Early influenza surge in Andorra strains paediatric services

Andorra is seeing an earlier‑than‑usual rise in influenza and other respiratory viruses, with cases accelerating in the first week of December. The health ministry’s surveillance report for 1–7 December put influenza incidence at 137.77 cases per 100,000 inhabitants, up from 26.41 the previous week. That level is above the season’s average threshold of 115.19 per 100,000 but remains below the high‑level threshold of 160.12.

Laboratory surveillance showed 18.6% of respiratory samples were positive in the latest week, compared with about 12.5% the week before. Of the positive specimens, 69.23% were influenza A, 23.08% respiratory syncytial virus (RSV) and 8% rhinovirus/enterovirus. Reports of acute respiratory infection (ARI) also rose sharply, to 398.35 cases per 100,000 in the most recent reporting period, from roughly 223 per 100,000 the previous week.

Children are the most affected group. Incidence is highest in the 0–4 age band, with infants under one year particularly impacted, followed by children aged 5–14. The surge has placed pressure on paediatric services: the out‑of‑hours primary care clinic at Meritxell recorded about 40 visits per day during a recent three‑day holiday, and some families reported waits of more than five hours in paediatric emergency.

Health authorities and the Servei Andorrà d’Atenció Sanitària (SAAS) say the rise reflects both increased community circulation and the usual concentration of demand during holiday periods. Local clinicians note that heightened caution following the death of an infant about ten days earlier — a case now under investigation — has led to more thorough assessments and longer consultations, which has contributed to longer waits.

Regional surveillance links the earlier start and rapid spread to a so‑called K variant, described as carrying up to seven mutations compared with earlier strains and appearing more transmissible. To date it has not been associated with greater clinical severity, though older adults and people with underlying conditions remain at higher risk of complications and hospitalisation.

Andorra’s influenza vaccination campaign began on 6 October and continues to target people aged 60 and over and younger individuals with medical risk conditions (the latter currently require a prescription). The campaign has already delivered around 7,400 doses and will remain active into January. There have been no changes to that plan; neighbouring Catalonia opened vaccination to the whole population on 1 December to boost immunity ahead of the holiday season.

The hospital implemented a mask requirement in emergency departments, intensive care and inpatient wards and at the Cedre facility in early November; the measure is in place through 31 March. Officials continue to advise standard prevention measures: vaccination for those at risk, ventilating indoor spaces, practising hand hygiene and wearing masks when in contact with people who are vulnerable. The government says it is monitoring the situation but does not currently plan extraordinary measures beyond ongoing surveillance and existing precautions.