National flu and COVID-19 surveillance report: 27 February (week 9)
Updated 27 February 2025
Applies to England
This report summarises the information from the surveillance systems which are used to monitor COVID-19 (caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)), influenza, and diseases caused by seasonal respiratory viruses in England. The report is based on data up to week 8 of 2025 (between 17 February and 23 February 2025).
Main points
The main messages of this report are:
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influenza activity overall decreased across most indicators and was at low activity levels. There have been increases in influenza B activity, predominantly in children of school going age and adults up to 44 years of age.
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COVID-19 activity showed a mixed picture across indicators and was circulating at baseline levels
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respiratory syncytial virus (RSV) activity trends showed a mixed picture across indicators and was circulating at baseline levels
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Summary of all respiratory virus activity
Influenza activity
Influenza activity overall decreased across most indicators and was at low activity levels. There have been increases in influenza B activity, predominantly in children of school going age and adults up to 44 years of age. Emergency department (ED) attendances for influenza-like-illness (ILI) increased overall. The number of influenza-confirmed acute respiratory infections (ARI) incidents in week 8 remained stable compared with the previous week. A case of influenza A(H5N1) has been detected in West Midlands, England, for more information please see Human case of avian flu detected in England.
This season, so far influenza A(H1N1) has been the predominant subtype detected. In recent weeks there has been an increase in influenza B positivity rates. There have also been a small number of influenza A(H3N2) detections.
Reporting of weekly influenza vaccine uptake for the 2024 to 2025 season concluded in week 6. Monthly vaccine uptake data is reported today for GP patients, school-aged children and frontline healthcare workers.
Indicator | Trend | Level [note 1] | Comments |
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Laboratory surveillance | Stable | Medium | Influenza positivity remained stable with a weekly mean positivity rate of 12.4% compared with 12.7% in the previous week |
ILI general practice (GP) consultations | Decreasing | Low | The weekly ILI consultation rate decreased to 10.1 per 100,000 registered population in participating GP practices compared with 11.3 per 100,000 in the previous week |
GP swabbing positivity | Decreasing | Low | In week 7, among all tested samples, 14.3% were positive for influenza, compared with 17.4% in the previous week |
Hospital admissions | Decreasing | Low | The overall weekly hospital admission rate for influenza decreased to 4.15 per 100,000 compared with 4.79 per 100,000 in the previous week |
Intensive care units (ICU)/High-dependency unit (HDU) admissions | Decreasing | Baseline | The overall ICU or HDU rate for influenza decreased to 0.09 per 100,000 compared with 0.15 per 100,000 in the previous week |
Note 1: these indicators use the moving epidemic method (MEM) and the mean standard deviation method (MSD) to define thresholds to determine their respective levels of activity. Further information on these methods can be found in Influenza surveillance in Europe: establishing epidemic thresholds by the Moving Epidemic Method and Setting thresholds to determine COVID-19 activity levels using the mean standard deviation (MSD) method, England, 2022 to 2024. The MEM approach is well-established for some influenza surveillance indicators, however, for other indicators both the MEM and MSD are experimental and may be subject to future revision. Influenza laboratory surveillance (from week 1) and GP swabbing positivity (from week 2) have transitioned from using MEM to using MSD. These approaches will be considered alongside expert opinion and triangulation of other data sources.
COVID-19 activity
COVID-19 activity showed a mixed picture across indicators and was circulating at baseline levels. ED attendances for COVID-19-like remained stable. The number of reported SARS-CoV-2 confirmed acute respiratory infections (ARI) incidents in week 8 remained stable compared with the previous week.
In sequenced samples, the most prevalent lineages was XEC.
Indicator | Trend | Level [note 2] | Comments |
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Laboratory surveillance | Stable | Baseline | COVID-19 PCR (polymerase chain reaction) positivity in hospital settings remained stable with a weekly mean positivity rate of 2.8% compared with 2.8% in the previous week |
GP swabbing positivity | Decreasing | Baseline | In week 7, among all tested samples, 1% were positive for SARS-CoV-2, compared with 1.3% in the previous week |
Hospital admissions | Increasing | Baseline | The overall weekly hospital admission rate for COVID-19 increased to 1.32 per 100,000 compared with 1.15 per 100,000 in the previous week |
ICU/HDU admissions | Stable | Baseline | The overall ICU or HDU rate for COVID-19 remained stable at 0.02 per 100,000 compared with 0.05 per 100,000 in the previous week |
Note 2: these indicators use the MSD to define thresholds to determine their respective levels of activity. Further information on this method can be found in Setting thresholds to determine COVID-19 activity levels using the mean standard deviation (MSD) method, England, 2022 to 2024. The MEM approach is well-established for influenza surveillance, however, for other indicators both the MEM and MSD are experimental and may be subject to future revision. These approaches will be considered alongside expert opinion and triangulation of other data sources.
Respiratory syncytial virus activity
RSV activity trends showed a mixed picture across indicators and was circulating at baseline levels overall. ED attendances for acute bronchiolitis decreased.
Indicator | Trend | Level [note 1] | Comments |
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Laboratory surveillance | Decreasing slightly | Baseline | RSV positivity decreased slightly to 1.9% compared with 2.3% in the previous week. |
GP swabbing positivity | Increasing | Baseline | In week 7, among all tested samples, 2% were positive for RSV compared with 1.3% in the previous week |
Hospital admissions | Increasing slightly | Baseline | The overall weekly hospital admission rate for RSV slightly increased to 0.67 per 100,000 compared with 0.62 per 100,000 in the previous week |
Note 1: these indicators use the MEM to define thresholds to determine their respective levels of activity. Further information on this method can be found in Influenza surveillance in Europe: establishing epidemic thresholds by the Moving Epidemic Method. The MEM approach is well-established for influenza surveillance, however, for other indicators both the MEM and MSD are experimental and may be subject to future revision. These approaches will be considered alongside expert opinion and triangulation of other data sources.
Other viruses
Indicator | Trend | Level [note 3] | Comments |
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Adenovirus | Increasing slightly | Medium | Adenovirus positivity (laboratory surveillance) increased slightly to 4.4% compared with 4.2% in the previous week |
Human metapneumovirus (hMPV) | Increasing | Medium | hMPV positivity (laboratory surveillance) increased to 5.6% compared with 4.2% in the previous week |
Parainfluenza | Decreasing slightly | Baseline | Parainfluenza positivity (laboratory surveillance) decreased slightly to 1.5% compared with 1.6% in the previous week |
Rhinovirus | Decreasing slightly | Baseline | Rhinovirus positivity (laboratory surveillance) decreased slightly to 11.2% compared with 11.8% in the previous week |
Note 3: these indicators use the MEM (hMPV) and the MSD (adenovirus, parainfluenza and rhinovirus) to define thresholds to determine their respective levels of activity.
Further information is available on the MEM and the MSD. The MEM approach is well-established for influenza surveillance, however, for other indicators both the MEM and MSD are experimental and may be subject to future revision. These approaches will be considered alongside expert opinion and triangulation of other data sources.
Laboratory-confirmed cases
The Second Generation Surveillance System (SGSS) captures test result information for notifiable infectious diseases, including COVID-19 and influenza, from laboratories in England. The unified sample dataset (USD), used to calculate the percentage tests positive for SARS-CoV-2 among all SARS-CoV-2 tests, stores all SARS-CoV-2 test results reported to SGSS, Respiratory DataMart, and UKHSA laboratories.
COVID-19 cases
As of 26 February 2025, there were a total of 909 COVID-19 cases identified in hospital settings in week 8, increasing slightly from 831 cases in the previous week. COVID-19 PCR positivity in hospital settings remained stable in week 8, with a weekly average positivity rate of 2.8% compared with 2.8% in the previous week. Positivity rates were highest in those aged 85 years and over at a weekly average positivity rate of 4.9%. This remained stable when compared with week 7, when positivity rates were at 5% among those aged 85 years and over.
Figure 1. Weekly confirmed COVID-19 episodes tested in hospital settings, England
Figure 2. Daily percentage of tests positive for SARS-CoV-2 among all reported SARS-CoV-2 tests (7-day rolling average), England 2022 to present [note 4][note 5]
Note 4: data from previous seasons is aligned by day.
Note 5: testing policy and practice may change over time which can impact positivity rates, therefore comparisons over time should be interpreted with caution. Notable changes in testing policy occurred during 2022 to 2023, which are outlined in the data sources report.
Figure 3. Daily percentage of tests positive for SARS-CoV-2 among all reported SARS-CoV-2 tests by age group (7-day rolling average), England [note 6]
Note 6: the highlighted line corresponds to the age group in the subplot title, grey lines correspond to all other age groups.
Influenza cases
As of 26 February 2025, influenza positivity in week 8 remained stable with a weekly average positivity rate of 12.4% compared with 12.7% in the previous week. Influenza positivity rates were highest in those aged between 5 and 14 years at a weekly average positivity rate of 30.1%. This has remained stable from 31% among those aged between 5 and 14 years in week 7.
Figure 4. Daily percentage of tests positive for influenza among all reported influenza tests (7-day rolling average), England [note 4]
Note 4: data from previous seasons is aligned by day.
Figure 5. Daily percentage of tests positive for influenza among all reported influenza tests by age group (7-day rolling average), England [note 6]
Note 6: the highlighted line corresponds to the age group in the subplot title, grey lines correspond to all other age groups.
Respiratory DataMart System
Respiratory DataMart is a sentinel laboratory-based surveillance system where participating laboratories report positive and negative test results for a number of respiratory viruses from samples primarily taken in hospital. A small proportion of primary care samples are also included in this reporting.
In week 8, data is based on reporting from 8 out of the 14 sentinel laboratories.
In week 8, 7,077 respiratory specimens reported through the Respiratory DataMart System were tested for influenza. There were 699 positive samples for influenza: 222 influenza A (not subtyped), 66 influenza A (H3N2), 77 influenza A (H1N1)pdm09, and 334 influenza B. Overall, influenza positivity decreased slightly to 9.9% in week 8 compared with 10.7% in the previous week.
In week 8, 6,758 respiratory specimens reported through the Respiratory DataMart System were tested for SARS-CoV-2. There were 194 positive samples for SARS-CoV-2. SARS-CoV-2 positivity remained stable at 2.9% compared with 2.9% in the previous week, with the highest positivity in those aged 80 years and over at 5.3%.
RSV positivity decreased slightly to 1.9%, with the highest positivity in those aged under 5 years at 3.6%.
Adenovirus positivity increased slightly to 4.4%, with the highest positivity in those aged under 5 years at 14.2%.
Human metapneumovirus (hMPV) positivity increased to 5.6%, with the highest positivity in those aged under 5 years at 10.2%.
Parainfluenza positivity decreased slightly to 1.5%, with the highest positivity in those aged under 5 years at 3.2%.
Rhinovirus positivity decreased slightly to 11.2%, with the highest positivity in those aged under 5 years at 25.7%.
DataMart data is provisional and subject to retrospective updates.
Figure 6a. Respiratory DataMart weekly percentage of tests positive for influenza, SARS-CoV-2, RSV and rhinovirus, England [note 7]
Note 7: shading represents 95% confidence intervals.
Figure 6b. Respiratory DataMart weekly percentage of tests positive for adenovirus, hMPV and parainfluenza, England [note 7]
Note 7: shading represents 95% confidence intervals.
Figure 7. Respiratory DataMart weekly cases by influenza subtype, England
Figure 8. Respiratory DataMart weekly percentage testing positive for RSV by season, England
Figure 9. Respiratory DataMart weekly percentage testing positive for RSV by age, England [note 6]
Note 6: the highlighted line corresponds to the age group in the subplot title, grey lines correspond to all other age groups.
SARS-CoV-2 lineages
UKHSA conducts genomic surveillance of SARS-CoV-2 lineages.
This section provides an overview of circulating lineages in England, derived from data on sequenced PCR-positive SARS-CoV-2 samples in SGSS.
The prevalence of UKHSA-designated lineages among sequenced cases is presented in Figure 10.
To account for reporting delays, we report the proportion of lineages within COVID-19 cases that have had a sequenced positive sample between 20 January 2025 and 2 February 2025. Of those sequenced in this period 49.3% were classified as XEC, 15.49% were classified as LP.8.1, 12.68% were classified as JN.1, 8.45% were classified as KP.3.1.1 and 1.41% were classified as JN.1.11.1.
Please note that lineages will be grouped independently from their parent lineage once they reach sufficient prevalence, and may be re-grouped into their parent lineage if their prevalence subsequently falls. The data sources and methodology page contains more information on lineage groupings.
Figure 10. Prevalence of SARS-CoV-2 lineages amongst available sequenced cases for England from 19 February 2024 to 9 February 2025
Influenza virus characterisation
Between week 40 2024 (week ending 1 September 2024) and week 8 2025 (week ending 23 February 2025), the UKHSA respiratory virus unit (RVU) has genetically characterised 1718 seasonal influenza viruses, and identified 184 influenza A(H3N2) viruses, 981 influenza A(H1N1)pdm09 viruses and 553 influenza B viruses. Details of the characterised viruses are shown in Table 1. RVU has confirmed by genome sequencing the detection of live attenuated influenza vaccine (LAIV) viruses in 3 influenza A and 5 influenza B positive samples collected from children aged between 2 and 16 years. RVU have also characterised one influenza A(H5N1) virus.
Table 1. Number of influenza viruses characterised by genetic and antigenic analysis at the UKHSA Respiratory Virus Unit since week 40 of 2024
Type | Subtype | Clade | Subclade | Reference virus name | Detections | Notes |
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A | H1N1 | 5a.2a | C.1.9 | A/Netherlands/10468/2023 | 924 | |
A | H1N1 | 5a.2a.1 | D.3 | Not assigned yet | 45 | |
A | H1N1 | 5a.2a.1 | D.5 | Not assigned yet | 7 | |
A | H1N1 | 5a.2a.1 | D.1 | Not assigned yet | 4 | |
A | H1N1 | 5a.2a.1 | D | A/Victoria/4897/2022 | 1 | A/Victoria/4897 is the (H1N1)pdm09 component of the 2024/2025 NH egg-based vaccine |
A | H3N2 | 2a.3a.1 | J.2 | A/Sydney/878/2023 | 150 | |
A | H3N2 | 2a.3a.1 | J.2.2 | A/Lisboa/216/2023 | 22 | |
A | H3N2 | 2a.3a.1 | J.2.1 | A/West Virginia/51/2024 | 7 | |
A | H3N2 | 2a.3a.1 | J.1.1 | A/Canberra/331/2023 | 3 | |
A | H3N2 | 2a.3a | G.1.3.1 | Not assigned yet | 2 | |
A | H5N1 | 2.3.4.4b | DI | A/Greylag_Goose/England/141175/2024 | 1 | |
B | Victoria | V1A.3a.2 | C.5.1 | B/Catalonia/2279261NS/2023 | 223 | |
B | Victoria | V1A.3a.2 | C.5.6 | B/Brisbane/145/2023 | 205 | |
B | Victoria | V1A.3a.2 | C.5.7 | B/SouthAustralia/78/2023 | 116 | |
B | Victoria | V1A.3a.2 | C.5 | B/Connecticut/01/2021 | 7 | |
B | Victoria | V1A.3a.2 | C.3 | B/Moldova/2030521/2023 | 2 |
UKHSA RVU performs antigenic characterisation of influenza A(H1N1)pdm09, influenza A(H3N2) and influenza B viruses using haemagglutination inhibition (HI) assays. Data from these assays are used to compare how similar the currently circulating influenza viruses are to the strains included in seasonal influenza vaccines, and to monitor for changes in circulating influenza viruses. Similarity of currently circulating influenza strains to vaccine strains is defined as having an antibody titre within 4-fold when compared to reference viruses representative of the vaccine strain.
Influenza virus antigenic characterisation
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A(H1N1)pdm09: 83 A(H1N1)pdm09 viruses have been antigenically characterised and 83 (100%) were similar to reference viruses representative of the A/Victoria/4897/2022 (H1N1)pdm09‑like Northern Hemisphere 2024/25 (H1N1)pdm09 vaccine strain
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A(H3N2): 17 A(H3N2) viruses have been antigenically characterised and 9 (53%) were similar to reference viruses representative of the A/Thailand/8/2022 (H3N2)‑like Northern Hemisphere 2024/25 (H3N2) vaccine strain
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B/Victoria: 25 influenza B viruses have been antigenically characterised and 25 (100%) were similar to reference viruses representative of the B/Austria/1359417/2021 (B/Victoria lineage)‑like Northern Hemisphere 2024/25 influenza B vaccine strain
Influenza virus antiviral susceptibility surveillance
Influenza positive samples are screened for mutations in the virus neuraminidase and the cap-dependent endonuclease of the polymerase acidic protein genes known to confer neuraminidase inhibitor (Oseltamivir and Zanamivir) or Baloxavir resistance, respectively. Results from this surveillance are given in Tables 2 and 3.
Table 2. Number of influenza viruses tested for inhibition by Oseltamivir and Zanamivir since week 40 of 2024 using whole genome sequencing
Subtype | Antiviral | Normal inhibition | Reduced inhibition | Highly reduced inhibition |
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H1N1pdm09 | Oseltamivir | 955 | 2 | 8 |
H1N1pdm09 | Zanamivir | 964 | 1 | 0 |
H3N2 | Oseltamivir | 175 | 0 | 0 |
H3N2 | Zanamivir | 175 | 0 | 0 |
B/Victoria | Oseltamivir | 545 | 1 | 0 |
B/Victoria | Zanamivir | 545 | 1 | 0 |
H5N1 | Oseltamivir | 1 | 0 | 0 |
H5N1 | Zanamivir | 1 | 0 | 0 |
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Patient 1: 1 sample with H275Y detected. Immune compromised adult patient known to have received oseltamivir treatment
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Patient 2: 1 sample with H275Y detected. Immune compromised adult patient known to have received oseltamivir treatment
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Patient 3: 1 sample with H275Y detected. Immunocompetent patient with preexisting severe lung disease and known to have received oseltamivir treatment
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Patient 4: 1 sample with H275Y detected. Immune compromised adult patient not known to have received oseltamivir treatment
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Patient 5: 1 sample with H275Y detected. Immune compromised adult patient known to have received oseltamivir treatment
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Patient 6: 1 sample with I427T detected. Immunocompetent adult patient known to have not receive oseltamivir treatment
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Patient 7: 1 sample with I223M detected. Immunocompetent infant who did not receive oseltamivir treatment
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Patient 8: 1 sample with H275Y detected. Immune compromised adult patient known to have received oseltamivir treatment
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Patient 9: 1 sample with H275Y detected. Immune compromised adult patient known to have received oseltamivir treatment
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Patient 10: 1 sample with H275Y detected. Immune compromised adult patient known to have received oseltamivir treatment
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Patient 11: 1 sample with T146K detected, collected from an immunocompetent adult patient who did not receive oseltamivir treatment. T146K has been identified as having a weak association with reduced susceptibility to Oseltamivir and Zanamivir, however the clinical implications are unclear due to lack of available information.
Table 3. Number of influenza viruses tested for inhibition by Baloxavir marboxil since week 40 of 2024 using whole genome sequencing
Subtype | Normal susceptibility | Reduced susceptibility |
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H1N1pdm09 | 684 | 0 |
H3N2 | 170 | 0 |
B/Victoria | 534 | 0 |
H5N1 | 1 | 0 |
Community surveillance
Acute respiratory infection incidents (ARI)
Data is presented on viral ARI incidents in different settings that are reported to UKHSA health protection teams (HPTs).
Please note that prior to July 2024, ARI incidents were recorded in HPZone, a previous case and incident management system. From July to September 2024, HPTs transitioned to a new system, the Case and Incident Management System (CIMS). Any interpretation of seasonal and temporal trends since 1 July 2024 should consider the likelihood of differences in reporting of ARI incidents due to this change.
There were 98 new ARI incidents reported in week 8 in England. These included:
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87 incidents from care homes, of which 17 were due to influenza A, 9 were due to multiple pathogens, 7 were due to RSV, 5 were due to SARS-CoV-2, 5 were due to influenza (no type information available), 4 were due to influenza B and 4 were due to other pathogens
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9 incidents from hospitals, of which 5 were due to influenza A and 3 were due to SARS-CoV-2
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1 incident from educational settings for which no tests were available
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no incidents from prisons
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1 incident from other settings for which no tests were available
Figure 11. Number of ARI incidents by setting, England
Figure 12. Number of ARI incidents in all settings by virus type, England
FluSurvey (England)
FluSurvey is an internet-based participatory surveillance system based on the InfluenzaNet platform. It monitors trends of influenza-like illness (ILI) in the community using self-reported respiratory symptoms from registered participants.
The European Centre for Disease Control (ECDC) ILI case definition of sudden onset of symptoms with at least one of fever (chills), malaise, headache, muscle pain and at least one of cough, sore throat, shortness of breath is used for reporting. Please note that ILI is a broad definition and can include other respiratory illnesses such as COVID-19.
Healthcare use is presented as self-reported use of health services among participants meeting the ILI ECDC case definition. Where a person reports use of more than one health care service, secondary care will be indicated over primary care use and physical attendance to primary care will be indicated over use of remote services (for example, online NHS services, telephoning their GP or 111).
During week 8 2025:
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there were 1,226 participants who completed the weekly symptoms questionnaire
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126 (10.3%) reported fever or cough and 48 (3.9%) met the ILI case definition
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8.3% of participants meeting the ILI case definition reported contact with healthcare services as a result of self-reported symptoms; the most frequently reported contact was both a visit to the hospital and a visit to the GP
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the proportion of participants meeting the ILI case definition slightly increased compared with the previous report week (3.9% compared with 3.7% in week 7)
Figure 13. Rates of fever or cough and influenza-like illness (ILI) per 1,000 FluSurvey participants, England
Figure 14. Proportion of healthcare use by type among FluSurvey participants meeting the influenza-like illness case definition, England
Flu Detector
We are pausing the reporting of Flu Detector whilst we investigate an issue with the data source indicated by an unusual pattern in the data in recent weeks.
Syndromic surveillance
Syndromic surveillance collects data from various healthcare sources where presentations are classified by patterns of symptoms compatible with specific infections. In some settings, the syndromic diagnosis can be supplemented by (rapid) testing. In this report, ED attendances are displayed. Further details and data from other syndromic surveillance systems can be found in the syndromic surveillance weekly summaries.
During the week ending on 23 February 2025, ED attendances for acute respiratory infection remained stable and were above seasonally expected levels. ED attendances for influenza-like illness increased and were above seasonally expected levels. ED attendances for COVID-19-like illness remained stable. ED attendances for acute bronchiolitis, a syndrome related to RSV infection, decreased and were below seasonally expected levels.
Daily NHS 111 calls for acute respiratory infections remained stable. GP out-of-hours contacts for acute respiratory infections remained stable and were similar to seasonally expected levels. Contacts for influenza-like illness remained stable.
Figure 15a. Daily emergency department attendances for acute respiratory infection nationally, England [note 8]
Note 8: seven-day moving average is adjusted for bank holidays. Grey columns show weekends and bank holidays.
Figure 15b. Daily emergency department attendances for acute respiratory infection by age group, England [note 9]
Note 9: scales vary in each graph to enable trend comparisons. The black line is the 7-day moving average adjusted for bank holidays.
Figure 16a. Daily emergency department attendances for COVID-19-like illness nationally, England [note 8]
Note 8: seven-day moving average is adjusted for bank holidays. Grey columns show weekends and bank holidays.
Figure 16b. Daily emergency department attendances for COVID-19-like illness by age group, England [note 9]
Note 9: scales vary in each graph to enable trend comparisons. The black line is the 7-day moving average adjusted for bank holidays.
Figure 17a. Daily emergency department attendances for ILI nationally, England [note 8]
Note 8: seven-day moving average is adjusted for bank holidays. Grey columns show weekends and bank holidays.
Figure 17b. Daily emergency department attendances for ILI by age group, England [note 9]
Note 9: scales vary in each graph to enable trend comparisons. The black line is the 7-day moving average adjusted for bank holidays.
Figure 18a. Daily emergency department attendances for acute bronchiolitis nationally, England [note 8]
Note 8: seven-day moving average is adjusted for bank holidays. Grey columns show weekends and bank holidays.
Figure 18b. Daily emergency department attendances for acute bronchiolitis by age group, England [note 9]
Note 9: scales vary in each graph to enable trend comparisons. The black line is the 7-day moving average adjusted for bank holidays.
Primary care surveillance
Primary care surveillance is undertaken in collaboration with the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC), using a national sentinel surveillance system of around 2,000 GP practices covering over 19 million registered patients of all ages across England. More information on the methodology can be found in the RCGP methodology report.
RCGP clinical indicators (England)
The weekly ILI consultation rate through the RCGP surveillance decreased to 10.1 per 100,000 registered population in participating GP practices in week 8 compared with 11.3 per 100,000 in the previous week.
This rate is in the low activity level (Figure 19). By age group, the highest rates were seen in those aged between 15 and 44 years (13.6 per 100,000), followed by those aged between 1 and 4 years (11.9 per 100,000).
The lower respiratory tract infections (LRTI) consultation remained stable at 96.5 per 100,000 in week 8 compared with 96.2 per 100,000 in the previous week.
Further details are available in the weekly RSC communicable and respiratory disease report for England.
Figure 19. RCGP ILI consultation rates per 100,000, all ages, England
MEM thresholds are based on data from the 2016 to 2017 season to the 2023 to 2024 season. Please note the 2019 to 2020, 2020 to 2021 and 2021 to 2022 seasons have been removed.
RCGP sentinel swabbing scheme in England
There were no results for week 8.
598 samples were taken in week 7 through the GP sentinel swabbing, and 41 tested positive (Figure 20). As of week 4 2024, contemporaneous enterovirus differentiation has stopped.
Starting from week 44 2024, reporting of rhinovirus and enterovirus has been grouped into rhinovirus/enterovirus. Starting from week 48 2024, samples with more than 10 days between the sample collection date and the symptom onset date have been excluded.
Among 196 tested samples in week 7, 1% were positive for SARS-CoV-2, 14.3% for influenza, 2% for RSV, 1% for adenovirus, 2.5% for hMPV, and 0% for enterovirus or rhinovirus (Figure 21).
Due to the number of samples which have not yet been categorised, data should be interpreted with caution when compared with previous weeks. The proportion of detections among all tested samples is not calculated when the number of samples with a result is fewer than 50.
Figure 20. Number of samples tested for respiratory viruses in England by week, GP sentinel swabbing scheme [note 10] [note 11] [note 12]
Note 10: unknown category corresponds to samples with no result yet.
Note 11: starting from week 40 2024, testing for seasonal coronavirus has been suspended.
Note 12: reporting of rhinovirus and enterovirus follows a greater lag than for other respiratory pathogens.
Figure 21. Percentage of detected respiratory virus among all samples with completed testing in England by week, GP sentinel swabbing scheme [note 11] [note 12] [note 13]
Note 11: starting from week 40 2024, testing for seasonal coronavirus has been suspended.
Note 12: reporting of rhinovirus and enterovirus follows a greater lag than for other respiratory pathogens.
Note 13: data from the most recent week is not shown on this graph due to reporting delays.
Figure 22. Percentage of detected respiratory viruses among all samples with completed testing in England by age group, GP sentinel swabbing scheme, week 4 to week 7 [note 12] [note 13]
Note 12: reporting of rhinovirus and enterovirus follows a greater lag than for other respiratory pathogens.
Note 13: data from the most recent week is not shown on this graph due to reporting delays.
Figure 23. Weekly positivity for SARS-CoV-2, influenza and RSV in England, GP sentinel swabbing scheme [note 13]
Note 13: data from the most recent week is not shown on this graph due to reporting delays.
Secondary care surveillance
COVID-19 hospital and ICU or HDU admissions
Surveillance of COVID-19 hospitalisations to all levels of care and admissions to intensive care units (ICU) or high dependency units (HDU) are both mandatory, with data required from all acute NHS trusts in England.
Please note that SARI Watch data is provisional and subject to retrospective updates. ICU or HDU admission rates may also be affected by lags from admission to hospital to an ICU or HDU ward. Rates are presented per 100,000 trust catchment population.
COVID-19 hospitalisations for all levels of care in week 8 2025 based on 92 NHS trusts in England were as follows:
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the overall weekly hospital admission rate for COVID-19 increased to 1.32 (compared with 1.15 per 100,000 in the previous week)
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hospital admission rates for COVID-19 were highest in the West Midlands region (increasing to 2.22 per 100,000 compared with 1.93 in the previous week). Please refer to the supplementary graphs and data file for regional breakdowns
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the highest hospital admission rate for COVID-19 was in those aged 85 years and over (remained stable at 13.14 per 100,000 compared with 13.11 in the previous week)
COVID-19 ICU-HDU admissions in week 8 2025 based on 75 NHS trusts in England were as follows:
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the overall ICU or HDU rate for COVID-19 remained low at 0.02 per 100,000 (compared with 0.05 per 100,000 in the previous week). Note that with low rates in critical care, small random fluctuations may occur
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ICU or HDU admission rates for COVID-19 were highest in the London region (decreasing to 0.07 per 100,000 compared with 0.21 in the previous week). Please refer to the supplementary graphs and data file for regional breakdowns
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the highest ICU or HDU admission rate for COVID-19 was in those aged between 75 and 84 years (slightly increasing to 0.10 per 100,000 compared with 0.10 in the previous week)
Figure 24. Weekly overall COVID-19 hospital admission rates per 100,000 trust catchment population reported through SARI Watch mandatory surveillance, England [note 14]
Note 14: please note that a correction has been made to 2020 week numbers.
Figure 25. Weekly hospital admission rate by age group for new COVID-19 positive cases reported through SARI Watch mandatory surveillance, England [note 6]
Note 6: the highlighted line corresponds to the age group in the subplot title, grey lines correspond to all other age groups.
Figure 26. Weekly overall COVID-19 ICU or HDU admission rates per 100,000 trust catchment population reported through SARI Watch mandatory surveillance, England [note 14]
Note 14: please note that a correction has been made to 2020 week numbers.
Figure 27. Weekly ICU or HDU admission rate by age group for new COVID-19 positive cases reported through SARI Watch mandatory surveillance, England [note 6]
Note 6: the highlighted line corresponds to the age group in the subplot title, grey lines correspond to all other age groups.
Influenza hospital and ICU or HDU admissions
Surveillance of influenza hospitalisations to all levels of care is based on data from a small sentinel network of acute NHS trusts in England. Surveillance of admissions to ICU or HDU for influenza is mandatory with data required from all acute NHS trusts in England.
Please note that SARI Watch data is provisional and subject to retrospective updates. Rates are presented per 100,000 trust catchment population.
Influenza hospitalisations to all levels of care in week 8 2025 based on 26 sentinel NHS trusts in England were as follows:
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the overall weekly hospital admission rate for influenza decreased to 4.15 per 100,000 (compared with 4.79 per 100,000 in the previous week)
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this rate is in the low impact range (1.77 to less than 4.29 per 100,000)
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hospital admission rates for influenza were highest in those aged 85 years and over (17.06 per 100,000). Please refer to the supplementary graphs and data file for regional breakdowns
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there were 490 new hospital admissions for influenza (296 influenza A(not subtyped), 12 influenza A(H1N1)pdm09, 3 influenza A(H3N2), and 179 influenza B)
Influenza ICU-HDU admissions in week 8 2025 based on 94 NHS trusts in England were as follows:
-
the overall ICU or HDU rate for influenza decreased to 0.09 per 100,000 (compared with 0.15 per 100,000 in the previous week). Note that with low rates in critical care, small random fluctuations may occur
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this rate is in the baseline impact range (less than 0.1 per 100,000)
-
please refer to the supplementary graphs and data file for regional breakdowns
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there were 39 new ICU or HDU admissions for influenza (26 influenza A(not subtyped), 4 influenza A(H1N1)pdm09, 0 influenza A(H3N2), and 9 influenza B)
Figure 28. Weekly overall influenza hospital admission rates per 100,000 trust catchment population with MEM thresholds, reported through SARI Watch sentinel surveillance, England [note 15]
Note 15: please note that a correction has been made to 2019 week numbers.
Figure 29. Weekly influenza hospital admissions by influenza type, reported through SARI Watch sentinel surveillance, England
Figure 30. Weekly hospital admission rate by age group for new influenza reported through SARI Watch sentinel surveillance, England [note 6] [note 16]
Note 6: the highlighted line corresponds to the age group in the subplot title, grey lines correspond to all other age groups.
Note 16: please note this sentinel influenza surveillance did not routinely operate between weeks 21 and 39 2024 inclusive. The data presented in this period is based on a subset of trusts that voluntarily reported out of season.
Figure 31. Weekly overall influenza ICU or HDU admission rates per 100,000 trust catchment population with MEM thresholds, reported through SARI Watch mandatory surveillance, England [note 15]
Note 15: please note that a correction has been made to 2019 week numbers.
Figure 32. Weekly influenza ICU or HDU admissions by influenza type, reported through SARI Watch mandatory surveillance, England
Figure 33. Weekly ICU or HDU admission rate by age group for new influenza cases, reported through SARI Watch mandatory surveillance, England [note 6] [note 16]
Note 6: the highlighted line corresponds to the age group in the subplot title, grey lines correspond to all other age groups.
Note 16: please note this mandatory influenza surveillance did not routinely operate between weeks 21 and 39 2024 inclusive. The data presented in this period is based on a subset of trusts that voluntarily reported out of season.
RSV hospital admissions
Surveillance of respiratory syncytial virus (RSV) hospitalisations (excluding ICU or HDU admissions) is based on data from a small sentinel network of acute NHS trusts in England.
Please note that SARI Watch data is provisional and subject to retrospective updates. Rates are presented per 100,000 trust catchment population.
RSV hospitalisations, excluding ICU or HDU admissions, in week 8 2025 based on 19 sentinel NHS trusts in England were as follows:
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the overall weekly hospital admission rate for RSV slightly increased to 0.67 per 100,000 (compared with 0.62 per 100,000 in the previous week)
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in children aged under 5 years, the hospitalisation rate for RSV slightly increased to 1.83 per 100,000 (compared with 1.70 per 100,000 in the previous week)
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in adults aged 75 years and over, the hospitalisation rate for RSV increased to 2.73 per 100,000 (compared with 2.44 per 100,000 in the previous week). Broken down further, rates were 1.90 per 100,000 in those aged between 75 and 84 years, and 4.81 per 100,000 in those aged 85 years and over in week 8
Figure 34. Weekly hospital admission rates (excluding ICU or HDU) of RSV positive cases per 100,000 population reported through SARI Watch sentinel surveillance, England [note 14] [note 17]
Note 14: please note that a correction has been made to 2020 week numbers.
Note 17: please note this sentinel RSV surveillance has routinely operated between week 40 and week 20 in previous seasons. RSV surveillance paused earlier following week 16 2024 to facilitate an earlier start in week 36 for the 2024 to 2025 season. In the 2020 to 2021 and 2021 to 2022 seasons only, surveillance was extended to week 39 due to urgent public health need.
Figure 35. Weekly hospital admission rates (excluding ICU or HDU) of RSV positive cases per 100,000 population in those aged under 5 years and aged over 75 years reported through SARI Watch sentinel surveillance, England [note 17]
Note 17: please note this sentinel RSV surveillance has routinely operated between week 40 and week 20 in previous seasons. RSV surveillance paused earlier following week 16 2024 to facilitate an earlier start in week 36 for the 2024 to 2025 season. In the 2020 to 2021 and 2021 to 2022 seasons only, surveillance was extended to week 39 due to urgent public health need.
Figure 36. Weekly count of hospital admissions of RSV positive cases reported through SARI Watch sentinel surveillance by level of care, England
Figure 37. Weekly hospital admission rates (excluding ICU or HDU) by age group for RSV cases reported through SARI Watch sentinel surveillance, England [note 6] [note 18]
Note 6: the highlighted line corresponds to the age group in the subplot title, grey lines correspond to all other age groups.
Note 18: please note this sentinel RSV surveillance did not routinely operate between weeks 17 and 35 2024 inclusive. The data presented in this period is based on a subset of trusts that voluntarily reported out of season.
ECMO admissions
Surveillance of extra corporeal membrane oxygenation (ECMO) admissions is based on data from severe respiratory failure (SRF) centres in the UK. Please refer to Sources of surveillance data for influenza, COVID-19 and other respiratory viruses for additional information.
Please note that SARI Watch data is provisional and subject to retrospective updates.
There were 4 new ECMO admissions reported in week 8 2025 in adults:
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2 were due to an ARI (other viral, bacterial or fungal)
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1 admission was due to sepsis (non-respiratory origin)
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1 admission was due to a non-infectious cause
Please note that the other group includes other viral, bacterial or fungal ARI, suspected ARI, non-infection (such as asthma, primary cardiac and trauma) and sepsis of non-respiratory origin.
Figure 38. Laboratory confirmed ECMO admissions in adults (COVID-19, influenza and non-COVID-19 confirmed) to severe respiratory failure centres in the UK
Vaccine coverage
Influenza vaccination coverage
This week, monthly data which cover vaccinations that were given between 1 September and 31 January 2025 for GP patients, school aged children and frontline healthcare workers has been published. Data is not comparable to previous seasons for those aged 65 years and over, those aged under 65 years in clinical risk groups and frontline healthcare workers. This is because in previous seasons, these cohorts have been eligible from 1 September, rather than from 3 October this season.
Influenza vaccine uptake in GP patients
For GP patients up to 31 January 2025, the provisional proportion of people in England who had received an influenza vaccine this season in targeted groups was as follows:
Main survey (98.6% of GP practices reporting through ImmForm):
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39.8% in those aged under 65 years in a clinical risk group
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34.8% in all pregnant women
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74.7% in those aged 65 years and over
Children’s survey (99.2% of GP practices reporting):
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41.5% in children aged 2 years
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43.3% in children aged 3 years
The monthly GP report includes ethnicity data for at-risk groups, pregnant women, those 65 years and over, 2 and 3 years of age, and primary and secondary school-aged children. For all cohorts, trends are similar to previous seasons.
Influenza vaccine uptake in school age children
This week, provisional monthly data on influenza vaccine uptake in children of school years Reception to Year 11 was published, showing the provisional proportion of children who received the 2024 to 2025 influenza vaccine via school, pharmacy or GP practice between 1 September and 31 January 2025. For primary school aged children (4 to 10 years of age), national vaccine uptake was 54.6%, which is comparable to the same timepoint last season; and for secondary school aged children (11 to 15 years of age) was 46.4%, which is over 3 percentage points higher than the comparable time point last season. This is the last monthly publication for school-aged children this season.
Influenza vaccine uptake in frontline healthcare workers
This week, provisional monthly data on influenza vaccine uptake in frontline healthcare workers was published, showing vaccine uptake at national, commissioning region, and Trust level, and by staff group, between 1 September and 31 January 2025. National vaccine uptake is 38.1%. Data is not comparable to previous seasons for frontline healthcare workers because in previous seasons, this cohort has been eligible from 1 September, rather than from 3 October this season.
COVID-19 vaccination
On 27 February, monthly data for frontline healthcare workers has been published. This covers vaccinations that were given between 1 September and 31 January 2025 and is available under the joint flu and COVID-19 vaccine uptake report although vaccinations were only due to begin from 3 October 2024.
Data sources and methodology
For additional information regarding data sources please refer to the sources of surveillance data for influenza, COVID-19 and other respiratory viruses.
Background information
Related statistics
COVID-19 deaths
For further information on COVID-19 related deaths in England please see the [COVID-19
dashboard for death](https://ukhsa-dashboard.data.gov.uk/).
All-cause mortality assessment (England)
For further information on all-cause mortality in England please see the:
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Excess mortality within England post-pandemic method report, which uses Office for National Statistics (ONS) death registration data
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the all-cause mortality surveillance report, which uses the European mortality monitoring (EuroMOMO) model to identify weeks with higher than expected mortality
Syndromic surveillance
For further information on syndromic surveillance please see the syndromic surveillance weekly summaries.
Flu Detector
For further information on Flu detector please see the daily influenza-like illness rates.
Further information and contact details
Feedback and contact information
To provide feedback and for all queries relating to this document, please contact respdsr.enquiries@ukhsa.gov.uk
Official statistics
Our statistical practice is regulated by the Office for Statistics Regulation (OSR). OSR sets the standards of trustworthiness, quality and value in the Code of Practice for Statistics that all producers of official statistics should adhere to.
You are welcome to contact us directly by emailing respdsr.enquiries@ukhsa.gov.uk with any comments about how we meet these standards.
Alternatively, you can contact OSR by emailing regulation@statistics.gov.uk or via the OSR website.
UKHSA is committed to ensuring that these statistics comply with the Code of Practice for Statistics. This means users can have confidence in the people who produce UKHSA statistics because our statistics are robust, reliable and accurate. Our statistics are regularly reviewed to ensure they support the needs of society for information.