Flu, COVID-19 and RSV were all circulating at low or baseline levels in England in the week to 18 October, the UK Health Security Agency said on Thursday.
Flu positivity in laboratory surveillance was 6.3 per cent in week 42, compared with 6.2 per cent the week before. Flu hospital admissions edged up to 1.94 per 100,000 from 1.81 per 100,000.
COVID-19 positivity was 8.9 per cent, against 8.8 per cent. COVID-19 hospitalisations rose slightly to 2.64 per 100,000 from 2.48 per 100,000, while admissions to intensive care or high dependency units stayed low at 0.05 per 100,000, down from 0.06.
RSV positivity was 0.9 per cent, compared with 0.8 per cent. The weekly RSV hospital admission rate rose to 0.33 per 100,000 from 0.23 per 100,000, having been 0.11 per 100,000 in the week to 4 October.
Dr Jamie LopezBernal, a consultant epidemiologist at UKHSA, said the early rise in flu seen in previous weeks had slowed and that all the major respiratory viruses would be tracked through the winter.
He said levels could not easily be predicted over the coming weeks and that “vaccination remains our best defence”. Eligible people are urged to book free NHS flu, COVID-19 or RSV vaccines, and parents to have children given the nasal spray flu vaccine.
The latest national surveillance report shows flu vaccine uptake behind last season in most groups at the same point. Among people aged 65 and over it was 44.1 per cent, compared with 49.3 per cent.
Uptake was 19.9 per cent, against 22.1 per cent, among people aged six months to under 65 in clinical risk groups. It was 26.0 per cent among 2-year-olds, against 26.9 per cent, and 25.8 per cent among 3-year-olds, against 26.8 per cent.
Pregnant women were the exception, at 26.0 per cent compared with 25.1 per cent. Some vaccination groups were left out of the week 42 figures because of data problems and have since been added.
Between week 35 and week 42, the agency’s respiratory virus unit genetically characterised 242 seasonal flu viruses. Of these, 148 were A(H1N1)pdm09, 72 were A(H3N2) and 22 were influenza B.
Observations from a World Health Organization vaccine composition meeting in September suggested low reactivity of some viruses in the D.3.1.1 subclade with the H1N1 component of the 2026/27 vaccine. Of five H1N1 viruses antigenically characterised by UKHSA, three were similar to the vaccine strain.
Stomach bugs are running at different levels. Norovirus laboratory reports for weeks 41 and 42 were 32.6 per cent below the five-season average for the same two weeks, having been 9.8 per cent below in the two weeks to 4 October.
Norovirus outbreaks reported by hospitals were 42.0 per cent below the five-season average. Rotavirus activity was 9.8 per cent above its five-season average.
The norovirus and rotavirus figures come from live reporting systems, so counts for the most recent weeks may rise as more reports arrive. The bulletin is published weekly through the winter, according to UKHSA.
People with diarrhoea and vomiting are advised not to return to work, school or nursery until 48 hours after symptoms have stopped. UKHSA also said alcohol gels do not kill norovirus.