Official Statistics

National flu and COVID-19 surveillance report: 16 October 2025 (week 42)

Updated 16 October 2025

Applies to England

This report summarises the information from the surveillance systems which are used to monitor COVID-19 (caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)), influenza, respiratory syncytial virus (RSV) and diseases caused by other seasonal respiratory viruses in England. The report is based on data up to week 41 of 2025 (between 6 October and 12 October 2025).

Main points

The main messages of this report are:

  • influenza activity showed increasing activity across indicators, particularly in children, and was at baseline levels
  • COVID-19 activity showed slightly decreasing activity, circulating at medium levels
  • RSV showed increasing activity across some indicators and was circulating at baseline levels

Summary of all respiratory virus activity

Influenza activity

Influenza showed increasing activity across indicators and was at baseline levels. Higher circulation was seen in children and remained high in young adults. Emergency department (ED) attendances for influenza-like-illness (ILI) increased. The number of influenza-confirmed acute respiratory infection (ARI) incidents remained low. Of influenza viruses typed/subtyped at the UKHSA Respiratory Virus Unit since week 35, the majority were A(H3N2).

Weekly influenza vaccine uptake for the 2025 to 2026 season is reported for week 41 (data up to 12 October 2025). Compared with the equivalent week last season (2024 to 2025), vaccine uptake is higher for pregnant women and comparable in all other cohorts (for those aged 2 and 3 years, those aged under 65 years in clinical risk groups and those aged 65 years and over).

Indicator Trend Level [note 1] Comments
Laboratory surveillance Increasing Baseline Influenza positivity increased with a weekly mean positivity rate of 5% compared with 3.3% in the previous week
ILI general practice (GP) consultations Increasing Baseline The weekly ILI consultation rate increased to 5.4 per 100,000 registered population in participating GP practices compared with 4.2 per 100,000 in the previous week
GP swabbing positivity Decreasing Baseline In week 40, among all tested samples, 2.5% were positive for influenza, compared with 2.9% in the previous week
Hospital admissions Increasing Baseline The overall weekly hospital admission rate for influenza hospitalisations was increasing at 1.27 per 100,000 compared with 0.73 per 100,000 in the previous week
Intensive care units (ICU)/high-dependency unit (HDU) admissions Remained low Baseline The overall weekly hospital admission rate for influenza ICU-HDU remained low at 0.03 per 100,000 compared with 0.03 per 100,000 in the previous week

COVID-19 activity

COVID-19 showed slightly decreasing activity across indicators and was circulating at medium levels. ED attendances for COVID-19-like illness remained stable. The number of reported SARS-CoV-2 confirmed acute respiratory infections (ARI) incidents in week 41 decreased compared with the previous week.

By the end of week 41 2025 (week ending 12 October 2025) 29.3% of all people aged 75 years and over, and 14.1% of all people aged under 75 years with a weakened immune system had been vaccinated with an autumn 2025 dose since 1 October 2025.

Indicator Trend Level [note 1] Comments
Laboratory surveillance Slightly decreasing Low COVID-19 PCR (polymerase chain reaction) positivity in hospital settings decreased slightly with a weekly mean positivity rate of 12% compared with 13.1% in the previous week
GP swabbing positivity Increasing Medium In week 40, among all tested samples, 12.1% were positive for SARS-CoV-2, compared with 8.9% in the previous week
Hospital admissions Slightly decreasing Medium The overall weekly hospital admission rate for COVID-19 was slightly decreasing at 4.09 per 100,000 compared with 4.50 per 100,000 in the previous week
ICU/HDU admissions Decreasing Low The overall weekly ICU or HDU admission rate for COVID-19 was decreasing at 0.09 per 100,000 compared with 0.14 per 100,000 in the previous week

Respiratory syncytial virus activity

RSV activity showed increasing activity across some indicators and was circulating at baseline levels. ED attendances for acute bronchiolitis remained stable.

Reporting of weekly RSV hospital admissions for the 2025 to 2026 season has begun.

Indicator Trend Level [note 1] Comments
Laboratory surveillance Increasing Baseline RSV positivity increased to 1.1% compared with 0.6% in the previous week.
GP swabbing positivity Decreasing Baseline In week 40, among all tested samples, 0% were positive for RSV compared with 0.8% in the previous week
Hospital admissions Increasing Baseline The overall weekly hospital (excluding ICU-HDU) admission rate for RSV was increasing at 0.18 per 100,000 compared with 0.14 per 100,000 in the previous week

Other viruses

Indicator Trend Level [note 1] Comments
Adenovirus Decreasing Baseline Adenovirus positivity (laboratory surveillance) decreased to 1.4% compared with 2.2% in the previous week
Human metapneumovirus (hMPV) Decreasing Baseline hMPV positivity (laboratory surveillance) decreased to 0.1% compared with 0.8% in the previous week
Parainfluenza Increasing slightly Baseline Parainfluenza positivity (laboratory surveillance) increased slightly to 1.5% compared with 1.4% in the previous week
Rhinovirus Decreasing Low Rhinovirus positivity (laboratory surveillance) decreased to 16.5% compared with 19.6% in the previous week

Note 1: these indicators use the moving epidemic method (MEM) and the mean standard deviation method (MSD) to define thresholds to determine their respective levels of activity. Further information on these methods can be found in Influenza surveillance in Europe: establishing epidemic thresholds by the Moving Epidemic Method and Setting thresholds to determine COVID-19 activity levels using the mean standard deviation (MSD) method, England, 2022 to 2024. The MEM approach is well-established for some influenza surveillance indicators, however, for other indicators both the MEM and MSD are experimental and may be subject to future revision. Influenza laboratory surveillance (from week 1) and GP swabbing positivity (from week 2) have transitioned from using MEM to using MSD. These approaches will be considered alongside expert opinion and triangulation of other data sources.

Laboratory surveillance

Laboratory-confirmed cases

The Second Generation Surveillance System (SGSS) captures test result information for notifiable infectious diseases, including COVID-19 and influenza, from laboratories in England. The unified sample dataset (USD), used to calculate the percentage tests positive for SARS-CoV-2 among all SARS-CoV-2 tests, stores all SARS-CoV-2 test results reported to SGSS, Respiratory DataMart, and UKHSA laboratories.

COVID-19 cases

As of 14 October 2025, there were a total of 2,323 COVID-19 cases identified in hospital settings in week 41, decreasing from cases in the previous week. SARS-CoV-2 (COVID-19) PCR positivity in hospital settings decreased slightly in week 41, with a weekly average positivity rate of 12% compared with 13.1% in the previous week. Positivity rates were highest in those aged 85 years and over at a weekly average positivity rate of 18.8%. This remained stable when compared with week 40, when positivity rates were at 19.4% among those aged 85 years and over.

Figure 1. Weekly confirmed COVID-19 episodes tested in hos3,057pital settings, England.

Figure 2. Daily percentage of tests positive for SARS-CoV-2 among all reported SARS-CoV-2 tests (7-day rolling average), England 2022 to present [note 2] [note 3]

Note 2: data from previous seasons is aligned by day.

Note 3: testing policy and practice may change over time which can impact positivity rates, therefore comparisons over time should be interpreted with caution. Notable changes in testing policy occurred during 2022 to 2023, which are outlined in the data sources report.

Figure 3. Daily percentage of tests positive for SARS-CoV-2 among all reported SARS-CoV-2 tests by age group (7-day rolling average), England [note 4]

Note 4: the highlighted line corresponds to the age group in the subplot title, grey lines correspond to all other age groups.

Influenza cases

As of 14 October 2025, influenza positivity in week 41 increased with a weekly average positivity rate of 5% compared with 3.3% in the previous week. Influenza positivity rates were highest in those aged between 15 and 24 years at a weekly average positivity rate of 20.1%. This has increased from 17.2% among those aged between 15 and 24 years in week 40.

Figure 4. Daily percentage of tests positive for influenza among all reported influenza tests (7-day rolling average), England [note 2]

Note 2: data from previous seasons is aligned by day.

Figure 5. Daily percentage of tests positive for influenza among all reported influenza tests by age group (7-day rolling average), England [note 4]

Note 4: the highlighted line corresponds to the age group in the subplot title, grey lines correspond to all other age groups.

Respiratory DataMart System

Respiratory DataMart is a sentinel laboratory-based surveillance system where participating laboratories report positive and negative test results for a number of respiratory viruses from samples primarily taken in hospital. A small proportion of primary care samples are also included in this reporting.

In week 41, data is based on reporting from 9 out of the 14 sentinel laboratories.

In week 41, 4,714 respiratory specimens reported through the Respiratory DataMart System were tested for influenza. There were 319 positive samples for influenza: 177 influenza A (not subtyped), 115 influenza A (H3N2), 23 influenza A (H1N1)pdm09, and 5 influenza B. Overall, influenza positivity increased to 6.8% in week 41 compared with 4.8% in the previous week.

In week 41, 4,530 respiratory specimens reported through the Respiratory DataMart System were tested for SARS-CoV-2. There were 377 positive samples for SARS-CoV-2. SARS-CoV-2 positivity decreased slightly to 8.3% compared with 9.1% in the previous week, with the highest positivity in those aged 80 years and over at 13%.

RSV positivity increased to 1.1%, with the highest positivity in those aged under 5 years at 6.4%.

Adenovirus positivity decreased to 1.4%, with the highest positivity in those aged under 5 years at 3.8%.

Human metapneumovirus (hMPV) positivity decreased to 0.1%, with the highest positivity in those aged between 45 and 64 years at 0.4%.

Parainfluenza positivity increased slightly to 1.5%, with the highest positivity in those aged under 5 years at 3%.

Rhinovirus positivity decreased to 16.5%, with the highest positivity in those aged under 5 years at 32.7%.

DataMart data is provisional and subject to retrospective updates.

Figure 6a. Respiratory DataMart weekly percentage of tests positive for influenza, SARS-CoV-2, RSV and rhinovirus, England [note 5]

Note 5: shading represents 95% confidence intervals.

Figure 6b. Respiratory DataMart weekly percentage of tests positive for adenovirus, hMPV and parainfluenza, England [note 5]

Note 5: shading represents 95% confidence intervals.

Figure 7. Respiratory DataMart weekly cases by influenza subtype, England

Figure 8. Respiratory DataMart weekly percentage testing positive for RSV by season, England

Figure 9. Respiratory DataMart weekly percentage testing positive for RSV by age, England [note 4]

Note 4: the highlighted line corresponds to the age group in the subplot title, grey lines correspond to all other age groups.

SARS-CoV-2 lineages

This section is updated fortnightly. Data below was last updated in the week 41 report.

UKHSA conducts genomic surveillance of SARS-CoV-2 lineages.

This section provides an overview of circulating lineages in England, derived from data on sequenced PCR-positive SARS-CoV-2 samples in SGSS.

The prevalence of UKHSA-designated lineages among sequenced cases is presented in Figure 1.

To account for reporting delays, we report the proportion of lineages within COVID-19 cases that have had a sequenced positive sample between 1 September 2025 and 14 September 2025. Of those sequenced in this period 81.94% were classified as XFG, 7.41% were classified as XDV, 1.85% were classified as JN.1 and 1.39% were classified as JN.1.11.1. Note that low sequencing numbers will impact the accuracy of the prevalence estimates.

Please note that lineages will be grouped independently from their parent lineage once they reach sufficient prevalence, and may be re-grouped into their parent lineage if their prevalence subsequently falls. The data sources and methodology page contains more information on lineage groupings.

Figure 10. Prevalence of SARS-CoV-2 lineages amongst available sequenced cases for England from 30 September 2024 to 21 September 2025

Influenza virus characterisation

Between week 35 2025 (week ending 31 August 2025) and week 41 2025 (week ending 12 October 2025), the UKHSA respiratory virus unit (RVU) has genetically characterised 38 seasonal influenza viruses, and identified 23 influenza A(H3N2) viruses, 12 influenza A(H1N1)pdm09 viruses, and 3 influenza B viruses. Details of the characterised viruses by subtype are shown in tables 1, 2 and 3. The RVU has confirmed by genome sequencing the detection of live attenuated influenza vaccine (LAIV) viruses in two influenza A positive samples collected from children aged between 2 and 16 years.

Table 1. Number of influenza A H1N1(pdm09) viruses characterised by genetic and antigenic analysis at the UKHSA Respiratory Virus Unit since week 35 2025

Clade Subclade Detections
5a.2a C.1.9.3 2
5a.2a.1 D.3.1 10

Table 2. Number of influenza A(H3N2) viruses characterised by genetic and antigenic analysis at the UKHSA Respiratory Virus Unit since week 35 2025

Clade Subclade Detections
2a.3a.1 J.2 3
2a.3a.1 J.2.4 20

Table 3. Number of influenza B viruses characterised by genetic and antigenic analysis at the UKHSA Respiratory Virus Unit since week 35 2025

Clade Subclade Detections
V1A.3a.2 C.5.6.1 1
V1A.3a.2 C.5.7 2

Influenza virus antiviral susceptibility surveillance

Influenza positive samples are screened for mutations in the virus neuraminidase (NA) and the cap-dependent endonuclease of the polymerase acidic protein (PA) genes known to confer neuraminidase inhibitor (Oseltamivir and Zanamivir) or Baloxavir resistance, respectively. Results from this surveillance are given in Tables 4 and 5.

Table 4. Number of influenza viruses tested for inhibition by Oseltamivir and Zanamivir since week 35 of 2025 using whole genome sequencing

Subtype Antiviral Normal inhibition Reduced inhibition Highly reduced inhibition
H1N1pdm09 Oseltamivir 12 0 0
H1N1pdm09 Zanamivir 12 0 0
H3N2 Oseltamivir 23 0 0
H3N2 Zanamivir 23 0 0
BVic Oseltamivir 3 0 0
BVic Zanamivir 3 0 0

Table 5. Number of influenza viruses tested for inhibition by Baloxavir marboxil since week 35 2025 using whole genome sequencing

Subtype Normal susceptibility Reduced susceptibility Highly reduced inhibition
H1N1pdm09 12 0 0
H3N2 22 0 0
BVic 3 0 0

Community surveillance

Acute respiratory infection incidents (ARI)

Data is presented on viral ARI incidents in different settings that are reported to UKHSA health protection teams (HPTs).

Please note that reporting practices are known to vary between seasons and between regions. Any interpretation of temporal and regional trends should consider the likelihood of differences in reporting of ARI incidents over time and between regions.

There were 146 new ARI incidents reported in week 41 in England. These included:

  • 127 incidents from care homes, of which 57 were due to SARS-CoV-2, 7 were due to influenza A, 2 were due to multiple pathogens, 2 were due to other pathogens and 1 was due to influenza (no type information available)

  • 9 incidents from hospitals, of which 9 were due to SARS-CoV-2

  • 6 incidents from educational settings, of which 1 was due to RSV, 1 was due to SARS-CoV-2 and 1 was due to influenza A

  • no incidents from prisons

  • 4 incidents from other settings, of which 2 were due to SARS-CoV-2

Figure 11. Number of ARI incidents by setting, England

Figure 12. Number of ARI incidents in all settings by virus type, England

Syndromic surveillance

Syndromic surveillance collects data from various healthcare sources where presentations are classified by patterns of symptoms compatible with specific infections. In some settings, the syndromic diagnosis can be supplemented by (rapid) testing. In this report, ED attendances are displayed. Further details and data from other syndromic surveillance systems can be found in the syndromic surveillance weekly summaries.

During the week ending on 12 October 2025, ED attendances for acute respiratory infection increased and were similar to seasonally expected levels. ED attendances for influenza-like illness increased and were above seasonally expected levels. ED attendances for COVID-19-like illness decreased. ED attendances for acute bronchiolitis, a syndrome related to RSV infection, remained stable and were below seasonally expected levels.

Daily NHS 111 calls for acute respiratory increased and were similar to seasonally expected levels. GP out-of-hours contacts for acute respiratory infections were stable.

Figure 13a. Daily emergency department attendances for acute respiratory infection nationally, England [note 6]

Note 6: 7-day moving average is adjusted for bank holidays. Grey columns show weekends and bank holidays.

Figure 13b. Daily emergency department attendances for acute respiratory infection by age group, England [note 7]

Note 7: scales vary in each graph to enable trend comparisons. The black line is the 7-day moving average adjusted for bank holidays.

Figure 14a. Daily emergency department attendances for COVID-19-like illness nationally, England [note 6]

Note 6: 7-day moving average is adjusted for bank holidays. Grey columns show weekends and bank holidays.

Figure 14b. Daily emergency department attendances for COVID-19-like illness by age group, England [note 7]

Note 7: scales vary in each graph to enable trend comparisons. The black line is the 7-day moving average adjusted for bank holidays.

Figure 15a. Daily emergency department attendances for ILI nationally, England [note 6]

Note 6: 7-day moving average is adjusted for bank holidays. Grey columns show weekends and bank holidays.

Figure 15b. Daily emergency department attendances for ILI by age group, England [note 7]

Note 7: scales vary in each graph to enable trend comparisons. The black line is the 7-day moving average adjusted for bank holidays.

Figure 16a. Daily emergency department attendances for acute bronchiolitis nationally, England [note 6]

Note 6: 7-day moving average is adjusted for bank holidays. Grey columns show weekends and bank holidays.

Figure 16b. Daily emergency department attendances for acute bronchiolitis by age group, England [note 7]

Note 7: scales vary in each graph to enable trend comparisons. The black line is the 7-day moving average adjusted for bank holidays.

Primary care surveillance

Primary care surveillance is undertaken in collaboration with the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC), using a national sentinel surveillance system of around 2,000 GP practices covering over 20 million registered patients of all ages across England. More information on the methodology can be found in the data quality report.

RCGP clinical indicators (England)

The weekly ILI consultation rate through the RCGP surveillance increased to 5.4 per 100,000 registered population in participating GP practices in week 41 compared with 4.2 per 100,000 in the previous week. This rate is in the Baseline activity level (Figure 16). By age group, the highest rates were seen in those aged between 15 and 44 years (6.7 per 100,000), and those aged under one year (5.4 per 100,000).

The lower respiratory tract infections (LRTI) consultation rate remained stable at 79.6 per 100,000 in week 41 compared with 76.2 per 100,000 in the previous week.

Further details are available in the weekly RSC communicable and respiratory disease report for England.

Figure 17. RCGP ILI consultation rates per 100,000, all ages, England

MEM thresholds are based on data from the 2017 to 2018 season to the 2024 to 2025 season. Please note the 2019 to 2020, 2020 to 2021 and 2021 to 2022 seasons have been removed.

RCGP sentinel swabbing scheme in England

There were fewer than 50 samples with a result for week 41.

355 samples were taken in week 40 through the GP sentinel swabbing, and 117 tested positive (Figure 17). As of week 4 2024, contemporaneous enterovirus differentiation has stopped. Starting from week 44 2024, reporting of rhinovirus and enterovirus has been grouped into rhinovirus/enterovirus. Starting from week 48 2024, samples with more than 10 days between the sample collection date and the symptom onset date have been excluded.

Among 323 tested samples in week 40, 12.1% were positive for SARS-CoV-2, 2.5% for influenza, 0% for RSV, 0% for adenovirus, 0.6% for hMPV, 0.3% for seasonal coronavirus, and 20.7% for enterovirus and rhinovirus (Figure 18). Due to the number of samples which have not yet been categorised, data should be interpreted with caution when compared with previous weeks. The proportion of detections among all tested samples is not calculated when the number of samples with a result is fewer than 50.

Figure 18. Number of samples tested for respiratory viruses in England by week, GP sentinel swabbing scheme [note 8] [note 9]

Note 8: unknown category corresponds to samples with no result yet.

Note 9: reporting of rhinovirus and enterovirus follows a greater lag than for other respiratory pathogens.

Figure 19. Percentage of detected respiratory virus among all samples with completed testing in England by week, GP sentinel swabbing scheme [note 9]

Note 9: reporting of rhinovirus and enterovirus follows a greater lag than for other respiratory pathogens.

Figure 20. Percentage of detected respiratory viruses among all samples with completed testing in England by age group, GP sentinel swabbing scheme, week 37 to week 40 [note 9]

Note 9: reporting of rhinovirus and enterovirus follows a greater lag than for other respiratory pathogens.

Figure 21. Weekly positivity for SARS-CoV-2, influenza and RSV in England, GP sentinel swabbing scheme

Secondary care surveillance

COVID-19 hospital and ICU or HDU admissions

Surveillance of COVID-19 hospitalisations to all levels of care and admissions to intensive care units (ICU) or high dependency units (HDU) are both mandatory, with data required from all acute NHS trusts in England.

Please note that SARI Watch data is provisional and subject to retrospective updates. ICU or HDU admission rates may also be affected by lags from admission to hospital to an ICU or HDU ward. Rates are presented per 100,000 trust catchment population.

COVID-19 hospitalisations for all levels of care in week 41 2025 based on 89 NHS trusts in England were as follows:

  • the overall weekly hospital admission rate for COVID-19 slightly decreased to 4.09 (compared with 4.50 per 100,000 in the previous week)

  • hospital admission rates for COVID-19 were highest in the West Midlands region (decreasing to 6.03 per 100,000 compared with 7.03 in the previous week). Please refer to the supplementary graphs and data file for regional breakdowns

  • the highest hospital admission rate for COVID-19 was in those aged 85 years and over (remained stable at 46.23 per 100,000 compared with 47.29 in the previous week)

COVID-19 ICU-HDU admissions in week 41 2025 based on 79 NHS trusts in England were as follows:

  • the overall ICU or HDU rate for COVID-19 decreased to 0.09 per 100,000 (compared with 0.14 per 100,000 in the previous week). Note that with low rates in critical care, small random fluctuations may occur

  • ICU or HDU admission rates for COVID-19 were highest in the North West region (increasing to 0.24 per 100,000 compared with 0.19 in the previous week). Please refer to the supplementary graphs and data file for regional breakdowns

  • the highest ICU or HDU admission rate for COVID-19 was in those aged between 75 and 84 years (increasing to 0.47 per 100,000 compared with 0.41 in the previous week)

Figure 22. Weekly overall COVID-19 hospital admission rates per 100,000 trust catchment population reported through SARI Watch mandatory surveillance, England

Figure 23. Weekly hospital admission rate by age group for new COVID-19 positive cases reported through SARI Watch mandatory surveillance, England [note 10]

Note 10: the highlighted line corresponds to the most recent 2025 to 2026 season, grey lines correspond to the previous 2024 to 2025 season.

Figure 24. Weekly overall COVID-19 ICU or HDU admission rates per 100,000 trust catchment population reported through SARI Watch mandatory surveillance, England

Figure 25. Weekly ICU or HDU admission rate by age group for new COVID-19 positive cases reported through SARI Watch mandatory surveillance, England [note 10]

Note 10: the highlighted line corresponds to the most recent 2025 to 2026 season, grey lines correspond to the previous 2024 to 2025 season.

Influenza hospital and ICU or HDU admissions

Surveillance of influenza hospitalisations to all levels of care is based on data from a small sentinel network of acute NHS trusts in England. Surveillance of admissions to ICU or HDU for influenza is mandatory with data required from all acute NHS trusts in England.

Please note that SARI Watch data is provisional and subject to retrospective updates. Rates are presented per 100,000 trust catchment population.

Influenza hospitalisations to all levels of care in week 41 2025 based on 21 sentinel NHS trusts in England were as follows:

  • the overall weekly hospital admission rate for influenza hospitalisations was increasing at 1.27 per 100,000 compared with 0.73 per 100,000 in the previous week

  • this rate is in the baseline impact range (less than 1.95 per 100,000)

  • hospital admission rates for influenza were highest in those aged 85 years and over (5.85 per 100,000). Please refer to the respiratory virus section of the data dashboard for regional breakdowns

  • there were 109 new hospital admissions for influenza (77 influenza A(not subtyped), 14 influenza A(H1N1)pdm09, 14 influenza A(H3N2), and 4 influenza B)

Influenza ICU-HDU admissions in week 41 2025 based on 90 NHS trusts in England were as follows:

  • the overall weekly hospital admission rate for influenza ICU-HDU remained low at 0.03 per 100,000 compared with 0.03 per 100,000 in the previous week

  • this rate is in the baseline impact range (less than 0.1 per 100,000)

  • please refer to the respiratory virus section of the data dashboard for regional breakdowns

  • there were 14 new ICU or HDU admissions for influenza (13 influenza A(not subtyped), 0 influenza A(H1N1)pdm09, 1 influenza A(H3N2), and 0 influenza B)

Figure 26. Weekly overall influenza hospital admission rates per 100,000 trust catchment population with MEM thresholds, reported through SARI Watch sentinel surveillance, England

Figure 27. Weekly influenza hospital admissions by influenza type, reported through SARI Watch sentinel surveillance, England

Figure 28. Weekly hospital admission rate by age group for new influenza reported through SARI Watch sentinel surveillance, England [note 10]

Note 10: the highlighted line corresponds to the most recent 2025 to 2026 season, grey lines correspond to the previous 2024 to 2025 season.

Figure 29. Weekly overall influenza ICU or HDU admission rates per 100,000 trust catchment population with MEM thresholds, reported through SARI Watch mandatory surveillance, England

Figure 30. Weekly influenza ICU or HDU admissions by influenza type, reported through SARI Watch mandatory surveillance, England

Figure 31. Weekly ICU or HDU admission rate by age group for new influenza cases, reported through SARI Watch mandatory surveillance, England [note 10]

Note 10: the highlighted line corresponds to the most recent 2025 to 2026 season, grey lines correspond to the previous 2024 to 2025 season.

RSV hospital admissions

Surveillance of respiratory syncytial virus (RSV) hospitalisations (excluding ICU or HDU admissions) is based on data from a small sentinel network of acute NHS trusts in England submitting data volunatrily. Trusts submit weekly aggregate counts of new RSV admissions and these are summed and converted to rates by linking to catchment populations of participating trusts in that week. Please see Sources of surveillance data for influenza, COVID-19 and other respiratory viruses for additional details on SARI-Watch RSV data and other SARI-Watch collections.

Please note recent changes to the operational period of RSV surveillance. From the 2024 to 2025 season, surveillance of RSV commenced earlier (starting week 36) to routinely capture earlier activity, pausing earlier at week 14 due to substantial decreases in activity that typically occur by this time. In prior seasons, RSV surveillance operated routinely between week 40 and week 20 in the following year (except in 2023 to 2024 where surveillance paused at week 16). In order to view activity from week 36, the current season 2025 to 2026 is compared to 2024 to 2025 only. Where comparisons involve more seasons, data from week 40 to week 14 are presented.

SARI Watch data is provisional and subject to retrospective updates. Rates are presented per 100,000 trust catchment population.

RSV hospitalisations, excluding ICU or HDU admissions, in week 41 2025 were based on 15 sentinel NHS trusts in England:

  • the overall weekly hospital admission rate for RSV increased to 0.18 per 100,000 (compared with 0.14 per 100,000 in the previous week)

  • in children aged under 5 years, the hospitalisation rate for RSV increased to 2.68 per 100,000 (compared with 1.62 per 100,000 in the previous week)

  • in adults aged 75 years and over, the hospitalisation rate for RSV decreased to 0.00 per 100,000 (compared with 0.18 per 100,000 in the previous week). Broken down further, rates were 0.00 per 100,000 in those aged between 75 and 84 years, and 0.00 per 100,000 in those aged 85 years and over in week 41

RSV ICU-HDU admissions in week 41 2025 were based on 15 sentinel NHS trusts in England:

  • the overall weekly ICU-HDU admission rate for RSV remained low at 0.02 per 100,000 (compared with 0.00 per 100,000 in the previous week)

Figure 32. Weekly overall hospital admission rates (excluding ICU or HDU) of RSV positive cases per 100,000 population reported through SARI Watch sentinel surveillance, England

Figure 33. Weekly hospital admission rates (excluding ICU or HDU) of RSV positive cases per 100,000 population in those aged under 5 years and aged over 75 years reported through SARI Watch sentinel surveillance, England

Figure 34. Weekly hospital admission rates (excluding ICU or HDU) by age group for RSV cases reported through SARI Watch sentinel surveillance, England [note 10]

Note 10: the highlighted line corresponds to the most recent 2025 to 2026 season, grey lines correspond to the previous 2024 to 2025 season.

ECMO admissions

Surveillance of extra corporeal membrane oxygenation (ECMO) admissions is based on data from severe respiratory failure (SRF) centres in the UK. Please refer to Sources of surveillance data for influenza, COVID-19 and other respiratory viruses for additional information.

Please note that SARI Watch data is provisional and subject to retrospective updates.

There were 7 new ECMO admissions reported in week 41 2025 in adults:

  • 1 admission was due to an ARI (other viral, bacterial or fungal)

  • 6 were due to non-infectious causes

Please note that the other group includes other viral, bacterial or fungal ARI, suspected ARI, non-infection (such as asthma, primary cardiac and trauma) and sepsis of non-respiratory origin.

Figure 35. Laboratory confirmed ECMO admissions in adults (COVID-19, influenza and non-COVID-19 confirmed) to severe respiratory failure centres in the UK

Vaccine coverage

COVID-19 vaccine uptake in England

Cumulative data up to the end of week 41 2025 (Sunday 12 October 2025) was extracted from the Immunisation Information System (IIS), formerly the National Immunisation Management Service (NIMS). Data is extracted on the next working day following the end of reporting week (Monday 13 October 2025). Age is calculated as age on date of extraction.

Data is provisional and subject to change following further validation checks. Any changes to historic figures will be reflected in the most recent publication.

Autumn 2025 campaign

The autumn 2025 data reported below covers any dose administered from 1 October 2025 (ISO Week 40) provided there is at least 20 days from the previous dose. Eligible groups for the campaign are defined in Green Book chapter on COVID-19. By the end of week 41 2025 (week ending 12 October 2025) 29.3% of all people aged 75 years and over, and 14.1% of all people aged under 75 years with a weakened immune system, who are living and resident in England had been vaccinated with an autumn 2025 dose since 1 October 2025 (Figure 35).

Figure 36. Cumulative weekly COVID-19 vaccine uptake by target group in England [note 11]

Note 11: the month is taken from the Monday of an international organisation for standardisation (ISO) week.

For data on the real-world effectiveness of the COVID-19 vaccines, please see the epidemiology of COVID-19 in England reports.

For COVID-19 management information on the number of COVID-19 vaccinations provided by the NHS in England, please see the COVID-19 vaccinations webpage.

For UK COVID-19 daily vaccination figures and definitions, please see the Vaccinations section of the UK COVID-19 dashboard.

Influenza vaccination

Influenza vaccine uptake in GP patients

Weekly vaccine uptake data is provisional.

Influenza vaccination is reported by GP practice through the ImmForm website. ImmForm provides a secure online platform for vaccine uptake data collection for several immunisation surveys, including the seasonal influenza vaccine uptake collection. Details can be found at sources of surveillance data for influenza, COVID-19 and other respiratory viruses.

For the 2025 to 2026 season’s vaccination programme, as in previous seasons children and pregnant women have been eligible since 1 September. For this current season and the previous season (2025 to 2026 and 2024 to 2025 seasons respectively), adult groups (excluding pregnant women) were eligible from the start of October (1 October 2025 and 3 October 2024, respectively), rather than 1 September as in previous seasons. See the Timing section of the annual flu letter for more information.

Up to the end of week 41 of 2025 (Sunday 12 October 2025), the provisional proportion of people in England who had received an influenza vaccine this season in targeted groups was as follows:

Adults (99.1% of GP practices reporting through Immform):

  • 16.1% in those aged under 65 years in a clinical risk group

  • 21.4% in all pregnant women

  • 37.2% in all those aged over 65 years

Children (99% of GP practices reporting):

  • 22.4% in children aged 2 years

  • 22.4% in children aged 3 years

Figure 37. Cumulative weekly influenza vaccine uptake by target group in England [note 12]

Note 12: for pregnant women in the previous season (2024 to 2025 season) data should be interpreted with caution due to issues with the denominator for this group at that time in the previous season.

On 27 November 2025, monthly vaccine uptake data will be published for the first time this season, which covers influenza vaccinations given between 1 September and 31 October 2025 for GP patients, school-aged-children and frontline healthcare workers.

Data sources and methodology

For additional information regarding data sources please refer to the sources of surveillance data for influenza, COVID-19 and other respiratory viruses.

Background information

Annual epidemiological reports for the 2024 to 2025 season:

COVID-19 deaths

For further information on COVID-19 related deaths in England please see the COVID-19 dashboard for death.

All-cause mortality assessment (England)

For further information on all-cause mortality in England please see the:

Syndromic surveillance

For further information on syndromic surveillance please see the syndromic surveillance weekly summaries.

Further information and contact details

Feedback and contact information

To provide feedback and for all queries relating to this document, please contact respdsr.enquiries@ukhsa.gov.uk

Official statistics

Our statistical practice is regulated by the Office for Statistics Regulation (OSR). OSR sets the standards of trustworthiness, quality and value in the Code of Practice for Statistics that all producers of official statistics should adhere to.

You are welcome to contact us directly by emailing respdsr.enquiries@ukhsa.gov.uk with any comments about how we meet these standards.

Alternatively, you can contact OSR by emailing regulation@statistics.gov.uk or via the OSR website.

UKHSA is committed to ensuring that these statistics comply with the Code of Practice for Statistics. This means users can have confidence in the people who produce UKHSA statistics because our statistics are robust, reliable and accurate. Our statistics are regularly reviewed to ensure they support the needs of society for information.