Respiratory Trend Report

Week ending October 26th, 2025

HealthTrackRx
Trend Update

Respiratory virus activity is beginning to show seasonal shifts across the U.S. While Rhinovirus/Enterovirus continues to be the most commonly detected virus, its positivity rate continues to decline from its late summer peak at 42.1% in August. Parainfluenza viruses (types 1-4) are slightly decreasing, now at 8.3%, signaling stable infectious rate. Adenovirus detection dipped slightly to 2.3%, while Respiratory Syncytial Virus (RSV) is showing a gradual rise nationally to 1.9%, with significantly higher levels observed in parts of the Southeast – reaching 9.1% in Florida and 3.3% in Alabama. COVID-19 (SARS-CoV-2) continues its post-summer decline, dropping to 1.4%, and Enterovirus D68 slightly decreased to 2.5%. Influenza A and B activity remains low overall now at 0.9% nationally, with Florida reporting the highest positivity rates at 3.2%.

Respiratory Trend Report

Week ending October 26th, 2025

Get Updates

HealthTrackRx
Trend Update

Respiratory virus activity is beginning to show seasonal shifts across the U.S. While Rhinovirus/Enterovirus continues to be the most commonly detected virus, its positivity rate continues to decline from its late summer peak at 42.1% in August. Parainfluenza viruses (types 1-4) are slightly decreasing, now at 8.3%, signaling stable infectious rate. Adenovirus detection dipped slightly to 2.3%, while Respiratory Syncytial Virus (RSV) is showing a gradual rise nationally to 1.9%, with significantly higher levels observed in parts of the Southeast – reaching 9.1% in Florida and 3.3% in Alabama. COVID-19 (SARS-CoV-2) continues its post-summer decline, dropping to 1.4%, and Enterovirus D68 slightly decreased to 2.5%. Influenza A and B activity remains low overall now at 0.9% nationally, with Florida reporting the highest positivity rates at 3.2%.

Infection Trends

Rhinovirus/Enterovirus: Remains dominant, but decreased to 30.0%.
Parainfluenza (types 1–4): Decreased from 8.8% to 8.3%, continuing to rise early in the respiratory season.
Adenovirus: Slight decrease from previous weeks from 2.5% to 2.3%.
Respiratory Syncytial Virus (RSV): Increase to 1.9%, with levels reaching as high as 9.1% last week in Florida and 3.3% in Alabama.
COVID-19 (SARS-CoV-2): Declined from 1.6% to 1.4%, consistent with tapering circulation after summer peaks.
Enterovirus D68: Slight decrease to 2.5% positivity.
Influenza A & B: Slight decrease to 0.9%, with the highest positivity rate noted in Florida at 3.2% positivity.

Infection Trends

Rhinovirus/Enterovirus: Remains dominant, but decreased to 30.0%.
Parainfluenza (types 1–4): Decreased from 8.8% to 8.3%, continuing to rise early in the respiratory season.
Adenovirus: Slight decrease from previous weeks from 2.5% to 2.3%.
Respiratory Syncytial Virus (RSV): Increase to 1.9%, with levels reaching as high as 9.1% last week in Florida and 3.3% in Alabama.
COVID-19 (SARS-CoV-2): Declined from 1.6% to 1.4%, consistent with tapering circulation after summer peaks.
Enterovirus D68: Slight decrease to 2.5% positivity.
Influenza A & B: Slight decrease to 0.9%, with the highest positivity rate noted in Florida at 3.2% positivity.

Seasonal Outlook

Rhinovirus/Enterovirus is expected to remain a major driver of respiratory illness through October but is not expected to significantly climb as RSV and Influenza begin to more widely circulate and dominate the respiratory landscape.
Respiratory Syncytial Virus (RSV) is showing slight growth and may contribute more substantially as we progress through the fall and early winter.
COVID-19 continues to wane, but should be monitored closely for potential shifts with seasonal changes.
RSV and Influenza are continuing to climb with higher positivity rates already noted in certain states, such as Alabama, Florida, Louisiana, and Texas.

Seasonal Outlook

Rhinovirus/Enterovirus is expected to remain a major driver of respiratory illness through October but is not expected to significantly climb as RSV and Influenza begin to more widely circulate and dominate the respiratory landscape.
Respiratory Syncytial Virus (RSV) is showing slight growth and may contribute more substantially as we progress through the fall and early winter.
COVID-19 continues to wane, but should be monitored closely for potential shifts with seasonal changes.
RSV and Influenza are continuing to climb with higher positivity rates already noted in certain states, such as Alabama, Florida, Louisiana, and Texas.

Trending Up

Respiratory syncytial virus (RSV)
Human metapneumovirus

Trending Down

Rhinovirus/ Enterovirus
Adenovirus
Parainfluenza (Types 1-4)
Enterovirus D68
COVID-19 Coronavirus (SARS-CoV-2)

Remaining Level

Coronavirus (229E, NL63, OC43, and HKU1)
Influenza A/B

Trending Up

Respiratory syncytial virus (RSV)
Human metapneumovirus

Trending Down

Rhinovirus/ Enterovirus
Adenovirus
Parainfluenza (Types 1-4)
Enterovirus D68
COVID-19 Coronavirus (SARS-CoV-2)

Remaining Level

Coronavirus (229E, NL63, OC43, and HKU1)
Influenza A/B

7-Day Positivity Rate of RSV

This report reflects observed trends in HealthTrackRx testing positivity data, does not convey medical advice, and is provided for informational purposes only. Individuals experiencing respiratory symptoms should consult with their healthcare provider.

Download Respiratory Trend Reports [PDF]