Viral respiratory diseases (including influenza and COVID-19) in Scotland surveillance report

About this release

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

REVISION 18 December 2023: Table 1 was revised. For Week 47, the 'Rate (per 100,000)' was corrected for Influenza, from 2.1 to 2.2. This was stated correctly elsewhere in the text throughout the report and on the dashboard. Additionally, revisions to reporting on the Winter Coronavirus Infection Study were made, to provide updated hyperlinks to the ONS and UKHSA reports.

Main points

Overall assessment 27 November 2023 to 3 December 2023 (ISO week 48):

• Measures of respiratory symptoms in the community and via attendances at GP consultations (NHS24 and GP ILI) show Baseline activity levels of respiratory disease activity during the reporting period.
• In the CARI community surveillance system, which tests for 10 different pathogens, rhinovirus swab positivity decreased from 26.9% in week 47 to 24.1% in week 48, followed by RSV dropping from 14.1% to 11.9%, and Mycoplasma pneumoniae decreasing from 9.9% to 8.7%. SARS-CoV-2 remained stable at 6.3%, and influenza A was consistent at 6.2%.
• Virology data show influenza circulated at Low activity level and RSV decreased from Extraordinary to High activity level. For RSV, the 5-14 age group decreased to High activity level, the under 1 age group decreased to Moderate activity level and the 1-4 age group decreased to Low activity level. Two of 14 NHS Boards (NHS Shetland and Tayside) showed Extraordinary activity level. Mycoplasma pneumoniae decreased from Moderate to Low activity level.
• The overall number of emergency hospital admissions because of RSV and COVID-19 decreased since the last week. This decreased from 323 to 246 in RSV cases and from 189 to 180 in COVID-19 cases. However, hospital admissions for influenza increased slightly. The largest proportion of admissions were for RSV. ICU/HDU admissions remained low.
• All-cause excess mortality for week 45 (week ending 12 November 2023, the latest week not impacted by reporting delays) remained at Baseline activity level overall, and for all age groups.
• Since 4 September 2023 (the current Winter 2023 vaccination programme) 1,498,953 influenza (Adult 18+), 472,470 influenza (Children 6 months to 17 years) and 1,254,934 COVID-19 vaccines were administered in Scotland. Among adults aged 75 years and older, 80.6% were vaccinated against influenza and 80.1% were vaccinated against COVID-19 this winter.

Background

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 14 December 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:

• Viral respiratory diseases Open Data platform
• Flu and COVID vaccination uptake Open Data platform

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