Community Acute Respiratory Infection (CARI) surveillance in primary care
End of season (2025–26) annual report: 19 May 2025 to 17 May 2026

About this release

This annual release by Public Health Scotland (PHS) presents a summary analysis of respiratory samples from patients with acute respiratory infection submitted by 149 sentinel GP practices as part of the CARI respiratory surveillance programme. The samples were taken between 19 May 2025 and 17 May 2026. The purpose of CARI is to monitor the burden and impact of acute respiratory infection in the community.

The report summarises test positivity for ten respiratory pathogens, with further analyses by age, sex, health board and Scottish Index of Multiple Deprivation (SIMD) level (a deprivation measure associated with patient postcode). The ten pathogens are: adenovirus, COVID-19, human metapneumovirus, influenza A, influenza B, Mycoplasma pneumoniae, parainfluenza, respiratory syncytial virus (RSV), rhinovirus and seasonal coronavirus (non-SARS-CoV-2).

Throughout the year, CARI data are updated and summarised weekly on the public dashboard: Viral Respiratory Diseases (including Influenza and COVID-19) Surveillance in Scotland.

Main points

This is the fourth year that the CARI community surveillance system has operated in its current format, providing comparable data across respiratory seasons. The main points from the current reporting period are: 

• Results were available for 19,044 viable samples of 20,162 submitted as part of the Scottish CARI sentinel GP surveillance programme between 19 May 2025 and 17 May 2026.
• Overall, 149 GP practices from across Scotland submitted samples, with some fluctuations in the number as practices joined or left the programme throughout the year.
• Overall test positivity (defined as positive for at least one of 10 respiratory pathogens tested for) was 57.9%.
• Rhinovirus was the highest circulating pathogen during the surveillance period (test positivity of 22.8%) as it is generally common throughout the entire year. This was followed by influenza A (13.6%), and parainfluenza (5.8%).
• The 2025-26 season presented:
  • a period of elevated respiratory activity in winter
  • an earlier start, and an earlier and slightly lower peak, in influenza A activity compared with the previous two seasons
  • a small wave of heightened COVID-19 activity during the summer months
  • a slightly lower and later peak in RSV compared to the 2024-25 season
  • very little circulation of influenza B and Mycoplasma pneumoniae
  • no other fluctuations in viral activity that were unusual or unexpected.
• Overall test positivity was significantly higher in males (60.4%) compared to females (56.4%). It was highest in the 0-4 age group at 83.3% followed by the 5-14 age group at 69.2%.
• Overall test positivity was similar across five levels of the Scottish Index of Multiple Deprivation (SIMD).
• Overall test positivity was lowest in NHS Borders (51.9%) and highest in NHS Lanarkshire (60.2%) and NHS Tayside (60.0%) (excluding island boards where there were few samples).
• Severe disease (resulting in hospital admission or death) occurred in fewer than 2% of CARI patients who tested positive for a respiratory pathogen.

This figure is an area chart illustrating the number of samples positive for each pathogen as a proportion of those samples tested for all pathogens through the CARI programme from week 21, 2023 to week 20, 2026.

Close

Number of samples that were positive for each pathogen as a proportion of samples tested for all pathogens over time, from 2023-2026

Background

An overview of the programme with programme aims and further information for participating clinicians and recruited patients is available on the PHS website. Full details of the methods used for CARI surveillance are outlined in the CARI protocol.

Further information

Data from this publication are available from the public dashboard: Viral Respiratory Diseases (including Influenza and COVID-19) Surveillance in Scotland.

The next iteration of this publication is due in summer 2027.