WIREDGOV

Weekly national influenza and COVID-19 report, COVID-19 activity, seasonal flu and other seasonal respiratory illnesses.

This COVID-19, flu, RSV and norovirus surveillance bulletin (formally Weekly Winter Briefing) brings together the latest surveillance data, along with the latest public health advice for COVID-19, flu, RSV and norovirus.

In week 42:

• COVID-19 activity remained stable or decreased slightly across most indicators, but remained at moderate levels
• influenza activity increased slightly across some indicators but remained at low levels
• respiratory syncytial virus (RSV) remained low overall with slightly increasing activity across most indicators and more pronounced increases in those aged below 5 years of age

For more information, see the:

• Flu, COVID-19 and RSV surveillance report
• Norovirus surveillance report

COVID-19 surveillance data for week 42

In week 42:

• COVID-19 activity remained stable or decreased slightly across most indicators, but remained at moderate levels
• SARS-CoV-2 weekly average positivity rate decreased slightly at 13.3% compared to 14.4% in the previous week. This is based on a percentage of people who test positive in hospital settings
• COVID-19 hospitalisations remained stable at 4.64 per 100,000 compared to 4.60 per 100,000 in the previous week
• COVID-19 ICU admissions decreased slightly to 0.12 per 100,000 in week 10 compared with 0.13 per 100,000 in the previous week
• there were 53 COVID-19 acute respiratory incidents reported in week 42
• positivity rates were highest in those aged 85 or more years, at a weekly average positivity rate of 21.4%, a slight decrease from the previous week
• the highest hospital admission rate is currently in the North East at 8.26 per 100,000, decreasing slightly from 8.91 per 100,000 in the previous week
• those aged 85 years and over had the highest hospital admission rate, which remained stable at 54.13 per 100,000 compared with 52.69 in the previous week
• up to the end of week 42, 12.7% of those under 65 years in a clinical risk group and 35.8% of all people aged over 65 years old, who are living and resident in England had been vaccinated with an Autumn 2024 booster dose

Flu surveillance data for week 42

In week 42:

• influenza activity was at low levels but increased across most indicators
• influenza positivity increased slightly to 2.5% in week 42 compared to 2.3% in the previous week; this is based on a percentage of people who test positive among those with symptoms tested at sentinel “spotter” laboratories, reported through the Respiratory DataMart surveillance system
• overall, influenza hospitalisations remained stable at 0.55 per 100,000
• the weekly influenza-like illnesses (ILI) General Practice (GP) consultation rate increased to 3.9 per 100,000 compared with 3.6 per 100,000 in the previous week
• for the 2024/25 season’s vaccination programme, children and pregnant women have been eligible since 1 September, whilst clinical risk groups, older adults (those aged 65 years and over) and frontline healthcare workers have been eligible since 3 October.

Up to the end of week 42, vaccine uptake stands at:

• 20.8% of those under 65 years in a clinical risk group
• 21.4% in all pregnant women
• 48.2% in people aged 65 years and over
• 26.4% of children aged 2 years old
• 26.3% of children aged 3 years old

Dr Jamie Lopez Bernal, Consultant Epidemiologist at UKHSA, said:

This week’s data shows that flu is gradually increasing but remains at low levels. COVID-19 continues to circulate at moderate levels and we encourage all those eligible to get vaccinated against COVID-19 and flu, as we expect both infections to increase in the coming weeks.

Our current surveillance shows that around 13% of sequenced COVID-19 cases are the ‘XEC’ lineage however current information doesn’t suggest we should be more concerned about this variant. We are monitoring this closely and vaccination still offers the best protection.

If you are showing symptoms of flu or COVID-19 such as a high temperature, cough, and feeling tired and achy, try to limit your contact with others, especially those who are vulnerable.

Respiratory Syncytial Virus (RSV) surveillance data for week 42

In week 42:

• respiratory syncytial virus (RSV) activity increased across most indicators however remained at low levels
• emergency department attendances for acute bronchiolitis increased nationally.
• RSV positivity increased to 3.4% compared with 2% in the previous week
• overall, hospital admissions increased to 0.98 per 100,000 compared with 0.42 per 100,000

Dr Conall Watson, Consultant Epidemiologist at UKHSA, said:

The latest RSV surveillance is showing increasing cases in children under 5 years of age, as is typical for this time of the year, with increasing numbers of infants under 1 year old being seen in hospital emergency departments for bronchiolitis.  

Vaccination programmes were launched in September to prevent severe RSV in infants and older adults. I would encourage anyone who is 28 or more weeks pregnant to have the vaccine to protect their baby, along with people aged 75-79 years who are also offered the vaccine by the NHS as part of the new programmes.

Washing your hands regularly and using tissues can reduce the spread of RSV and other viruses. People who are unwell with colds should try and avoid visiting newborn babies and other vulnerable groups.

Since 1 September 2024, pregnant women have been offered RSV vaccination around the time of their 28 week antenatal appointment. Having the vaccine in week 28 or within a few weeks of this will help build a good level of antibodies to pass on to their baby before birth. This will give the newborn baby the best protection, including if they are born early. Those who turn 75 and those age 75 to 79 are also eligible for a free NHS vaccine to protect them from RSV.

Norovirus surveillance data for week 42

In week 42:

• norovirus activity in the 2-week period between 30 September to 13 October was 39% higher than the previous 2-week period; total reports were more than double the 5-season average for the same 2-week period
• rotavirus reporting has remained high in recent weeks, with activity during weeks 40 to 41 of 2024; 43% higher than the 5-season average for the same 2-week period
• since the start of the 2024/25 season, the number of norovirus outbreaks reported in hospital settings was 29% higher than the 5-season average
• it is likely that multiple factors are contributing to the observed increase in laboratory reports, such as ongoing changes to the epidemiology following the COVID-19 pandemic, or changes in testing and reporting to national surveillance
• there has been an increase GII.17 variant since April 2024, and during the first 15 weeks of the 2024/2025 season this was the most commonly detected norovirus genotype; the increase of the variant has been observed in other counties and is being closely monitored
• norovirus symptoms include nausea, vomiting and diarrhoea but can also include a high temperature, abdominal pain and aching limbs; norovirus infections can cause dehydration, especially in vulnerable groups such as young children and older or immunocompromised people, so if you do get ill it is important to drink plenty of fluids during that time

Amy Douglas, epidemiologist at UKHSA said:

As we head into the winter season, we are seeing norovirus levels higher than usual, and we expect the virus to spread more in the coming weeks.

Recently, we’ve seen the biggest rise in cases in adults, especially those aged 65 and over.

To help reduce the spread of norovirus you can take steps to avoid passing the infection on. If you have diarrhoea and vomiting, do not return to work, school or nursery until 48 hours after your symptoms have stopped and don’t prepare food for others in that time either. If you are unwell, avoid visiting people in hospitals and care homes to prevent passing on the infection in these settings.

Washing your hands with soap and warm water and using bleach-based products to clean surfaces will also help stop infections from spreading. Alcohol gels do not kill norovirus so don’t rely on these alone.