SITUATION WITH INFLUENZA IN MACEDONIA, season 2018/2019 (week 47 up to 25.11.2018)

During the 47^thweek of 2018, (19.12018 – 25.11.2018) the Republic of Macedonia registered 74 influenza cases/flu-like diseases(I=3.6/100.000). Compared with the number of registered cases in the last week, are decreased (14.9%))and decreased for 53.2% compared with the cases of the last season.(n=158)

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=47; 63.5% cases) and the highest incidence is registered in the age group, 0-4 years. (I=8.6 /100.000).

This week the biggest number of influenza cases is registered in Kumanovo, n= 21 and Tetovo (n=13)

In the 2017/2018 season, the total number of influenza cases is 344 (I = 16.6/ 100.000).

Compared with the same period last season (n = 367), there is a decrease in the total number of reported cases by 26.4%, and in relation to the model for the last 8 seasons (n ​​= 438) a decrease of 38.3% .

Cumulatively this season, sick persons from 19 reporting units have been reported, and in 8 reporting units the number of reported infected persons is ≥10. The highest number of patients (n = 69; 20.1%,  I = 34.5 / 100.000) were registered in CPH Tetovo, and the highest cumulative incidence was registered in RO Sveti Nikole (I = 107.3 / 100.000).

Regarding the distribution of the diseased by age groups, the cumulative number of cases was reported in the age group of 15-64 years – 213 cases (61.9%), and the highest cumulative incidence of 39.6 / 100.000 was registered in the youngest, children 0-4 years old

During the week 47 of 2018, the laboratory for virology of IPH has received 2 samples, materials for laboratory diagnostics, which are negative for the presence of influenza. Since the beginning of the season 2017/2018, the laboratory received 8 materials which were negative for the presence of influenza virus.

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):

Pregnant women at any stage of pregnancy

children aged 6 months to 5 years

elderly people aged 65 years and over,

People with chronic diseases and conditions of weaken immunity

Health workers.

For the first time, since this season of influenza, Macedonia launched a free influenza vaccination for a particular category of population. For that purpose, the Ministry of Health has purchased 28,000 doses for people over 65 years of age with an average, under-average pension or no income. Additional 17672 doses were procured by the Public Health Centers as commercial vaccines for the rest of the population.

Vaccination with free and commercial influenza vaccines is carried out by CPH / RO, as well as the previous seasons, and for the first time this season, the appointment for free vaccines is through a family doctor in the My Term system.

According to the data from the Department of E-health, from the beginning of the vaccination on 05.11.2018, and as of the closing of this report, a total of 17995 persons (64.3%)were vaccinated.

Table 1. Vaccinated persons with a free vaccine, by CPH / RO, R. of Macedonia, season 2018/2019

In terms of commercial vaccines, according to available data from CPH / RO, 16834 people were vaccinated. The largest number of vaccinated are over the age of 65 years – 9720 or 57.7%, aged 30-64 years – 6264 or 37.2%, while at the age of 5-29 are 147 or 0.9 %. 4 children under the age of 5 were vaccinated. From the category of health workers, 699 persons or 4.2% were vaccinated. No vaccinated pregnant women. From the total number of vaccinated patients, 12388 persons or 73.6% have a history of chronic diseases.

Of the total number of reporting units (31), two – CPH Gevgelija and RO Negotino did not submit a vaccination report in week 47, while RO Sveti Nikole has not sent a report at all for purchased and spent commercial vaccines from the beginning of the vaccination.

During the 47th week, a report on vaccine against seasonal influenza in PZU Neuromedica was received. According to the data, in the Neuromedica Clinic, 35 people were vaccinated from a total of 200 procured vaccines (17.5%). The majority of the vaccinated (42.9%) are in the age group of 30-64 years. From the total number of vaccinated patients in PHI Neuromedica, 40.0% have a history of chronic  disease.

EUROPE

According to records presented in Flu News Europe (46^th   week/2018), the activity of influenza virus in Europe is low, and only a few countries reported sporadic detection of influenza viral infections. 3.2% 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 83.3%, and most of the viruses are subtyped as A (H1N1)pdm09, with 70.4%