During the 4th week of 2019, (21.01-27.01.2019) the Republic of Macedonia registered 643 influenza cases/flu-like diseases(I=31.1/100.000). Compared with the number of registered cases in the last week, are increased 20.2%))and decreased for 40.7 % compared with the cases of the last season.(n=1085).
This week, the laboratory for virology of IPH has received 19 samples, materials for laboratory diagnostics, of which 12 (63,2%) are positive for the presence of influenza virus. 10 Influenza A(H1N1)pdm09 and 2 Influenza A(H3).
Chart 1. Distribution of cases of seasonal influenza by week, typical epidemic curve of the seasons 2010-2018, 2017/2018 and 2018/2019
Regarding the distribution of patients by age groups, the largest number of cases this week have been reported in the age group of 15-64 years (n=457; 71.1% cases) and the highest incidence is registered in the age group, 0-4 years. (I=50.8 /100.000).(Chart3)
This week the biggest number of influenza cases is registered in Skopje (n=85), and the highest incidence is registered in Debar, I=209.0/100 000. (chart 1)
Cumulatively 1 reporting units reported very low activity and 9 reported low(seasonal) actrivity and 2 registered average activity (Image1)
Image 1. Level of influenza activity according to the incidence of 100,000 inhabitants, 4 week 2019
In the 2018/2019 season, the total number of influenza cases is 2873 (I=107.8/100.000).
Compared with the same period last season (n = 3478), there is a decrease in the total number of reported cases by 17.4%, and in relation to the model for the last 8 seasons (n = 8978) a decrease of 68.0% .
Cumulatively this season, sick persons from 28 reporting units have been reported. The highest number of patients Gostivar (n=568; 19.8%; I=474.2/100.000), Tetovo (n=359; 12.5%; I=179.7/100.000) Skopje (n=283; 9.9%; I=45.8/100.000) The highest cumulative incidence was registered in Gostivar and also higher than 300 is registered in Kavadarci, Sveti Nikole, Debar (chart 2; 1)
Chart 1. Distribution of cases of seasonal influenza per CPH / RO and the incidence of 100,000 inhabitants, season 2018/2019
Regarding the distribution of the diseased by age groups, the cumulative number of cases was reported in the age group of 15-64 years – 2048 cases (71.3%), and the highest cumulative incidence of 214.3 / 100.000 was registered in 0-4 years. (chart 3; 1)
Chart 3. Distribution of seasonal flu / influenza-like illnesses by age group – incidence of 100,000 inhabitants, season 2018/2019
Distribution of seasonal flu patients by months (Table 1 in the Appendix):
October – 51 cases or 1.8%
November – 383 cases or 13.3%
December – 784 cases or 27.3%
January – 1655 cases or 57.6%
From the beginning of the season, the laboratory for virology of IPH has received 99 samples, materials for laboratory diagnostics, of which 21 (21,2%) are positive for the presence of influenza virus. (chart 4) Influenza A – 21 (100%), A(H1N1)pdm09=15 (71,4%), Influenza A/H3=4 (19,0%) and Influenza A non-subtyped.=2(9,6%)
Chart 4. Weekly distribution of number and percentage of positive samples
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 19942 persons (71.2%)were vaccinated.
In terms of commercial vaccines, according to available data from CPH / RO, 19328 people were vaccinated. The largest number of vaccinated are over the age of 65 years – 10957 or 56.7%, aged 30-64 years – 7370 or 38.1%, while at the age of 5-29 are 196 or 1.0 %. 4 children under the age of 5 were vaccinated. From the category of health workers, 801 persons or 4.1% were vaccinated. No vaccinated pregnant women. From the total number of vaccinated patients, 14095 persons or 72.9% have a history of chronic diseases. (table 3)
During the 3rd week, a report on vaccine against seasonal influenza in PZU Neuromedica was received. According to the data, in the Neuromedica Clinic, 50 people were vaccinated from a total of 200 procured vaccines (25.0%). The majority of the vaccinated (42.0%) are in the age group of 30-64 years. One pregnant women is vaccinated and 11 health workers. From the total number of vaccinated patients in PHI Neuromedica, 38.0% have a history of chronic disease.
According to records presented in Flu News Europe (3rd week/2019), the activity of influenza virus in Europe is low. 48.8% 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 98.6%, and most of the viruses are subtyped as A(H3N2) and A(H1N1)pdm09