2.1 Episodes of influenza, RSV and COVID-19

The number of new influenza episodes decreased in week 03, with 193 unique episodes identified. There were 316 episodes reported in week 02. There were 123 new RSV episodes identified in week 03, an increase from week 02 when 104 episodes were identified (Figure 2.1).

Influenza and RSV episode rates by age groups are shown in (Figure 2.2). The highest influenza episode rate in week 03 was in 75+ age group (42.2 per 100,000 population). The highest RSV episode rate in week 03 was in the 0-4 age group (54.9 per 100,000 population).

Influenza and RSV episode rates across local government districts (LGD) are shown in (Figure 2.3). Mid Ulster had the highest influenza episode rate in week 03 (19.3 per 100,000 population). Derry City and Strabane had the highest RSV episode rate in week 03 (11.3 per 100,000 population).

The number of new COVID-19 episodes increased slightly in week 03, with 55 unique episodes identified. There were 43 episodes reported in week 02 (Figure 2.1).

COVID-19 episode rates by age groups are shown in (Figure 2.2). The highest COVID-19 episode rate in week 03 was in the 75+ age group (10.6 per 100,000 population).

COVID-19 episode rates across LGD are shown in (Figure 2.3). Mid and East Antrim had the highest COVID-19 episode rate in week 03 (5.8 per 100,000 population).

Supplementary tables of unique episodes and weekly episode rates are shown at the end of this report.

Figure 2.1: Weekly number of unique episodes of influenza, RSV and COVID-19 by epidemiological week

Figure 2.2: Weekly episode rates of influenza, RSV and COVID-19 per 100,000 population, by age group and epidemiological week

Figure 2.3: Weekly episode rates of influenza, RSV and COVID-19 per 100,000 population, by local government district and epidemiological week

2.2 Testing and positivity (%)

In week 03 there were 2,425 influenza tests, 202 of which were positive (8.3% positivity). This is a decrease from week 02 (12.5% positivity) (Figure 2.4). Influenza positivity in week 03 was highest in the 15-44 age group (12.6% positivity) (Figure 2.5).

There were 1,282 RSV tests, 111 of which were positive (8.7% positivity). This is higher than week 02 (6.7% positivity) (Figure 2.4). RSV positivity in week 03 was highest in the 0-4 age group (31.8% positivity) (Figure 2.5).

There were 2,396 COVID-19 tests, 60 of which were positive (2.5% positivity). This is similar to week 02 (2.0% positivity) (Figure 2.4). COVID-19 positivity in week 03 was highest in the 5-14 age group (4.9% positivity) (Figure 2.5).

Supplementary tables of testing and positivity are shown at the end of this report.

Figure 2.4: Weekly positivity for influenza, RSV and COVID-19, by epidemiological week

Shading represents 95% confidence intervals.

Figure 2.5: Weekly positivity for influenza, RSV and COVID-19, by age group and epidemiological week

Shading represents 95% confidence intervals.

In week 03 there were 410 rhinovirus tests, 46 of which were positive (11.2% positivity). This is an increase from week 02 (7.7% positivity) (Figure 2.6).

There were 410 adenovirus tests, 11 of which were positive (2.7% positivity). This is slightly higher to week 02 (2.1% positivity) (Figure 2.6).

There were 411 parainfluenza tests, nine of which were positive (2.2% positivity). This is lower to week 02 (3.5% positivity) (Figure 2.6).

There were 411 human metapneumovirus (hMPV) tests, 26 of which were positive (6.3% positivity). This is lower to week 02 (8.4% positivity) (Figure 2.6).

Figure 2.6: Weekly positivity for rhinovirus, adenovirus, parainfluenza and Human metapneumovirus, by year and epidemiological week

Shading represents 95% confidence intervals.

2.3 Influenza sub-typing

Of the 193 new influenza episodes identified in week 03, 11 were typed as Flu A (H1), 75 were Flu A (H3), 105 were Flu A (not subtyped) and two were Flu B (Figure 2.7).

A supplementary table of influenza sub-typing is shown at the end of this report.

Figure 2.7: Weekly number of unique episodes of influenza, by subtype and epidemiological week

2.4 Sentinel surveillance

Sentinel surveillance plays a role in monitoring and understanding the spread and impact of respiratory viruses like influenza and COVID-19 in the community. It involves a systematic and targeted approach to collect data from a geographical representative subset of GP practices (~15% population representative) to provide information about virus activity across Northern Ireland.

In week 03, 16 samples were positive for influenza from 40 samples submitted for testing to the Regional Virus Laboratory (RVL) (40.0% positivity). Of these, one was typed as Flu A (H1) and 15 were Flu A (H3). Three samples were positive for RSV from 40 samples submitted for testing (7.5% positivity). One sample was positive for COVID-19 from 39 samples submitted for testing (2.6% positivity) (Table 1).

Total sentinel cases of influenza, RSV and COVID-19 by age group for the previous year are shown in (Figure 2.8), (Figure 2.9) and (Figure 2.10), and cumulatively for the 2025/26 influenza season in Table 2.

A supplementary table of testing and positivity is shown at the end of this report.

Figure 2.8: Weekly sentinel influenza cases, by age group and epidemiological week

Figure 2.9: Weekly sentinel RSV cases, by age group and epidemiological week

Figure 2.10: Weekly sentinel COVID-19 cases, by age group and epidemiological week

2.5 Non-sentinel surveillance

Non-sentinel surveillance is the monitoring of respiratory viruses from virology data collected from settings such as hospitals and GPs (excluding the sentinel GPs). This provides information about virus activity across Northern Ireland.

In week 03, 186 samples were positive for influenza from 2,385 samples submitted for testing to laboratories across Northern Ireland (7.8% positivity). Of these, 11 were typed as Flu A (H1), 67 were Flu A (H3), 106 were Flu A (not subtyped) and two were Flu B. 108 samples were positive for RSV from 1,242 samples submitted for testing (8.7% positivity). 59 samples were positive for COVID-19 from 2,357 samples submitted for testing (2.5% positivity) (Table 3).

Total non-sentinel cases of influenza, RSV and COVID-19 by age group for the previous year are shown in (Figure 2.8), (Figure 2.9) and (Figure 2.13), and cumulatively for the 2025/26 influenza season in Table 4.

A supplementary table of testing and positivity is shown at the end of this report.

Figure 2.11: Weekly non-sentinel influenza cases, by age group and epidemiological week

Figure 2.12: Weekly non-sentinel RSV cases, by age group and epidemiological week

Figure 2.13: Weekly non-sentinel COVID-19 cases, by age group and epidemiological week

2.6 SARS-CoV-2 variants

In the 8 weeks from the 03 November 2025 to 28 December 2025, 93 COVID-19 samples were sequenced. Of these, 33 were XFG (35.5% of all sequenced samples), 29 were XFG.3 (31.2% of all sequenced samples), 17 were LP.8.1 (18.3% of all sequenced samples), 7 were NB.1.8.1 (7.5% of all sequenced samples), 3 were BA.3 (3.2% of all sequenced samples) and 1 was KP.3 and XEC (both 1.1% of all sequenced samples). Due to small numbers of samples sequenced, the level of confidence in precision of the estimate is low, and the percentages of each variant may change as further results become available.A more detailed COVID-19 Genomics Bulletin containing a further breakdown of sub-lineages is published weekly.

Parent lineages displayed are subject to change based on lineages under monitoring by the UKHSA horizon scanning team.

Figure 2.14: Total number of sequenced variants of COVID-19 by Pangolin lineage, by epidemiological week

Recombinant refers to any recombinant lineage, starting “X”, that does not fall under the parent lineage of a defined variant.

3.1 Consultation rates for influenza/influenza-like-illness (‘flu/ILI’)

The general practice (GP) flu/ILI consultation rate during week 03 was 16.0 per 100,000 population. This is a decrease from week 02 (24.3 per 100,000 population). Rates are at low activity levels (10.7 to <25.8 per 100,000 population) (Figure 3.1).

The highest rate in week 03 was in the 75+ age group (32.3 per 100,000 population) (Figure 3.2).

The highest rate in week 03 was in the Southern Trust (21.1 per 100,000 population) (Figure 3.3).

Supplementary tables of GP consultation rates are shown at the end of this report.

Figure 3.1: Northern Ireland GP consultation rates for ‘flu/ILI’, 2021/22 – 2024/25

The baseline MEM threshold for Northern Ireland is <10.7 per 100,000 population for 2025/26. Low activity is 10.7 to <25.8, moderate activity 25.8 to <55.2, high activity 55.2 to <77.1 and very high activity is >77.1 per 100,000 population.

Figure 3.2: GP consultation rates for ‘flu/ILI’, by age group, 2022/23 – 2025/26

Figure 3.3: GP consultation rates for ‘flu/ILI’, by HSCT, 2022/23 – 2025/26

3.2 Consultation rates for acute respiratory infection (ARI)

The GP ARI consultation rate during week 03 was 220.1 per 100,000 population. This is a decrease from week 02 (254.9 per 100,000 population) (Figure 3.4).

The highest rate in week 03 was in the 0-4 age group (639.2.6 per 100,000 population) (Figure 3.5).

The highest rate in week 03 was in the Western Trust (313.6 per 100,000 population) (Figure 3.6).

Supplementary tables of GP consultation rates are shown at the end of this report.

Figure 3.4: Northern Ireland GP consultation rates for ARI, 2022/23 – 2025/26

Figure 3.5: GP consultation rates for ARI, by age group, 2022/23 – 2025/26

Figure 3.6: GP consultation rates for ARI, by HSCT, 2022/23 – 2025/26

3.3 Consultation rates for COVID-19

The GP COVID-19 consultation rate during week 03 was 0.9 per 100,000 population. This is similar to week 02 (1.0 per 100,000 population) (Figure 3.7).

The highest rate in week 03 was in the 75+ age group (2.9 per 100,000 population) (Figure 3.8).

The highest rate in week 03 was in the Southern Trust (1.2 per 100,000 population) (Figure 3.9).

Supplementary tables of GP consultation rates are shown at the end of this report.

Figure 3.7: Northern Ireland GP consultation rates for COVID-19, 2022/23 – 2025/26

Figure 3.8: GP consultation rates for COVID-19, by age group, 2022/23 – 2025/26

Figure 3.9: GP consultation rates for COVID-19, by HSCT, 2022/23 – 2025/26

4.1 Influenza, RSV and COVID-19 care homes outbreaks

There were four confirmed outbreaks reported in care home settings to the Public Health Agency (PHA) Health Protection Acute Response Duty Room in week 03. All outbreaks were Flu A (not subtyped). In week 02 there were five confirmed outbreaks reported in care home settings (four Flu A (not subtyped) and one RSV) (Figure 4.1).

Figure 4.1: Weekly number of confirmed influenza, RSV and COVID-19 outbreaks, by epidemiological week

5.1 Admissions and occupancy

There were 136 new community-acquired emergency hospital admissions during week 03 (Figure 5.1). Of these, 72 were influenza A, 44 were RSV and 20 were COVID-19. In week 02 there were 167 hospital admissions. Of these, 114 were influenza A, 39 were RSV and 14 were COVID-19.

Community-acquired emergency hospital admission rates in week 03 were highest in the 75+ age group for influenza (21.8 per 100,000 population), the 0-4 age group for RSV (30.1 per 100,000 population), and the 75+ age group for COVID-19 (3.3 per 100,000 population) (Figure 5.2).

Supplementary tables of emergency hospital admissions and rates by age group are shown at the end of this report.

Figure 5.1: Weekly number of community-acquired emergency influenza, RSV and COVID-19 hospital admissions, by epidemiological week

Figure 5.2: Weekly community-acquired emergency influenza, RSV and COVID-19 hospital admission rates per 100,000 population, by age group and epidemiological week

Community-acquired emergency influenza inpatients have decreased while RSV and COVID-19 inpatients have remained stable (Figure 5.3). Community-acquired emergency inpatients by age group for the previous year are shown in (Figure 5.4).

Figure 5.3: Influenza, RSV and COVID-19 community acquired emergency inpatients, by day

Figure 5.4: Influenza, RSV and COVID-19 community acquired emergency inpatients, by age group and day

6.1 Deaths related to influenza and/or pneumonia

NISRA death statistics are published weekly. These statistics report on deaths where influenza and/or pneumonia was mentioned anywhere on the death certificate. As a result, the counts will reflect deaths where influenza or pneumonia has contributed to a death but was not necessarily the underlying cause of the death.

The latest data is available for week ending 09 January 2026. In week 02, there were 112 influenza and/or pneumonia related deaths out of 507 deaths reported (22.1%). This is similar to the previous week (22.2%) (Figure 6.1).