Cold season getting worse, coronavirus remains key pathogen in Hungary

If you find a lot of people around you - in your family, workplace, on the bus or in the store - blowing their nose or coughing, you should know that Hungary is having the most serious epidemic of respiratory infections of at least the past five years.
vírus, fertőzés, mikróba, járvány, baktérium

Key findings

  • The number of samples tested remains low, but is still more than three times higher than a year ago.
  • The coronavirus positivity rate has remained largely unchanged after a jump a week ago, with nearly 73% of patients hospitalised with SARI treated with SARS-CoV-2 infection.
  • For the second time in the current flu season, a few people infected by influenza and respiratory syncytial virus (RSV) also needed hospital care.
  • The number of people hospitalised with SARI and those in intensive care jumped 36% and 70%, respectively from a week ago.

The flu season generally peaks between the 7th and 10th week of the year, but the highest figures can vary greatly from one year to another. The coronavirus pandemic, for instance, put a serious dent into the spread of the flu (see graph below).

The start of this year's flu season looks rather dramatic on this particular chart, and we have no reason to believe that the epidemiological curve will magically flatten out. There will be a dip around Christmas, though, as in the holiday season people customarily go and shower their beloved relatives with gifts and viruses rather than going to the doctor. It's just a runny nose and a wee cough after all, yeah?


On the 50th week, a total of 295,600 people sought medical help with severe acute respiratory infection (SARI), of whom 40,200 (13.6%) had flu-like symptoms. The former figure marks a 12.6% increase over the 49th week and the latter a 29.3% leap, which come come after way smaller increases of 5.2% and 7.6%, respectively. The dip in the columns came on the back of two short weeks, with public holidays on 1 Nov and 23 Oct., when fewer people went to the doctor, and the autumn break in schools also helped in this respect.


The graph below allows a comparison with weeks 40 to 50 of 2022, showing higher figures for this year for both the number of SARI "patients" and those that visited GPs with flu-like symptoms.


We can also compare the SARI and flu numbers for 100,000 inhabitants. These charts will say more when we have more than just a couple weeks of data, but - unlike up to the 46th week - they suggest that the flu season will be more severe in 2023/24 than in 2022/23.


We need to highlight that this year authorities perform way more tests than a year ago, even though the number of samples tested remains extremely low (327 in total on a national level last week, up slightly from 317 a week earlier).


The number of samples tested on the 50th week was only a tad higher than on the 49th week, with the COVID-19 positivity rate down by a smidge. Testing is almost non-existent and we may draw only extremely cautious conclusions from these findings as regards the bigger picture on the current epidemiological situation. This is basically the only set of Covid data authorities provide besides weekly wastewater sampling results. Looking at the numbers, however, it's a pretty safe bet that SARS-CoV-2 remains the key pathogen.


As regards all samples tested up to the 50th week, the Covid positivity rate continues to stand out.


As authorities have been publishing separate SARI and flu statistics only since 2022, a longer-term comparison is possible only for the number of people seeking medical help with influenza-like symptoms. This is basically a magnification of the first ten weeks of the flu season depicted on very first graph above.


There were 339 people in hospital with SARI on the 50th week, versus 252 a week earlier. This marks a nearly 36% growth. Almost three quarters (72.9%) of them were treated with COVID-19, up slightly from 72.2% a week earlier. Coronavirus was the main pathogen found in samples early in the flu season last year too. Actually, the first time the share of flu viruses in samples was higher than the share of SARS-CoV-2 occurred only at the start of this year in the 2022/23 flu season.

For the second consecutive week in this flu season, however, people tested positive for influenza virus and RSV also had to be hospitalised. The 47th week was the first one in this cold season when one of the samples showed influenza infection (up at 39 in total by the end of the 50th week). Other pathogens identified between the 40th and 50th week were SARS-CoV-2 (741), respiratory syncytial virus (RSV, 7), adenovirus (1), parainfluenza (3), human metapneumovirus (HMPV, 6), and rhinovirus (28).


178 (60.2%) of the 247 COVID-19 patients were aged 60 and over, which compares with 114 (50.8%) a week ago. The other two metrics, i.e. people in hospital with Covid, and 60+ Covid patients, show a sharp increase from the previous week, +35.7% and +56%, respectively.


21.8% of those hospitalised with SARI were children aged 2 years or younger, while over 60% of them were aged 60 and over. The first figure marks a slight drop, the latter a sharp increase from a week ago. There was an increase in the number of both groups (orange and green columns).


Another important indicator of the severity of an epidemic is how many of those hospitalised end up in the intensive care unit (or in the morgue for that matter). The NNK does not reveal mortality stats, though.

As mentioned above, there were 339 people with SARI in hospital on the week under review, up from 252 a week earlier. 46 of them were in the ICU, which corresponds to a 13.6% ratio, up from 10.7% a week earlier.


Finally, we have an age breakdown both for SARI and flu patients. Children up to the age of 14 are on top of the SARI age rankings in terms of numbers, while they are only on the 3rd spot in the flu rankings, behind those between 35 and 59 and the hardest-hit 15-34 age group. The right-hand charts show the share of people with SARI and flu-like symptoms by age group.

Looking back on the 2022/23 data we find that the 0-14 age group was the hardest hit throughout the flu season in terms of SARI, while in terms of flu-like symptoms they were the most affected age group between the 3rd and the 15th week of this year, i.e. from mid-January to mid-April.


We have asked for flu vaccination data from the NNK and received them for the past five cold seasons. A separate article will be published about COVID-19 and flu shots later on, but until then, here's the gist of the latter on a single graph. Note that these figures show only free-of-charge 3Fluart flu shots available for risk groups, i.e.

  • people over 60 (regardless of health),
  • people with chronic respiratory, cardiovascular or metabolic diseases,
  • persons with reduced immunity,
  • women who are pregnant or planning to have children.

The NNK said earlier that for this year's flu season, a total of 949,000 doses of 3Fluart vaccine are available those over 3 years of age, while 3,000 doses of Vaxigrip Tetra and 1,000 doses of Fluenz Tetra vaccine are soon be available for children under 3 years of age.


Cover photo: Getty Images


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