This bulletin reports on the epidemiological situation of COVID-19,
influenza, respiratory syncytial virus (RSV) and other respiratory
viruses (ORVs) in Ireland. It replaces previous reports in which
COVID-19 data was published separately from data on influenza, RSV and
ORVs. An integrated approach to both the surveillance and the reporting
of respiratory viruses is recommended by the European Centre for Disease
Prevention and Control (ECDC) and the World Health Organization (WHO).
HPSC and surveillance partners operate several integrated programmes
which monitor cases of COVID-19, influenza, RSV and ORVs simultaneously.
Integrated reporting will provide a more comprehensive picture of the
overall impact of these viruses on the population and the health
service.
The report is interactive. For graphs – data labels can be seen by
hovering over graph lines or bars. Specific categories can be selected
or deselected by clicking on the relevant category in the legend.
Readers can skip to specific sections by clicking on the table of
contents to the left of the screen.
This report will be published weekly during the winter season (week
40 to week 20). For some surveillance programmes, more detailed
programme-specific reports will continue to be published. Links to these
are available here.
Key messages
During week 43 2024, influenza and RSV activity increased, though
numbers remain relatively low. COVID-19 activity continued to decrease.
Rhino and enteroviruses are circulating at high levels. Other seasonal
respiratory viruses remain at low levels.
Summary for week 43
2024
Primary Care Surveillance
The sentinel GP Acute Respiratory Infection (ARI) consultation rate
declined to 65.2/100,000 population during week 43, compared to
68.0/100,000 in week 42. Overall, the ARI rate has been trending upward
since week 31. Sentinel percentage positivity for rhinovirus or
enterovirus was 19.6% in week 43. Rhino or enterovirus positivity has
been above the 10% positivity threshold since week 35 2024. All other
respiratory pathogens remain below the threshold, although COVID-19,
influenza and RSV positivity all increased in week 43. Similar to the
ARI consultation rate, calls to GP Out-of-Hours Services for
self-reported cough declined in week 43 compared to week 42, but overall
have been trending upwards since week 31. Calls for self-reported flu
cases remain below the threshold.
COVID-19
COVID-19 activity decreased across all indicators in week 43.
COVID-19 cases fell by 24.9% from 333 cases notified in week 42 to 250
cases in week 43. Hospitalised cases decreased by 33.3%, with 92 cases
in week 43 compared to 138 cases in week 42. ICU admissions and deaths
remained low. KP.3.1.1 is the dominant sub-lineage, accounting for 51.6%
of samples sequenced between weeks 37 and 41, 2024. Emerging variant XEC
continues to increase and accounted for 16.1% of sequences in the same
time period. SARS-CoV-2 viral loads in wastewater are decreasing in most
catchment areas in week 43 2024.
Influenza
Influenza activity increased in week 43 2024. The overall
notification rate was 1.8/100,000 population. There were 93 cases
(double the number reported in week 42), 33 hospitalisations, no ICU
cases and no deaths reported. The highest notification rates were in
those aged 1-4 years. Influenza A virus is currently the dominant type
accounting for 86% of cases.
RSV
RSV activity increased in week 43 but numbers of reported cases
remain low. The overall notification rate was 0.6/100,000 population.
There were 29 cases (almost double the number reported in week 42), 13
hospitalisations, no ICU admissions and no deaths reported. Notified and
hospitalised cases remain low in all age groups.
Severe Acute Respiratory Infection (SARI)
Based on data from one sentinel hospital site, although SARI activity
decreased slightly in week 43 with 17 cases reported compared to 21 the
previous week, SARS-CoV-2 positivity increased to 37.5% from 14.3%.
During week 43, 6.3% (n=1) were positive for RSV, while none were
positive for influenza.
Outbreaks
COVID-19 outbreaks decreased by 52% in week 43 compared to week 42
2024. A total of 14 COVID-19 outbreaks were reported including nine in
hospitals and two in nursing homes. During week 43, two other ARI
outbreaks were reported, both in nursing homes. No influenza or RSV
outbreaks were reported.
Technical notes
General
Data are provisional and subject to ongoing review, validation and
update. As a result, figures in this report may differ from previously
published figures.
Data based on statutory notifications were extracted from
Computerised Infectious Disease Reporting (CIDR) system which is
described here.
The weekly calendar runs from Sunday to Saturday for respiratory
virus notifiations on CIDR (as per the Infectious Disease Regulations
1982 and subsequent amendments) and Monday to Sunday for the sentinel GP
and SARI surveillance systems (as per ISO week). Further information on
epidemiological dates and weeks can be found on the HPSC website.
Other data sources include:
National Virus Reference Laboratory (NVRL), GP Out-of-hours (GP00Hs)
services, Sentinel GP surveillance system, National SARS-CoV-2 Whole
Genome Sequencing Surveillance Programme (NSWGSSP), National SARS-CoV-2
Wastewater Surveillance Programme, Severe Acute Respiratory Infections
(SARI) surveillance system, HSE’s Covax system (the natrional vaccine
management system used to administer COVID-19 and influenza vaccinations
across Ireland) and General Register Office (GRO) (deaths
registrations).
The case definitions used for COVID-19, influenza and RSV in
2024/2025 are available here.
Population data were taken from Census 2022.
Activity
GPOOHs: National data on calls to GP Out-of-Hours services in Ireland
are collated by HPSC. Five out of 14 GPOOHs services currently
participate in this programme. Records of calls with clinical symptoms
self-reported as ‘flu’ or ‘cough’ are included in the analysis.
Sentinel GP and NVRL: Currently, 100 general practices (located in
all HSE-Areas) are recruited to report electronically, on a weekly
basis, the number of patients who consulted with acute respiratory
infection (ARI) and influenza-like illness (ILI). The combined patient
population in these practices is 10% of the national population.
Sentinel GPs sent combined nose and throat swabs to the NVRL from ARI
patients each week. The NVRL routinely test sentinel GP and non-sentinel
respiratory specimens for SARS-CoV-2, influenza, RSV and a panel of
other seasonal respiratory viruses (ORV).
Test Positivity
Positive tests refer to all positive specimens and includes
duplicates and individuals who were retested.
Since 28/02/2022 (week 9), PCR testing is only recommended for
symptomatic people in the community within certain risk groups: those
who have not had booster vaccination and are aged 55 years and older;
those with a high-risk medical conditions; those who are
immunocompromised; those who live in the same household as a person who
is immunocompromised; those who provide care or support for person they
know to be immunocompromised; those who are pregnant; Healthcare
Workers.
Since 30/03/2023 (week 13, 2023), COVID-19 Community Test Centres
closed and PCR testing for SARS-CoV-2 is only performed based on
clinical assessment.
Severity
The number of cases hospitalised and admitted to ICU described in
this report relate only to notified cases during this reporting period,
with known hospitalisation/ICU status at the time of reporting.
SARI cases are identified from new admissions through the Emergency
Department, based on clinical symptoms. Patients that develop SARI
during their admission, or are admitted through alternate routes, are
not included. A SARI case is definefd as a person hospitalised for at
least 24 hours with acute respiratory infection, with at least one of
the following symptoms: cough, fever, shortness of breath OR sudden
onset of anosmia, ageusia or dysgeusia with onset of symptoms within 14
days prior to hospital admission. A SARI case refers to an individual
patient episode of care.
COVID-19, influenza and RSV deaths are defined as a death in a person
with laboratory confirmation of COVID-19, influenza or RSV infection as
per the COVID-19, influenza and RSV surveillance case definitions (this
includes cases detected postmortem) where COVID-19, influenza or RSV is
reported in any of the four cause of death fields on the death
certificate. Deaths where there is a clear alternative cause of death
(e.g. trauma, suicide) are not recorded as COVID-19/influenza/RSV
deaths. Deaths where there is a period of complete recovery (as assessed
by a clinician) between a COVID-19, influenza or RSV episode of illness
and death, are also not recorded as deaths.
Excess mortality refers to the number of deaths from all causes
during a period of time above and beyond what we would have normally
expected to see. Excess deaths are typically defined as the difference
between the observed number of deaths in a specific time period and the
expected number of deaths in the same time period. The Health Protection
Surveillance Centre (HPSC) receives daily registered deaths data from
the General Register Office (GRO) on all deaths from all causes
registered in Ireland. These data have been used since 2009 to monitor
excess all‐cause deaths in Ireland as part of a wider European Mortality
Monitoring Project known as EuroMOMO. There is a substantive
delay in the registration of deaths in Ireland which impacts on the
timeliness of these data.
Outbreaks
For surveillance purposes, the following outbreak definition is used
for notifying confirmed outbreaks/clusters of respiratory infection:
• Two or more cases of acute respiratpry infection with the same
pathogen (COVID-19, influenza or Respiratory Syncytial Virus (RSV))
confirmed by a laboratory test or near patient test carried out by a
health professional, and there is reason to consider that these cases
may be epidemiologically linked in place and time.
OR
• Other ARI outbreaks refer to outbreaks of acute respiratory
infection caused by respiratory pathogens other than influenza,
SARS-CoV-2 and RSV and consists of two or more cases of illness with
symptoms consistent with the same pattern of infection related illness,
and at least one person is laboratory confirmed and there is reason to
consider that they may be epidemiologically linked in place and
time.
Regional Departments of Public Health currently prioritise the
investigation and reporting of outbreaks in settings that benefit most
from public health and clinical intervention. These settings include
acute hospitals, nursing homes, community hospital/long-stay units,
residential institutions and other healthcare settings. The outbreak
data reported here focuses on these key settings/groups.
Virology
The type/subtype of laboratory confirmed influenza notifications are
reported on the CIDR system. The NVRL report on influenza type/subtype
of sentinel GP ARI and non-sentinel respiratory specimens on a weekly
basis.
The HPSC link sequencing results received from laboratories to
epidemiological data on COVID-19 cases reported on the CIDR system. This
report summarises WGS results and epidemiological data for COVID-19
cases that have been sequenced in Ireland since week 51 2020 (specimen
dates between 13/12/2020 and 12/10/2024). The SARS-CoV-2 sequencing
results included in this report reflect all data available as of
29/10/2024.
The SARS-CoV-2 sequencing sampling framework currently focuses on
notified COVID-19 cases with severe disease (hospitalisation, ICU
admission) and deaths, COVID-19 outbreaks in health and care settings,
sentinel surveillance programmes in the community and acute hospitals
and targeted sequencing based on public health risk assessment/clinical
requests and virological changes e.g. new variant of concern.
There is typically a lag time of 1-3 weeks between a COVID-19 case
being notified, selected for sequencing and SARS-CoV-2 sequencing being
completed. Therefore, the proportion of notified COVID-19 cases notified
in this time period from whom specimens are ultimately sequenced will be
higher than currently reported here.
Variant working definitions for ‘SARS-CoV-2 variants of concern’
(VOC), ‘SARS-CoV-2 variants of interest’ (VOI) and ‘SARS-CoV-2 variants
under monitoring’ (VUM) are available on the WHO
website and ECDC
website.
Wastewater
A detailed description of the process involved for wastewater
collection, sampling and analyses is available in the routinely
published national SARS-CoV-2 wastewater surveillance programme reports
available here
Appendix
Appendix Table 1:
Confirmed cases of COVID-19, influenza and RSV by age, sex and health
region, from week 40 2024, to week 43 2024. Data source: CIDR.
Number of cases (incidence per 100,000 population) |
|---|
| All pathogens | COVID-19 | Influenza | RSV |
|---|
Cases | 1,620 (31.5) | 1,318 (25.6) | 226 (4.4) | 76 (1.5) |
Age groups (years) |
|
|
|
|
<1 | 79 (136.7) | 60 (103.8) | 4 (6.9) | 15 (26.0) |
1-4 | 79 (33.2) | 26 (10.9) | 26 (10.9) | 27 (11.4) |
5-14 | 60 (8.4) | 18 (2.5) | 39 (5.4) | 3 (0.4) |
15-44 | 229 (11.1) | 174 (8.4) | 49 (2.4) | 6 (0.3) |
45-64 | 307 (23.7) | 255 (19.7) | 45 (3.5) | 7 (0.5) |
65-79 | 396 (66.5) | 359 (60.3) | 31 (5.2) | 6 (1.0) |
80+ | 470 (259.6) | 426 (235.3) | 32 (17.7) | 12 (6.6) |
Median age (IQR) | 68 (40-81) | 71 (50-82) | 42 (9-69) | 3 (1-62) |
Sex |
|
|
|
|
Male | 785 (30.9) | 642 (25.2) | 113 (4.4) | 30 (1.2) |
Female | 834 (32.0) | 676 (26.0) | 113 (4.3) | 45 (1.7) |
HSE Health Regions |
|
|
|
|
Dublin and North East | 306 (5.9) | 261 (22) | 35 (2.9) | 10 (0.8) |
Dublin and Midlands | 269 (5.2) | 215 (20) | 41 (3.8) | 13 (1.2) |
Dublin and South East | 350 (6.8) | 298 (30.7) | 37 (3.8) | 15 (1.5) |
South West | 284 (5.5) | 236 (31.9) | 47 (6.3) | 1 (0.1) |
Mid West | 148 (2.9) | 118 (28.6) | 18 (4.4) | 12 (2.9) |
West and North West | 263 (5.1) | 190 (25) | 48 (6.3) | 25 (3.3) |
Appendix Table 2:
Hospitalised cases of COVID-19, influenza and RSV by age, sex and health
region, from week 40,2024, to week 43 2024. Data source: CIDR.
Number of cases (incidence per 100,000 population) |
|---|
Title | All pathogens | COVID-19 | Influenza | RSV |
|---|
Cases | 651 (12.6) | 538 (10.4) | 73 (1.4) | 40 (0.8) |
Age groups (years) |
|
|
|
|
<1 | 34 (58.8) | 21 (36.3) | 3 (5.2) | 10 (17.3) |
1-4 | 32 (13.5) | 13 (5.5) | 8 (3.4) | 11 (4.6) |
5-14 | 36 (5.0) | 12 (1.7) | 21 (2.9) | 3 (0.4) |
15-44 | 53 (2.6) | 44 (2.1) | 7 (0.3) | 2 (0.1) |
45-64 | 97 (7.5) | 84 (6.5) | 8 (0.6) | 5 (0.4) |
65-79 | 173 (29.1) | 157 (26.4) | 12 (2.0) | 4 (0.7) |
80+ | 226 (124.8) | 207 (114.3) | 14 (7.7) | 5 (2.8) |
Median age (IQR) | 73 (46-83) | 75 (58-84) | 29 (8-74) | 4 (1-61) |
Sex |
|
|
|
|
Male | 343 (13.5) | 284 (11.2) | 41 (1.6) | 18 (0.7) |
Female | 308 (11.8) | 254 (9.8) | 32 (1.2) | 22 (0.8) |
HSE Health Regions |
|
|
|
|
Dublin and North East | 54 (1) | 41 (3.5) | 7 (0.6) | 6 (0.5) |
Dublin and Midlands | 118 (2.3) | 98 (9.1) | 13 (1.2) | 7 (0.6) |
Dublin and South East | 103 (2) | 88 (9.1) | 7 (0.7) | 8 (0.8) |
South West | 130 (2.5) | 115 (15.5) | 15 (2) | 0 (0) |
Mid West | 78 (1.5) | 65 (15.7) | 6 (1.5) | 7 (1.7) |
West and North West | 168 (3.3) | 131 (17.2) | 25 (3.3) | 12 (1.6) |
Appendix Table 3: Total
number tested, and number and percentage positive Sentinel GP ARI
specimens by respiratory virus, for week 42 2024, week 43 2024, and the
2024/2025 season. Data source: NVRL.
| Week 42 2024 (N = 96) | Week 43 2024 (N = 51) | 2024/2025 (N = 375) |
|---|
Virus | Total positive | % positive | Total positive | % positive | Total positive | % positive |
|---|
SARS-CoV-2 | 2 | 2.1 | 5 | 9.8 | 23 | 6.1 |
Influenza Virus | 7 | 7.3 | 4 | 7.8 | 17 | 4.5 |
Respiratory Syncytial Virus (RSV) | 0 | 0.0 | 2 | 3.9 | 2 | 0.5 |
Rhino/enterovirus | 29 | 30.2 | 10 | 19.6 | 105 | 28.0 |
Adenovirus | 0 | 0.0 | 1 | 2.0 | 3 | 0.8 |
Bocavirus | 1 | 1.0 | 0 | 0.0 | 3 | 0.8 |
Human metapneumovirus (hMPV) | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 |
Parainfluenza virus type 1 (PIV-1) | 3 | 3.1 | 0 | 0.0 | 5 | 1.3 |
Parainfluenza virus type 2 (PIV-2) | 0 | 0.0 | 1 | 2.0 | 8 | 2.1 |
Parainfluenza virus type 3 (PIV-3) | 0 | 0.0 | 1 | 2.0 | 4 | 1.1 |
Parainfluenza virus type 4 (PIV-4) | 2 | 2.1 | 0 | 0.0 | 4 | 1.1 |
Appendix Table 4: Total
number tested, and number and percentage positive NVRL non-sentinel
respiratory specimens by respiratory virus, week 42 2024, week 43 2024,
and the 2024/2025 season. Data source: NVRL.
| Week 42 2024 (N = 191) | Week 43 2024 (N = 97) | 2024/2025 (N = 626) |
|---|
Virus | Total positive | % positive | Total positive | % positive | Total positive | % positive |
|---|
SARS-CoV-2 | 11 | 5.8 | 6 | 6.2 | 41 | 6.5 |
Influenza Virus | 10 | 5.2 | 4 | 4.1 | 25 | 4.0 |
Respiratory Syncytial Virus (RSV) | 0 | 0.0 | 1 | 1.0 | 1 | 0.2 |
Rhino/enterovirus | 37 | 19.4 | 15 | 15.5 | 142 | 22.7 |
Adenovirus | 4 | 2.1 | 2 | 2.1 | 8 | 1.3 |
Bocavirus | 3 | 1.6 | 1 | 1.0 | 5 | 0.8 |
Human metapneumovirus (hMPV) | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 |
Parainfluenza virus type 1 (PIV-1) | 4 | 2.1 | 1 | 1.0 | 10 | 1.6 |
Parainfluenza virus type 2 (PIV-2) | 3 | 1.6 | 1 | 1.0 | 6 | 1.0 |
Parainfluenza virus type 3 (PIV-3) | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 |
Parainfluenza virus type 4 (PIV-4) | 0 | 0.0 | 2 | 2.1 | 5 | 0.8 |
Appendix Table 5:
Influenza type and sub-type distribution among sentinel GP ARI and
non-sentinel respiratory influenza positive specimens, for week 42 2024,
week 43 2024, and the 2024/2025 season. Data source: NVRL.
| | | Influenza A | Influenza B |
|---|
Time period | Specimen source | Total influenza positive | Total | A(H1)pdm09 | A(H3) | A(not subtyped) | Total | B Victoria | B (upspecified) |
|---|
Week 42 2024 | Sentinel GP ARI | 7 | 7 | 4 | 3 | 0 | 0 | 0 | 0 |
Non-sentinel respiratory | 10 | 9 | 9 | 0 | 0 | 1 | 0 | 1 |
Total | 17 | 16 | 13 | 3 | 0 | 1 | 0 | 1 |
Week 43 2024 | Sentinel GP ARI | 4 | 4 | 3 | 1 | 0 | 0 | 0 | 0 |
Non-sentinel respiratory | 4 | 4 | 0 | 3 | 1 | 0 | 0 | 0 |
Total | 8 | 8 | 3 | 4 | 1 | 0 | 0 | 0 |
Week 40 2024 | Sentinel GP ARI | 17 | 17 | 8 | 8 | 1 | 0 | 0 | 0 |
Non-sentinel respiratory | 25 | 21 | 14 | 5 | 2 | 4 | 0 | 4 |
Total | 42 | 38 | 22 | 13 | 3 | 4 | 0 | 4 |
Appendix Table 6: RSV type
distribution among sentinel GP ARI and non-sentinel respiratory RSV
positive specimens, for week 42, 2024 week 43 2024, and the 2024/2025
season. Data source: NVRL.
Time period | Specimen source | Total RSV positive | RSV A | RSV B | RSV (unspecified) |
|---|
Week 42 2024 | Sentinel GP ARI | 0 | 0 | 0 | 0 |
Non-sentinel respiratory | 0 | 0 | 0 | 0 |
Total | 0 | 0 | 0 | 0 |
Week 43 2024 | Sentinel GP ARI | 2 | 1 | 1 | 0 |
Non-sentinel respiratory | 1 | 0 | 1 | 0 |
Total | 3 | 1 | 2 | 0 |
Week 40 2024 | Sentinel GP ARI | 2 | 1 | 1 | 0 |
Non-sentinel respiratory | 1 | 0 | 1 | 0 |
Total | 3 | 1 | 2 | 0 |
