The flu season 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 confirmed influenza cases 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 season has already passed. Influenza cases reported so far have been almost exclusively due to influenza A, in particular the A(H3N2) subtype, which accounts for approximately 75% of cases.

Hospital admissions for influenza rose sharply by the end of December, with 825 admissions to general wards in calendar week (CW) 52 compared with 102 admissions four weeks earlier. Since the turn of the year, admissions appear to be falling again: 756 admissions to general wards were recorded in the first week of January. As corrections and late reports are to be expected on an ongoing basis, the data may still change. AGES wastewater monitoring has again recorded an increase since the start of the year.

In the European Union and the European Economic Area (EU/EEA), influenza circulation is high, though the peak appears to have passed in most countries. Hospital admissions remain at a high level, although an overall downward trend is being observed, as is the case in primary care. Influenza A(H3N2) remains the dominant subtype. 

The best preventive measure against severe influenza is the annual flu vaccination. The currently circulating subclade K exhibits genetic changes compared to the A(H3N2) vaccine strain selected for vaccination. Initial data on vaccine effectiveness suggest that the seasonal vaccines available in the EU offer protection against infection with influenza A(H3N2). These results are consistent with findings from England. However, a definitive assessment of vaccine effectiveness can only be made retrospectively after the end of the season. 

In Austria, flu vaccination is recommended from the age of 6 months and is available free of charge to all age groups under the public vaccination programme run by the federal government, the provinces and the social insurance scheme. 

Vaccination is particularly important for people at risk of severe illness and their close contacts/household contacts, as well as for people who are at increased risk of infection due to their living circumstances (including pregnant women) or occupation. A live nasal vaccine is available for children and adolescents aged 2 to 18 years. Further details can be found at www.impfen.gv.at/influenza and in the current 2025/2026 vaccination schedule.

In episode 003 – Influenza & Co: How do I navigate the flu wave safely? of the AGES podcast “Mut zum Risiko”, infectious disease epidemiologist Fiona Költringer explains what the flu is all about and how best to protect yourself against it. 

Flu - AGES

Since the end of December, the number of respiratory syncytial virus (RSV) cases detected in the sentinel surveillance system has been rising. The positivity rate stands at 4.1%, which is below the level recorded at the same time last year. In wastewater monitoring, RSV has been detected at low levels in recent weeks. Hospital admissions for RSV infections have risen since early December: in the first week of January, 63 patients were admitted to general wards, compared with 16 in early December. Last year, the RSV season began in December and peaked in January and February 2025.

In the rest of the EU and the 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 rising in a few countries, particularly among children under five. 

Children under five and people over 65 are at particularly high risk of developing severe RSV infection. The RSV vaccine is recommended for everyone aged 60 and over.

There is currently no approved RSV vaccine for active immunisation in children. However, monoclonal antibodies are available for passive immunisation: Beyfortus (nirsevimab) is authorised and recommended for the prevention of lower respiratory tract RSV disease in newborns, infants and young children during their first RSV season, as well as 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 again be available in the autumn or winter of 2025/2026 as part of the free childhood vaccination programme funded by the federal government, the Länder and social insurance. A vaccination for pregnant women is also authorised for the passive immunisation of children. Further information on the vaccinations and passive immunisation is available at RSV (Respiratory Syncytial Virus) | Vaccination simply protects. and in the current 2025/2026 vaccination schedule.

RSV - AGES

In the Sentinel system, the proportion of positive coronavirus samples was low at around 5% in mid-January. The positivity rate has been falling since the end of October. In wastewater monitoring, the detection of SARS-CoV-2 has fluctuated, 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 stood at around 320 per week in December and appears to have been declining since the turn of the year. The NB.1.8.1 variant, classified by the World Health Organisation (WHO) as a ‘variant under monitoring’, has been on the rise in Austria since November: in the analysis dated 12 January 2026, the proportion of NB.1.8.1 stood at 41%. The WHO assesses the overall risk posed by this variant as low.

In the EU and the EEA, SARS-CoV-2 is circulating at low levels across all age groups. The impact on hospital admissions has so far been limited. 

The COVID-19 vaccine is available free of charge in Austria and is recommended for everyone aged 12 and over who wishes to reduce the risk of a potentially severe course of the disease. Further information on the vaccine and its indications can be found in the Austrian Vaccination Schedule 2025/2026 or at COVID-19 | Vaccination simply protects.

Coronavirus - AGES

In mid-December 2025, the first case of Mpox of clade Ib was detected in Berlin. Since early 2026, further locally acquired infections of this clade have been identified in the city. International cases have also been reported where infection occurred in Berlin. All those affected are men, the majority of whom cited sexual contact with men as the likely source of infection. It can therefore be assumed that Mpox viruses of clade Ib are now circulating within the MSM community (MSM – men who have sex with men) in Berlin. (LAGeSo, as of 08/01/2026) During the Mpox outbreak of clade II in 2022 and 2023, Berlin was the hardest-hit city in Germany. 

Prior to the detection of the Berlin cases, 15 Mpox infections of clade Ib had been detected in Germany, most of which had been contracted abroad. (WHO, as of 5 December 2025) 

A total of 96 Mpox cases of clade Ib have been identified to date in the WHO European Region. Clade Ib has not yet been detected in Austria. (WHO, as of 16 January 2026) 

In early December, a new recombinant Mpox virus was identified in England in a person who had recently travelled to Asia: the viral genome contained elements of clade Ib and clade IIb. This is not unexpected, as both clades are circulating, but it underlines the ongoing potential of the Mpox virus to evolve.

Mpox is mainly transmitted through close (sexual) contact, particularly through direct contact with skin lesions (blisters, scabs, etc.). The available Mpox vaccine is recommended exclusively for people at risk, including men who have sex with men and those with frequently changing sexual partners. Post-exposure vaccination is available to prevent infection following contact with a person infected with Mpox. The vaccine is not available on the open market in Austria and is offered free of charge only at selected vaccination centres in the federal states.

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 cases of MERS-CoV were confirmed in France. They were part of a group that had travelled to the Arabian Peninsula. These are the first cases of MERS-CoV in France in 12 years. As a precautionary measure, both patients were admitted to hospital for treatment whilst in a stable condition. The health of their fellow travellers was also monitored. No secondary infections were identified. (ANRS, as of 14 January 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 5 January 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 main source of infection for humans. Most cases occur in the Middle East; in the EU/EEA, only sporadic imported cases linked to travel are reported. Human-to-human transmission is possible, but occurs predominantly through close contact, particularly in healthcare settings. The clinical spectrum ranges from asymptomatic cases to severe respiratory illness with a potentially fatal outcome.

The ECDC continues to assess the risk to the EU and the EEA as low. The likelihood of human-to-human transmission in the general population of Europe remains very low.

Cast out and marginalised. For centuries, the fight against leprosy was waged not only on a medical front but also on a social one. People with leprosy were routinely marginalised and banished to islands; after all, the disease was considered highly contagious, incurable and a sign of moral failure. These perceptions still have an impact today. As one of humanity’s oldest diseases, leprosy is virtually ‘forgotten’ today, yet it remains stigmatised and neglected. World Leprosy Day, observed annually on the last Sunday in January, aims to raise awareness of the stigma attached to this disease. Today it is clear: leprosy is highly treatable if detected early. The disease continues to occur in around 120 countries worldwide – isolated cases are also reported in Europe. A look at the figures, transmission routes and treatment paints a different picture from the stigma that has developed over time. 

Leprosy – also known as Hansen’s disease – is classified as a neglected tropical disease (NTD). In recent years, the number of newly registered cases has gradually declined. Leprosy is considered ‘eliminated’ when the prevalence is below 1 per 10,000. Globally, this target was achieved in 2000. Most countries in the world attained this status by 2010. 

Despite this positive trend, more than 200,000 new cases are still being recorded worldwide every year, across all WHO regions. In absolute terms, the highest number of new cases in 2024 were recorded in Indonesia (14,698), Brazil (22,129) and India (100,957). (WHO, as of 08/09/2025) 

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, progressive and permanent disabilities can result, as nerve damage leads to sensory disturbances and those affected may lose the ability to feel pain or temperature. Injuries often go unnoticed, and if bacteria enter the wound, open sores can become infected. Prolonged inflammation or untreated injuries can cause limbs to become deformed or shortened. In particularly severe cases, this can even lead to the loss of the affected limb. If nerves responsible for muscle control are damaged, paralysis may occur.

The incubation period can be up to 30 years; on average, the disease manifests after 3 to 4 years. Transmission occurs via droplets from the mouth and nose of untreated patients. The bacterium does not spread through casual interactions such as handshakes, hugs or sitting next to one another. Contrary to some assumptions, unprotected contact with untreated leprosy patients over a long period of time is required for infection to occur. The ECDC cites 20 hours per week for at least 3 months. The shedding of the bacterium, and thus its infectiousness, ceases as soon as drug treatment begins. The currently recommended treatment consists of three drugs – dapsone, rifampicin and clofazimine – and is known as combination therapy (MDT – Multidrug Therapy). MDT kills the pathogen and cures those affected. Early diagnosis and immediate treatment can help prevent disabilities. The MDT recommended by the WHO in 1981 represents a milestone in the treatment of leprosy: for example, in India, the National Leprosy Eradication Programme (NLEP) was launched in 1983 following 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); by 2004, it had reached 2.4 per 10,000. 

Isolated cases in Europe

Although leprosy is considered to have been eliminated in Europe, cases continue to occur from time to time, mostly following stays in endemic areas. Most recently, Romania and Croatia reported cases of leprosy in December 2025 – the first in over 30 years. In Romania, the cases involved women from Asia working as masseuses. In [country], a man from Nepal tested positive for Mycobacterium leprae. In Austria, leprosy was last diagnosed in May 2025 in a man who travelled extensively for work to remote regions of the tropics and Africa (see AGES Radar of 15 May 2025).

Even though some headlines paint a different picture, the disease is not a cause for concern in Europe. The risk of infection is low, and it can be treated and cured – provided it is diagnosed in time. 

Stigma as a risk factor

Headlines designed to attract attention sometimes reinforce fear of and prejudice against leprosy (and those affected by it). Misconceptions about the disease, such as its supposedly high infectiousness or the 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 people diagnosed with leprosy are treated. For centuries, people with leprosy worldwide were excluded from the rest of society in so-called ‘leprosariums’ or leprosy colonies. On Spinalonga, a small island off Crete, one of Europe’s last leprosariums closed in 1957 – just under 70 years ago. In other parts of the world, such as India and Brazil, leprosy colonies still exist today. Furthermore, in India, for example, over 90 laws contain provisions that discriminate against people with leprosy. Among other things, they prevent access to employment, public transport and elected office, thereby reinforcing the stigma surrounding the disease. 

Consequently, the disease not only has physical effects; it can also severely impair mental well-being. Over 30% of those affected suffer from depression, anxiety, low self-esteem or even suicidal thoughts. Many describe a feeling of hopelessness or emotional numbness, which is often attributable to years of stigmatisation, social isolation and fear of discrimination. The fear of discrimination prevents people from seeking help and receiving treatment, leading to long-term complications and the continued spread of leprosy. The neutral name ‘Hansen’s disease’ is increasingly being used, named after its discoverer, Gerhard Armauer Hansen.

The WHO’s World Leprosy Day 2026 will be observed under the slogan “Leprosy is curable; the real challenge is stigma.” Combating stigma and upholding human rights form one of the four pillars of the Global Leprosy Strategy 2021–2030 “Towards zero leprosy”. The implementation of the strategy involves, among others, organisations and networks of people affected by leprosy; the aim is to facilitate access to social support and rehabilitation and to amend discriminatory laws. India has also included the abolition of discriminatory laws in its NLEP. 

Another key focus is on improving the knowledge and attitudes of those working in the health, education and social sectors, as well as community and religious leaders. In a leprosy-endemic region of Uzbekistan, for example, training sessions for healthcare staff were held as part of the implementation of the “Towards Zero Leprosy” strategy, attended by ophthalmologists, neurologists, epidemiologists and general practitioners. These training sessions 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 recognition, diagnosis and management of leprosy and other neglected tropical diseases is essential to enable prompt 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 Infectious Disease Epidemiology, analysed national surveillance data on West Nile virus (WNV) infections in Austria between 2009 and 2024.

In 2024, 37 laboratory-confirmed cases of WNV in humans were recorded – the highest number ever documented since systematic recording began in 2009. Of these, 34 infections were locally acquired. Notable is the high proportion of severe cases: 19 patients developed West Nile neuroinvasive disease (WNND). WNV infections are usually only included in the differential diagnosis when neurological symptoms are present, a rare form of the disease; asymptomatic or milder cases are mainly detected during routine screening of blood donors. It must therefore be assumed that there is a high number of unreported WNV infections.

In Northern Burgenland, 16 WNV cases were recorded in 2024, accounting for half of all autochthonous cases in Austria. The incidence rose from below 0.63 in 2023 to 6.64 per 100,000 inhabitants in 2024. The authors interpret this as a clear indication of the further spread of endemic transmission within Austria into a previously little-affected area, facilitated 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. For the first time, the South-Eastern European sub-cluster of WNV lineage 2 was detected in a case from Northern Burgenland. WNV is firmly established in Austria as a relevant pathogen sensitive to climate change, and its impact on the health of the Austrian population has increased significantly. 

Significant rise in West Nile virus cases in Austria

Significant rise in West Nile virus cases - gesundheitswirtschaft.at

Case numbers for notifiable diseases under the Epidemics Act; the figures shown are for the previous month and, for the period from the start of the year to the end of the previous month, the figures for the current year, the previous year, and the median of the last five years for comparison (Epidemiological Reporting System, as at 11 March 2026).

^a Diseases are assessed in accordance with 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. Changes may still occur due to late reporting or subsequent entries.

^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 involving pneumonia.

^e Due to the lack of a case definition prior to 2025, only cases from 2025 onwards are shown; the median is also calculated only from 2025 onwards.

^f Mpox has been a notifiable disease since 2022; the median is calculated only for the years in which it is a notifiable disease.