Flu And COVID-19 Surveillance Report Published - 7 November 2024

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 44:

COVID-19 activity decreased across most indicators and was at low levels.
Influenza activity remained stable across most indicators and was at low levels.
Respiratory Syncytial Virus (RSV) activity increased and is circulating above baseline levels overall, driven by substantial increases in those aged below 5 years of age.

The flu, COVID-19 and RSV surveillance report has been published here.

The Norovirus surveillance report has been published here.

COVID-19 surveillance data for week 44

COVID-19 activity decreased across most indicators and was at low levels
SARS-CoV-2 weekly average positivity rate decreased to 9.3% compared to 11.9% in the previous week - this is based on a percentage of people who test positive in hospital settings
COVID-19 hospitalisations decreased to 2.79 per 100,000 compared to 3.66 per 100,000 in the previous week
COVID-19 ICU admissions decreased to 0.10 per 100,000 compared with 0.14 per 100,000 in the previous week
there were 20 COVID-19 acute respiratory incidents reported in week 44.
positivity rates were highest in those aged 85 or more years, at a weekly average positivity rate of 16.4%, a decrease from the previous week, when positivity rates were at 20.1% among those aged 85 years and over.
the highest hospital admission rate is currently in the North East at 6.17 per 100,000, decreasing from 7.70 per 100,000 in the previous week
those aged 85 years and over had the highest hospital admission rate, which decreased to 32.56 per 100,000 compared with 39.27 in the previous week
up to the end of week 44, 17.9% of those under 65 years in a clinical risk group and 48.3% 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 44

Influenza activity was at low levels and remained stable across most indicators
Influenza positivity remained stable with a weekly mean positivity rate of 2.8% in week 44 compared to 2.9% 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 increased to 1.11 per 100,000, compared with 0.99 per 100,000 in the previous week
weekly influenza-like illnesses (ILI) General Practice (GP) consultation rate remained stable at 3.6 per 100,000 compared with 3.8 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 44, vaccine uptake stands at 29% of those under 65 years in a clinical risk group, 27% in all pregnant women and 63.1% in all those aged 65 years and over. 33.1% of children aged 2 years of age and 33.4% of children aged 3 years of age have been vaccinated

Respiratory Syncytial Virus (RSV) surveillance data for week 44

Respiratory Syncytial Virus (RSV) activity increased further and is now circulating above baseline levels overall, with more pronounced increases in those aged below 5 years of age
emergency department attendances for acute bronchiolitis increased nationally.
RSV positivity increased to 7.1% compared with 5.2% in the previous week
overall, hospital admissions increased to 1.92 per 100,000 compared with 1.19 per 100,000 in the previous week

Dr Jamie Lopez Bernal, Consultant Epidemiologist at UKHSA, said:
"RSV is now circulating at higher levels, particularly amongst those aged 5-years-old and under. While other respiratory illnesses remain at baseline levels, we expect to see this change in the next few weeks and we urge everyone eligible to get vaccinated against the three main winter threats.

"For the first time this year, vaccination is being offered against RSV as well as for flu and covid. Ahead of the peak season, eligible groups are reminded to get vaccinated as it offers the best protection heading into winter.

"As we are also now seeing more emergency department attendances caused by RSV, it’s important to be able to spot the signs.

"If your baby has a cold that is getting worse, or that is causing unusual breathing or problems feeding, call NHS 111 or contact your GP practice. As a parent trust your judgement and if your baby seems seriously unwell please go to A&E or call 999.

"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. Washing your hands regularly and using tissues can reduce the spread of respiratory illnesses."

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 44

Norovirus activity in the 2-week period between 14 October to 27 October was 16% 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 decreased in recent weeks, and was within expected levels during the 2-week period of weeks 42 and 43
since the start of the 2024/2025 season, the number of norovirus outbreaks reported in hospital settings was 26% 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
during the 2024/2025 season to date, the most commonly detected norovirus genotype has been GII.17 (67%) - an increase of this variant has also been observed in other counties during 2024 and is being closely monitored and at present there is no indication it leads to more severe illness
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:
"The usual increase we see in norovirus cases heading into the winter has started earlier compared to previous seasons.

"We’re seeing more cases of a particular strain of norovirus this year, but at present there is no indication it leads to more severe illness.

"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."