RKI: 5.5 Million Germany Respiratory Cases, Flu Wave Pending
- Millions of people across Germany are currently falling ill with acute respiratory infections, though the annual influenza wave has not yet begun, according to the Robert Koch Institute...
- The current infection activity remains at a moderate level typical for the autumn season.
- Laboratory testing conducted by the National Reference Center for Influenzaviren sheds light on the specific pathogens driving the current wave.
Millions of people across Germany are currently falling ill with acute respiratory infections, though the annual influenza wave has not yet begun, according to the Robert Koch Institute (RKI). In its weekly report for October 2026, the public health agency recorded approximately 5.5 million new cases of acute respiratory illnesses nationwide during the 42nd calendar week, spanning October 12 to October 18, 2026. This translates to roughly 6,500 infections per 100,000 residents, marking a slight decrease from the previous week’s rate of approximately 6,900 infections per 100,000 residents.
The current infection activity remains at a moderate level typical for the autumn season. National health estimates from the RKI indicate that about 1.1 million doctor visits during the reporting week were attributed to respiratory ailments, a figure that remained largely stable compared to the preceding week. The broad case count encompasses various respiratory illnesses, including standard colds, influenza, and COVID-19, meaning the high totals do not signify millions of active flu infections.
Infection Activity and Viral Breakdown in October 2026
Laboratory testing conducted by the National Reference Center for Influenzaviren sheds light on the specific pathogens driving the current wave. Out of 106 tested samples collected from 39 medical practices during the 42nd calendar week, specialists identified at least one respiratory virus in 59 percent of the specimens. Rhino and enteroviruses, which frequently trigger common cold symptoms, appeared most frequently in the sample group.
- Rhino and enteroviruses: 38% of positive samples
- Parainfluenza viruses: 10% of positive samples
- Adenoviruses: 9% of positive samples
- Influenza viruses A and B: 4% of positive samples
- SARS-CoV-2: 2% of positive samples
- Respiratory syncytial virus (RSV): 1% of positive samples
Because these figures derive from a limited sample, the RKI notes they cannot be directly extrapolated to every infection across the country. While cold viruses dominate the ongoing wave, influenza detections remain scarce. Reported influenza cases submitted to the RKI did not increase during the 42nd reporting week.
The Onset Timeline of the Influenza Season
The formal influenza season on the Northern Hemisphere begins at the start of October, but an official influenza wave only starts once influenza viruses are detected at significantly higher frequencies over an extended period. The RKI typically designates the start of a flu wave when virological positivity rates from medical practices reach at least 20 percent. With the current positive influenza sample rate sitting at four percent, the wave has not yet materialized.
Historical patterns show that seasonal flu waves in Germany frequently commence around the turn of the year, though timing and intensity vary annually. Across Europe, the European Centre for Disease Prevention and Control (ECDC) reported on October 23, 2026, that influenza activity across the European Union and the European Economic Area remained low, with RSV infections characterized as very rare.
Updated Vaccination Guidance for Influenza, COVID-19, and RSV
The Standing Committee on Vaccination (STIKO) advises annual influenza vaccinations specifically for populations facing heightened risks of severe illness. This priority group includes individuals aged 60 and older, residents of nursing homes, people with compromised immune systems, and patients managing chronic metabolic, heart, or lung conditions. Pregnant individuals are advised to receive the flu shot starting in their second trimester, or from the first trimester if underlying medical conditions elevate their personal health risk.
For adults aged 60 and older, the STIKO recommends specialized formulations, such as high-dose vaccines or MF59-adjuvanted vaccines, designed to stimulate a stronger immune response in aging immune systems. The RKI designates October through mid-December as the optimal window for vaccination, noting that the body requires ten to 14 days following the shot to build full protection.
Immunization recommendations for COVID-19 and RSV follow different criteria as of 2026. The STIKO now advises an annual COVID-19 booster primarily for individuals aged 75 and older, adjusting the standard age threshold upward from the previous benchmark of 60 years. Annual boosters remain recommended for specific risk groups, including individuals with underlying medical conditions and residents in long-term care facilities. For RSV, the committee recommends a single immunization for adults aged 75 and older, and for individuals aged 60 to 74 who live in nursing homes or suffer from severe chronic illnesses.
Preventive Measures and Future Outlook
In addition to immunizations, the RKI encourages basic hygiene and isolation habits to limit viral transmission. Wearing masks during unavoidable interactions and maintaining regular room ventilation can further lower transmission risks in public spaces.
The extent to which influenza activity will intensify during the winter months remains uncertain as the nation moves deeper into the autumn infection season.