German Infectious Disease Trends: Old Infections Return

Entrance road to a COVID-19 vaccination centre in Hof
File photo: the entrance to the Hofer Land vaccination centre in Hof, Bavaria, April 2021. Photo: PantheraLeo1359531 via Wikimedia Commons, CC BY 4.0.
Old infections returnUpdated 6 October 2026

Trend summary

  • Since COVID-19 restrictions ended in 2023, Germany has seen familiar infections come back strongly, while respiratory winters have settled into a heavy but more predictable pattern.
  • In winter 2025/26 hospitals treated about 429,000 cases of severe acute respiratory infection, and around 22,700 of those patients died, according to the Robert Koch Institute’s first combined season report (estimates for all of Germany).
  • Whooping cough reached 22,379 notified cases by 19 November 2024, already the highest yearly count since nationwide reporting began in 2013.
  • Germany lost its “interrupted transmission” status for measles after 645 cases in 2024, and the official map now lists 185 districts as risk areas for tick-borne encephalitis.
22,700deaths among hospital patients with severe respiratory infection, winter 2025/26 (RKI estimate)
22,379whooping cough cases, Germany, 2024 (to 19 November)
185districts designated TBE risk areas, 2026
4,070tuberculosis cases, Germany, 2025 (provisional)

What the numbers show

Germany’s main source is the Robert Koch Institute (RKI), the federal public health institute, which collects reports of notifiable diseases from local health offices under the Infection Protection Act (Infektionsschutzgesetz) and publishes them in its weekly Epidemiologisches Bulletin (in German). In October 2026 it released its first season report on acute respiratory illness (in German). It estimates about 180 million respiratory illnesses in winter 2025/26, 37 million doctor visits, about 429,000 hospital cases of severe acute respiratory infection (SARI) and around 22,700 deaths among those patients. The flu wave ran for 15 weeks, from week 48 of 2025 to week 10 of 2026, starting two to three weeks earlier than in the two previous seasons. The RKI rated the season moderate overall and similar to the rest of Europe.

Several other infections have risen since the pandemic years. Whooping cough (pertussis) had been unusually low from 2020 to 2023; in 2024 the RKI counted 22,379 cases by 19 November (in German), about twice the weekly rate of 2015–2019, with babies under one year hit hardest. The RKI estimates that 2,300 people acquired HIV in 2024 (in German), about 200 more than in 2023. Tuberculosis is moving the other way: 4,070 cases were reported in 2025 (provisional, in German), down about 8% from 4,408 in 2024, though the RKI says the fall needs to be well over 10% a year to meet the 2050 elimination target.

What is driving it

The rebound partly reflects immunity gaps left by the lockdown years, when few people caught or passed on common bacteria and viruses, and partly low vaccine uptake. The RKI found that only about 10% of children and teenagers with chronic conditions had a flu vaccination in recent seasons, leaving 1.1 million of an estimated 1.2 million unprotected (in German). For measles, the RKI reported in May 2026 that Germany had been moved back to “re-established endemic transmission” (in German) after the 645 cases of 2024. The country must now show three years of interrupted spread again, starting with 2025, despite the measles vaccination requirement for children in nurseries and schools that took effect in 2020.

Climate and travel are adding new risks. Tick-borne encephalitis (FSME in German) is concentrated in Bavaria, Baden-Württemberg and parts of Hesse, Thuringia, Saxony, Brandenburg and Saxony-Anhalt, and two more districts were added in 2026, bringing the total to 185 risk areas (in German). West Nile virus, spread by native Culex mosquitoes, has caused between 4 and 35 locally acquired human infections every year since 2019. Food-borne outbreaks still happen: an EHEC outbreak of serotype O45:H2 that began in August 2025 had 183 confirmed cases by 22 October 2025 (in German), mostly children under 10, including 48 with the kidney complication HUS. It was far smaller than the 2011 EHEC O104:H4 outbreak.

Recent cases

  • 1 October 2026: the RKI publishes its first combined season report on acute respiratory illness, estimating about 429,000 SARI hospital cases and around 22,700 deaths among those patients in winter 2025/26 (RKI, in German).
  • 17 September 2026: ahead of the flu season, the RKI and the Standing Committee on Vaccination (STIKO) warn that nine in ten children and teenagers with chronic conditions are not vaccinated against flu (RKI, in German).
  • 4 September 2026: the Friedrich-Loeffler-Institut, the federal animal health institute, reports only moderate West Nile virus activity in Germany this year, with two locally acquired human cases confirmed by the RKI, one in Rhineland-Palatinate and one in Berlin (FLI).

Press releases and official reports, 2023–2026

Five key releases a year for the last four years, newest first. Most come from German federal and state government agencies, regulators, accident investigators and national statistics; a few news reports are included where they are the clearest public record of an event. Many official releases are published only in German; for those we give an English translation of the title and mark the link (in German). Releases from 2007–2022 are in the expandable list after 2023.

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View 20 years of major German infectious disease press releases (2007–2026)80 more from 2007–2022, up to five a year, newest first

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Photo list

The public health office building in Leipzig
File photo: the public health office in Leipzig, Saxony, 2025. Photo: Lukas Beck via Wikimedia Commons, CC BY 4.0.
The Robert Koch Institute building in Berlin around 1900
Historic photo: the Robert Koch Institute on Nordufer, Berlin-Wedding, around 1900. Photo: unknown photographer via Wikimedia Commons, public domain.

Related on ROR Labs

How this page is built. Figures come from the official statistical releases linked above; where agencies publish provisional numbers we say so, because they are revised. German statistics are often published separately by each federal state (Land) and some only in German, so we say which area and period each figure covers and translate titles. Photos are public-domain or Creative Commons images credited in each caption; file photos are illustrative and are not from the events described unless the caption says so. This page tracks trends and is not personal safety, medical, legal or financial advice.