During the 10th week of 2019, (04.03-10.03.2019) the Republic of Macedonia registered 2429 influenza cases/flu-like diseases(I=117.4/100.000). Compared with the number of registered cases in the last week, are decreased for 9.3% (n=2678) and decreased for 3.7 % compared with the cases of the last season.(n=2781). (chart1)

The number of registered cases this week is 28.5% higher than the 10th week of the previous season (n = 1890), and compared to the number of week 10 of the typical epidemic curve (modeled from the last 8 seasons) there is an increase of 2.2. times (chart 1).

The registered incidence this week is above the weekly limit of the seasonal (low) activity of the influenza virus, according to the MEM model for determining the intensity of seasonal influenza activity (Chart 1).

During this week, 4 flu-related death were registered. It’s about 2 people from Skopje and one from Tetovo and Ohrid. The age of the deceased ranges from 50-73 years. 2 people have chronic diseases / co-morbidity. In all cases, influenza A (H1pdm)  virus has been confirmed.

This week, the laboratory for virology of IPH received 84 influenza test materials, of which 55 (65.5%) were positive for the influenza virus – 44 Influenza A (H1) pdm (80%), 5 Influenza A (H3) and 6 Influenza A are non-subtyped. (chart 5)

Chart 1. Levels of intensity and weekly distribution of influenza / influenza-like illness patients according to the expected epidemic curve 2010-2018, season 2017/2018 and season 2018/2019

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This week most of the cases have been registered in a group 15-64 years (n=1553; 63.9%)and the highest incidence is registered in children 0-4 years, I=243.6/100 000. (chart 2).

Chart 2. Weekly distribution of seasonal flu / influenza-like illnesses by age group – incidence of 100,000 inhabitants, season 2018/2019

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This week were reported cases from 28 reporting units. Most of the cases have been registered in Skopje (n=650)and the highest incidence is registered in Kavadarci, I=601.8/100 000. (chart 1).

Cumulatively 2 Regional Units registered very high and high activity. (RU Kavadarci and Strumica) (image 1)

Image 1. Level of influenza activity according to the incidence of 100,000 inhabitants, 10 week 2019

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In the 2018/2019 season, the total number of influenza cases is 17630 (I=852.0/100.000).

Compared with the same period last season (n = 19210), there is a decrease in the total number of reported cases by 16.4%, and in relation to the model for the last 8 seasons (n ​​= 22970) a decrease of 26.8% .

Cumulatively this season, most of the cases have been reported from Strumica(n=2138), Kavadarci n=1627, Skopje (n=2915), Bitola (n=1285) (chart 3; 1)

The highest cumulative incidence of 3780.7/100.000 habitants was registered in Kavadarci  and also high incidence over 1500,0/100 000h. was registered in Strumica, Debar and Sveti Nikole(chart 3;1)

Chart 3. Distribution of cases of seasonal influenza per CPH / PE and incidence of 100,000 inhabitants, season 2018/2019

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Regarding the distribution of the diseased by age groups, the cumulative number of cases was reported in the age group of 15-64 years – 11181 cases (63.4%), and the highest cumulative incidence of 1696.3 / 100.000 was registered in 0-4 years. (chart 1)

Most of the cases are reported in February – 11076 (62.8%) (chart 4; 1)

Chart 4. Distribution of cases of seasonal flu by month, season 2018/2019

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From the beginning of the season, the laboratory for virology of IPH has received 628 samples, materials for laboratory diagnostics, of which 348 (55.4%) are positive for the presence of influenza virus, all are Influenza A: 275 (79%) are Influenza A(H1N1)pdm, 38 (10.9%) are Influenza A(H3), аnd 35 (10.1%) are Influenza А non-subtyped(chart 5)

Chart 5. Weekly distribution of number and percentage of Influenza positive samples 2018/2019

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Vaccination against seasonal influenza is the most effective protection against this disease, therefore the Public Health Institute recommends vaccination of the entire population, especially for people belonging to risk groups (according to WHO recommendations):

According to the data from the Department of E-health, from the beginning of the vaccination, and as of the closing of this report, a total of 19992 persons (71.4%)were vaccinated.

In terms of commercial vaccines, according to available data from CPH / RO, 19348 people were vaccinated. The largest number of vaccinated are over the age of 65 years – 10977 or 56.7%, From the category of health workers, 801 persons were vaccinated. From the total number of vaccinated patients, 14111 persons or 72.9% have a history of chronic diseases.

According to the data a report on vaccine against seasonal influenza in (Private healthcare clinics) 50 people were vaccinated. 38.0% have a history of chronic disease.



According to records presented in Flu News Europe (9th week/2019), the activity of influenza virus in Europe is the following: 41.8% samples were confirmed as positive.(from the sentinel surveillance tests in countries reporting to the TESSy system of the ECDC). So far, influenza type A is predominant with 99.6%, and most of the viruses are subtyped as A(H3N2) and A(H1N1)pdm09

On 21 February 2019, the WHO published recommendations for the composition of a vaccine against influenza that will be used in the 2019-2020 season of the Northern Hemisphere. The recommendation for the type of influenza B is unchanged, for type A (H1N1) pdm09 has been updated, and the decision for type A (H3N2) has been postponed until March 21, 2019.