---
title: "From Flu Season to Continuous Risk: Lessons from the 2025–26 Respiratory Season"
description: A review of the 2025–26 respiratory season, highlighting multi-pathogen trends, emerging risks, and implications for hospital infection prevention.
---

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# [From Flu Season to Continuous Risk: Lessons from the 2025–26 Respiratory Season](https://breezymed.com/news/from-flu-season-to-continuous-risk)

 Written by [Chris Ziomek](https://breezymed.com/news/author/chris-ziomek) | Apr 2, 2026 2:25:44 PM

The 2025–26 respiratory season reflects a continued transition in infectious disease dynamics within healthcare environments. Peer-reviewed literature no longer supports viewing “flu season” as a singular, predictable event. Instead, hospitals are managing a **multi-pathogen landscape** shaped by evolving viral behavior, persistent healthcare-associated organisms, and emerging high-consequence threats. This season reinforces a critical shift: respiratory infection risk is no longer seasonal—it is continuous and overlapping.

## A Multi-Pathogen Respiratory Season

Peer-reviewed studies from the past two years show that respiratory illness patterns have not fully returned to pre-pandemic norms. Instead, the 2025–26 season reflects a broader mix of circulating pathogens, including influenza, SARS-CoV-2, RSV, rhinovirus, adenovirus, and human metapneumovirus (hMPV) [[1](https://breezymed.com/news/from-flu-season-to-continuous-risk?hs_amp=true#references)][[2](https://breezymed.com/news/from-flu-season-to-continuous-risk?hs_amp=true#references)].

Recent analyses demonstrate:

- **Rhinovirus and adenovirus** continue to circulate year-round
- **RSV and influenza** have re-established seasonality, though with variable timing
- **Co-circulation of multiple viruses** is now common rather than episodic

 

A 2025 multinational study found a consistent post-pandemic sequence of viral resurgence, with rhinovirus returning first, followed by seasonal coronaviruses, RSV, and influenza. For healthcare systems, this results in **overlapping respiratory burdens rather than a single peak period**.

## COVID-19: Continued Evolution Without Dominance

COVID-19 is now endemic, with ongoing evolution and continued clinical relevance. While it no longer dominates hospital operations, it remains a persistent component of respiratory disease burden. Recent studies in *The Lancet Infectious Diseases* and *Cell Reports* describe emerging variants, including BA.3.2 and NB.1.8.1, with:

- Increased **immune evasion capabilities**
- Alterations in spike protein binding
- Greater ability to evade immunity from prior vaccination or infection [[3](https://breezymed.com/news/from-flu-season-to-continuous-risk?hs_amp=true#references)][[4](https://breezymed.com/news/from-flu-season-to-continuous-risk?hs_amp=true#references)][[5](https://breezymed.com/news/from-flu-season-to-continuous-risk?hs_amp=true#references)] 

 

At the same time, comparative studies (e.g. JAMA) suggest that **short-term hospitalization risk for COVID-19 is now more comparable to influenza**, though longer-term outcomes may still differ [[7](https://breezymed.com/news/from-flu-season-to-continuous-risk?hs_amp=true#references)].

The implication is clear: COVID-19 has transitioned from a dominant crisis to a **persistent, evolving component** of respiratory disease burden.

## Influenza and RSV: Persistent Variability

Influenza and RSV continued to demonstrate **seasonal resurgence with variability**, rather than predictable annual patterns.

Peer-reviewed findings from recent seasons show:

- Shifting timing and duration of influenza peaks
- Regional variability in dominant strains (e.g. emerging H3N2 subclades, including subclade K) [[7](https://breezymed.com/news/from-flu-season-to-continuous-risk?hs_amp=true#references)]
- Continued RSV burden, particularly among pediatric and older adult populations

 

This variability complicates staffing, capacity planning, and infection prevention workflows, reinforcing the need for **flexible and scalable response strategies**.

## Expanding Respiratory Risk: Measles and H5N1

 Measles: rare, but operationally disruptive

Peer-reviewed literature highlights a global resurgence of measles driven by **declining vaccination coverage and post-pandemic immunity gaps **[[8](https://breezymed.com/news/from-flu-season-to-continuous-risk?hs_amp=true#references)]. With a basic reproduction number (R₀) of 12–18, measles is among the most transmissible human pathogens.

Although incidence remains low in the U.S., even a single case can trigger **extensive exposure investigations, staff furloughs, and significant operational disruption within healthcare settings**.

### H5N1 avian influenza: preparedness over prevalence

H5N1 continues to be monitored due to its **pandemic potential**, despite limited human-to-human transmission. Recent spillover events into mammals have increased scientific attention [[9](https://breezymed.com/news/from-flu-season-to-continuous-risk?hs_amp=true#references)].

For healthcare systems, the primary implication is **preparedness**, not current burden. 

## Emerging Risks: Resistant Pathogens and Environmental Persistence

Alongside a broad range of respiratory viruses requiring constant vigilance, resistant pathogens continue to emerge and evolve, challenging infection prevention and treatment strategies.

### Candida auris: environmental persistence and outbreak risk

*C. auris* continues to emerge as a significant multidrug-resistant organism in healthcare settings. Peer-reviewed studies emphasize its ability to **persist on surfaces and equipment**, contributing to prolonged outbreaks and transmission [[10](https://breezymed.com/news/from-flu-season-to-continuous-risk?hs_amp=true#references)].

Transmission remains primarily healthcare-associated, reinforcing the importance of **environmental disinfection and monitoring**.

### Clostridioides difficile infection: sustained burden

*C. difficile* infections remain one of the most common healthcare-associated infections. Its **spore-forming nature** enables long-term environmental survival and resistance to many disinfectants [[11](https://breezymed.com/news/from-flu-season-to-continuous-risk?hs_amp=true#references)].

Recent literature highlights stable overall incidence but growing attention to **community-associated infections and antimicrobial resistance trends**.

## What This Season Makes Clear

Across peer-reviewed research and observed healthcare trends, a consistent conclusion emerges. Healthcare systems are now managing:

- **Concurrent respiratory viruses** with overlapping peaks
- **A growing number of persistent, resistent healthcare-associated pathogens** with environmental transmission 
- **Threats of high-impact outbreaks **driven by a growing set of organisms of concern

 

## Implications for Infection Prevention

Today's continuous, multi-pathogen respiratory risk places new demands on infection prevention programs:

- Increased need for **whole-environment coverage**, not just targeted cleaning
- Stronger reliance on **data, validation, and repeatable workflows**

 

As the pathogen landscape becomes more complex, the most effective strategies are those that can be applied **reliably across use cases—regardless of pathogen type or timing**. 

## Conclusion

The 2025–26 season marked a clear shift rather than a return to prior patterns. Infection risk in healthcare settings** continues to be more challenging, less seasonal in nature, and driven by multiple overlapping factors.**

For hospital leaders, infection prevention is no longer about preparing for the next surge. It is about building systems that perform every day, across every pathogen scenario.

**Greater emphasis must now placed on approaches that provide consistent, routine, whole-environment coverage—supported by validated protocols and data—to reduce variability and improve reliability across use cases.**

Breezy Med’s aerosolized hydrogen peroxide systems are designed to support this model, enabling repeatable, whole-room disinfection with audit-ready documentation.

Healthcare organizations interested in contributing to the evidence base are encouraged to participate in the [Breezy Med Clinical Evidence and Research Network](https://breezymed.com/clinical-evidence-and-research-network).

## References

[1] [Olsen SJ et al. “Changes in Influenza and Other Respiratory Virus Activity During the COVID-19 Pandemic.” *J Infect Dis.*](https://doi.org/10.1111/ajt.16049)

[2] [Agha R, Avner JR. “Delayed Seasonal RSV Surge Observed During the COVID-19 Pandemic.” *Pediatrics.*](https://doi.org/10.1542/peds.2021-052089)

[3] [Cao Y et al. “Imprinted SARS-CoV-2 humoral immunity induces convergent Omicron RBD evolution.” *Nature.*](https://doi.org/10.1038/s41586-022-05644-7)

[4] [Guo C, Yu Y, Liu J et al. "Antigenic and virological characteristics of SARS-CoV-2 variants BA.3.2, XFG, and NB.1.8.1." *Lancet Infectious Diseases.*](https://doi.org/10.1016/S1473-3099(25)00308-1)

[5] [Mellis I, Wu M, Hong H et al. "Antibody evasion and receptor binding of SARS-CoV-2 LP.8.1.1, NB.1.8.1, XFG, and related subvariants." *Cell Reports.*](https://doi.org/10.1016/j.celrep.2025.116440)

[6] [Xie Y, Choi T, Al-Aly Z. "Mortality in Patients Hospitalized for COVID-19 vs Influenza in Fall-Winter 2023-2024." *JAMA*.](https://doi.org/10.1001/jama.2024.7395)

[7] [Lucaccioni H, et al. "Influenza vaccine effectiveness from nine studies during drifted A(H3N2) subclade K predominance, Europe, September 2025 to January 2026." *Euro Surveill.*](https://doi.org/10.2807/1560-7917.ES.2026.31.7.2600109)

[8] [Patel MK et al. “Progress Toward Regional Measles Elimination.” *Lancet Infect Dis.*](https://doi.org/10.15585/mmwr.mm6945a6)

[9] [Uyeki TM “Human Infection with Highly Pathogenic Avian Influenza A (H5N1) Virus: Review of Clinical Issues.” *Clin Infect Dis.*](https://doi.org/10.1086/600035)

[10] [Jeffery-Smith A et al. “Candida auris: a Review of the Literature.” *Clin Microbiol Rev.*](https://doi.org/10.1128/cmr.00029-17)

[11] [Guh AY, Kutty PK. “Clostridioides difficile Infection.” *Ann Intern Med.*](https://doi.org/10.7326/aitc201810020)

 

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