Date Published: 19/12/2025

Christmas gatherings could drive flu cases in Spain even higher, warn experts

With schools across Spain about to close, flu is expected to increase among older people

Flu infections are continuing to climb across the country, although the rate of increase has thankfully slowed over the past week. The outbreak is hitting younger age groups particularly hard, with emergency room doctors describing the situation in hospitals as already "very complex."

Hospital admissions throughout Spain have now reached 9 cases per 100,000 inhabitants, a figure that's already surpassed last season's peak of 7.3 cases, which wasn't reached until the second week of January.

The most concerning aspect is where these cases are concentrated. Those over 80 and infants are bearing the brunt of severe illness, with hospitalisations of children up to 12 months old doubling in just the last week analysed, jumping from 22.8 to 48.8 cases per 100,000 inhabitants.

The experts are predicting that the peak of infections will arrive at the end of the year, right in the middle of the Christmas holidays when people gather for numerous social celebrations in enclosed spaces.

Many regions are closing schools for the holidays this Friday, which adds another layer of complexity to the situation.

Dr Susana Monge, a member of the surveillance working group of the Spanish Society of Epidemiology, explained that Christmas could bring "opposing dynamics." What this means is that transmission, which is currently concentrated among schoolchildren, could slow down because of the holidays and school closures. However, the intergenerational gatherings typical of this time of year could lead to the risk of new infections in other age groups.

Epidemiologist and paediatrician Quique Bassat shares these concerns. The fact that the peak of transmission is expected around Christmas means that "there will foreseeably be many more infections" and "much more mixing of children with adults." With grandparents taking care of their grandchildren during the holidays, he has stressed that it is "essential" for the elderly to get vaccinated and for children with symptoms to protect them by wearing masks.

Dr Monge emphasises that the current flu incidence is "the highest since the Covid-19 pandemic (2020), but hospitalisations are not at such high levels. This is for two reasons: the incidence is concentrated in children, who do not usually have high rates of severe illness, and because hospitalisations always occur about two weeks after infection."

She adds that "in some autonomous communities, you have to go back 10 to 15 years to find an epidemic like the current one."

Several factors are driving this particularly intense flu season, which has arrived more than a month earlier than usual. The K subclade of the A(H3N2) variant is playing a role, carrying mutations that partially escape acquired immunity, though thankfully these mutations haven't been shown to cause more severe illness.

The early arrival of this flu epidemic has put hospital services under severe strain once again. In many regions, services are already stretched thin or completely overwhelmed by the demand from seriously ill flu patients. The Spanish Society of Emergency Medicine has warned that "the confluence of influenza A, RSV, and exacerbations of chronic conditions is causing a significant increase in pressure on healthcare services, with some hospitals experiencing days of collapse and difficulties in finding available hospital beds."

Dr Javier Millán, the society's vice president, stated in a press release that "we are already in a very complex situation in many emergency services, with saturated waiting rooms, long delays and patients waiting for hospital beds."

Image: Freepik

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