How surveillance is helping prepare for Scotland’s winter respiratory season 2026

With the start of the winter approaching, the Viral Respiratory team at Public Health Scotland (PHS) is updating their surveillance of respiratory infections. In our latest blog, Kirstin Leslie, Principal Healthcare Scientist, tells us why gathering and sharing this information helps ensure Scotland is better prepared for winter.

As the colder months set in, you may notice more coughs, sneezes and sniffles circulating in workplaces, schools and communities.

While respiratory infections (such as flu, COVID-19, and RSV) can be mild for most people who catch one this winter, for some – especially young children, pregnant women, older adults and people with underlying health conditions – it can lead to more serious illnesses

That’s why for PHS’s respiratory team, October marks the return to weekly reporting. We track respiratory infections at different stages of the NHS care pathway to better understand where pressures are most critical, who’s most at risk, and where resources are needed.

We share this in our report and on our dashboard.

What's new this winter?

Building on PHS’s fresh reporting measures last winter, we’ve continued to improve the way we monitor and report respiratory infections.

This year, we’re introducing activity thresholds for community acute respiratory infection (CARI) data. These thresholds show whether levels of respiratory infections are at expected levels or higher than usual among people attending GPs. They help us identify unusual increases in illness and enable us to compare trends across different sources of information, such as laboratory testing, NHS 24 and GP data. CARI thresholds may also give us an earlier insight when specific respiratory infections start to increase compared to our laboratory data.

We’ve also been reviewing and improving our PHS surveillance systems that monitor respiratory viruses across Scotland. For example:

• We’ve improved how we collect and analyse GP consultation data. As GP practices across Scotland move to a new national software system, these changes will help us continue to track illness trends reliably and consistently
• We’ve updated how we identify respiratory-related calls in NHS 24 data by reviewing the signs and symptoms we use. We’ve also applied these changes to data from previous seasons, helping us compare what we’re seeing this winter with previous years
• We’ve expanded the hospitals included in severe acute respiratory infection (SARI) surveillance. This now covers all intensive care units (ICUs) and high dependency units (HDUs) in Scotland. For the first time, this includes both paediatric ICU sites
• We’ve worked with laboratory teams across the nation to improve how we monitor different flu strains and track how they are changing over time. This helps us understand earlier whether the flu vaccine is a good match for the strains that are circulating and how well it is protecting people
• We’re updating our webpages to provide more information about the different types of surveillance included in this report. This will help people better understand how we collect and use data, and why this information is important for monitoring respiratory infections in Scotland

What can you do this winter?

Everyone has a role to play in reducing the spread of respiratory infections. Here are some simple but effective steps:

• If you're eligible, get vaccinated against flu, RSV and COVID-19. Vaccination is the best way to protect yourself from severe illness. Early evidence suggests this season's flu vaccine is well matched to the viruses currently circulating in Scotland
• Practise good hygiene – wash your hands regularly and cover your mouth and nose when you cough or sneeze
• Avoid unnecessary contact with others while you’re feeling unwell. If you have a fever or flu-like symptoms, try to rest at home until you’re feeling better. This protects others, especially those at higher risk
• Know where to get the right care – Many winter illnesses can be managed at home with rest, fluids, and over-the-counter medication. NHS inform has helpful advice on self-care. NHS 24 (111) can help if you need urgent care out of hours
• Look out for others – Check in on elderly relatives, neighbours, or anyone who may struggle to cope if they fall ill

Further information

Learn more about the winter vaccine programme Winter vaccines | NHS inform