RKI Report Details RSV Burden and Hospitalisation Trends in Germany for 2024/25 Season
BERLIN, 27 January 2026 – A comprehensive seasonal review from Germany’s Robert Koch Institute (RKI) has provided a detailed analysis of respiratory virus activity for the 2024/25 season, with a specific focus on Respiratory Syncytial Virus (RSV). The data, published in the Epidemiologisches Bulletin, underscores a significant burden of disease, particularly among the very young and the elderly, and reinforces the critical role of preventive measures. Concurrently, European health authorities report ongoing RSV circulation across the continent for the 2025/26 winter season.
Key Findings from the RKI’s 2024/25 Seasonal Review
The RKI’s analysis, covering reporting weeks 40/2024 to 20/2025, tracked COVID-19, influenza, and RSV infections. The season began with a peak of COVID-19 activity in late 2024, which was notably lower than in previous years. This was followed by concurrent waves of influenza and RSV. A central finding was that the distribution of hospitalised and fatal cases highlighted both the age-specific burden of these viruses and the paramount importance of timely outbreak management and prevention.
For RSV specifically, the report noted that the proportion of hospitalised outbreak cases increased significantly compared to the previous season, rising from 7.0% to approximately 20%. However, this figure remained lower than the overall hospitalisation rate for all reported RSV infections, which stood at 26%. The majority of RSV outbreaks were concentrated in daycare and after-school care settings (Kita/Hort).
Burden of Disease and Surveillance in Germany
Multiple studies and surveillance systems underscore the substantial impact of RSV in Germany. A 2024 data analysis suggested a potential under-detection of hospitalisations and deaths in adults aged 60 and older. Research indicates that infants under six months and adults over 75 are at the highest risk of severe disease requiring hospital care.
Germany employs a multi-layered surveillance approach for RSV, as detailed in a 2025 review. This includes the RKI’s mandatory reporting and sentinel systems, nationwide hospital discharge data, and specialised networks like the German Society for Pediatric Infectious Diseases (DGPI) reporting system and the RespVir clinical virology network. This patchwork provides data on outpatient and inpatient incidence, age distribution, and seasonality.
Prevention: Vaccines and Monoclonal Antibodies
The landscape for preventing severe RSV disease has evolved rapidly. For older adults, the Standing Committee on Vaccination (STIKO) recommends vaccination for individuals aged 60 and over. For infant protection, Germany has implemented a fully funded national programme using long-acting monoclonal antibodies (mAbs), such as nirsevimab.
According to a November 2025 ECDC assessment, Germany is among 16 EU/EEA countries with a funded infant RSV immunisation programme using mAbs. The European agency notes that real-world data from settings including Germany show high efficacy (83.2%) for nirsevimab against RSV-associated hospitalisation.
Current Respiratory Virus Context in Europe
As of early 2026, respiratory virus activity remains significant across the EU/EEA. The ECDC’s weekly update for March 2025 reported an ongoing RSV epidemic alongside the annual flu season. The World Health Organization, in a Disease Outbreak News item from 7 January 2025, confirmed that increases in acute respiratory infections across the Northern Hemisphere, including RSV, are expected for the winter period and do not represent an unusual pattern.
The ECDC advises that countries should strengthen integrated RSV surveillance and that eligible individuals are strongly encouraged to seek vaccination. Standard preventive measures such as hand hygiene, maintaining distance in crowded settings, and wearing masks in healthcare environments are recommended to reduce transmission.
Key Statistics: 2024/25 Season in Germany (RKI Data)
| Metric | Data |
|---|---|
| RSV Hospitalisation Rate (All Cases) | 26% of reported infections |
| RSV Hospitalisation in Outbreaks | ~20% (up from 7.0% in 2023/24) |
| Primary Outbreak Setting for RSV | Daycare/After-School Care (Kita/Hort) |
| High-Risk Age Groups | Infants under 2 years; Adults 60+ (especially ≥75) |
| Infant Prevention Programme | Fully funded long-acting mAbs (e.g., nirsevimab) |
Frequently Asked Questions
What is RSV and who is most at risk?
Respiratory Syncytial Virus (RSV) is a common respiratory virus that typically causes mild, cold-like symptoms. However, it can lead to severe lower respiratory tract infections like bronchiolitis and pneumonia. Those at highest risk for severe disease are infants under six months, especially those born prematurely, adults aged 75 and older, and individuals of any age with chronic heart or lung disease or weakened immune systems.
What are the symptoms of RSV?
Initial symptoms often include a runny nose, decrease in appetite, and cough, which may progress to sneezing, fever, and wheezing. In very young infants, the only signs may be irritability, decreased activity, and breathing difficulties. Severe symptoms requiring urgent medical attention include difficulty breathing, bluish colour of the lips or fingernails, and high fever.
How can RSV be prevented?
Prevention strategies include good hand hygiene, covering coughs and sneezes, and cleaning frequently touched surfaces. Crucially, immunisation products are available: a vaccine is recommended for adults aged 60 and over (and all those 75+), while infants can be protected either via a maternal vaccine given during pregnancy or a dose of long-acting monoclonal antibodies given shortly after birth.
Is there a treatment for RSV?
There is no specific antiviral treatment for RSV. Management focuses on supportive care, such as ensuring adequate fluid intake and using fever reducers like paracetamol. Severe cases requiring hospitalisation may need oxygen therapy or help with breathing.