During the 19th week of 2019, (05.05.2019-12.05.2019) the Republic of North Macedonia registered 58 influenza cases/flu-like diseases(I=2.8/100.000). Compared with the number of registered cases in the last week, are decreased for 2 times (n=25)

The incidence this week is below the weekly limit of seasonal (low) activity of the influenza virus (Chart 1).

Over the past week, there has been no registered deaths associated with influenza. This week, the virological laboratory of the IPH has received 16 influenza testing materials, all negative for the presence of influenza.

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=36; 62.1%)and the highest incidence is registered in children aged 0-4, I=7.8/100 000.

This week were reported cases from 10 reporting units. Most of the cases have been registered in Debar (n=16)and the highest incidence is registered also there, I=57.7/100 000. (chart 1).

In the 2018/2019 season, the total number of influenza cases is 21404 (I=1034.4/100.000).

Compared with the same period last season , there is a decrease in the total number of reported cases by 10.6%, and in relation to the model for the last 8 seasons (n=25928) a decrease of 17.4% .

Cumulatively this season, most of the cases have been reported from Strumica(n=2488), Kavadarci n=1897, Skopje (n=3713), Prilep (n=1577), Gostivar (n=1657) (chart 2;1)

The highest cumulative incidence of 4408.1/100.000 habitants was registered in Kavadarci and also in Strumica(2626.7/100,000).  and also high incidence over 1500,0/100 000h. was registered in Debar, Resen, Sveti Nikole, Kratovo, Prilep(chart2)

Chart 2. Distribution of cases of seasonal influenza per CPH / RO and incidence of 100,000 inhabitants, season 2018/2019

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Over the season, have been registered 29 deaths associated with influenza. 13 people from Skopje.  In 21 people (72,4%), pre-chronic disease has been identified, ie co-morbidity.The age of the deceased ranges from 5 months to 86 years.

Regarding the distribution of the diseased by age groups, the cumulative number of cases was reported in the age group of 15-64 years – 13612 cases (63.6%), and the highest cumulative incidence of 2031.1 / 100.000 was registered in 0-4 years.

Most of the cases are reported in February – 11076 (51.7%) (chart 3)

Chart 3. 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 853 samples, materials for laboratory diagnostics, of which 433 (50.8%) are positive for the presence of influenza virus, all are Influenza A: 324 (74.8%) are Influenza A(H1N1)pdm, 57 (13.2%) are Influenza A(H3), аnd 52 (12.0%) are Influenza А non-subtyped(chart 5)

Chart 4. Weekly distribution of number and percentage of Influenza positive samples 2018/2019

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According to records presented in Flu News Europe (18th week/2019), the activity of influenza virus in Europe is the following: All countries reported a low intensity of the influenza virus.3.8% samples were confirmed as positive.(from the sentinel surveillance tests in countries reporting to the TESSy system of the ECDC).

During the 2018/2019 season, the two subtypes of influenza A circulate, with some countries registering co-circulation, while other countries report the dominance of A (H1N1) pdm09 or the A (H3N2) subtype.

From the beginning of the 40th week, over 99% of influenza A viruses detected by SARI (severe acute respiratory infection) cases were subtyped, and 79% of them were A (H1N1) pdm09.

In general, current influenza vaccines tend to act better against influenza A (H1N1) pdm09 and influenza virus B than against influenza A (H3N2).

For the 2019-2020 season of the northern hemisphere, WHO recommends a four-valent vaccine containing:

  • A / Brisbane / 02/2018 (H1N1) pdm09-like virus;
  • A / Kansas / 14/2017 (H3N2) -like virus;
  • B / Colorado / 06/2017-like virus (B / Victoria / 2/87 lineage);
  • B / Phuket / 3073/2013-like virus (B / Yamagata / 16/88 lineage).