During the 5th week of 2019, (28.01-03.02.2019) the Republic of Macedonia registered 1252 influenza cases/flu-like diseases(I=60.5/100.000). Compared with the number of registered cases in the last week, are increased 2 times (double) and decreased for 37.4 % compared with the cases of the last season.(n=2001). (chart1)

This week, the laboratory for virology of IPH has received 50 samples, materials for laboratory diagnostics, of which 28 (56%) are positive for the presence of influenza virus. 24 Influenza A(H1N1)pdm09 2 Influenza A(H3) and Influenza non subtyped.

Chart 1. Distribution of cases of seasonal influenza by week, typical epidemic curve of the seasons 2010-2018, 2017/2018 and 2018/2019

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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=826; 66.0% cases) and the highest incidence is registered in the age group, 5-14 years. (I=91.6 /100.000).(Chart3)

This week the biggest number of influenza cases is registered in Strumica (n=176), and the highest incidence is registered in Kratovo, I=313.5/100 000. (chart 1)

Cumulatively 6 reporting units reported very low activity and 15 reported low(seasonal) actrivity , 3 registered average activity and in one is high activity(Image1)

Image 1. Level of influenza activity according to the incidence of 100,000 inhabitants, 5 week 2019

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In the 2018/2019 season, the total number of influenza cases is 4125 (I=199.4/100.000).

Compared with the same period last season (n = 5479), there is a decrease in the total number of reported cases by 24.7%, and in relation to the model for the last 8 seasons (n ​​= 12334) a decrease of 66.6% .

Cumulatively this season, cases from 28 reporting units have been reported. The highest number of patients Gostivar (n=644; 15.6%; I=537.7/100.000), Tetovo (n=469),Strumica (n=418) and Skopje (n=418) (chart 2; 1)

The highest cumulative incidence was registered in Debar and also higher than 185 is registered in Kavadarci, Sveti Nikole, Delcevo, Kratovo, Strumica, Gostivar (chart 2; 1)

Chart 1. Distribution of cases of seasonal influenza per CPH / RO and the 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 – 2874 cases (69.7%), and the highest cumulative incidence of 304.7 / 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

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Distribution of seasonal flu patients by months (Table 1 in the Appendix):

October – 51 cases or 1.2%

November – 383 cases or 9.3%

December – 784 cases or 19.0%

January – 2907 cases or 70.5%

 

From the beginning of the season, the laboratory for virology of IPH has received 149 samples, materials for laboratory diagnostics, of which 49 (32.9%) are positive for the presence of influenza virus. (chart 4)   39 (79,6%) are Influenza A(H1N1)pdm, 6 (12,2%) are Influenza A(H3), аnd 4 (8,2%) are Influenza А non-subtyped

Chart 4. Weekly distribution of number and percentage of positive samples

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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 19960 persons (71.3%)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.

During the 5th  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. The majority of the vaccinated are in the age group of 30-64 years. Also, 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.

 

EUROPE

According to records presented in Flu News Europe (4rd week/2019), the activity of influenza virus in Europe is the following: 51.3% 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 98.8%, and most of the viruses are subtyped as A(H3N2) and A(H1N1)pdm09