844 confirmed cases in a week, 16 deaths so far, and hospital wards that are still quiet: flu starts its German season on schedule

Flu has begun its season in Germany, and it has done so on the timetable. In reporting week 45, 2 to 8 November, 844 laboratory-confirmed influenza cases were notified to the Robert Koch Institute, up from 726 the week before and 492 the week before that¹. The RKI says the numbers are rising again and are “similar to last year at this time”¹. Since the season’s count began in week 40, 3,569 cases have been notified, and 16 deaths with confirmed influenza, mostly in people aged 60 or over¹.

Read the hospital figure with its footnote. Of the 504 cases this week with information on hospital status, 212, or 42%, were admitted¹. That is a share of people who were tested and reported, not of everyone with flu, and the RKI notes that from this season it is calculated only among cases with that information, so it cannot be compared with earlier seasons’ reports¹. Notified cases are the tip of what doctors test; the base of the pyramid is far wider.

That base is measured too. The RKI’s GrippeWeb panel puts acute respiratory illness at about 6,600 per 100,000 people in week 45, up from 5,700, which it translates into roughly 5.5 million new respiratory illnesses in a week, within the usual range for the season¹. Most of that is not flu: in the doctors’ sentinel samples, rhinoviruses and enteroviruses led at 33%, influenza followed at 10%, and RSV was at 1%¹. The flu viruses found so far are mainly A(H1N1)pdm09¹.

The part worth underlining is the quiet one. In hospitals, the incidence of severe acute respiratory infection stayed stable at a low level in week 45, and 4% of those patients had an influenza diagnosis¹. Nine flu outbreaks with at least five cases have been reported this season, none of them in week 45 so far¹. A surveillance system that tells you calmly, every week, that a predictable thing is happening predictably is doing exactly what you pay it for. The rest is up to the ordinary machinery: appointments, stock in pharmacies, and the GP’s calendar.