to think about getting a COVID vaccine when you go in and get your Flu shot. If you have recently gotten COVID, then you may want to wait a few months or so to get the COVID vaccine.

*As always, please talk to your healthcare provider about when to get vaccinated, and which vaccinations are right for you.

Oct 29

Flu season is coming. It is time to go get that Flu shot before the season starts to take off! Looking back at last Flu season, it was one of the biggest we have had in the past 5 years. Last season, Flu kicked off in mid-November, a little later than the previous season. Flu seasonality is still recovering from the COVID pandemic, but is starting to get back to normal. The past two seasons we have seen Flu cases peak around mid-December (probably because we are all gathering with family and friends to celebrate the holiday season). We will have to wait and see what this season brings, but I think that it will be similar to the past two years.

RSV activity is still low for the 2024-2025 season. Last year was a fairly mild RSV season, with the total number of cases being lower than the past two seasons. Part of this decrease may be due to the new RSV vaccine that came out last year. For information on who can get this, please check out the resources tab up top and chat with your primary care physician to see if its right for you. Compared to Flu, RSV season tends to start a little earlier in November. I hope with the continued uptake of the RSV vaccine, we will continue to see lower RSV rates than previous seasons.

In with the snow and out with the “summer wave” of COVID-19. COVID wastewater concentrations have return to low from all three watersheds after elevated levels for most of the summer. If you escaped the “summer wave” without getting COIVD, then you may want to think about getting a COVID vaccine when you go in and get your Flu shot. If you have recently gotten COVID, then you may want to wait a few months or so to get the COVID vaccine.

Oct 8

Welcome to the first edition of Between Two Graphs with Nancy Porter, your Summit County Epidemiologist. Each week I will provide my take of what is going on with respiratory diseases in the county.

Flu season - So far, we don’t have any laboratory reported cases of Flu for the 2024-2025 season. It is time to go get that Flu shot before the season starts to take off! Looking back at last Flu season, it was one of the biggest we have had in the past 5 years. Last season, Flu kicked off in mid-November, a little later than the previous season. Flu seasonality is still recovering from the COVID pandemic, but is starting to get back to normal. The past two seasons we have seen Flu cases peak around mid-December (probably because we are all gathering with family and friends to celebrate the holiday season). We will have to wait and see what this season brings, but I think that it will be similar to the past two years.

For RSV, no lab reported cases yet for the 2024-2025 season. Last year was a fairly mild RSV season, with the total number of cases being lower than the past two seasons. Part of this decrease may be due to the new RSV vaccine that came out last year. For information on who can get this, please check out the resources tab up top and chat with your primary care physician to see if its right for you. Compared to Flu, RSV season tends to start a little earlier in November. I hope with the continued uptake of the RSV vaccine, we will continue to see lower RSV rates than previous seasons.

Now for COVID. We have been experiencing a “summer wave” of COVID-19, like much of the country, which you can see in the wastewater graphs at the bottom of the page. COVID concentrations have been elevated for most of the summer, with the exception of the Coalville watershed, which has been bouncing between low and elevated since July. Hopefully this “summer wave” dies down soon. If you have escaped the “summer wave” without getting COIVD, then you may want to think about getting a COVID vaccine when you go in and get your Flu shot. If you have recently gotten COVID, then you may want to wait a few months or so to get the COVID vaccine.