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J Infect . Epidemiology of virologically confirmed RSV, influenza and COVID-19 in adults in England, 2023-2024: Primary Care Observational Study of

tetano

Editor, Senior Moderator
J Infect


. 2026 Feb 21:106714.
doi: 10.1016/j.jinf.2026.106714. Online ahead of print.
Epidemiology of virologically confirmed RSV, influenza and COVID-19 in adults in England, 2023-2024: Primary Care Observational Study of Acute Respiratory Infection (ObservatARI)

José M Ordóñez-Mena[SUP] 1 [/SUP], Jennifer M Radin[SUP] 2 [/SUP], Uy Hoang[SUP] 1 [/SUP], Andre B Araujo[SUP] 2 [/SUP], Orsolya Balogh[SUP] 3 [/SUP], Ahreej Eltayeb[SUP] 2 [/SUP], Gavin Jamie[SUP] 1 [/SUP], William H Elson[SUP] 1 [/SUP], L U Tianyi[SUP] 2 [/SUP], G U Xinchun[SUP] 1 [/SUP], Fatima Batool[SUP] 1 [/SUP], Joan Madia[SUP] 4 [/SUP], Xuejuan Fan[SUP] 1 [/SUP], Rachel Byford[SUP] 1 [/SUP], Ellya Enesca[SUP] 1 [/SUP], Elizabeth Button[SUP] 1 [/SUP], David Martin[SUP] 2 [/SUP], Filipa Ferreira[SUP] 1 [/SUP], Katja Hoschler[SUP] 5 [/SUP], Beatrix Kele[SUP] 5 [/SUP], Jade Cogdale[SUP] 5 [/SUP], Tiina Talts[SUP] 5 [/SUP], Praveen Sebastian-Pillai[SUP] 5 [/SUP], Maria Zambon[SUP] 6 [/SUP], Simon de Lusignan[SUP] 7 [/SUP]


Affiliations
Abstract

Objectives: To describe the positivity, clinical presentation and predictors of respiratory syncytial virus (RSV) in adult primary care patients compared to influenza and SARS-CoV-2, prior to the introduction of RSV vaccines.
Methods: We analyzed data from primary care patients aged ≥40 years with an acute respiratory infection. Between 02/10/2023 and 10/04/2024 virology swabs were tested by the UK Health Security Agency for RSV, influenza A and B, and SARS-CoV-2. Percent positivity with 95% confidence intervals (CIs) were estimated. Multivariable logistic regression identified predictors of infection. Clinical presentations were described and compared.
Results: Among 6,161 individuals tested, influenza A had the highest positivity (3.25%, 95% CI: 2.83-3.72), followed by SARS-CoV-2 (2.30%, 95% CI: 1.96-2.71), RSV (2.26%, 95% CI: 1.91-2.66), and influenza B (0.28%, 95% CI: 0.17-0.44). RSV positivity was higher in people aged 60-74 compared to those aged 40-49. RSV cases presented with ILI less often than COVID or influenza A cases.
Conclusions: During the 2023/24 winter season in England, medically-attended RSV presented a significant disease burden, with a positivity comparable to SARS-CoV-2 and approximately 70% of influenza. Given well-established vaccination programmes for influenza and COVID-19, these findings demonstrate an opportunity to introduce an RSV vaccination program for adults.

Keywords: Communicable Diseases; Epidemiology; Influenza, Human; Primary Health Care; Respiratory Syncytial Viruses; SARS-CoV-2; Sentinel Surveillance.

 
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