Economy 6 February 2025, 3:41pm

Influenza epidemic abates none in Hungary, authority expects moderation

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Hungary's National Centre for Public Health and Pharmacy (NNGYK) has downplayed the current respiratory season as a "medium-intensity influenza epidemic", while the only time the number of influenza-like illnesses per 100,000 inhabitants exceeded the figure for week 5 was in the 2016/17 season. Almost half of Hungarians hospitalised with severe acute respiratory infection (SARI) have influenza, and more than a third of them are aged two years or younger, while more than 80% of people hospitalised with respiratory syncytial virus (RSV) are also in this age group.

gyorfi pal koronavirus tajekoztato maszkhasznalat

Key findings:

Almost half (47.7%) of the samples tested on the 5th week of 2025 showed infection with some kind of influenza virus;
the influenza positivity rate for all samples tested (19.8%) continues to exceed the cumulated Covid positivity rate (10.3%), while the flu rate never took the lead in the 2023/24 season;
the coronavirus positivity rate was up slightly at 2.3% from 1.4% and
the RSV positivity rate also rose to 2.9% from 1.6%;
the number of human metapneumovirus (HMPV) infections reached 35 or 0.7% of all samples tested, which figures compare with 24 and 0.6% a year earlier;
the number of people hospitalised with severe acute respiratory infection (SARI) was the highest yet in the current respiratory season at 317, exceeding the 2023/24 (291) and 2022/23 (249) prints;
only 0.6% of those hospitalised tested positive for COVID-19, while there were already 148 people with influenza infection in hospital, which corresponds to 46.7% of all SARI patients; and already 48 people were treated in hospital with RSV infection (15.1% of all SARI patients);
of the 317 people in hospital with SARI, 114 (36.0%) were aged two years or younger, slightly up from the 3rd week but down from almost 40% on the first week, while 98 (33.4%) were aged 60 years and older.

Nothing to see here...

On the 5th week of 2025 (27 January-2 February), 322,600 people sought medical help with acute respiratory infections (ARI), including 83,600 people with influenza-like illness (ILI), according to data released by the National Centre for Public Health and Pharmacy (NNGYK) on Thursday.

Note that both the 43rd and 44th weeks had only four working days due to national holidays, hence the fewer number of cases in the statistics and the dips in the graphs. The dataset for the 52nd week is full of holes, as the NNK published an abridged report with only some testing figures.) The respiratory season (often and erroneously referred to as 'flu season') generally peaks between the 4th and the 9th week of the year.

A short-term comparison (for the last three seasons of respiratory illnesses) shows that the number of patients with ARI, including those with ILI was much higher than at this point in the previous two respiratory seasons.

The share of influenza-like illness in ARI was up at 25.9% from 23.7% on the 4th week, exceeding the comparative readings from the past two seasons (17.5% and 15.6%, respectively), meaning that effectively a quarter of ARI patients showed symptoms of influenza.

We also have data for ARIs and flu-like symptoms per 100,000 inhabitants, although a long-term data series is available only for the latter.

in terms both ari and flu-like symptoms per 100,000 people, the situation is currently way worse than in either of the previous two respiratory seasons.

In the graph below you can compare to the flu situation with the previous 13 respiratory seasons, and find that the situation has been worse than currently (yellow line) only once in 2016/17. Perhaps that's what the NNGYK referred to our inquiry as a "medium-intensity influenza epidemic".

"We also keep a close eye on the rate of serious illness. Currently, 0.09 percent of all patients require hospitalisation. This also shows that the virus currently circulating is not causing more severe illness than we are used to," the authority reassured us in response to our enquiries.

The percentage (hospitalisations divided by the number of people seeking medical help with ARI) was actually 0.098% on the 5th week or, let's round it up a bit, 0.1%, but who counts it, right? It was indeed a smidge lower than in 2023/24 (0.107% and 2022/23 (0.102%).

"Based on the sewage results, the increase in influenza A infections should stop in the near future," the authority predicted, but added that "the number of cases could be affected by the emergence of other variants (e.g. influenza B)."

Positivity rates

A total of 511 samples were tested on the 4th week (yet another record for the current respiratory season), with 12 coming back COVID-19 positive (up from 7 on the 4th week). The 2.3% positivity rate compares with 4.5% (18 cases) a year ago and 14.3% (21 cases) two years ago.

The share of influenza (47.7%) in the tested samples is well above the previous two years' respective prints (32.4% and 31.3%, respectively), while that of respiratory syncytial virus (RSV) remains lower at 2.9% than in 2023/24 (6.0%) and 2022/23 (11.6%).

The following graph may seem a bit fuzzy at first but at least it shows a side-by side comparison of the weekly positivity rates for influenza (green), Covid (orange), and RSV (blue) for the past three respiratory seasons up to the 5th week. It is evident how the flu positivity rate stands out this year, whether we compare it to the corresponding rates in the previous two years or to the Covid and RSV positivity rates.

As regards the individual positivity rates in all the samples, the 'switch' never took place in the 2023/24 respiratory season (i.e. the total number of positive Covid tests in all samples tested remained higher than the number of positive flu tests) in and occurred by the end of the 3rd week in the 2022/23 season.

As the chart below attests, SARS-CoV-2 is no longer the main pathogen in samples, with 508 positive tests (10.3% of the 4,911 samples tested), as influenza took over (first on the 4th week) with 971 positive samples (19.8% of all samples), followed by rhinovirus (49), RSV (60), human metapneumovirus (HMPV, 35), parainfluenza (5), and adenovirus (4).

Hospitalisations

317 people with severe acute respiratory infection (SARI) were hospitalised on the 5th week of 2025, of whom 34 (or 10.7%) required intensive care. The former figure is the highest so far in the current respiratory season, while the ICU/hospitalised ratio also dropped from 12.3% on the 4th week. The respective figures for the 5th week of 2024 were 291 people in hospital, and 35 (12%) in ICUs.

Further breakdown shows that 2 people (0.6% of SARI patients) were hospitalised with SARS-CoV-2 infection, down from 13 a week earlier and way less than either a year ago (59, 20.3%) or two years ago (31, 12.4%).

A total of 148 people in hospital with SARI tested positive for influenza, which corresponds to 46.7% of all SARI patients.

This compares with only 74 influenza patients (25.4% of all SARI patients) in hospital on the 5th week of 2024 and 24 (9.6%) on the same week of 2023.

The share of RSV patients rose further to 15.1% (48) from 9.6% (28), which compares with 15.1% (44) a year earlier and 23.7% (59) two years earlier.

Age distribution of hospitalised SARI patients

Of the 317 people in hospital with SARI, 114 (36%) were aged two years or younger, which shows a rise from 77(26.3%) a week earlier, while 95 (30%) were aged 60 years and older, a moderate drop from the 4th week (98 or 33.4%).

One of the two COVID-19 patients were over 60 years of age. A year ago, of the 291 people in hospital with SARI, 88 (30.2%) were aged two or younger, while 115 (30.5%) were 60 or older. Also, 48 (81.4%) of the 59 COVID-19 patients were over 60 years of age.

The age breakdown of people seeking medical help with ARI and flu-like symptoms are shown below.

The majority of ARI patients belonged in the 0-14 age group throughout the 'flu season' last year (and so far this year too), while the share of people going to the doctor with flu-like symptoms was the highest in the 15-34 age group up to the 2nd week of last year when the youngest were in majority for nine weeks and then it was back and forth between the 13th and 20th week. You fund a heat map for the previous season in one of our previous articles here.

The number and share of children up to 14 years of age was again higher among people with influenza-like illness than the number and share of those in the 15-34 age group, for the third week in a row, after a brief switch on the first two weeks of 2025.

Almost 160,000 of people with ARI and over 38,000 of people with ILI were in the 0-14 age group on the 5th week of 2025. The former compares with some 140,000 a year earlier, while the latter is almost double of the base period's figure.

Whooping cough remains with us too

The number of suspected pertussis cases does not seem to be dropping, either. Based on the figures for the first three weeks of the year, it looks likely that 2025 will bring another record, unless a dramatic improvement occurs along the way.

The number of suspected whooping cough cases closed at an absolute record of 1,354 cases in 2024. After a w/w doubling of suspected cases to 17 from 8 on the 2nd week of 2025, authorities reported 17 suspected cases for the 3rd week and 12 cases for the 4th week, with over 40% of the 54 cases so far this year being infants. Also, half of the infections were detected in the 0-14 age group and 57.4% in the 0-19 age group.