What is this article about?

This report provides an overview of the epidemiology of the major respiratory pathogens causing influenza-like illness and pneumonia in South Africa during 2024. Using data from the National Institute for Communicable Diseases’ sentinel surveillance programmes, we describe the circulation, seasonality and burden of influenza, respiratory syncytial virus (RSV), SARS-CoV-2, and Bordetella pertussis. The report also highlights which age groups and populations were most affected, providing an evidence base for public health planning and disease prevention strategies.

Why does this matter?

Respiratory pathogens continue to place a substantial burden on South Africa’s healthcare system, particularly among young children, older adults, and people with underlying medical conditions. Ongoing surveillance allows us to detect changes in disease patterns, identify populations at greatest risk, and monitor emerging variants and strains. These data are essential for guiding vaccination strategies, preparing for seasonal surges and ensuring that healthcare resources are allocated where they are needed most.

How did this article come about?

This report is the culmination of a year of collaborative work involving surveillance officers, laboratory scientists, clinicians, epidemiologists and data managers across South Africa. Thousands of respiratory specimens collected through the influenza-like illness and pneumonia surveillance programmes were tested and analysed to provide a national picture of respiratory pathogen circulation in 2024. Bringing these data together into a single report ensures that the findings are available to clinicians, researchers, and policymakers to support evidence-based decision-making.

What was your role in the development of this article?  

I performed the epidemiological analyses, interpreted the surveillance findings and led the writing and integration of the report. This involved working closely with colleagues across the surveillance, laboratory, and data management teams to ensure the analyses were accurate, the results were clearly communicated, and the report reflected the collective contributions of the multidisciplinary team.

Why should people read this article?

The report provides one of the most comprehensive summaries of respiratory pathogen activity in South Africa during 2024. It offers insights into the timing and severity of seasonal epidemics, identifies the populations most affected and demonstrates how surveillance data can be translated into actionable public health recommendations. It is a valuable resource for healthcare professionals, researchers, policymakers, and anyone involved in planning or responding to respiratory diseases.

What impact doyou hope this article will have on public health policy and healthcare access?

I hope this report strengthens the evidence base for public health decision-making in South Africa. I hope it supports sustained investment in respiratory disease surveillance, informs vaccination and prevention strategies (especially including the implementation of new RSV preventive interventions), and helps ensure that limited healthcare resources are directed towards the populations at greatest risk. The overall goal is to improve preparedness, reduce the burden of severe respiratory disease, and contribute to better health outcomes for all South Africans.

Dr Kleynhans was a senior epidemiologist at the Centre for Respiratory Diseases and Meningitis at the National Institute for Communicable Diseases until April 2026.

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