Respiratory illness activity remains low or close to baseline across reporting countries in the European Union and European Economic Area, but SARS-CoV-2 is still the main virus detected in both primary-care and hospital surveillance, according to the latest weekly update from the European Centre for Disease Prevention and Control (ECDC).

The bulletin covers week 43 of 2026 and was published on 3 November. It offers an early-season snapshot rather than a forecast. The figures are provisional, reporting practices differ between countries, and a small number of countries with high testing volumes can have a large influence on pooled results.

What the surveillance data show

ECDC reports that consultation rates for respiratory illness in both primary and secondary care remain low or at baseline levels in all countries submitting data. This means healthcare systems are not yet seeing broad respiratory-virus pressure comparable with a typical winter peak.

Within that low overall activity, SARS-CoV-2 remains the largest contributor. Median test positivity was 5.2% in primary-care surveillance and 4.8% in secondary care. Positivity measured through syndromic surveillance exceeded 5% in seven countries in primary care and two countries in secondary care.

Laboratory-based systems are also reporting increases in SARS-CoV-2 detections in some settings. Among patients in secondary care, most detections were in adults aged over 65 years. That age pattern matters because older adults are more likely to experience severe outcomes, even when population-wide activity is not high.

Influenza remains at baseline

Influenza activity was still at baseline or low levels overall. Only small numbers of detections were reported in primary and secondary care, and the hospital detections were concentrated mainly among adults over 65.

The influenza viruses characterised during the week were type A, with A(H1N1)pdm09 the main identified subtype. A subtype label does not by itself indicate how severe the season will be. Severity depends on many factors, including the number of infections, population immunity, vaccine uptake, age distribution and the match between circulating viruses and the seasonal vaccine.

RSV activity is very low

Respiratory syncytial virus (RSV) activity was described as very low. RSV can be especially important for infants, some older adults and people with certain underlying conditions, but the week-43 data do not show a broad rise across the surveillance network.

Low activity in one week should not be interpreted as a guarantee for the rest of the season. Respiratory-virus patterns can change quickly as temperature, school calendars, travel, indoor contact and local outbreaks alter transmission conditions.

Why weekly surveillance matters

Public-health agencies do not rely on a single indicator. ECDC’s European Respiratory Virus Surveillance Summary combines information from primary care, hospitals, laboratories and genetic characterisation. Each source answers a different question.

Consultation rates indicate how many people are seeking care for respiratory symptoms. Test positivity shows the proportion of tested samples that contain a particular virus. Hospital surveillance provides a view of more severe illness, while genetic sequencing helps track which influenza subtypes and SARS-CoV-2 variants are circulating.

Looking at these signals together helps distinguish a true seasonal rise from changes caused by testing intensity, reporting delays or activity concentrated in a small number of countries.

What the figures do not say

The update does not mean respiratory viruses are absent. A low regional average can coexist with local outbreaks, and people can still become seriously ill during periods of modest overall activity. The bulletin also cannot predict precisely when influenza or RSV will increase.

ECDC explicitly notes that the data are provisional and may be affected by incomplete reporting. Pooled European figures are useful for direction and comparison, but national and local public-health updates remain important for decisions in a specific community.

A practical reading of the early-season picture

The most accurate conclusion is measured: Europe’s respiratory-virus season had not accelerated broadly by week 43, yet SARS-CoV-2 continued to account for the largest share of detected activity. Influenza and RSV remained low, while older adults represented most secondary-care detections reported for SARS-CoV-2 and influenza.

People should follow current guidance from their national health authority, particularly on vaccination, testing and steps to reduce transmission when unwell. Anyone with severe symptoms or concerns about personal risk should seek advice from a qualified healthcare professional.

Source: ECDC, “Overview of respiratory virus epidemiology in the EU/EEA, week 43, 2026,” published 3 November 2026. Featured image: illustrative public-health laboratory photograph by Julia Koblitz, used under the Unsplash License.