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 11 December 2023 to 17 December 2023 (ISO week 50):

  • Measures of respiratory symptoms in the community show Low activity level (via calls to NHS24) and Baseline activity level (via attendances at GP consultations - GP ILI) of respiratory disease activity during the reporting period.
  • In the CARI community surveillance system, increases were seen in swab positivity for Influenza A (from 11.9% in week 49 to 13.3% in week 50), SARS-CoV-2 (from 7.4% to 9.8%) and Human metapneumovirus (from 2.3% to 5.8%). Swab positivity decreased for Mycoplasma pneumoniae (from 11.0% to 8.8%) and Parainfluenza (from 2.0% to 0.5%). RSV remained elevated but stable at 12.3%.
  • Virology data showed influenza remained at Moderate activity level in week 50. Moderate activity levels were observed among all age groups. Swab positivity for influenza was 10.6% compared to 6.6% in week 49. Mycoplasma pneumoniae and RSV decreased from Extraordinary to Moderate activity level.
  • Emergency hospital admissions because of influenza saw an increase, from 133 to 232, and for COVID-19, from 232 to 258. In contrast, RSV decreased from 229 to 186. ICU/HDU admissions remained low.
  • All-cause excess mortality for week 47 (week ending 26 November 2023, the latest week not impacted by reporting delays) remained at Baseline activity level overall, and for all age groups.
  • In winter 2023/24, Scotland administered 1,607,014 Influenza (Adult 18+), 523,944 Influenza (Children 6 months to 17 years), and 1,351,850 COVID-19 vaccines since September 4, 2023. Among adults 65+, 77.7% got influenza, and 77.0% got COVID-19 vaccines by week 50. Uptake is lower compared to winter 2022/23.


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 community 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

Due to the festive period, there will be no report published on 28 December 2023. The next release will be on 5 January 2024.

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 14 September 2023 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
  • The COVID-19 Vaccine Wastage datafile was updated on 18 April 2024 to include the most recent information.

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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