Spain's respiratory-infection rate rose 28.2% in one week and crossed the epidemic threshold. COVID-19 is driving the increase, while hospital pressure remains limited but measurable.
From 21 to 27 September, Spain's rate of acute respiratory infections reached 478.2 cases per 100,000 inhabitants. The figure rose 28.2% in one week. The Instituto de Salud Carlos III classifies the current intensity as low.
COVID-19 is driving the increase. Influenza and respiratory syncytial virus are not.
COVID-19 incidence reached 119.2 cases per 100,000 people, up from 92.6 the previous week. In primary-care samples, SARS-CoV-2 made up 27.2% of positive results. Influenza accounted for 4.1%, while respiratory syncytial virus accounted for 0.2%.
Before the overall respiratory-infection index crossed the epidemic threshold, independent Spanish reports had already recorded a rise in estimated primary-care COVID-19 incidence from 50.4 to 85 cases per 100,000 inhabitants.
The three viruses are moving in different directions. Influenza incidence fell to 12 cases per 100,000 inhabitants from 22.5. Respiratory syncytial virus reached one case after recording none the previous week.
Last year showed a similar early-season pattern. Respiratory infections had already reached the epidemic phase and stood at 445.6 cases per 100,000 inhabitants.
The youngest children face the clearest pressure.
Among children under five, bronchitis and bronchiolitis rose to 194.3 cases per 100,000 inhabitants. That was an 86.3% weekly increase from 104.3. The rate for COVID-19 syndrome rose from 21.6 to 29.4. Influenza syndrome rose from 13.9 to 16.9.
Catalonia’s local surveillance system also reported a roughly 26% weekly rise in respiratory infections. Reports from the region attributed the main contribution there to rhinovirus rather than COVID-19, showing that the national trend is not uniform across Spain.
Hospitals are seeing a smaller rise. The rate of hospitalisation for severe acute respiratory infection reached 9.2 cases per 100,000 inhabitants, up from nine the week before.
SARS-CoV-2 positivity in hospital samples rose to 21% from 15.3%. Influenza positivity fell to 7.1% from 10.9%. Respiratory syncytial virus stood at 0.4%.
COVID-19 hospitalisation rose to 1.7 cases per 100,000 inhabitants from 1.1. Since the season began, 22.5% of hospitalised COVID-19 cases have included pneumonia. Intensive-care admission occurred in 4.3% of cases, and the case-fatality rate was 8.7%.
The corresponding influenza figures were 27.3% for pneumonia, 4.7% for intensive care and 7.3% for case fatality. For respiratory syncytial virus, the figures were 16.1%, 8% and 3.4%.
Influenza hospitalisation declined to 0.6 cases per 100,000 inhabitants from 1.1. Respiratory syncytial virus hospitalisation reached 0.1 after registering zero the previous week.
MoMo estimates recorded 8,137 deaths in Spain during week 39. The expected number was 7,705.
The viral picture is shifting as Spain's vaccination campaign begins. Genomic sequencing identifies XFG as the dominant SARS-CoV-2 variant in recent weeks. It made up 55.08% of characterised cases. BA.3.2 represented 11.08% and was declining.
On 25 September 2026, the ECDC called for close monitoring of XFG, BA.3.2 and the variant of interest BA.2.86.
The vaccination campaign began in the final week of September and will continue through October. The timing depends on vaccine availability and type. Spain's autonomous communities are organising access locally.
People who have not received the recommended 2026 to 2027 dose may be vaccinated later in the year after an individual assessment. At least three months must have passed since their last dose or COVID-19 infection.
Sanidad prioritises people aged 70 and over, residents of care homes and people from six months of age with severe chronic disease or immunosuppression. The recommendations also cover people over 12 with specified risk conditions, pregnant women, healthcare and social-care workers, and carers or household members of highly vulnerable people.
For children, the recommendation is limited to those over six months with particular vulnerability and those aged 12 or more with defined risk conditions.
The rise is not spread evenly across respiratory viruses. COVID-19 is increasing. Influenza is falling. Bronchitis and bronchiolitis are rising quickly among young children.
Spain has crossed the epidemic threshold, but the Instituto de Salud Carlos III describes the epidemic as low intensity. Hospital positivity is rising, yet the data do not point to a health-system overload. Vaccination guidance and local access now matter more than broad alarm.
