Respiratory Trend Report

Week ending November 2nd, 2025

HealthTrackRx
Trend Update

Last week had the first significant increase in Influenza activity of the season, reaching 1.5% nationally. While still low overall, the increase in positivity is largely driven by increasing cases in the southeast and west regions of the United States. HealthTrackRx data shows that Florida has the highest Influenza positivity rates at 3.8%, followed by both Texas and Nevada at 3.4%. Louisiana, Colorado, and Maryland have all crossed the 2.0% threshold for Influenza activity, while all other states remain below.

Respiratory syncytial virus (RSV) circulation continues to follow a non-standard pattern compared to previous respiratory seasons. While the southeastern states are seeing the expected increase in RSV circulation, that has not yet translated to RSV positivity among other states. States where RSV is currently > 3% include Florida (9.2%), South Carolina (3.6%), Georgia (3.6%), Alabama (4.0%), Texas (4.6%), and Delaware (8.0%).

Respiratory Trend Report

Week ending November 2nd, 2025

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HealthTrackRx
Trend Update

Last week had the first significant increase in Influenza activity of the season, reaching 1.5% nationally. While still low overall, the increase in positivity is largely driven by increasing cases in the southeast and west regions of the United States. HealthTrackRx data shows that Florida has the highest Influenza positivity rates at 3.8%, followed by both Texas and Nevada at 3.4%. Louisiana, Colorado, and Maryland have all crossed the 2.0% threshold for Influenza activity, while all other states remain below.

Respiratory syncytial virus (RSV) circulation continues to follow a non-standard pattern compared to previous respiratory seasons. While the southeastern states are seeing the expected increase in RSV circulation, that has not yet translated to RSV positivity among other states. States where RSV is currently > 3% include Florida (9.2%), South Carolina (3.6%), Georgia (3.6%), Alabama (4.0%), Texas (4.6%), and Delaware (8.0%).

Infection Trends

Rhinovirus/Enterovirus: positivity is maintained, hovering around 30% for the last 3 weeks.
Parainfluenza (types 1–4): rates are declining, currently at 7.9% after reaching what may be the seasonal peak of 8.8% the week of 10/12/25.
Respiratory Syncytial Virus (RSV): reached 2.2% nationally, with higher rates observed in the southeast.
Seasonal Coronaviruses: are showing their first signs of increasing this season, rising from 0.7% to 1.2% in the last 5 weeks.

Infection Trends

Rhinovirus/Enterovirus: positivity is maintained, hovering around 30% for the last 3 weeks.
Parainfluenza (types 1–4): rates are declining, currently at 7.9% after reaching what may be the seasonal peak of 8.8% the week of 10/12/25.
Respiratory Syncytial Virus (RSV): reached 2.2% nationally, with higher rates observed in the southeast.
Seasonal Coronaviruses: are showing their first signs of increasing this season, rising from 0.7% to 1.2% in the last 5 weeks.

Seasonal Outlook

RSV circulation is trending 2–3 weeks behind where it is expected nationally for early November. While southern states are observing the expected number of cases, it remains unclear why this has not translated to northern states. Is circulation behind schedule, and we can expect an increase in RSV activity in the coming weeks? Or can we expect low RSV rates to continue throughout this respiratory season?
Unlike RSV, Influenza virus circulation appears to be following the expected pattern of spread throughout the US, beginning in the south and progressing north. Current increasing positivity indicates we can expect typical seasonal Influenza activity.
Seasonal Coronaviruses (Non-COVID strains) tend to align with typical respiratory seasonality, and low, but increasing rates are another indicator that we’re heading into respiratory season.

Seasonal Outlook

RSV circulation is trending 2–3 weeks behind where it is expected nationally for early November. While southern states are observing the expected number of cases, it remains unclear why this has not translated to northern states. Is circulation behind schedule, and we can expect an increase in RSV activity in the coming weeks? Or can we expect low RSV rates to continue throughout this respiratory season?
Unlike RSV, Influenza virus circulation appears to be following the expected pattern of spread throughout the US, beginning in the south and progressing north. Current increasing positivity indicates we can expect typical seasonal Influenza activity.
Seasonal Coronaviruses (Non-COVID strains) tend to align with typical respiratory seasonality, and low, but increasing rates are another indicator that we’re heading into respiratory season.

Trending Up

Respiratory syncytial virus (RSV)
Influenza A/B
Coronavirus (229E, NL63, OC43, and HKU1)

Trending Down

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

Remaining Level

Adenovirus
Human metapneumovirus
Rhinovirus/ Enterovirus

Trending Up

Respiratory syncytial virus (RSV)
Influenza A/B
Coronavirus (229E, NL63, OC43, and HKU1)

Trending Down

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

Remaining Level

Adenovirus
Human metapneumovirus
Rhinovirus/ Enterovirus

7 Day Influenza Map

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.

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