Summary
Influenza activity remains at a high level, the positivity rate is declining. RSV detections have been increasing since the end of December. The SARS-CoV-2 concentration in wastewater has risen again in recent weeks.
In Berlin, Mpox clade Ib was detected for the first time, now also in locally acquired infections. The UK was the first country to report a recombinant Mpox virus - from clade Ib and clade IIb.
In France, the first MERS-CoV cases in 12 years were reported in December, both of which were travellers returning from the Arabian Peninsula.
Exposed and marginalised: In the topic of the month, we get to the bottom of the stigmas associated with leprosy and shed light on this exotic infectious disease.
In the news, we report on a study on the West Nile virus in Austria, which was carried out in collaboration between MedUni Vienna and AGES.
Influenza
The flu epidemic officially began in the first week of December, around four weeks earlier than in previous seasons. By the turn of the year, the number of influenza cases detected in the virological sentinel system had risen. Influenza activity remains at a high level; the positivity rate is declining. It is therefore possible that the peak of the flu epidemic has already passed. Influenza A, in particular subtype A(H3N2), which accounts for approx. 75 % of cases, has so far accounted for almost all influenza cases.
Hospital admissions with influenza rose sharply until the end of December, with 825 admissions to normal wards in calendar week (CW) 52 compared to 102 admissions four weeks earlier. Since the turn of the year, admissions appear to be decreasing again: In the first week of January, 756 admissions to normal wards were recorded. As corrections and late reports are to be expected on an ongoing basis, the data may still change. AGES wastewater monitoring has recorded an increase again since the beginning of the year.
Influenza circulation is high in the European Union and the European Economic Area (EU/EEA) and appears to have peaked in most countries. Hospital admissions are at a high level, with an overall downward trend being observed, as is the case in primary care. Influenza A(H3N2) continues to be the dominant subtype.
The best preventive measure against severe influenza is the annual influenza vaccination. The currently circulating subclade K has genetic changes compared to the A(H3N2) vaccine strain selected for vaccination. https://www.ecdc.europa.eu/en/news-events/early-estimates-seasonal-influenza-vaccine-effectiveness-against-influenza-requiringErsteVaccine effectiveness data suggest that the seasonal vaccines available in the EU provide protection against influenza A(H3N2) infection. These results are consistent with findings from England. However, a final assessment of vaccine effectiveness can only be made retrospectively after the end of the season.
In Austria, influenza vaccination is recommended from the age of 6 months and is available free of charge for all age groups in the public vaccination programme of the federal government, provinces and social insurance.
Vaccination is particularly important for people with health risks for a severe course of the disease and their contact persons/household contacts, as well as for people who have an increased risk of infection due to their living conditions (including pregnant women) or occupation. A live nasal vaccine is available for children and adolescents from the age of 2 up to the age of 18. Details can be found at www.impfen.gv.at/influenza and in the current 2025/2026 vaccination plan.
In episode 003 - Influenza & Co: How do I surf safely through the flu wave? of the AGES podcast "Courage to take risks", infection epidemiologist Fiona Költringer explains what the flu is all about and how you can best protect yourself against it.
RSV
Since the end of December, detections of the respiratory syncytial virus (RSV) in the in the sentinel surveillance system has been increasing. Positivity is at 4.1 % and thus below the level of the same time last year. RSV has been detected at a low level in wastewater monitoring in recent weeks. Hospital admissions with RSV infections have increased since the beginning of December: In the first week of January, 63 patients were admitted to normal wards, compared to 16 at the beginning of December. Last year, the RSV season started in December and peaked in January and February 2025.
In the rest of the EU/EEA , RSV circulation is elevated and continues to rise slowly. Hospitalisations due to RSV are lower than in the last four years at this time of year. They are now increasing in a few countries, especially in children under five.
Children under the age of five and people over the age of 65 are at particularly high risk of severe RSV infection. RSV vaccination is recommended for everyone over the age of 60.
There is currently no approved RSV vaccine for active immunisation of children. However, there are monoclonal antibodies for passive immunisation: Beyfortus (nirsevimab) is approved and recommended for the prevention of lower respiratory tract RSV disease in newborns, infants and young children during their first RSV season and in children up to 24 months of age who remain susceptible to severe RSV disease during their second RSV season. Passive immunisation against RSV will be available again in autumn or winter 2025/2026 in the free childhood vaccination programme of the federal government, the provinces and social insurance.
A vaccination for pregnant women is also approved for the passive immunisation of children. Further information on the vaccinations can be found under RSV (respiratory syncytial virus) | Vaccination simply protects. and in the current 2025/2026 vaccination schedule .
In the Sentinel system, the proportion of positive coronavirus samples in mid-January is low at around 5%. The positivity rate has been decreasing since the end of October. In wastewater monitoring, the detection of SARS CoV 2 fluctuates, but has been rising again since the end of December.
The number of hospital admissions due to severe acute respiratory infections caused by COVID-19 was around 320 per week in December and appears to have been decreasing since the turn of the year. The variant NB.1.8.1 classified by the World Health Organisation (WHO) as "Variant under Monitoring" has been increasing in Austria since November: in the evaluation of 12.01.2026, the proportion of NB.1.8.1 was 41%. The WHO estimates the general risk from this variant to be low.
SARS CoV-2 continues to circulate in the European Union and the European Economic Area (EU/EEA), but is decreasing in all age groups. The impact on hospital admissions has so far been limited.
The COVID-19 vaccination is available free of charge in Austria and is recommended for anyone aged 12 and over who wants to reduce the risk of a potentially severe course of the disease. You can find more information on the vaccination and the indications in the Austria 2025/2026 vaccination plan or on COVID-19 | Vaccination simply protects.
The first case of Mpox clade Ib was detected in Berlin in mid-December 2025. Since the beginning of 2026, further locally acquired infections of this clade have been detected in the city. International cases have also been reported in which the infection occurred in Berlin. The infected persons are exclusively men, with the majority citing sexual contact with men as the probable source of infection. It can therefore be assumed that Mpox viruses of clade Ib are now widespread in Berlin within the MSM community (MSM - men who have sex with men)(LAGeSo, as of 8 January 2026). In the Mpox outbreak of clade II in 2022 and 2023, Berlin was the worst affected city in Germany.
Prior to the detection of the Berlin cases, 15 Mpox infections with clade Ib were detected in Germany, most of which had been contracted abroad(WHO, as of 5 December 2025). A total of 96 Mpox clade Ib cases have been identified in the WHO Europe region to date. Clade Ib has not yet been detected in Austria(WHO, as of 16/01/2026).
At the beginning of December, a new recombinant Mpox virus was identified in England in a person who had recently travelled to Asia: The virus genome contained elements of clade Ib and clade IIb. This is not unexpected, as both clades are circulating, but emphasises the continuing potential of the Mpox virus to evolve.
Mpox is mainly transmitted through close (sexual) contact, especially direct contact with skin lesions (vesicles, crusts, etc.). The available Mpox vaccination is only recommended for people at risk, including men who have sex with men and have frequent sexual contact. Post-exposure vaccination is available to prevent illness after contact with a person who has contracted Mpox. The vaccine is not available on the open market in Austria and is only offered free of charge at selected vaccination centres in the federal provinces.
Mpox - Monkeypox - Berlin.de
Mpox | Vaccination simply protects
RKI - Mpox - Mpox in Germany Broader transmission of mpox due to clade Ib MPXV - Global situation
Communicable disease threats report, 13-19 December 2025, week 51
Mpox outbreak: epidemiological overview, 8 January 2026 - GOV.UK
In early December 2025, two imported MERS-CoV cases were confirmed in France. They were part of a group that had travelled to the Arabian Peninsula. These MERS-CoV cases are the first in France in 12 years. As a precautionary measure, both patients were hospitalised in stable condition. The health of their fellow travellers was also monitored. No secondary infections were identified(ANRS, as of 14/01/2026).
A total of 19 cases were recorded worldwide in 2025 - in addition to the two imported cases in France, 17 cases occurred in Saudi Arabia. Four of the 19 cases have died(ECDC, as of 05.01.2025).
MERS-CoV (Middle East Respiratory Syndrome Coronavirus) is a zoonotic coronavirus that was first identified in Saudi Arabia in 2012. Dromedaries are considered the most important source of infection for humans. Most cases occur in the Middle East; in the EU/EEA, only sporadic imported cases related to travel are reported. Human-to-human transmission is possible, but mainly occurs in close contact, especially in healthcare settings. The clinical spectrum ranges from asymptomatic courses to severe respiratory diseases with potentially fatal outcomes.
The ECDC continues to assess the risk for the EU and EEA as low. The probability of human-to-human transmission in the general population in Europe remains very low.
Exposed and marginalised. For centuries, the fight against leprosy was not only medical, but also social. People with leprosy were regularly marginalised and deported to islands, as the disease was considered highly contagious, incurable and a sign of moral failure. These ideas still have an impact today. As one of the oldest diseases of mankind, leprosy is now almost "forgotten", stigmatised and neglected. World Leprosy Day, celebrated annually on the last Sunday in January, aims to raise awareness of the stigma attached to this disease. Today it is clear that leprosy is easily curable if it is recognised in time. The disease is still found in around 120 countries worldwide - with isolated cases also being reported in Europe. A look at the figures, transmission routes and treatment reveals a different picture to the stigma that has grown over time.
Leprosy - also known as Hansen's disease or Hansen's disease - is one of the neglected tropical diseases (NTDs). In recent years, the number of registered new cases has gradually decreased. Leprosy is considered "eliminated" when the prevalence is below 1 per 10,000. Globally, this target was reached in 2000. Most countries in the world achieved this status by 2010.
Despite the positive trend, more than 200,000 new cases continue to be registered worldwide every year, in all WHO regions. The highest number of new cases in absolute terms in 2024 was recorded in Indonesia with 14,698, Brazil with 22,129 and India with 100,957(WHO, as of 8 September 2025).
Leprosy is a chronic infectious disease caused by the bacterium Mycobacterium leprae. The disease mainly affects the skin and peripheral nerves as well as the mucous membranes of the upper respiratory tract and the eyes. Without treatment, it can lead to progressive and permanent disabilities, as the damage to the nerves causes sensory disturbances and those affected sometimes no longer feel any pain or temperature. Injuries often go unnoticed and if bacteria penetrate, open areas can become inflamed. Prolonged inflammation or untreated injuries can lead to limbs becoming deformed or shortened. In particularly severe cases, the affected limb may even be lost. If nerves responsible for muscle control are damaged, signs of paralysis are possible.
The incubation period can be up to 30 years, on average the disease breaks out after 3 to 4 years. Transmission occurs via droplets from the mouth and nose of untreated patients. The bacterium does not spread through occasional interactions such as shaking hands, hugging or sitting next to each other. Contrary to some assumptions, it requires unprotected contact with untreated leprosy sufferers over a long period of time to become infected. The ECDC speaks of 20 hours per week for at least 3 months. The excretion of the bacterium and thus the infectiousness ends as soon as drug treatment is started. The currently recommended treatment consists of three drugs - dapsone, rifampicin and clofazimine - and is known as multidrug therapy (MDT). MDT kills the pathogen and cures those affected. Early diagnosis and immediate treatment can help to prevent disability. MDT, which was recommended by the WHO in 1981, represents a milestone in leprosy treatment: For example, in India, the National Leprosy Eradication Programme (NLEP) started in 1983 after the introduction of MDT. Within a year, the prevalence of leprosy was reduced from 57.2 per 10,000 to 44.8 per 10,000 (March 1984), reaching a level of 2.4 per 10,000 by 2004.
Isolated cases in Europe
Even though leprosy is considered to have been eliminated in Europe, cases continue to occur, mostly following stays in endemic areas. Romania and Croatia last reported cases of leprosy in December 2025 - the first in over 30 years. In Romania, the cases involved women from Asia who work as masseuses. In Croatia, a man from Nepal tested positive for Mycobacterium leprae. In Austria, leprosy was last diagnosed in May 2025 in a man who travelled a lot in remote regions of the tropics and Africa on business (see AGES-Radar from 15 May 2025).
Even if some headlines paint a different picture, the disease is not a cause for concern in Europe. The risk of infection is low, it can be treated and cured - if it is diagnosed in time.
Stigma as a risk factor
Headlines with the aim of causing a stir partly reinforce the fear of and prejudices against leprosy (sufferers). Misconceptions about the disease, e.g. an allegedly high infectiousness or lack of treatment options, as well as the belief that the disease is caused by sin or a curse, contribute to the stigmatisation of those affected. These misconceptions influence the way in which people diagnosed with leprosy are treated. For centuries, leprosy sufferers around the world were marginalised from the rest of society in so-called "leprosariums" or leprosy colonies. On Spinalonga, a small island off the coast of Crete, one of the last leprosariums in Europe closed in 1957 - almost 70 years ago. In other parts of the world, such as India and Brazil, leprosy colonies still exist today. In India, for example, there are over 90 laws that discriminate against people with leprosy. Among other things, they prevent access to employment, public transport and elected offices, thereby deepening the stigma against the disease.
This means that the disease not only has a physical impact, it can also severely affect mental well-being. Over 30% of people affected suffer from depression, anxiety, low self-esteem or even suicidal thoughts. Many describe a feeling of hopelessness or emotional numbness, often due to years of stigmatisation, social isolation and fear of discrimination. Fear of discrimination prevents people from seeking help and treatment, leading to long-term complications and progressive leprosy transmission. Increasingly, the neutral name "Hansen's disease" is being used, attributed to the discoverer of Mycobacterium leprae, Gerhard Armauer Hansen.
The WHO's World Leprosy Day 2026 will be celebrated under the motto "Leprosy is curable, the real challenge is stigma.". Combating stigmatisation and respecting human rights are one of the four pillars of the Global Leprosy Strategy 2021-2030 "Towards zero leprosy". Among other things, organisations and networks of people affected by leprosy will be involved in the implementation of the strategy; access to social support and rehabilitation will be made possible and discriminatory laws will be amended. India has also included the abolition of discriminatory laws in its NLEP.
Another important starting point is to improve the knowledge and attitudes of people working in health, education and social services, as well as community and religious representatives. In a leprosy-endemic region of Uzbekistan, for example, as part of the implementation of the "Towards zero leprosy" strategy, training courses for healthcare staff were held in which ophthalmologists, neurologists, epidemiologists and general practitioners took part. These training courses are intended to improve the early detection and management of the disease. Even in non-endemic regions of the world, such as Europe, the continuous training of healthcare professionals in the detection, diagnosis and management of leprosy and other neglected tropical diseases is essential to enable rapid treatment and the successful implementation of measures such as contact tracing. The WHO has developed online modules for this purpose: WHO Academy | Learn to build a healthier world.
WHO:
World Leprosy Day 2026
World Leprosy Day
Leprosy still exists: the power of awareness and early detection
A study conducted by the Centre for Virology at the Medical University of Vienna in close collaboration with the AGES Institute for Infection Epidemiology analysed national surveillance data on West Nile virus (WNV) infections in Austria in the period from 2009 to 2024.
In 2024, 37 laboratory-confirmed WNV cases in humans were recorded - the highest number ever documented since systematic recording began in 2009. 34 of these infections were locally acquired. The high proportion of severe cases is remarkable: 19 patients developed West Nile neuroinvasive disease (WNND). WNV infections are usually only included in the differential diagnosis in the case of neurological symptoms, a rare form of the disease; asymptomatic or milder courses are mainly detected as part of routine screening of blood donors. A high number of unrecognised WNV infections must therefore be assumed.
In northern Burgenland, 16 WNV cases were registered in 2024, half of all autochthonous cases in Austria. The incidence rose from below 0.63 by 2023 to 6.64 per 100,000 inhabitants in 2024. The authors interpret this as a clear indication of a further spread of endemic transmission within Austria to an area that has been little affected to date, favoured by favourable vector conditions, bird habitats (birds are considered amplifying hosts) and climatic factors such as a mild winter and high summer temperatures.
All autochthonous WNV cases were assigned to lineage 2. The south-east European sub-cluster of WNV lineage 2 was detected for the first time in a case from northern Burgenland. WNV is firmly established as a relevant climate change-sensitive pathogen in Austria, and its impact on the health of the Austrian population has increased significantly.
Significant increase in cases of West Nile virus in Austria
Significant increase in cases of West Nile virus - gesundheitswirtschaft.at
The AGES Radar for Infectious Diseases is published monthly. The aim is to provide the Austrian health services and the interested public with a quick overview of current infectious diseases in Austria and the world. The diseases are briefly described, the current situation is described and, where appropriate and possible, the risk is assessed. Links lead to more detailed information. The "Topic of the month" takes a closer look at one aspect of infectious diseases.
How is the AGES radar for infectious diseases compiled?
Who: The radar is a co-operation between the AGES divisions "Public Health", Knowledge Management and Risk Communication.
What: Outbreaks and situation assessments of infectious diseases:
- National: Based on data from the Epidemiological Reporting System (EMS), outbreak investigation and regular reports from AGES and the reference laboratories
- International: Based on structured research
- Topic of the month (annual planning)
- Reports on scientific publications and events
Further sources:
Acute infectious respiratory diseases occur more frequently in the cold season, including COVID-19, influenza and RSV. These diseases are monitored via various systems, such as the Diagnostic Influenza Network Austria (DINÖ), the ILI (Influenza-like-Illness) sentinel system and the Austrian RSV Network (ÖRSN). The situation in hospitals is recorded via the SARI (Severe Acute Respiratory Illness) dashboard.
For the international reports, health organisations (WHO, ECDC, CDC, ...) specialist media, international press, newsletters and social media are monitored on a route-by-route basis.
For infectious diseases in Austria, the situation is assessed by AGES experts, as well as for international outbreaks for which no WHO or ECDC assessment is available.
Disclaimer: The topics are selected according to editorial criteria, there is no claim to completeness.
Suggestions and questions to:wima@ages.at
As the response to enquiries is also coordinated between all parties involved (knowledge management, MED, risk communication), please be patient. A reply will be sent within one week.
Case numbers of notifiable diseases according to the Epidemics Act, the figures are shown for the previous month and, in each case for the period from the beginning of the year to the end of the previous month, the figures for the current year, for the previous year, as well as the median of the last 5 years for comparison (Epidemiological Reporting System, as of 21.01.2026).
| Pathogens | 2025 | 2024 | 2020-2024 (median) | |
|---|---|---|---|---|
| Nov | Jan-Dec | Jan-Dec | Jan-Dec | |
| Amoebic dysentery (amoebiasis) | 0 | 9 | 13 | 9 |
| Botulism b | 0 | 0 | 1 | 1 |
| Brucellosis | 1 | 8 | 11 | 8 |
| Campylobacteriosis b | 407 | 7.082 | 6.858 | 6.271 |
| Chikungunya fever | 8 | 25 | 11 | 3 |
| Cholera | 0 | 0 | 0 | 0 |
| Clostridioides difficile infection, severe course | 34 | 669 | 769 | 571 |
| Dengue fever | 4 | 128 | 203 | 56 |
| Diphtheria | 0 | 3 | 3 | 3 |
| Ebola fever | 0 | 0 | 0 | 0 |
| Echinococcosis caused by fox tapeworm | 1 | 19 | 25 | 20 |
| Echinococcosis caused by dog tapeworm | 3 | 28 | 29 | 30 |
| Spotted fever (rickettsiosis caused by R. prowazekii) | 0 | 0 | 0 | 0 |
| Tick-borne encephalitis (TBE) | 1 | 146 | 163 | 163 |
| Yellow fever | 0 | 0 | 0 | 0 |
| Haemophilus influenzae, invasive a | 16 | 108 | 94 | 77 |
| Hantavirus disease | 3 | 32 | 19 | 30 |
| Hepatitis A | 10 | 249 | 73 | 41 |
| Hepatitis B | 87 | 970 | 1.050 | 997 |
| Hepatitis C | 72 | 1.001 | 1.048 | 916 |
| Hepatitis D | 0 | 6 | 11 | 8 |
| Hepatitis E | 3 | 56 | 48 | 61 |
| Whooping cough (pertussis) | 103 | 1.913 | 15.470 | 632 |
| Polio (poliomyelitis) | 0 | 0 | 0 | 0 |
| Lassa fever | 0 | 0 | 0 | 0 |
| Legionnaires' disease (legionellosis) d | 26 | 419 | 354 | 305 |
| Leprosy | 0 | 1 | 0 | 0 |
| Leptospirosis | 3 | 25 | 39 | 15 |
| Listeriosis b | 1 | 32 | 44 | 41 |
| Malaria | 8 | 77 | 80 | 74 |
| Marburg fever | 0 | 0 | 0 | 0 |
| Measles | 0 | 152 | 542 | 25 |
| Meningococcus, invasive c | 3 | 32 | 15 | 8 |
| Middle East respiratory syndrome (MERS) | 0 | 0 | 0 | 0 |
| Anthrax | 0 | 0 | 0 | 0 |
| Mpox f | 0 | 21 | 28 | 28 |
| Norovirus gastroenteritis b | 262 | 3.341 | 3.528 | 1.945 |
| Paratyphoid fever | 0 | 0 | 1 | 1 |
| Plague | 0 | 0 | 0 | 0 |
| Pneumococcus, invasive c | 92 | 932 | 810 | 558 |
| Smallpox | 0 | 0 | 0 | 0 |
| Psittacosis | 0 | 0 | 2 | 2 |
| Puerperal fever | 0 | 0 | 0 | 0 |
| Rotavirus gastroenteritis b | 45 | 1.125 | 882 | 526 |
| Glanders (Malleus) | 0 | 0 | 0 | 0 |
| Rubella | 0 | 0 | 0 | 0 |
| Relapsing fever | 0 | 0 | 0 | 0 |
| STEC | 53 | 1.014 | 853 | 469 |
| Salmonellosis b | 72 | 1.528 | 1.416 | 1.193 |
| Scarlet fever | 19 | 258 | 592 | 11 |
| Severe acute respiratory syndrome (SARS) | 0 | 0 | 0 | 0 |
| Shigellosis b | 31 | 356 | 276 | 85 |
| Other viral meningoencephalitis | 13 | 199 | 174 | 136 |
| Rabies | 0 | 0 | 0 | 0 |
| Trachoma (grain disease) | 0 | 0 | 0 | 0 |
| Trichinellosis | 0 | 1 | 5 | 6 |
| Tuberculosis | 23 | 379 | 389 | 389 |
| Tularemia | 4 | 70 | 118 | 53 |
| Typhoid fever | 1 | 6 | 12 | 6 |
| Bird flu (avian influenza) | 0 | 0 | 0 | 0 |
| West Nile virus disease | 0 | 1 | 37 | 4 |
| Yersiniosis b | 5 | 83 | 90 | 128 |
| Zika virus disease | 0 | 3 | 10 | 1 |
a The diseases are assessed according to the case definition. Diseases for which a case definition exists are shown, with the exception of transmissible spongiform encephalopathies. As a rule, confirmed and probable cases are counted. Subsequent notifications or entries may result in changes.
b Bacterial and viral food poisoning, in accordance with the Epidemics Act.
c Invasive bacterial disease, in accordance with the Epidemics Act.
d Includes only cases with pneumonia.
e Due to lack of case definition before 2025, only cases from 2025 onwards are shown; the median is also only calculated from 2025 onwards
f Mpox has been notifiable since 2022; the median is only calculated for the years in which notification is mandatory.
Last updated: 22.01.2026
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