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Respiratory infections stay above epidemic levels for a second week, as bronchiolitis climbs in young children
ISCIII data shows the national rate edging up again, while RSV cases keep rising steadily in under fives
Respiratory infections in Spain have now stayed above the epidemic threshold for a second consecutive week, following on from the first crossing reported at the end of September (Respiratory infections cross epidemic threshold in Spain). The latest figures from the Carlos III Health Institute, covering 28 September to 4 October, show the national rate climbing from 478.2 to 493.8 cases per 100,000 inhabitants, still comfortably above the 400 mark that defines epidemic level.Flu and Covid are starting to hold steady
Both flu and Covid appear to be levelling off for now, sitting at 16 and 29 cases per 100,000 respectively. It’s RSV, the virus behind bronchiolitis, that’s driving most of the latest rise, climbing from 194.3 to 206.8 cases per 100,000 among children under five.
That upward trend in young children has actually been building for three weeks now, starting the week of 14 September at just 104 cases per 100,000, roughly a week after the school term began. Babies under one are bearing the brunt of it, with a rate of 288 compared to 187 among one to five year olds. The reassuring part is that hospitalisations remain low, at just 0.2 cases per 100,000, something largely credited to the RSV immunisation programme using monoclonal antibodies that’s been running in Spain since 2023.
Covid easing in babies, but still rising in the over 80s
Covid, which had dominated headlines in recent weeks because of its impact on young children, is now showing signs of easing in that age group. Among infants under one, the community level rate dropped from 223 to 176.2 cases per 100,000, with a similar fall seen in children aged one to four and five to nineteen. Hospital admissions for this age group also fell, from 6.2 to 4.1 cases per 100,000.
The picture looks rather different for older residents though. Among those aged 80 and over, Covid incidence kept climbing, from 53.8 to 60.7 cases per 100,000 in primary care, albeit more slowly than the week before. The 60 to 69 age group also saw a rise, from 27 to 31.2, while the 70 to 79 bracket held fairly steady around 40. Hospitalisations followed a similar pattern, rising from 16.7 to 20.3 among the over 80s, with a smaller increase for those aged 60 to 79.
Flu, by contrast, barely moved, edging from 16.9 to 16.5 in primary care and from 0.6 to 0.4 in hospitals. The group most affected remains those aged 20 to 59, at 19.8 cases per 100,000, followed by children aged one to four at 17.3, with babies under one the least affected at 5.7.
No single virus is “crowding out” another
The Spanish Society of Epidemiology told 20minutos there’s no truth to the idea that Covid is somehow occupying the space flu would normally fill. Instead, they describe “the simultaneous coexistence of multiple pathogens with their own seasonal dynamics that take turns reaching epidemic peaks at different times.”
Historically, flu in Spain doesn’t tend to properly take off until late November or December, while Covid follows a far less predictable pattern, often responding to waning immunity, new variants, and the return to school and work in September. As the society put it, “both infections can perfectly well coincide or occur in succession throughout autumn and winter.”
They added that Covid waves have varied enormously since the virus first appeared, from the intense circulation of 2020 to 2022, through a quieter, less predictable period from 2022 to 2024, and lower circulation still between 2024 and 2026. Even so, there’s currently “no reason to believe that this new wave will be of greater intensity or duration than the waves of the last period.”
Image: Polina Tankilevitch/Pexels
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