This interactive bulletin reports on the latest epidemiology of
COVID-19, influenza, respiratory syncytial virus (RSV) and other
respiratory viruses (ORVs) in Ireland. HPSC monitors several integrated
respiratory virus surveillance systems that are included in this
bulletin. This report will be published weekly during the winter season
(week 40 to week 20).
How to use this interactive bulletin
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Key messages
COVID-19 activity decreased across all indicators and remained at low
to moderate levels. Influenza activity was at low levels, but there was
an increase in notified and hospitalised cases. RSV activity was at low
levels and has stabilised. Rhino/enteroviruses are circulating at high
levels.
Vaccination/immunisation remains one of the most effective ways to
reduce severe illness from influenza, RSV, and COVID-19. Strong
surveillance, immunisation programmes, and healthcare system readiness
(including Infection Prevention Control) are key to protecting public
health.
Summary for week 43
2025
Syndromic surveillance
The sentinel GP Acute Respiratory Infection (ARI) consultation rate
was stable and below baseline at 60/100,000 population during week 43
2025, compared to 62.5/100,000 in week 42. The highest rates were in
those aged <5 years at 205.2/100,000 population. Sentinel GP
influenza, SARS-CoV-2 and RSV test positivity levels were below the 10%
threshold. Influenza test positivity has increased in recent weeks and
is nearing the 10% threshold. Rhino/enterovirus test positivity has been
high in recent weeks and was at 32.7% in week 43. All other seasonal
respiratory pathogens’ test positivity levels were below the 10%
threshold in week 43. The percentage of GP Out-Of-Hours (GP-OOH) calls
for self-reported cough was above the overall baseline for all ages
during week 43. The percentage of self-reported influenza calls was
below the overall baseline for all ages during week 43.
COVID-19
COVID-19 activity was at low to moderate levels across all indicators
in week 43 2025. The overall incidence was 4.3/100,000 population.
COVID-19 cases decreased by 37.2%, from 352 cases notified in week 42 to
221 cases in week 43. Hospitalisations decreased by 18.3%, from 120
cases in week 42 to 98 cases in week 43. There were no ICU admissions
and no deaths notified in week 43. COVID-19 hospital bed occupancy has
been decreasing in recent weeks. XFG remained the predominant SARS-CoV-2
variant. XFG accounted for 83.1% of sequences between weeks 36 and 40
2025, while NB.1.8.1 accounted for 13.8% of samples sequenced during the
same time period.
Influenza
Influenza activity increased but was below baseline levels in week 43
2025. The overall incidence was 2.8/100,000 population. There were 144
influenza cases notified in week 43, compared to 119 in week 42. There
were 24 influenza hospitalisations, no influenza ICU admissions and no
deaths notified during week 43 2025. Although, influenza hospital bed
occupancy remained low, it has been increasing slightly in recent weeks.
Influenza B, influenza A(H1)pdm09 and influenza A(H3) detections were
all reported at low levels in recent weeks.
RSV
RSV activity was at low levels and has stabilised in week 43 2025.
The overall incidence was 0.7/100,000 population. There were 36 cases
notified compared to 40 in week 42 2025. There were 16 RSV
hospitalisations and no ICU admissions or deaths reported in week 43.
RSV hospital bed occupancy remained low and stable in recent weeks.
Severe Acute Respiratory Infection (SARI)
In week 43 2025, SARI activity remained stable and at low levels in
Ireland; 61 SARI cases were reported from three of the four sentinel
hospital sites, compared to 59 cases reported from the same three
sentinel sites in week 42 2025. SARS CoV-2 test positivity increased,
while influenza and RSV test positivity remained at low levels in week
43 (both at 3.8%). SARS CoV-2 test positivity increased from 2.7% in
week 42 to 11.3% in week 43, due in particular to an increase in test
positivity at one of the adult sentinel sites (27.8%).
Outbreaks
There were 20 acute respiratory infection (ARI) outbreaks notified
during week 43 2025 (15 COVID-19, 2 influenza, 3 other ARI), the same
number as reported during week 42. Of the 20 ARI outbreaks, 1 was in a
community/long-stay unit, 7 were in hospitals, 9 were in nursing homes
and 3 were in residential institutions. There were no RSV outbreaks
notified during week 43 2025.
Excess mortality
The latest HPSC excess mortality analysis of all registered deaths in
Ireland up to October 26th, 2025 using the standardised European
EuroMOMO algorithm shows that there has been no excess mortality
reported for the entire Irish population (all ages) during the 2025/2026
season (week 40 2025 on) and most recently in week 42 2025.
Note: These data are provisional due to the time delay with death
registration in Ireland. A country-specific adjustment function was
applied to correct for the typical delay in registrations of deaths in
Ireland. Nonetheless, estimates of excess mortality for the most recent
weeks are reported with some uncertainty and should be interpreted with
caution.
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.
The weekly calendar runs from Sunday to Saturday for respiratory
virus notifications 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.
Definitions
The case definitions for COVID-19, influenza and RSV are available
here. Only data on laboratory-confirmed cases, including cases diagnosed
using near patient molecular tests, are included in this report.
Sentinel GP ARI consultations are consultations to sentinel GP
practices for Acute Respiratory Infection (ARI), with ARI defined as
Sudden onset of symptoms AND at least one of the following four
respiratory symptoms: Cough, sore throat, shortness of breath, coryza
AND a clinician’s judgement that the illness is due to an infection.
GP out of hours calls refer to calls to GP out of hours services from
persons with self-reported clinical symptoms of ‘flu’ or ‘cough’.
Emergency Department cases refer to cases treated in emergency
departments, with no indication on CIDR that they have subsequently been
admitted to hospital.
Hospitalised cases are inpatients with laboratory-confirmed
SARS-CoV-2, influenza or RSV and includes inpatients with incidental
infections, where the infection is not the reason for their
admission.
Bed occupancy refers to the number of laboratory-confirmed cases
admitted to acute inpatient sites at 08:00 hrs on the day of
reporting.
A SARI case is defined as a person hospitalised for at least 24 hours
with acute respiratory infection and onset of symptoms within 14 days
prior to hospital admission, with at least one of the following
symptoms: cough, fever, shortness of breath OR sudden onset of anosmia,
ageusia or dysgeusia.
The case definition was adapted in Ireland for infants aged <6
months to include increased work of breathing and apnoea as relevant
symptoms, the revised definition was applied to cases admitted from week
40 2025. A SARI case refers to an individual patient episode of
care.
As of September 2024, ICU admissions for COVID-19, influenza and RSV
refer to those admitted to intensive care where COVID-19, influenza or
RSV were the primary or contributory cause of admission. Prior to
September 2024, ICU admissions for influenza and RSV included all
admissions where the patient tested positive for influenza or RSV,
irrespective of whether these pathogens were the cause of admission.
COVID-19, influenza and RSV deaths are defined as a death in a person
with laboratory-confirmed COVID-19, influenza or RSV infection. see case
definitions (this includes cases detected postmortem)
Moving Epidemic Method (MEM) thresholds have been established to
assess the intensity of respiratory virus activity. Thresholds have been
calculated using five years of historical notification data from
2017/2018 to 2024/2025. The seasons 2020/2021 and 2021/2022 were
excluded, due to low influenza and RSV in circulation during the
COVID-19 pandemic. SARS-CoV-2 has a bimodal epidemic pattern and
therefore is unsuitable for threshold analysis using the MEM. Further details
Test Positivity: Positive tests refer to all positive specimens and
includes duplicates and individuals who were re-tested.
Outbreaks are defined as two or more cases of acute respiratory
infection with the same pathogen (SARS-CoV-2, influenza or respiratory
syncytial virus (RSV)) confirmed by a laboratory test or near patient
test carried out by a health professional, and where there is reason to
consider that these cases may be epidemiologically linked in place and
time.
Other Acute Respiratory Infection (ARI) outbreaks are defined as: Two
or more cases of acute respiratory infection arising within the same
48hr period epidemiologically linked in place: Outbreaks are classified
as Suspect ARI outbreaks, where testing has not been completed, is
pending or has been negative for Influenza, RSV and SARS-CoV-2.
Outbreaks are classified as confirmed if other respiratory pathogens
(ORVs), e.g. Rhinovirus, hMPV, Coronavirus OC43 etc are identified via
laboratory confirmation. The outbreak data presented in this report
includes both confirmed and suspect outbreaks.
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.
Data sources
The Computerised Infectious Disease Reporting (CIDR) system: CIDR is
the source of statutory notification data on laboratory-confirmed
COVID-19, influenza, RSV (including data on notified, emergency
department, hospitalised and ICU cases and data on cases who died) and
data on outbreaks.
The type/subtype of laboratory-confirmed influenza notifications are
reported on the CIDR system. The number of cases hospitalised and
admitted to ICU described in this report relate only to cases notified
during this reporting period, with known hospitalisation/ICU status at
the time of reporting.
Regional Departments of Public Health currently prioritise the
investigation and reporting of outbreaks in settings that benefit most
from public health and clinical intervention. The outbreak data reported
here focuses on these key settings/groups. These settings include acute
hospitals, nursing homes, community hospital/long-stay units,
residential institutions (centres for disabilities, centres for older
people, children’s/TUSLA residential centres and mental health
facilities) and other healthcare settings.
Population denominator data for analyses of CIDR data on notified,
emergency department, hospitalised and ICU cases and deaths are taken
from Census 2022.
Sentinel GP surveillance system: This includes 100 participating
general practices (located in all HSE Health Regions). These practices
report electronically on a weekly basis, the number of patients who
consulted with acute respiratory infection (ARI) and influenza-like
illness (ILI) (identified using International Classification of Primary
Care 2 codes R74 and R80). These practices provide overall and
age-stratified denominator data on the number of registered patients who
have sought care at the practice during the previous three years. The
combined patient population in these practices is estimated to be
approximately 10% of the national population. Sentinel GPs take a
combined nose and throat swab from the first five patients attending
their practice each week who meet the ARI case definition and send these
to the NVRL for testing.
GP Out-of-hours (GPOOHs) services: Five out of 14 GPOOHs services
provide weekly data on the total and age-stratified number of out of
hours calls for 1) all reasons, 2) for self-reported cough and 3) for
self-reported flu. The denominator for calculations of percentage of
calls is the total number of calls for all reasons.
The HSE Performance Management and Improvement Unit (PMIU) provides
daily data on bed occupancy (the number of currents inpatients with
laboratory-confirmed COVID-19, influenza and RSV).
Severe Acute Respiratory Infections (SARI) surveillance system: SARI
cases are identified based on clinical symptoms from new admissions
through the Emergency Department in SVUH, SJH and UHL. In CHI-C cases
are recruited from emergency department and non-emergency department
routes (e.g. transfer from other hospitals, direct admission to
speciality wards), excluding day cases and elective admissions.
National Virus Reference Laboratory (NVRL): 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).
The NVRL report on influenza type/subtype of sentinel GP ARI and
non-sentinel respiratory specimens on a weekly basis.
The SARS-CoV-2
genomic 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. 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 40 2024 (specimen dates between 29/09/2024 and
02/10/2025). The SARS-CoV-2 sequencing results included in this report
reflect all data available as of 24/10/2025.
National SARS-CoV-2 Wastewater Surveillance Programme: 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 Report] (https://www.hpsc.ie/a-z/nationalwastewatersurveillanceprogramme/)
Appendix
Appendix Table 1: Number
and incidence of notified laboratory-confirmed cases of COVID-19,
influenza and RSV by age, sex and HSE Health Region, from week 40 2025,
to week 43 2025. Data source: CIDR
Number of cases (incidence per 100,000 population) |
|---|
| All pathogens | COVID-19 | Influenza | RSV |
|---|
Cases | 1,949 (37.9) | 1,446 (28.1) | 392 (7.6) | 111 (2.2) |
Age groups (years) |
|
|
|
|
<1 | 96 (166.1) | 61 (105.5) | 13 (22.5) | 22 (38.1) |
1-4 | 134 (56.4) | 22 (9.3) | 56 (23.6) | 56 (23.6) |
5-14 | 83 (11.6) | 18 (2.5) | 63 (8.8) | 2 (0.3) |
15-44 | 329 (15.9) | 208 (10.1) | 112 (5.4) | 9 (0.4) |
45-64 | 310 (24.0) | 247 (19.1) | 60 (4.6) | 3 (0.2) |
65-79 | 495 (83.2) | 428 (71.9) | 59 (9.9) | 8 (1.3) |
>80 | 502 (277.3) | 462 (255.2) | 29 (16.0) | 11 (6.1) |
Median age (IQR) | 66 (33-80) | 72 (50-82) | 32 (7-60) | 2 (1-26) |
Sex |
|
|
|
|
Male | 948 (37.3) | 704 (27.7) | 189 (7.4) | 55 (2.2) |
Female | 1,000 (38.4) | 742 (28.5) | 203 (7.8) | 55 (2.1) |
HSE Health Regions |
|
|
|
|
Dublin and North East | 414 (34.9) | 331 (27.9) | 70 (5.9) | 13 (1.1) |
Dublin and Midlands | 382 (35.4) | 281 (26.1) | 84 (7.8) | 17 (1.6) |
Dublin and South East | 398 (41) | 299 (30.8) | 77 (7.9) | 22 (2.3) |
South West | 337 (45.5) | 234 (31.6) | 93 (12.6) | 10 (1.4) |
Mid West | 143 (34.6) | 117 (28.3) | 15 (3.6) | 11 (2.7) |
West and North West | 275 (36.2) | 184 (24.2) | 53 (7) | 38 (5) |
Appendix Table 2: Number
and incidence of notified hospitalised laboratory-confirmed cases of
COVID-19, influenza and RSV by age, sex and HSE Health Region from week
40 2025 to week 43 2025. Data source: CIDR
Number of cases (incidence per 100,000 population) |
|---|
| All pathogens | COVID-19 | Influenza | RSV |
|---|
Cases | 683 (13.3) | 571 (11.1) | 63 (1.2) | 49 (1.0) |
Age groups (years) |
|
|
|
|
<1 | 43 (74.4) | 26 (45.0) | 4 (6.9) | 13 (22.5) |
1-4 | 50 (21.0) | 11 (4.6) | 11 (4.6) | 28 (11.8) |
5-14 | 23 (3.2) | 8 (1.1) | 13 (1.8) | 2 (0.3) |
15-44 | 62 (3.0) | 51 (2.5) | 9 (0.4) | 2 (0.1) |
45-64 | 92 (7.1) | 84 (6.5) | 8 (0.6) | 0 (0.0) |
65-79 | 201 (33.8) | 186 (31.2) | 13 (2.2) | 2 (0.3) |
>80 | 212 (117.1) | 205 (113.2) | 5 (2.8) | 2 (1.1) |
Median age (IQR) | 72 (42-82) | 75 (58-83) | 28 (5-68) | 1 (0-3) |
Sex |
|
|
|
|
Male | 356 (14.0) | 303 (11.9) | 29 (1.1) | 24 (0.9) |
Female | 326 (12.5) | 268 (10.3) | 34 (1.3) | 24 (0.9) |
HSE Health Regions |
|
|
|
|
Dublin and North East | 93 (7.8) | 86 (7.2) | 2 (0.2) | 5 (0.4) |
Dublin and Midlands | 162 (15) | 138 (12.8) | 15 (1.4) | 9 (0.8) |
Dublin and South East | 108 (11.1) | 79 (8.1) | 18 (1.9) | 11 (1.1) |
South West | 113 (15.3) | 102 (13.8) | 10 (1.4) | 1 (0.1) |
Mid West | 74 (17.9) | 58 (14) | 9 (2.2) | 7 (1.7) |
West and North West | 133 (17.5) | 108 (14.2) | 9 (1.2) | 16 (2.1) |
Appendix Table 3: Number
and percentage of test positive Sentinel GP ARI specimens by respiratory
virus for the most recent two weeks 42 2025, week 43 2025 and the
2025/2026 season to date. Data source: NVRL
| Week 42 2025 (N = 125) | Week 43 2025 (N = 55) | 2025/2026 (N = 435) |
|---|
Virus | Total positive | % positive | Total positive | % positive | Total positive | % positive |
|---|
SARS-CoV-2 | 7 | 5.6 | 3 | 5.5 | 31 | 7.1 |
Influenza Virus | 10 | 8.0 | 5 | 9.1 | 23 | 5.3 |
Respiratory Syncytial Virus (RSV) | 3 | 2.4 | 0 | 0.0 | 4 | 0.9 |
Rhino/enterovirus | 48 | 38.4 | 18 | 32.7 | 167 | 38.4 |
Adenovirus | 3 | 2.4 | 2 | 3.6 | 9 | 2.1 |
Bocavirus | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 |
Parainfluenza virus type 1 (PIV-1) | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 |
Parainfluenza virus type 2 (PIV-2) | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 |
Parainfluenza virus type 3 (PIV-3) | 0 | 0.0 | 0 | 0.0 | 2 | 0.5 |
Parainfluenza virus type 4 (PIV-4) | 2 | 1.6 | 2 | 3.6 | 13 | 3.0 |
Appendix Table 4: Number
and percentage positive NVRL non-sentinel respiratory specimens by
respiratory virus, week 42 2025, week 43 2025 and the 2025/2026 season
to date. Data source: NVRL
| Week 42 2025 (N = 209) | Week 43 2025 (N = 103) | 2025/2026 (N = 772) |
|---|
Virus | Total positive | % positive | Total positive | % positive | Total positive | % positive |
|---|
SARS-CoV-2 | 10 | 4.8 | 7 | 6.8 | 52 | 6.7 |
Influenza Virus | 8 | 3.8 | 0 | 0.0 | 33 | 4.3 |
Respiratory Syncytial Virus (RSV) | 3 | 1.4 | 0 | 0.0 | 12 | 1.6 |
Rhino/enterovirus | 55 | 26.3 | 29 | 28.2 | 180 | 23.3 |
Adenovirus | 3 | 1.4 | 0 | 0.0 | 8 | 1.0 |
Bocavirus | 0 | 0.0 | 0 | 0.0 | 3 | 0.4 |
Parainfluenza virus type 1 (PIV-1) | 0 | 0.0 | 0 | 0.0 | 1 | 0.1 |
Parainfluenza virus type 2 (PIV-2) | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 |
Parainfluenza virus type 3 (PIV-3) | 3 | 1.4 | 1 | 1.0 | 8 | 1.0 |
Parainfluenza virus type 4 (PIV-4) | 4 | 1.9 | 1 | 1.0 | 6 | 0.8 |
Appendix Table 5:
Influenza type and sub-type distribution among sentinel GP ARI and
non-sentinel respiratory influenza positive specimens for the most
recent two weeks 42 2025, week 43 2025 and the 2025/2026 season to date.
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 (unspecified) |
|---|
Week 42 2025 | Sentinel GP ARI | 10 | 10 | 3 | 7 | 0 | 0 | 0 | 0 |
Non-sentinel respiratory | 8 | 8 | 7 | 1 | 0 | 0 | 0 | 0 |
Total | 18 | 18 | 10 | 8 | 0 | 0 | 0 | 0 |
Week 43 2025 | Sentinel GP ARI | 5 | 5 | 2 | 3 | 0 | 0 | 0 | 0 |
Non-sentinel respiratory | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Total | 5 | 5 | 2 | 3 | 0 | 0 | 0 | 0 |
Season to date | Sentinel GP ARI | 23 | 23 | 8 | 15 | 0 | 0 | 0 | 0 |
Non-sentinel respiratory | 33 | 32 | 19 | 13 | 0 | 1 | 0 | 1 |
Total | 56 | 55 | 27 | 28 | 0 | 1 | 0 | 1 |
Appendix Table 6: RSV type
distribution among sentinel GP ARI and non-sentinel respiratory RSV
positive specimens for the most recent two weeks 42 2025, week 43 2025
and the 2025/2026 season to date. Data source: NVRL
Time period | Specimen source | Total RSV positive | RSV A | RSV B | RSV (unspecified) |
|---|
Week 42 2025 | Sentinel GP ARI | 3 | 0 | 3 | 0 |
Non-sentinel respiratory | 3 | 0 | 3 | 0 |
Total | 6 | 0 | 6 | 0 |
Week 43 2025 | Sentinel GP ARI | 0 | 0 | 0 | 0 |
Non-sentinel respiratory | 0 | 0 | 0 | 0 |
Total | 0 | 0 | 0 | 0 |
Season to date | Sentinel GP ARI | 4 | 0 | 4 | 0 |
Non-sentinel respiratory | 12 | 3 | 9 | 0 |
Total | 16 | 3 | 13 | 0 |
