About this release

This weekly release by Public Health Scotland presents epidemiological information on respiratory infection activity, including COVID-19, across Scotland.

Main points

Overall assessment for the period 23 October 2023 to 29 October 2023 (ISO week 43): 

  • Measures of respiratory symptoms in the community and via attendances at GP consultations show low levels of respiratory disease activity during the reporting period (NHS24 and GP ILI).
  • In the CARI community surveillance system, which tests for ten different pathogens, swab positivity was highest for rhinovirus at 18.9%, which was a considerable decrease from the previous week’s 26.9%. This was followed by RSV with a swab positivity of 14.4%, which was an increase from 12.7% the previous week. Swab positivity for MPN increased from 4.1% the previous week to 9.0% in week 43. SARS-CoV-2 decreased from a swab positivity of 7.5% in week 42 to 3.5% in week 43.
  • Virology data suggest influenza circulated at Baseline activity level. RSV was at High activity level. For RSV, the under 1 age group was at High activity level and the 1-4 age group was at Extraordinary activity level. Mycoplasma pneumoniae and HMPV were at Low activity level. Rhinovirus decreased from Low to Baseline activity level.
  • The overall number of emergency hospital admissions associated with RSV, influenza and COVID-19 was observed to have decreased since the last week. The largest proportion of admissions were for RSV. ICU/HDU admissions continue to be low.
  • All-cause excess mortality for week 40 (week ending 8 October 2023, the latest week not impacted by reporting delays) remained at Baseline activity level overall and for all age groups. Data for the most recent two weeks is still provisional and should be treated with caution.
  • During the current Winter 2023 vaccination programme a total of 1,020,912 Influenza (Adult 18+), 231,749 Influenza (Children 6 months to 17 years) and 810,960 COVID-19 vaccines have been administered to the Scottish population since 4 September 2023. Information on vaccine uptake for the COVID-19 and influenza vaccine programmes is available via the Public Health Scotland - vaccination surveillance.


Tracking infectious respiratory diseases, including COVID-19 and influenza, is essential, especially in the winter when the disease burden can be highest. In Scotland, respiratory infection and associated morbidity are monitored using enhanced surveillance. This approach combines data from microbiological sampling and laboratory test results from community and hospital settings with data from syndromic surveillance of NHS 24 calls, primary care consultations for respiratory symptoms, hospital (including intensive care) admissions and other settings.

The intelligence generated from surveillance of laboratory, syndromic and settings provide a comprehensive picture of current respiratory illness in Scotland. The data presented in this report provide a comprehensive and timely epidemiological picture that is essential for understanding transmission of infection and supporting patient care and NHS service planning and policy.

Seasonality patterns / seasonal variations

Respiratory illnesses are associated with seasonal increase in the autumn and winter. Seasonality patterns for both influenza viruses and non-influenza respiratory pathogens have been established through many years of surveillance data. Most influenza and non-influenza pathogens circulate in the autumn and winter in Scotland, although some are known to circulate in the spring and summer. Notably, COVID-19 transmission has been occurring in waves throughout the year as observed from surveillance data since the start of the pandemic in 2020.

Further information

The next release will be 9 November 2023.

Find out more

Previous Publications

Versions of the Weekly national respiratory report publication released before 30 November 2022 may be found on the Public Health Scotland website.

Versions of the COVID-19 weekly statistical report publication released before 30 November 2022 may be found on the Public Health Scotland website.

Open data

Open data from this publication is available from the following weblinks:

Further data

  • The COVID-19 Vaccine Wastage datafile was updated on 18 April 2024 to include the most recent information.
  • The COVID-19 in Adult Care Homes in Scotland datafile was updated on 27 July 2023 to include more recent information.
  • 28 September 2022 COVID-19 statistical report publication contains information on COVID-19 infection and vaccination in pregnancy in Scotland.
  • 2 March 2022 COVID-19 statistical report publication contains information on Highest Risk (shielding patients list)
  • 7 November 2023 Community Acute Respiratory Infection (CARI) surveillance in primary care contains information on flu Vaccine effectiveness in community settings.
  • 25 May 2023 Interim 2022/23 influenza vaccine effectiveness: six European studies, October 2022 to January 2023, contains information on flu Vaccine effectiveness in hospital settings.
  • 13 January 2024 Estimated number of lives directly saved by COVID-19 vaccination programs in the WHO European Region, December 2020 to March 2023, contains information on lives saved due to COVID-19 vaccination

General enquiries

If you have an enquiry relating to this publication, please email phs.flu@phs.scot.

Media enquiries

If you have a media enquiry relating to this publication, please contact the Communications and Engagement team.

Requesting other formats and reporting issues

If you require publications or documents in other formats, please email phs.otherformats@phs.scot.

To report any issues with a publication, please email phs.generalpublications@phs.scot.

Older versions of this publication

Versions of this publication released before 16 March 2020 may be found on the Data and Intelligence, Health Protection Scotland or Improving Health websites.

Last updated: 21 March 2024
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