India Sees Sharp Rise in Respiratory Infections: Experts Warn Early Detection Is Key

Monday, November 17, 2025, 17:07

Respiratory infections have been rising across many parts of India, including Kerala, and they continue to be a major public health concern. New viruses, changing environmental conditions, and faster travel, especially by air, are all contributing to this increase. This makes early detection and timely treatment even more important, both for individual patients and for the community.

We spoke to Dr Arjun P, Senior Consultant and Group Coordinator, Department of Respiratory Medicine, KIMSHEALTH, Trivandrum, Kerala, who explained respiratory infections in India, their causes, and preventive methods.

Nationwide Trends in Respiratory Infections

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Recent surveillance by the Indian Council of Medical Research (ICMR) has revealed a progressive increase in infectious diseases, including respiratory illnesses. In the first half of 2025, the overall infection positivity rate rose from 10.7% to 11.5%, a seemingly modest but epidemiologically significant jump. This rise reflects both seasonal surges and the continued emergence of novel pathogens.

The most commonly identified pathogens included Influenza A (especially in acute respiratory cases), RSV (Respiratory Syncytial Virus), dengue virus, hepatitis A, norovirus, and herpes simplex virus. Small outbreaks of COVID-19 are also not uncommon. Of particular concern is the "tripledemic," influenza, COVID-19, and RSV infections occurring as outbreaks almost simultaneously. All three viruses are known for affecting the respiratory system and can sometimes be fatal.

"Key reasons behind this rise include growing urban overcrowding, high air pollution, sudden weather changes, and changes in immunity after the COVID-19 pandemic. Poor waste management and the lingering effects of pandemic disruptions also make it easier for respiratory infections to spread. Seasonal dips in air quality, especially during winter, often lead to more hospital visits and admissions for breathing-related illnesses," explained Dr Arjun.

Specific Situation in Kerala

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"Kerala, known for its strong healthcare system, has still seen a steady rise in respiratory infections. The state often detects the country's first cases of new viral illnesses, such as monkeypox (Mpox), JN.1 COVID, and Nipah, largely because of its dense population, high mobility, and close-contact living patterns. With no clear divide between urban and rural areas, infections can spread quickly," said Dr Arjun.

In 2025, health officials reported that along with SARS-CoV-2, both Influenza A subtypes H1N1 and H3N2 are circulating, complicating diagnosis and raising the complexity of treatment. The current data shows H3N2 as the dominant strain of flu, and its symptoms often look very similar to COVID-19.

"A local study estimated that bacterial infection Mycoplasma pneumoniae accounted for 22.4% of community-acquired lower respiratory infections in children in South Kerala. The presentation of this illness is very similar to that of a viral infection, further confusing the diagnosis. Periodic outbreaks of Nipah virus continue in Kerala, which again needs good contact tracing and public awareness," highlighted Dr Arjun.

Urgency and Approaches for Early Diagnosis

"Timely identification of respiratory infections is crucial for outbreak containment, early treatment, and reduction in morbidity. The ICMR thus advocated a surveillance-driven diagnostic pathway for Acute Respiratory Infections (ARI) through the integration of rapid molecular diagnostics, conventional microbiology testing, and clinical triaging," added Dr Arjun. The One Health approach, with its integrated surveillance across humans, animals, and the environment, assumes greater significance for India and Kerala, considering the biodiversity and risk for zoonotic diseases.

"For frontline clinicians, the Health authorities and ICMR have issued practical algorithms to differentiate influenza-like illness (ILI) from COVID-19 and other viral syndromes, enabling judicious use of antivirals and preventing antibiotic misuse," shared Dr Arjun.

Rapid nucleic acid amplification and multiplex PCR platforms have also been found to be particularly useful in paediatric respiratory infections, where targeted isolation and care is often required. These tests are extremely helpful for quick diagnosis of common viral and bacterial infections.

Prevention

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Keeping respiratory infections at bay often comes down to a mix of timely vaccinations and simple everyday habits. "Vaccines for influenza, COVID-19, and RSV offer strong protection, especially for people who need it the most. This includes older adults, those with chronic lung, heart, kidney, or liver diseases, individuals undergoing cancer treatment, people with autoimmune conditions, transplant recipients, and healthcare workers. For them, vaccines can make a life-saving difference," said Dr Arjun.

Right now, only the influenza vaccine is available in India, making preventive habits even more important.

Everyday Habits That Help

Wash hands often with soap and water or use an alcohol-based sanitizer.
Cover coughs and sneezes, ideally with a tissue or your elbow.
Wear a mask in crowded places or closed indoor settings.
Keep some distance from people who are visibly unwell.
Improve ventilation at home and workplaces whenever possible.
Clean frequently touched surfaces like doorknobs, phones, and desks.

These steps matter even more during outbreaks or if you belong to a high-risk group.

Why Stronger Preparedness Matters

Respiratory infections are rising across India - and Kerala's experience shows how quickly situations can escalate. This makes early and accurate diagnosis crucial. Better surveillance, stronger lab capacity, public awareness, and smooth coordination between government and private healthcare systems can help detect problems before they blow up.

Dr Arjun concluded, "If recent surges have taught us anything, it's that preparedness saves lives. Whether it was the Spanish Flu a century ago or the COVID-19 pandemic we all lived through, the lesson remains the same: communities that recognize symptoms early and respond quickly are far better protected from widespread outbreaks."

Disclaimer: The information provided in this article is for general informational and educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or a qualified healthcare provider with any questions you may have regarding a medical condition.