Community Acute Respiratory Infection (CARI) surveillance in primary care
End of season (2024–25) annual report: 20 May 2024 to 18 May 2025

Official statistics in development

Published: 24 June 2025 (Latest release)
Type: Statistical report
Author: Public Health Scotland

Health protection

About this release

This release by Public Health Scotland (PHS) presents a summary analysis of data from the CARI respiratory surveillance programme for the 2024-2025 season. The purpose of CARI is to monitor the burden and impact of acute respiratory infection in the community. Samples taken from patients with respiratory symptoms from 219 GP practices in the CARI programme between 20 May 2024 and 18 May 2025 were analysed. Trends in swab positivity for ten respiratory pathogens, with further analyses by age, sex, Health Board and Scottish Index of Multiple Deprivation (SIMD) are presented. The ten pathogens reported on are: SARS-CoV-2, seasonal coronavirus (non-SARS-CoV-2), respiratory syncytial virus, influenza A, influenza B, parainfluenza, rhinovirus, adenovirus, human metapneumovirus and Mycoplasma pneumoniae.

Data is held on the public dashboard COVID-19 & Respiratory Surveillance.

Main points

This is the third year that the CARI community surveillance system has operated in its current format, providing comparable data across these seasons. The main points from the current reporting period are:

Valid results were available for 27,353 of 28,626 samples submitted between 20 May 2024 and 18 May 2025.
Overall, 219 sentinel GP practices submitted samples, with some fluctuations in the number as practices joined or left the programme throughout the year.
Overall test positivity (defined as positive for at least one of the 10 pathogens tested for) was 58.6%. It was highest in the 0–4-year age group at 81.1% followed by the 5–14 age group at 67.0%.
Test positivity was significantly higher in males (61.2%) compared to females (56.6%).
Overall test positivity was similar across all SIMD quintiles.
Overall test positivity was highest in NHS Fife (64.3%) and lowest in NHS Borders (54.9%) (excluding island health boards where less data available for fair comparison).
Rhinovirus was the highest circulating pathogen during the surveillance period (test positivity at 21.8%), followed by influenza A (test positivity at 11.5%), and SARS-CoV-2 (test positivity at 6.7%).
Severe disease (hospital admission or death) were very rare in CARI patients who tested positive.
The season presented typically:
- a period of elevated respiratory activity in winter
- a pronounced spike in influenza A beginning at the year-end (December 2024)
- relatively high levels of influenza B infections following the influenza A peak
- low levels of SARS-CoV-2 throughout the year after increased incidence in summer 2024
No other respiratory viral activity was observed that was unusual or unexpected.

This figure is an area chart illustrating the number of samples positive for each pathogen as a proportion of those samples tested for all pathogens through the CARI programme for ISO week 40, 2022 to ISO week 20, 2023 of the 2022–2023 season, and the full 2023–2024 and 2024–2025 seasons.
The CARI surveillance programme pathogens are SARS-CoV-2, influenza virus A, influenza virus B, respiratory syncytial virus (RSV), adenovirus, seasonal coronavirus (non-SARS-CoV-2), human metapneumovirus (hMPV), rhinovirus, parainfluenza virus and Mycoplasma pneumoniae (M. pneumoniae).
In general, the 2024–2025 season was marked by a SARS-CoV-2 wave in the summer, and a heavy burden of influenza over the winter period. There was a high peak in influenza A at the end of December and in early January that took longer to decline compared to 2022–2023. This peak was followed by heightened influenza B activity. There were lower levels of Mycoplasma pneumoniae in 2024–2025 compared to 2023–2024, but higher hMPV activity towards the end of the season. The higher hMPV was still consistent with historical disease burden. — Image caption **Number of samples that were positive for each pathogen as a proportion of samples tested for all pathogens over time, from 2022-2025**

Background

An overview of the programme with programme aims and further information for participating clinicians and recruited patients is available. Full details of the methods used for CARI surveillance are outlined in the CARI protocol.

Further information

Data from this publication are available from the COVID-19 & Respiratory Surveillance dashboard.

The next iteration of this publication is due in summer 2026.

General enquiries

If you have an enquiry relating to this publication, please contact Josie Evans at phs.cari@phs.scot.

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Older versions of this publication

Versions of this publication released before 16 March 2020 may be found on the Data and Intelligence, Health Protection Scotland or Improving Health websites.