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Georgia is expecting a “typical” respiratory virus season for Covid, flu, and RSV, and the state public health department has instituted a new testing protocol to catch a potentially harmful virus among infants.
Those updates came Tuesday during the first meeting since May of the Georgia Department of Public Health board. The meeting was online, as the board has not resumed in-person gatherings since the Covid-19 outbreak.
State epidemiologist Dr. Cherie Drenzek said Georgia is seeing a “much more typical picture for the seasonality” of respiratory viruses Covid, influenza, and RSV.
In the past few years, RSV — respiratory syncytial virus — hit high levels in the summer. It is now peaking in the fall, closer to a pre-Covid pattern, Drenzek said. The same is true for flu.
High simultaneous rates of all three viruses could impact health care capacity.
Respiratory viruses are lower overall right now, Drenzek said, suggesting that as the Centers for Disease Control and Prevention has predicted, the chances of a “tripledemic” – the three viruses hitting the population at once – will be lower.
“We’re starting to see just some slight increases,” but the levels are low overall, Drenzek said, especially compared to the prior few years.
While Georgia is seeing a “record low” level of Covid cases, Drenzek said most of the cases, including hospitalizations and deaths, are among people over age 65.
While the KP.3.1.1 Covid variant is still predominant, about 20% of cases appear to be caused by a new strain called XEC that is a hybrid of two variants. The XEC variant could be the primary driver of winter infections, Drenzek said, but vaccines are effective against it and there is no evidence it causes more severe infections.
Flu levels are also low, Drenzek said, with few hospitalizations and the most outpatient visits among school-age children.
She expects flu to start peaking at the end of December and January, which is more typical of the virus’ pre-pandemic spread.
RSV is also following a more “traditional” pattern this year. Typically, RSV spread starts in October and is primarily concerning for infants.
Drenzek said there has been an increase in positive RSV tests in October, with about 16% of tests coming back positive. The positivity rate typically peaks at around 20%. Georgia is starting to see an increase in hospitalizations “but nowhere near where we were a year ago.”
Georgia seeing more kids with ‘walking pneumonia’
The state is seeing “large spikes” in “walking pneumonia,” or mycoplasma pneumoniae, in children. The infection typically affects older children but is now being found in children ages 2 to 4 or even younger. It is characterized by a fever, upper respiratory symptoms, and especially a lingering cough.
It’s called walking pneumonia because it’s “relatively mild,” Drenzek said, and children can end up returning to school or daycare while they are still infectious.
Children who do not have a fever for more than 24 hours without the use of fever-reducing drugs can return to school, Drenzek said.
In Georgia, the disease is not “notifiable” — health care providers do not have to report it to the state — and sometimes the diagnosis is based on symptoms, not testing.
That makes it hard to get exact numbers, Drenzek said, “but we have heard from many healthcare partners and pediatricians that they have seen more mycoplasma pneumonia in young kids than they really had ever seen before.”
Though there is no vaccine, it is treatable with antibiotics, if needed. Drenzek said “respiratory etiquette” and keeping kids home from school when they are sick can help stop the spread.
Respiratory illnesses are preventable, Drenzek said. New CDC guidance says seniors should get two doses of the latest Covid vaccine six months apart. There are immunizations for RSV for older adults and infants. And everyone over age 6 months is advised to get a flu shot.
Drenzek said Georgia has seen no cases of bird flu, which has affected almost 500 dairy herds in 15 states and 46 farmworkers in the United States.
“We have great plans in place in case we ever come across bird flu in our dairy birds or in our poultry,” Drenzek said.
Infant screening finds virus that can cause hearing loss
A new state screening regulation implemented last month has identified eight cases of congenital cytomegalovirus, Melanie Morris, child health deputy director at the department, told the board.
The new regulation requires all birthing facilities to screen newborns who fail hearing tests for cCMV before discharge or within 21 days of age, whichever comes first, Morris said.
The tests are designed to detect the congenital infection, which can cause hearing loss, that might not otherwise be caught among newborns. It’s not a universal screening protocol, Morris said, but only focuses on those infants who fail their hearing screenings.
Positive cases must be reported to the state health department so the agency can follow up with health care providers and parents or guardians.
The tests are typically performed via saliva or urine samples.
Since the new regulation was implemented on Oct. 10, eight cases have been found, Morris said.
The board’s next meeting is scheduled for Jan. 14, 2025.
Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.
