England is seeing a marked uptick in norovirus activity, with UK surveillance indicating approximately a 47% rise in the first two weeks of 2026. While overall winter virus activity remains within the seasonal range, health agencies report more norovirus‑associated outbreaks in hospitals and continue to emphasise practical steps that curb transmission. Levels of flu, COVID-19 and RSV eased during the opening week of the year, but NHS planners and regional incident teams are keeping a close eye on system pressures as winter continues.
What the latest surveillance shows
Routine gastrointestinal and respiratory monitoring continues to guide operational decisions across the NHS, including escalation plans agreed through England’s winter resilience frameworks. Recent UK Health Security Agency (UKHSA) surveillance signals are summarised below.
| Pathogen | Current signal (early Jan 2026) | Activity level | Settings most affected |
|---|---|---|---|
| Norovirus | ~47% rise in the first fortnight of 2026 | Within expected seasonal range | Hospitals and care homes; hospital outbreaks rising |
| Influenza | Declining in the initial week of the year | Within expected seasonal range | Community and acute care |
| COVID-19 | Declining in the initial week of the year | Within expected seasonal range | Community and acute care |
| RSV | Declining in the initial week of the year | Within expected seasonal range | Paediatrics and older adults; respiratory wards |
Norovirus, sometimes called the “winter vomiting bug”, is a leading cause of viral gastroenteritis globally and is responsible for a large share of non‑bacterial gastroenteritis outbreaks in institutional settings such as hospitals, schools and care homes.[1]
Frontline view: keeping cases and outbreaks in check
Amy Douglas, Lead Epidemiologist at UKHSA, said: “We have seen a notable increase in norovirus cases in recent weeks among those aged 65 years and over, with more hospital outbreaks also being reported. While this is still within expected levels, there are simple steps that people can take to reduce the spread of norovirus and ensure levels don’t rise further.”
“Washing your hands with soap and warm water and using bleach-based products to clean surfaces will also help stop infections from spreading. Alcohol gels do not kill norovirus so don’t rely on these alone.”
“If you have diarrhoea and vomiting, don’t return to work, school or nursery until 48 hours after your symptoms have stopped and don’t prepare food for others in that time either. If you are unwell, avoid visiting people in hospitals and care homes to prevent passing on the infection to those most vulnerable.”
These frontline messages align with the statutory infection prevention duties that providers must observe under the Health and Social Care Act 2008 Code of Practice on the prevention and control of infections, which requires boards and care‑home operators to demonstrate robust hand‑hygiene, isolation and environmental‑cleaning standards.[2]
Why norovirus creates winter pressure
- Low infectious dose and rapid person‑to‑person spread make it easy for outbreaks to seed across shared spaces such as bays, day rooms and staff areas.
- Environmental persistence means surfaces and equipment need thorough decontamination between uses to avoid re‑seeding wards and communal facilities.
- Staff sickness and patient cohorting can reduce available beds and slow patient flow, compounding seasonal pressures on urgent and emergency care.
| System capacity considerations | Operational implications |
|---|---|
| Ward closures or bay cohorting during outbreaks | Temporary reduction in bed availability; rescheduling of elective activity where necessary and re‑prioritisation of winter pressures plans |
| Staff exclusion periods after symptoms | Short-term staffing constraints; need for cross‑cover, temporary redeployment and use of bank and agency capacity |
| Enhanced cleaning with chlorine‑releasing agents | Increased facilities workload; prioritisation of high‑touch areas and shared equipment, including bathrooms, mobility aids and staff kitchens |
| Visitor policies in hospitals and care homes | Risk‑based restrictions to protect vulnerable patients and residents, with communication plans to manage the impact on families and carers |
Public‑health measures being emphasised
- Hand hygiene with soap and warm water is prioritised for gastrointestinal pathogens; alcohol gels are not effective against norovirus.
- Bleach‑based products are used for surface decontamination during suspected or confirmed outbreaks, particularly in shared bathrooms, dining areas and clinical spaces.
- Good indoor ventilation reduces the risk of transmission for respiratory infections such as flu, COVID‑19 and RSV, supporting existing infection‑control guidance.
- Exclusion from work, school and childcare for 48 hours after diarrhoea and vomiting stop; pausing food preparation for others during that period; avoiding visits to hospitals and care homes while unwell.
For local authorities and integrated care boards, these measures feed into broader outbreak‑control plans, including decisions on communications campaigns, surge staffing and coordination with social‑care providers.
Vaccination remains available for those at higher risk
Respiratory virus activity can fluctuate late into the season. Dr Alex Allen, Consultant Epidemiologist at UKHSA, said: “It’s encouraging to see that levels of flu and RSV have fallen for another week. But we mustn’t be complacent because our data from previous years tell us that the end of the flu season could still be some months away.”
“Respiratory viruses are unpredictable but there are steps people can take to reduce the spread and ensure we continue on this downward trend – including taking up a vaccine if you haven’t yet.”
“Vaccine appointments are still available on the NHS national booking system and those most at risk who haven’t yet had their vaccine should make sure they take it up now to ensure they are protected for the remainder of the season.”
“RSV vaccination remains open year-round for pregnant women and any older adults aged 75 to 80 who haven’t yet had a dose.”
| Vaccine | Eligible groups | Availability window |
|---|---|---|
| Flu |
|
Appointments continue this season; check official NHS flu vaccine information for eligibility and booking. |
| RSV |
|
Ongoing offer for older adults who have not yet received a dose; year‑round for pregnant women. |
Although norovirus itself is not vaccine‑preventable in routine programmes, maintaining high uptake of flu, COVID-19 and RSV vaccines in eligible groups reduces the overall burden on beds, staff and diagnostics, giving hospitals more room to manage sudden gastrointestinal outbreaks.
Implications for workplaces, schools and care settings
- Self‑isolation in this context means staying off work and school until 48 hours after gastrointestinal symptoms stop, with exclusion from food preparation duties during that period.
- Care homes and hospitals routinely strengthen visitor policies during outbreaks to protect residents and patients, especially those aged 65+ and people with underlying conditions, in line with local infection‑control policies.
- Facilities management teams prioritise chlorine‑based cleaning and clear communication with staff, parents and visitors when cases are detected, ensuring that operational leaders understand the trade‑offs between access, safety and capacity.
For employers and education leaders, the message from public‑health officials is that enforcing stay‑at‑home and hygiene rules now may prevent more disruptive closures later in the season. For health‑service managers, the sharp rise in norovirus is another reminder that winter resilience planning hinges as much on controlling gastrointestinal outbreaks as it does on tracking respiratory waves.
