Other official information and services: www.belgium.be 
Discover the new page on cerebrovascular diseases.
The pages on general and premature mortality have been updated with 2023 data.
The page on diabetes has been updated with 2022 data.
Please note that there are different definitions and guidelines available to describe long COVID. Based on the definition used, the results may be different.
The COVIMPACT study in Sciensano was developed based on the definition of the National Institute of Health and Care Excellence (NICE): "symptoms persist or develop for more than 3 months after a COVID-19 infection and cannot be explained by another diagnosis” [1].
The coronavirus disease 2019 (COVID-19) pandemic started in December 2019 in the city of Wuhan, China. COVID-19 is caused by the virus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). On 11 March 2020, the Director-General of the World Health Organization declared COVID-19 a global pandemic.
The virus is transmitted from human to human by infectious droplets. People can remain asymptomatic or present with a broad spectrum of symptoms. The risk of severe disease increases markedly with age and previous underlying conditions. For the general public, vaccination, handwashing, social distancing, avoiding crowded indoor spaces, and wearing a face mask are the recommended measures to protect oneself. Vaccines are available in Belgium since January 2021; more information on vaccines can be found here.
An overview of the scientific information about COVID-19 based on updated literature monitoring is available in the Sciensano fact sheet.
In Belgium, the first confirmed case was reported on 3 February 2020, in an asymptomatic person repatriated from Wuhan. The second case was registered almost one month later, on 1 March 2020. This case was followed by a rapid growth in the number of cases occurring after the Carnival holidays. Since then, the virus is widely spreading in the country.
The Belgian institute for health, Sciensano, monitors the epidemic based on the data collected by its surveillance networks and reports on the latest figures and trends.
Four key indicators are followed; for the three first ones a moving average is computed on the last 7 days and compared to the average of the 7 previous days:
Moreover, the reproduction rate, that is the average number of people infected by a person carrying the virus, is calculated. If the reproduction rate is over 1, the disease is spreading in the population. Additional indicators are followed as the number of occupied beds in hospitals and ICU, vaccination coverage, the number of tests performed, and the percentage of those that are positive (positivity rate).
More information on COVID-19 mortality can be found on the following pages: ad-hoc surveillance of COVID-19 mortality 2020-2022, causes of death, causes of premature death.
Since the data are in constant evolution, this sheet refers to the main web pages where figures are updated regularly. Data can be consulted in several places and in several forms:
Comparisons among countries should be interpreted with caution due to differences in testing strategy, in laboratory capacities, and in the effectiveness of the surveillance. Comparisons of COVID-19 deaths are also hampered by differences in the methodology of counting COVID-19 deaths.
Epidemiological International data can be consulted on several platforms:
In the COVIMPACT study, the overall occurrence of long COVID was 47% three months after a SARS-CoV-2 infection, and 32% after 6 months. These numbers are in line with the international literature, which reports a prevalence of 47% and 30% for long COVID at 3 and 6 months [3].
Although the proportion of long COVID differs slightly according to age, it is not a significant risk factor. Among participants with an age between 18 and 25 years, 47% reported persistent symptoms 3 months after a SARS-Cov-2 infection. This is similar to participants aged between 26 and 45 years where 51% reported persistent symptoms, but higher compared to the other age categories 46-65 years (42%) and 66+ (36%). At 6 months, the prevalence of long COVID has decreased among all age categories to 27%, 26%, 37%, and 21% respectively [3].
In the COVIMPACT study, 37% of the participants were men and 63% of them were women. The proportion of long COVID at 3 months is higher amongst women (56%) in comparison to men (42%). After 6 months, the proportion decreased in women to 40% and men to 27%. Women are 1.4 times more likely to have long COVID than men at 3 and 6 months.
Among participants with a lower educational status, 56% reported persistent symptoms 3 months after infection, which is slightly higher compared to patients with a higher educational level (47%). After 6 months, these proportions decrease to respectively 41% and 32%.
The most prevalent symptoms reported by participants with long COVID at 3 and 6 months post-infection are fatigue and exhaustion (49% and 50%), headache (27% and 32%), memory problems (26% and 32%), respiratory problems (21% and 27%), sleeping problems (19% and 22%), loss of smell (20% and 17%) and taste (14% and 13%).
The health-related quality of life has been assessed with the EQ-5D questionnaire, which contains questions on mobility, autonomy, daily activities, pain/discomfort, and anxiety/depression. After 3 months, 18% of participants with long COVID reported mobility problems, 4% autonomy problems, 30% had problems with daily activities, 48% had pain and 40% of them reported anxiety and depression. After 6 months, these proportions were respectively 21% (mobility), 5% (autonomy), 33% (daily activities), 56% (pain), and 49% (anxiety and depression).
The mean score of health-related quality of life was assessed among COVIMPACT participants before their SARS-CoV-2 infection, at the time of infection, and after 3 and 6 months. Before infection, the average quality of life score was 92.6/100 and it significantly decreased at the time of infection to 81.7/100. For the scores 3 and 6 months after infection, a comparison was made between people who recovered from their infection and those who had long COVID. People who recovered from the infection had a higher quality of life score 3 and 6 months after infection (95.7/100 and 95.8/100) than people with long COVID (86/100 and 83.6/100).
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Would you like more information about COVID-19?
Besides his mission of surveillance, Sciensano is also involved in scientific research projects on COVID-19. In collaboration with partners, Sciensano coordinates and participates in projects aiming to better understand the virus and its effects on population health. Here is an overview of the existing projects.
Specific aspects of COVID-19 monitoring, prevention, and control are competencies of the regions. Further information on these aspects is available via the following websites:
We invite you to consult the following links: latest news, current measures taken by the Belgian government, guidelines to follow when COVID-19 symptoms appear.
If you are a professional, you can find the procedures for managing COVID cases on the Sciensano website.
In Belgium and worldwide, at the beginning of the COVID-19 pandemic, the focus was on managing the acute phase of the disease. However, some people continue to experience symptoms beyond the acute phase of infection [4] [5]. This phenomenon is referred to as "long COVID" or "Post COVID-19 condition" [6].
There is currently no consensus on the definition of long COVID. Still, many studies apply the definition proposed by the National Institute of Health and Care Excellence: "symptoms persist or develop for more than 3 months after a COVID-19 infection and cannot be explained by another diagnosis [1].
In the COVIMPACT study, the two definitions used to describe long COVID 3 and 6 months after acute infection are (1) having at least one symptom related to the SARS-CoV-2 infection three months after it, (2) still have at least one persistent symptom related to the SARS-CoV-2 infection six months after it. The objective of the COVIMPACT project is to constitute a cohort of people who test positive for COVID-19 in order to:
COVIMPACT is a prospective online observational cohort study. The target group is people who have had a COVID-19 infection confirmed by a laboratory test. When a COVID-19 test is positive, the lab sends the information to a central database that is used by call centers to contact COVID-19 cases and trace their contacts. At the end of the call, the call center agents inform people aged 18 and over about our online survey and ask if they agree to receive a link by SMS for more information on the study, and potentially participate in the study and complete the first questionnaire. Follow-up questionnaires are sent by Sciensano every 3 months until the end of the study in April 2023. Depending on when participants entered the study, the follow-up varies from 3 months to 2 years. Between 29 April 2021 and 1 May 2022, 2092 people completed the first questionnaire and the two follow-up questionnaires (3 and 6 months after infection). Full details on the sample and design are described in the latest COVIMPACT study report. The following topics were assessed in the study: COVID-19, quality of life, breathing difficulties, fatigue, functional limitations, mental health, physical activity, employment, and economic status.
All these results can be found on the COVIMPACT website.
Please cite this page as: Sciensano. Communicable Diseases: COVID-19, Health Status Report, 26 Oct 2022, Brussels, Belgium, https://www.healthybelgium.be/en/health-status/communicable-diseases/covid-19
In 2022, 852 new cases of tuberculosis were reported in Belgium (7.4 cases/100,000 inhabitants). Men were approximately 2 times more often affected by the disease than women, with 68% of new cases occurring among men in 2022 in Belgium. Of all cases, 39% of the tuberculosis patients diagnosed in 2022 were aged 25-44 years.
Of the total number of new registered cases, 44% of tuberculosis cases were registered in the Flemish Region (n=371), 32% in the Brussels Capital Region (n=272) and 25% in the Walloon Region (n=209). Considering the number of inhabitants in each region, the incidence rate was four times higher in the Brussels Capital Region (22.2 cases/100,000) as compared to the Walloon Region (5.7 cases/100,000) and the Flemish Region (5.5 cases/100,000). The incidence rates in the Flemish Region and the Walloon Region were similar, with slightly higher rates in the Walloon Region.
In 2022, 62% of the new tuberculosis cases occurred among people with a foreign nationality in Belgium. This proportion was higher in the Brussels Capital Region (70%) compared to the Walloon Region and the Flemish Region (respectively 54% and 62%). Among Belgians, the incidence rate was 4.3 times higher in the Brussels Capital Region (10.3/100,000) compared to the Flemish Region (2.4/100,000), and 3.4 times higher compared to the Walloon Region (3.0/100,000). Among non-Belgians, the incidence rate was 1.5 times higher in the Brussels Capital Region (43.5/100,000) compared to the Flemish Region (29/100,000), and 1.2 times higher compared to the Walloon Region (34.8/100,000).
Tuberculosis incidence per 100,000 by nationality and by region, Belgium, 2022
Source: Belgian tuberculosis registry, FARES/VRGT [2,3]
New cases of tuberculosis by nationality and by region, Belgium, 2022
Source: Belgian tuberculosis registry, FARES/VRGT [2,3]
The distribution of the incidence by age and sex varied according to nationality in 2022. Among Belgians, the incidence increased with age in men, peaking in the 60-74 years group. Incidence was higher in men than in women across all age categories, except for children (0-14 years). The overall male-female ratio tended to increase with age, with incidence rates being 4.0 times higher in men among those over 75 years.
Among non-Belgians, the highest incidence was observed in the 15-29 years age group, with particularly high rates in men. The lowest incidence rates among non-Belgians were seen in women aged 60-74 and in boys (0-14 years). Excluding children (0-14 years), the incidence rate was 1.6 to 4.3 times higher in men compared to women across the all age groups, with the highest male-to-female ratios in the 60-74 years and 15-29 years age groups.
Tuberculosis incidence per 100,000 by age and sex, Belgian people, 2022
Source: Belgian tuberculosis registry, FARES/VRGT [2,3]
Tuberculosis incidence per 100,000 by age and sex, non-Belgian people, 2022
Source: Belgian tuberculosis registry, FARES/VRGT [2,3]
In 2022, tuberculosis occurred more frequently in big cities where more people at risk are living:
The number of new cases of tuberculosis is decreasing for more than 40 years, although the diminution is slowing down since the nineties and tends to stagnate over the last few years. The incidence rate dropped below the level of 10 cases/100,000 for the first time in 2007, ranking the country among low-incidence countries. In 2022, the incidence rate (7.4 cases/100,000; n=852) remained low and was even slightly lower compared to the incidence rate of 2021 (7.6 cases/100,000; n=875). It is slightly higher than in 2020 (7.2/100,000), which was the lowest incidence ever observed in Belgium, probably due to the context of the COVID-19 pandemic (including difficulty accessing healthcare, more complex data collection, under-reporting, containment measures, barrier measures, provision of emergency housing for vulnerable populations, border closures, etc.,). While the lower incidences in 2020 and 2021 could be explained by COVID-19, this is no longer the case for the low incidence in 2022.
Since 1981, the incidence rate is decreasing in all three regions, with more variations in Brussels:
In 2022, according to World Health Organization (WHO) [4], the estimated incidence rate in Belgium was above the EU-14 average, ranking the country 3rd in the EU-14 after Portugal and Luxembourg.
International comparisons made on reported data must be interpreted with caution, since methods for collecting data are different depending on the country. That is why the WHO Global Task Force on TB Impact Measurement [1] has developed a methodology to take into account under reporting, over and under-diagnosis in tuberculosis estimates. This explains why the incidence rate in Belgium presented in this international comparison (7.8 new cases per 100,000) is different compared to the incidence rate extracted from the Belgian tuberculosis registry publication (7.4 cases per 100,000).
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Fonds des affections respiratoires (FARES)
Vereniging voor Respiratoire Gezondheid (VRGT)
Tuberculosis is a disease caused by a bacterium called Mycobacterium tuberculosis that usually affects the lungs.
According to the World Health Organization (WHO), more than 10 million new cases of tuberculosisoccur every year. The disease is one of the top 10 causes of death worldwide, and the second leading cause of death from a single infectious agent after COVID-19 in 2022. Belgium is situated among the “low-incidence countries” with less than 10 new cases of tuberculosis per 100,000 inhabitants per year [1].
Tuberculosis can nowadays be effectively treated with a success rate of 81% in 2021 in Belgium. In Belgium, treatment is free of charge for the entire population, also for people without health insurance. However, 7.4% of tuberculosis patients still die before the end of treatment [2].
The main risk factors for tuberculosis are contacts with infected people, poverty, poor nutritional status and immunodeficiency. Some people are more likely to get infected with tuberculosis since they are more exposed to the risk factors, like health care professionals and vulnerable populations such as homeless people, prisoners and migrants originating from countries with high tuberculosis prevalence.
Data presented in this chapter are extracted from the Belgian tuberculosis registry 2022 report written by the Fonds des Affections Respiratoires (FARES) [2] and the Vereniging voor Respiratoire Gezondheid (VRGT) [3].
The incidence rate is calculated as the number of new cases divided by the number of people registered at the National registry. Incidence rate in non-Belgians is slightly overestimated, as cases in unregistered migrants are counted in the numerator, while the denominator could only include the registered migrants.
Please cite this page as: Sciensano. Communicable Diseases: Tuberculosis, Health Status Report, 29 July 2024, Brussels, Belgium, https://www.healthybelgium.be/en/health-status/communicable-diseases/tuberculosis
In 2022, 597 new diagnoses of HIV infections were made in Belgium (5.1 new diagnoses per 100.000 inhabitants, or on average 1.6 cases a day). Among those, 68% were men. 77% of the HIV infections were diagnosed in people aged 20-49.
The number of new HIV diagnoses has increased by 14% in 2022 compared to 2021. But in comparison to previous years, the total number of new HIV diagnoses is still substantially lower (-12% compared to 2019).
Between the start of the epidemic in the early 80s and the end of 2022, a total of 31,139 persons were diagnosed with HIV, and a total of 5,458 cases of AIDS were reported.
In 2022, of the 597 newly diagnosed persons, 194 were resident in the Brussels-Capital Region, 249 in the Flemish Region, 147 in the Walloon Region, and 7 were residing abroad.
When accounting for the number of inhabitants, the incidence rates in the Flemish Region and in the Walloon Region are comparable, while the rate in the Brussels Capital Region is much higher. This difference is not surprising since a higher HIV prevalence is a common phenomenon in a big city. The Brussels Capital Region can indeed be considered a big city - with the socio-cultural characteristics of an urban context – while the two other regions mix rural, semi-urban, and urban contexts.
The decline over the last decade observed at national level is mirrored in all three regions, with particularly low numbers of people diagnosed in 2020, followed by a slight increase in 2021 and 2022. This recent increase is particularly marked in the Brussels-Capital region.
Since the start of the HIV epidemic in Belgium, two key populations have been particularly affected: men who have sex with men (MSM) of Belgian nationality, and heterosexual men and women from sub-Saharan Africa.
However, among both MSM and heterosexuals, the distribution of nationalities changes significantly over time. Among people infected through heterosexual contact, the share of people of sub-Saharan nationality is declining (54% in 2013 to 44% in 2022). However, in 2022, the number of diagnoses among heterosexuals has risen by 26% compared with 2021. This increase is mainly due to the large number of diagnoses among heterosexual women of sub-Saharan origin.
In 2022, 248 new HIV diagnoses were made among MSM; this represents a 5% decrease compared to 2021, continuing the downward trend of previous years. While we observed a decrease of 17% among MSM of Belgian nationality, the number of diagnosis of Latin American has increased. In 2022, half of all HIV diagnoses among MSM were among men of Belgian nationality, 19% had a Latin American nationality and 17% another European nationality. In the 20-29 age group, there has been an increase in diagnoses over the past 2 years (+34% compared with 2021).
Number of new HIV diagnoses in MSM by nationality, Belgium, 1995-2022
Source: Epidémiologie du SIDA et de l’infection à VIH en Belgique, Sciensano, 2023 [1]
Number of new HIV diagnoses in heterosexuals by nationality, Belgium, 1995-2022
Source: Epidémiologie du SIDA et de l’infection à VIH en Belgique, Sciensano, 2023 [1]
In 2022, Sciensano has estimated the number of people living with undiagnosed HIV [1] based on a tool developed by ECDC [2]. 627 people living with HIV in Belgium were not aware of their seropositivity. These estimates should be interpreted with caution, however, given the significant uncertainty surrounding the estimates for the last 2 years derived from this model. Based on the ECDC tool, the number of people living with undiagnosed HIV in Belgium appears to have been steadily declining since 2011.
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Sexually transmitted infections (STIs) such as human immunodeficiency virus (HIV) are spread primarily through person-to-person sexual contact. Additionally, HIV can be transmitted through blood products and tissue transfer, and from mother to child during pregnancy or breastfeeding.
HIV can be present without symptoms, which can facilitate transmission. It is one of the most serious communicable diseases in Europe. Infection with the virus can, if antiretroviral treatment (ART) is not initiated, lead to serious morbidity (Acquired Immunodeficiency Syndrome (AIDS)) and requires life-long treatment.
HIV is an avoidable infection since the transmission is largely preventable by behavioural measures (safe sex, safe injection). Therefore HIV incidence in a defined population is an indicator of the success/failure of control strategies. Since 2017, the use of pre-exposure prophylaxis to HIV (PrEP) is reimbursed in Belgium.
The epidemiological surveillance of HIV in Belgium dates from 1985 and is carried out by Sciensano on the basis of the registration of new HIV diagnoses. These data are reported by the seven AIDS reference laboratories that perform all confirmations of positive HIV screening tests. In addition to recording the number of newly diagnosed HIV positive, the laboratories also collect basic epidemiological data on gender, age, nationality, probable route of infection, and clinical stage at the time of diagnosis. Sciensano also collects data on the people living with HIV (PLWH) in Belgium (HIV cohort data) from the AIDS reference laboratories and the HIV reference centres.
Besides the newly diagnosed cases, Sciensano also estimates the number of people living with HIV: those who have not yet been diagnosed [1] and those living with a diagnosed infection. To estimate the undiagnosed population an instrument developed by the European Center for Disease Prevention and Control (ECDC), called the ECDC HIV Modeling Tool [2] is used. And HIV cohort data are used to estimate the number of people living with a diagnosed infection.
ECDC and the WHO Regional Office for Europe jointly coordinate HIV/AIDS surveillance in Europe [3]. The international comparability has some limitations since the national surveillance systems differ in levels of underreporting and reporting delay.
[1] Epidémiologie du VIH en Belgique. Situation au 31 décembre 2022. Bruxelles: Sciensano; 2023. https://www.sciensano.be/en/biblio/epidemiologie-du-vih-en-belgique-situation-au-31-decembre-2022
[2] European Centre for Disease Prevention and Control. HIV Modelling Tool. 2015. https://www.ecdc.europa.eu/en/publications-data/hiv-modelling-tool
[3] European Centre for Disease Prevention and Control/WHO Regional Office for Europe. HIV/AIDS surveillance in Europe 2023 – 2022 data. Stockholm: ECDC; 2023. https://www.who.int/europe/publications/i/item/9789289060462
Please cite this page as: Sciensano. Communicable Diseases: HIV, Health Status Report, 11 Jan 2023, Brussels, Belgium, https://www.healthybelgium.be/en/health-status/communicable-diseases/hiv-and-other-sexually-transmitted-infections
Influenza-like illness (ILI) is a medical diagnosis of possible influenza or other illness causing a set of symptoms. These symptoms commonly include fever, shivering, chills, malaise, dry cough, loss of appetite, body aches, and nausea, typically in connection with a sudden onset of illness. In most cases ILI is a benign illness, but for elderly people, pregnant women and people with chronic diseases, the complications of flu can be dangerous.
ILI is caused by a variety of respiratory pathogens, including, amongst others, influenza virus, parainfluenza virus, adenovirus, RSV, and Mycoplasma pneumoniae. The influenza A(H1N1) and A(H3N2) viruses as well as the influenza B virus are the cause of seasonal influenza epidemics in Belgium and circulate every year to different extents. Vaccination remains the best way of preventing transmission, complications and hospitalization of flu.
Sciensano coordinates sentinel networks of general practitioners and hospitals to ensure the permanent surveillance of ILI and influenza activity, intensity and severity of epidemics and impact on the population. The epidemic threshold is the minimum number of GP consultations for flu-like symptoms per 100,000 inhabitants per week needed to officially speak of an epidemic. This number is calculated by the European Centre for Disease prevention and Control (ECDC), and varied between 135 and 157 GP visits/100,000 inhabitants over the last 5 years. Sciensano also hosts the National Reference Centre (NRC) for influenza virus.
At the international level, influenza surveillance and pandemic preparedness is coordinated by ECDC and the World Health Organization.
More information on COVID-19 surveillance can be found on another page.
The Belgian flu epidemic of the 2018-2019 season lasted 8 weeks, which was average compared to previous seasons. The epidemiological threshold was exceeded from week 4/2019 (January 21 to January 27, 2019) to week 11/2019 (March 11 until March 17, 2019). The epidemic was of medium activity.
From week 40/2018 to week 18/2019, respiratory samples from patients diagnosed with ILI were collected by the sentinel network of general practitioners and analyzed at the National Influenza Center. Of these samples, 53% were positive for influenza viruses.
Based on surveillance through the sentinel network of general practitioners, it was estimated that about 506,000 Belgians consulted their GP for flu-like symptoms and, if they were all systematically tested, about 307,000 of them would actually be infected with the flu virus.
All age groups were affected at the approximately same weeks during the epidemic, with peak incidences in weeks 7/2019 and 8/2019.
Although there were many hospital admissions for a severe acute respiratory tract infection (SARI) during this intense season, the severity indicators of the confirmed flu cases (estimated through the network of 6 sentinel hospitals) indicated that this flu epidemic was relatively no more serious than in previous seasons.
The average length of stay for a serious flu infection during this season was 8.8 days (varying in age from 3.6 days in the age of 0-4 to 13.3 days in persons aged 85 years and older). This is comparable to the other seasons.
About 2% to 3% of people with influenza were hospitalized. Among those, 13% had serious complications, which were fatal in 6% of hospitalized patients; these indicators are however similar to those observed in the previous seasons. The vast majority of patients who suffered from severe complications had pre-existing comorbidity (91%).
Deaths were only observed in people aged 54 and over and 90% of these deaths were in patients with one or more comorbidities. The median age of death of patients without comorbidities was 87 years (range: 71-90 years) and the median age of death of patients with comorbidities was 79 years (range: 54-97 years).
The observations in Belgium were in line with those in the rest of Europe.
At European level, influenza activity started in week 49/2018, peaked in week 7/2019 and returned to baseline levels in week 17/2019. Influenza viruses started circulating at high levels in week 52/2018 until week 12/2019.
Intensive care unit (ICU) cases were mainly aged 65 years and older, but in certain countries there was a substantial number of hospitalizations in persons aged 40–64 years.
Each year, between 300,000 and 900,000 people visit their GP because of influenza-like illness in Belgium. Among these, the annual number of influenza infections is estimated between 116,000 and 472,000.
Since 2012, between 11% and 15% of patient hospitalized with a confirmed influenza infection have developed severe complications, including 4% to 9% who have died in the course of hospital stay.
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Results of the surveillance of influenza and influenza-like illness in Belgium
Laboratory surveillance of influenza in Belgium
Please cite this page as: Sciensano. Communicable Diseases: Influenza and influenza-like illness, Health Status Report, 06 Sept 2020, Brussels, Belgium, https://www.healthybelgium.be/en/health-status/communicable-diseases/influenza-and-influenza-like-illness