Official Statistics

National flu and COVID-19 surveillance report: 31 October (week 44)

Updated 31 October 2024

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 43 of 2024 (between 21 October and 27 October 2024).

Main points

The main messages of this report are:

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

Summary of respiratory virus activity

Influenza activity

Influenza activity was at low levels but increased accross some indicators compared with the previous reporting week. Emergency department (ED) attendances for influenza-like-illness (ILI) increased slightly overall. The number of influenza-confirmed ARI incidents in week 43 increased slightly compared with the previous week.

Weekly influenza vaccine uptake for the 2024 to 2025 season is reported for week 43 (data up to 27 October 2024). Compared with the equivalent week last season (2023 to 2024), vaccine uptake is slightly lower for those aged 2 years, comparable for those aged 3 years, and higher for pregnant women. Data is not comparable to previous seasons for those aged 65 years and over, and those aged under 65 years in clinical risk groups. This is because in previous seasons, these cohorts have been eligible from 1 September, rather than from 3 October this season.

Indicator	Trend	Level [note 1]	Comments
Laboratory surveillance	Increasing	Green	Influenza positivity increased with a weekly mean positivity rate of 2.7% compared with 2.3% in the previous week
ILI General Practice (GP) consultations	Stable	Green	The weekly ILI consultation rate remained stable at 3.8 per 100,000 registered population in participating GP practices compared with 3.9 per 100,000 in the previous week
GP swabbing positivity	Increasing	Green	In week 42, among all tested samples, 2.7% were positive for influenza, compared with 1.8% in the previous week
Hospital admissions	Decreasing slightly	Green	The overall weekly hospital admission rate for influenza slightly decreased to 0.70 per 100,000 compared with 0.76 per 100,000 in the previous week
Intensive care units(ICU)/High-dependency unit(HDU) admissions	Stable	Green	The overall ICU or HDU rate for influenza remained stable at 0.03 per 100,000 compared with 0.02 per 100,000 in the previous week

Note 1: for indicators where moving epidemic method (MEM) thresholds exist, these thresholds were used to determine the level of activity (green, amber, red). Baseline and low levels were combined into ‘green’, high and very high levels were combined into ‘red’, and the medium level was kept as ‘amber’. For indicators where MEM thresholds do not exist, the mean and standard deviation of activity over the past year was used as a guide to the level of activity (green, amber, red) alongside expert opinion and triangulation of other data sources. This method is experimental and is still under development.

COVID-19 activity

COVID-19 activity remained stable or decreased slightly across most indicators, and was at low levels. ED attendances for COVID-19 decreased overall. The number of reported SARS-CoV-2 confirmed acute respiratory infections (ARI) incidents in week 43 decreased compared with the previous week. By the end of week 43 2024 (week ending 27 October 2024), 43.5% of all people aged 65 years old and over who are living and resident in England had been vaccinated with an autumn 2024 booster dose since 3 October 2024. 15.9% of all people aged under 65 years old and in a clinical risk group who are living and resident in England had also been vaccinated with an autumn 2024 booster dose since 3 October 2024.

Indicator	Trend	Level [note 1]	Comments
Laboratory surveillance	Decreasing slightly	Green	SARS-CoV-2 positivity from DataMart decreased slightly to 8.9% compared with 10.7% in the previous week
GP swabbing positivity	Stable	Green	In week 42, among all tested samples, 7.5% were positive for SARS-CoV-2, compared with 7.3% in the previous week
Hospital admissions	Decreasing	Green	The overall weekly hospital admission rate for COVID-19 decreased to 3.91 per 100,000 compared with 4.40 per 100,000 in the previous week
ICU/HDU admissions	Increasing	Green	The overall ICU or HDU rate for COVID-19 increased to 0.13 per 100,000 compared with 0.11 per 100,000 in the previous week

Note 1: for indicators where moving epidemic method (MEM) thresholds exist, these thresholds were used to determine the level of activity (green, amber, red). Baseline and low levels were combined into ‘green’, high and very high levels were combined into ‘red’, and the medium level was kept as ‘amber’. For indicators where MEM thresholds do not exist, the mean and standard deviation of activity over the past year was used as a guide to the level of activity (green, amber, red) alongside expert opinion and triangulation of other data sources. This method is experimental and is still under development.

Respiratory syncytial virus activity

RSV activity remained low overall with increasing activity across most indicators, with more pronounced increases in those aged below 5 years of age. ED attendances for acute bronchiolitis increased nationally.

Indicator	Trend	Level [note 1]	Comments
Laboratory surveillance	Increasing	Green	RSV positivity increased to 5.2% compared with 3.2% in the previous week
GP swabbing positivity	Increasing	Green	In week 42, among all tested samples, 2.5% were positive for RSV compared with 1.2% in the previous week
Hospital admissions	Increasing	Green	The overall weekly hospital admission rate for RSV increased to 1.26 per 100,000 compared with 0.88 per 100,000 in the previous week

Note 1: for indicators where moving epidemic method (MEM) thresholds exist, these thresholds were used to determine the level of activity (green, amber, red). Baseline and low levels were combined into ‘green’, high and very high levels were combined into ‘red’, and the medium level was kept as ‘amber’. For indicators where MEM thresholds do not exist, the mean and standard deviation of activity over the past year was used as a guide to the level of activity (green, amber, red) alongside expert opinion and triangulation of other data sources. This method is experimental and is still under development.

Other viruses

Indicator	Trend	Level [note 1]	Comments
Adenovirus	Decreasing slightly	Green	Adenovirus positivity (laboratory surveillance) decreased slightly to 1.9%
Human metapneumovirus (hMPV)	Increasing slightly	Green	hMPV positivity (laboratory surveillance) increased slightly to 1.9%
Parainfluenza	Decreasing slightly	Green	Parainfluenza positivity (laboratory surveillance) decreased slightly to 2.2%
Rhinovirus	Decreasing slightly	Green	Rhinovirus positivity (laboratory surveillance) decreased slightly to 14.7%

Note 1: for indicators where moving epidemic method (MEM) thresholds exist, these thresholds were used to determine the level of activity (green, amber, red). Baseline and low levels were combined into ‘green’, high and very high levels were combined into ‘red’, and the medium level was kept as ‘amber’. For indicators where MEM thresholds do not exist, the mean and standard deviation of activity over the past year was used as a guide to the level of activity (green, amber, red) alongside expert opinion and triangulation of other data sources. This method is experimental and is still under development.

Laboratory surveillance

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

Due to a data processing issues, the COVID-19 section has not been updated this week, and will be updated in upcoming reports.

As of 29 October 2024, there were a total of 3,017 COVID-19 cases identified in hospital settings in week 42, decreasing slightly from 3,245 cases in the previous week. COVID-19 PCR positivity in hospital settings decreased slightly in week 42, with a weekly average positivity rate of 13.3% compared with 14.4% in the previous week. Positivity rates were highest in those aged 85 years and over at a weekly average positivity rate of 21.4%. This decreased slightly when compared with week 41, when positivity rates were at 23% among those aged 85 years and over.

Figure 1. Total daily COVID-19 cases and percentage of tests positive for SARS-CoV-2 among all reported SARS-Cov-2 tests, England

Figure 2. Percentage of tests positive for SARS-CoV-2 among all reported SARS-CoV-2 tests by age group, England

Influenza cases

As of 29 October 2024, influenza positivity in week 43 increased with a weekly average positivity rate of 2.7% compared with 2.3% in the previous week. Influenza positivity rates were highest in those aged between 5 and 14 years at a weekly average positivity rate of 6.6%. This has increased from 5.3% among those aged between 5 and 14 years in week 42.

Figure 3. Percentage of tests positive for influenza among all reported influenza tests, England [Note 2]

Note 2: data from previous seasons is aligned by day.

Figure 4. Percentage of tests positive for influenza among all reported influenza tests by age group, England

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 43, data is based on reporting from 10 out of the 14 sentinel laboratories.

In week 43, 5,599 respiratory specimens reported through the Respiratory DataMart System were tested for influenza. There were 183 positive samples for influenza: 111 influenza A (not subtyped), 26 influenza A (H3N2), 37 influenza A (H1N1)pdm09, and 17 influenza B. Overall, influenza positivity increased to 3.3% in week 43 compared with 2.3% in the previous week.

In week 43, 5,703 respiratory specimens reported through the Respiratory DataMart System were tested for SARS-CoV-2. There were 510 positive samples for SARS-CoV-2. SARS-CoV-2 positivity decreased slightly to 8.9% compared with 10.7% in the previous week, with the highest positivity in those aged 80 years and over at 15.9%.

RSV positivity increased to 5.2%, with the highest positivity in those aged under 5 years at 25.1%.

Adenovirus positivity decreased slightly to 1.9%, with the highest positivity in those aged under 5 years at 6.1%.

Human metapneumovirus (hMPV) positivity increased slightly to 1.9%, with the highest positivity in those aged under 5 years at 3%.

Parainfluenza positivity decreased slightly to 2.2%, with the highest positivity in those aged under 5 years at 7%.

Rhinovirus positivity decreased slightly to 14.7%, with the highest positivity in those aged under 5 years at 34%.

DataMart data is provisional and subject to retrospective updates.

Figure 5a. Respiratory DataMart weekly percentage of tests positive for influenza, SARS-CoV-2, RSV and rhinovirus, England [note 3]

Note 3: shading represents 95% confidence intervals.

Figure 5b. Respiratory DataMart weekly percentage of tests positive for adenovirus, hMPV and parainfluenza, England [note 3]

Note 3: shading represents 95% confidence intervals.

Figure 6. Respiratory DataMart weekly cases by influenza subtype, England

Figure 7. Respiratory DataMart weekly percentage testing positive for RSV by season, England

Figure 8. Respiratory DataMart weekly percentage testing positive for RSV by age, England [note 4]

Note 4: the highlighted line corresponds to the age group in the subplot title, grey lines correspond to all other age groups.

SARS-CoV-2 lineages

This section is updated fortnightly. Data below was last updated in the week 43 report.

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 9.

To account for reporting delays, we report the proportion of lineages within COVID-19 cases that have had a sequenced positive sample between 16 September 2024 and 29 September 2024. Of those sequenced in this period 56.64% were classified as KP.3.1.1, 13.57% were classified as XEC, 10.62% were classified as JN.1, 6.19% were classified as KP.2, 3.24% were classified as KP.3.3, 2.95% were classified as JN.1.11.1 and 2.65% were classified as KP.3.1.

Figure 9. Prevalence of SARS-CoV-2 lineages amongst available sequenced cases for England from 16 October 2023 to 6 October 2024

Influenza virus characterisation

Between week 35 2024 (week ending 1 September 2024) and week 43 2024 (week ending 27 October 2024), the UKHSA Respiratory Virus Unit (RVU) has genetically characterised 118 influenza viruses, and identified 56 influenza A(H3N2) viruses, 52 influenza A(H1N1)pdm09 viruses and 10 influenza B viruses. Details of the characterised viruses is shown in Table 1. RVU has confirmed by genome sequencing the detection of live attenuated influenza vaccine (LAIV) viruses in 4 influenza A positive sample collected from children aged 2 to under 16 years of age.

Table 1. Number of influenza viruses characterised by genetic and antigenic analysis at the UKHSA Respiratory Virus Unit since week 35 of 2024

Type	Subtype	Clade	Subclade	Reference virus name	Detections	Notes
A	H1N1	5a.2a	C.1.9	Not assigned yet	43
A	H1N1	5a.2a.1	C.1.1.1	A/Victoria/4897/2022	9	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	56
B	Victoria	V1A.3a.2	C.5.7	Not assigned yet	6
B	Victoria	V1A.3a.2	C.5.1	B/Catalonia/2279261NS/2023	2
B	Victoria	V1A.3a.2	C.5.6	B/Brisbane/145/2023	2

Influenza virus antiviral susceptibility surveillance

Influenza positive samples are screened for mutations in the virus neuraminidase (NA) and the cap-dependent endonuclease (PA) 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 35 of 2024 using whole genome sequencing

Subtype	Antiviral	Normal inhibition	Reduced inhibition	Highly reduced inhibition
H1N1pdm09	Oseltamivir	52	0	0
H1N1pdm09	Zanamivir	52	0	0
H3N2	Oseltamivir	53	0	0
H3N2	Zanamivir	53	0	0
B/Victoria	Oseltamivir	9	0	0
B/Victoria	Zanamivir	9	0	0

Table 3. Number of influenza viruses tested for inhibition by Baloxavir marboxil since week 35 of 2024 using whole genome sequencing

Subtype	Normal susceptibility	Reduced susceptibility
H1N1pdm09	37	0
H3N2	53	0
B/Victoria	8	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 76 new ARI incidents reported in week 43 in England. These included:

• 56 incidents were from care homes of which 29 due to SARS-CoV-2, 6 due to other pathogen, 3 due to multiple pathogens and 2 due to influenza A

• 11 incidents were from hospitals of which 11 due to SARS-CoV-2

• 3 incidents were from educational settings of which 1 due to SARS-CoV-2 and 1 due to influenza A

• no incidents from prisons

• 6 incidents were from other settings of which 4 due to SARS-CoV-2, 1 due to influenza and 1 due to parainfluenza

Figure 10. Number of ARI incidents by setting, England

Figure 11. Number of ARI incidents in all settings by virus type, England

Flu Detector

Flu Detector is a web-based model which assesses internet-based search queries for influenza-like-illness (ILI) in the general population. Daily ILI rate estimates are based on uniformly averaged search query frequencies for a weeklong period (including the current day and the 6 days before it). For week 43, the average daily ILI query rate increased compared with the previous week and was below baseline activity (Figure 12).

Figure 12. Daily estimated ILI Google search query rates per 100,000 population, England

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 27 October 2024, ED attendances for acute respiratory infection increased slightly and were in line with seasonally expected levels. ED attendances for influenza-like illness increased slightly and were in line with seasonally expected levels. ED attendances for COVID-19-like illness decreased. ED attendances for acute bronchiolitis, a syndrome related to RSV infection, increased and were at seasonally expected levels.

Daily NHS 111 calls for acute respiratory infection remained stable and were below baseline level. GP in-hours consultation rates for influenza-like illness decreased, and were similar to baseline level. GP out-of-hours contacts for acute respiratory infections remained stable and in line with expected seasonal activity. Contacts influenza-like illness decreased and remained just above expected seasonal activity.

Figure 13a. Daily emergency department attendances for acute respiratory infection nationally, England [note 5]

Note 5: 7-day moving average is adjusted for bank holidays. Grey columns show weekends and bank holidays.

Figure 13b. Daily emergency department attendances for acute respiratory infection by age group, England [note 6]

Note 6: scales vary in each graph to enable trend comparisons. The black line is the 7-day moving average adjusted for bank holidays.

Figure 14a. Daily emergency department attendances for COVID-19-like illness nationally, England [note 5]

Note 5: 7-day moving average is adjusted for bank holidays. Grey columns show weekends and bank holidays.

Figure 14b. Daily emergency department attendances for COVID-19-like illness by age group, England [note 6]

Note 6: scales vary in each graph to enable trend comparisons. The black line is the 7-day moving average adjusted for bank holidays.

Figure 15a. Daily emergency department attendances for ILI nationally, England [note 5]

Note 5: 7-day moving average is adjusted for bank holidays. Grey columns show weekends and bank holidays.

Figure 15b. Daily emergency department attendances for ILI by age group, England [note 6]

Note 6: 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 acute bronchiolitis nationally, England [note 5]

Note 5: 7-day moving average is adjusted for bank holidays. Grey columns show weekends and bank holidays.

Figure 16b. Daily emergency department attendances for acute bronchiolitis by age group, England [note 6]

Note 6: 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 remained stable at 3.8 per 100,000 registered population in participating GP practices in week 43 compared with 3.9 per 100,000 in the previous week. This rate is in the baseline activity level (Figure 1). By age group, the highest rates were seen in those aged under 1 year (5.7 per 100,000), followed by those aged between 45 and 64 years (4.6 per 100,000).

The lower respiratory tract infections (LRTI) consultation remained stable at 95 per 100,000 in week 43 compared with 95.6 per 100,000 in the previous week.

Further details are available in the weekly RSC communicable and respiratory disease report for England.

Figure 17. 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

Starting from week 51 2023, testing for enterovirus and rhinovirus has been delayed. There were no results for week 43.

745 samples were taken in week 42 through the GP sentinel swabbing, and 60 tested positive (Figure 2).

Among all tested samples, 7.5% were positive for SARS-CoV-2, 2.7% for influenza, 2.5% for RSV, 0.7% for adenovirus, 0.2% for hMPV, 0% for rhinovirus, and 0% for enterovirus (Figure 3). 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 18. Number of samples tested for respiratory viruses in England by week, GP sentinel swabbing scheme [note 7] [note 8] [note 9]

Note 7: unknown category corresponds to samples with no result yet.
Note 8: starting from week 40 2024, testing for seasonal coronavirus has been suspended.
Note 9: reporting of rhinovirus and enterovirus follows a greater lag than for other respiratory pathogens.

Figure 19. Percentage of detected respiratory virus among all samples with completed testing in England by week, GP sentinel swabbing scheme [note 8] [note 9] [note 10]

Note 8: starting from week 40 2024, testing for seasonal coronavirus has been suspended.
Note 9: reporting of rhinovirus and enterovirus follows a greater lag than for other respiratory pathogens.
Note 10: data from the most recent week is not shown on this graph due to reporting delays.

Figure 20. Percentage of detected respiratory viruses among all samples with completed testing in England by age group, GP sentinel swabbing scheme, week 39 to week 42 [note 9] [note 10]

Note 9: reporting of rhinovirus and enterovirus follows a greater lag than for other respiratory pathogens.
Note 10: data from the most recent week is not shown on this graph due to reporting delays.

Figure 21. Weekly positivity for SARS-CoV-2, influenza and RSV in England, GP sentinel swabbing scheme [note 10]

Note 10: data from the most recent week is not shown on this graph due to reporting delays.

Secondary care

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 43 2024 based on 90 NHS trusts in England were as follows:

• the overall weekly hospital admission rate for COVID-19 decreased to 3.91 (compared with 4.40 per 100,000 in the previous week)

• hospital admission rates for COVID-19 were highest in the North East region (slightly decreasing to 7.70 per 100,000 compared with 8.26 in the previous week). Please refer to the slideset and supplementary data file for regional breakdowns

• the highest hospital admission rate for COVID-19 was in those aged 85 years and over (decreasing to 41.26 per 100,000 compared with 52.19 in the previous week)

COVID-19 ICU-HDU admissions in week 43 2024 based on 82 NHS trusts in England were as follows:

• the overall ICU or HDU rate for COVID-19 increased to 0.13 per 100,000 (compared with 0.11 per 100,000 in the previous week). Note that with low rates in critical care, small random fluctuations may occur

• ICU or HDU admission rates for COVID-19 were highest in the South West region (increasing to 0.23 per 100,000 compared with 0.10 in the previous week). Please refer to the slideset and supplementary data file for regional breakdowns

• the highest ICU or HDU admission rate for COVID-19 was in those aged 85 years and over (increasing to 0.55 per 100,000 compared with 0.00 in the previous week)

Figure 22. Weekly overall COVID-19 hospital admission rates per 100,000 trust catchment population reported through SARI Watch mandatory surveillance, England [note 11]

Note 11: please note that a correction has been made to 2020 week numbers.

Figure 23. Weekly hospital admission rate by age group for new COVID-19 positive cases reported through SARI Watch mandatory surveillance, England [note 4]

Note 4: the highlighted line corresponds to the age group in the subplot title, grey lines correspond to all other age groups.

Figure 24. Weekly overall COVID-19 ICU or HDU admission rates per 100,000 trust catchment population reported through SARI Watch mandatory surveillance, England [note 11]

Note 11: please note that a correction has been made to 2020 week numbers.

Figure 25. Weekly ICU or HDU admission rate by age group for new COVID-19 positive cases reported through SARI Watch mandatory surveillance, England [note 4]

Note 4: 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 43 2024 based on 22 sentinel NHS trusts in England were as follows:

• the overall weekly hospital admission rate for influenza slightly decreased to 0.70 per 100,000 (compared with 0.76 per 100,000 in the previous week)

• this rate is in the baseline impact range (less than 1.77 per 100,000)

• hospital admission rates for influenza were highest in those aged 0 to 4 (2.04 per 100,000). Please refer to the slideset and supplementary data file for regional breakdowns

• there were 70 new hospital admissions for influenza (60 influenza A(not subtyped), 2 influenza A(H1N1)pdm09, 0 influenza A(H3N2), and 8 influenza B)

Influenza ICU-HDU admissions in week 43 2024 based on 93 NHS trusts in England were as follows:

• the overall ICU or HDU rate for influenza remained low at 0.03 per 100,000 (compared with 0.02 per 100,000 in the previous week). Note that with low rates in critical care, small random fluctuations may occur

• this rate is in the baseline impact range (less than 0.1 per 100,000)

• please refer to the slideset and supplementary data file for regional breakdowns

• there were 13 new ICU or HDU admissions for influenza (12 influenza A(not subtyped), 0 influenza A(H1N1)pdm09, 0 influenza A(H3N2), and 1 influenza B)

Figure 26. Weekly overall influenza hospital admission rates per 100,000 trust catchment population with MEM thresholds, reported through SARI Watch sentinel surveillance, England [note 12]

Note 12: please note that a correction has been made to 2019 week numbers.

Figure 27. Weekly influenza hospital admissions by influenza type, reported through SARI Watch sentinel surveillance, England

Figure 28. Weekly hospital admission rate by age group for new influenza reported through SARI Watch sentinel surveillance, England [note 4] [note 13]

Note 4: the highlighted line corresponds to the age group in the subplot title, grey lines correspond to all other age groups.

Note 13: 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 29. 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 12]

Note 12: please note that a correction has been made to 2019 week numbers.

Figure 30. Weekly influenza ICU or HDU admissions by influenza type, reported through SARI Watch mandatory surveillance, England

Figure 31. Weekly ICU or HDU admission rate by age group for new influenza cases, reported through SARI Watch mandatory surveillance, England [note 4] [note 13]

Note 4: the highlighted line corresponds to the age group in the subplot title, grey lines correspond to all other age groups.
Note 13: 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 43 2024 based on 19 sentinel NHS trusts in England were as follows:

• the overall weekly hospital admission rate for RSV increased to 1.26 per 100,000 (compared with 0.88 per 100,000 in the previous week)

• in children aged under 5 years, the hospitalisation rate for RSV increased to 17.25 per 100,000 (compared with 11.08 per 100,000 in the previous week)

• in adults aged 75 years and over, the hospitalisation rate for RSV increased to 1.29 per 100,000 (compared with 0.73 per 100,000 in the previous week). Broken down further, rates were 1.00 per 100,000 in those aged between 75 and 84 years, and 2.03 per 100,000 in those aged 85 years and over in week 43

Figure 32. Weekly hospital admission rates (excluding ICU or HDU) of RSV positive cases per 100,000 population reported through SARI Watch sentinel surveillance, England [note 11] [note 14]

Note 11: please note that a correction has been made to 2020 week numbers.
Note 14: 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 33. 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 14]

Note 14: 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 34. Weekly count of hospital admissions of RSV positive cases reported through SARI Watch sentinel surveillance by level of care, England

Figure 35. Weekly hospital admission rates (excluding ICU or HDU) by age group for RSV cases reported through SARI Watch sentinel surveillance, England [note 4] [note 15]

Note 4: the highlighted line corresponds to the age group in the subplot title, grey lines correspond to all other age groups.
Note 15: 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 43 2024 in adults:

• 1 admission was due to a suspected ARI
• 2 were due to sepsis (non-respiratory origin)
• 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 36. Laboratory confirmed ECMO admissions in adults (COVID-19, influenza and non-COVID-19 confirmed) to Severe Respiratory Failure centres in the UK

Vaccine coverage

COVID-19 vaccine uptake in England

Cumulative data up to week 43 2024 (week ending 27 October 2024), was extracted from the Immunisation Information System (IIS), formerly the National Immunisation Management Service (NIMS).

Age is calculated as age on date of extraction. From 3 October 2024 data is extracted on a Monday with data capped to the previous Sunday.

Data is provisional and subject to change following further validation checks. Any changes to historic figures will be reflected in the most recent publication.

Autumn 2024 campaign

The autumn 2024 data reported below covers any dose administered from 3 October 2024 provided there is at least 20 days from the previous dose. Eligible groups for the campaign are defined in the COVID-19 healthcare guidance Green Book.

By the end of week 43 2024 (week ending 27 October 2024) 43.5% of all people aged over 65 years old, and 15.9% of all people aged less than 65 years old and in a clinical risk group, who are living and resident in England had been vaccinated with an autumn 2024 booster dose since 3 October 2024 (Figure 37).

Figure 37. Cumulative weekly COVID-19 vaccine uptake by target group in England

For COVID-19 data on the real-world effectiveness of the COVID-19 vaccines, and on COVID-19 vaccination in pregnancy, please see the COVID-19 vaccine surveillance reports.

For COVID-19 management information on the number of COVID-19 vaccinations provided by the NHS in England, please see the COVID-19 vaccinations webpage.

For UK COVID-19 daily vaccination figures and definitions, please see the ‘Vaccinations’ section of the UK COVID-19 dashboard.

Influenza vaccination

Influenza vaccine uptake in GP patients

Weekly vaccine uptake data is provisional.

Influenza vaccination is reported by GP practice through the ImmForm website. ImmForm provides a secure online platform for vaccine uptake data collection for several immunisation surveys, including the seasonal influenza vaccine uptake collection. Details can be found at Sources of surveillance data for influenza, COVID-19 and other respiratory viruses.

For the 2024 to 2025 season’s vaccination programme, children and pregnant women have been eligible since 1 September, while clinical risk groups, older adults (those aged 65 years and over) and frontline healthcare workers have been eligible since 3 October. See the annual flu letter for more information. In previous seasons, these cohorts have all been eligible from 1 September.

Up to the end of week 43 of 2024 (Sunday 27 October 2024), the provisional proportion of people in England who had received an influenza vaccine this season in targeted groups was as follows:

Adults (95.5% of GP practices reporting through Immform):

• 25.7% in those aged under 65 years in a clinical risk group

• 24.6% in all pregnant women

• 57.3% in all those aged 65 years and over

Children (94.9% of GP practices reporting):

• 29.9% in children aged 2 years of age

• 30.1% in children aged 3 years of age

Figure 38. Cumulative weekly influenza vaccine uptake by target group in England

On 28 November 2024, monthly data which cover vaccinations that were given between 1 September and 31 October 2024 for GP patients, school-aged children and frontline healthcare workers will be published for the first time this season.

Data sources and methodology

For additional information regarding data sources please refer to 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.

All-cause mortality assessment (England)

For further information on all-cause mortality in England please see the Excess mortality within England: post-pandemic method report, which uses ONS death registration data, the Weekly all-cause mortality surveillance report, which uses the European mortality monitoring (EuroMOMO) model to identify weeks with higher than expected mortality and the ONS all-cause excess mortality report.

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.