During the 9th week of 2019, (25.02-03.03.2019) the Republic of Macedonia registered 2678 influenza cases/flu-like diseases(I=129.4/100.000). Compared with the number of registered cases in the last week, are decreased for 16.5% (n=3209) and decreased for 3.7 % compared with the cases of the last season.(n=2781). (chart1)

The number of registered cases this week is 3.7% lower than the 9th week of the previous season (n = 2.781), and compared to the number of week 9 of the typical epidemic curve (modeled from the last 8 seasons) there is an increase of 61.2% (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).

Over the past week, there have been 8 cases of influenza-related deaths.

During this week, 8 flu-related death were registered. It’s about 5 people from Skopje and one from Delcevo, Ohrid and Kavadarci. The age of the deceased ranges from 12-70 years. 7 people have chronic diseases / co-morbidity. In all cases, influenza A virus has been proven, with A (H1pdm) influenza confirmed in 5 cases.

This week, the laboratory for virology of IPH received 100 influenza test materials, of which 55 (55%) were positive for the influenza virus – 42 Influenza A (H1) pdm, 7 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

slika 1 grip 9


This week most of the cases have been registered in a group 15-64 years (n=1606; 60%)and the highest incidence is registered in children 0-4 years, I=296.1/100 000. (chart 2).

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

grip 9 slika 2


This week were reported cases from 28 reporting units. Most of the cases have been registered in Skopje (n=583)and the highest incidence is registered in Kavadarci, I=759.9/100 000. (chart 1).

Cumulatively 2 Regional Units registered very high and high activity. In 17 is seasonal, in 7-average, 2-very low and 3 did not register any activity. (img1)

Image 1. Level of influenza activity according to the incidence of 100,000 inhabitants, 9 week 2019

grip 9 kartogram

In the 2018/2019 season, the total number of influenza cases is 15201 (I=734.6/100.000).

Compared with the same period last season (n = 19210), there is a decrease in the total number of reported cases by 20.9%, and in relation to the model for the last 8 seasons (n ​​= 22970) a decrease of 33.8% .

Cumulatively this season, most of the cases have been reported from Strumica(n=1955), Kavadarci n=1368, Skopje (n=2355), Bitola (n=1211) (chart 3; 1)

The highest cumulative incidence of 3178.9/100.000 habitants was registered in Kavadarci  and also high incidence over 1500,0/100 000h. was registered in Strumica,Debar (chart 3;1)

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

grip 9 slika 4


Regarding the distribution of the diseased by age groups, the cumulative number of cases was reported in the age group of 15-64 years – 9628 cases (63.3%), and the highest cumulative incidence of 1452.8 / 100.000 was registered in 0-4 years. (chart 1)

Most of the cases are reported in February – 11076 (72.9%) (chart 4; 1)

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

grip 9 slika 5

From the beginning of the season, the laboratory for virology of IPH has received 544 samples, materials for laboratory diagnostics, of which 293 (53,9%) are positive for the presence of influenza virus, all are Influenza A: 231 (78.8%) are Influenza A(H1N1)pdm, 33 (11.3%) are Influenza A(H3), аnd 29 (9.9%) are Influenza А non-subtyped(chart 5)

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

grip 9 slika 6

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. No vaccinated pregnant women. From the total number of vaccinated patients, 14111 persons or 72.9% have a history of chronic diseases.

During the 8th  week, a report on vaccine against seasonal influenza in PC(Private healthcare clinics) 50 people were vaccinated. The majority of the vaccinated are in the age group of 30-64 years. 38.0% have a history of chronic disease.




According to records presented in Flu News Europe (8th week/2019), the activity of influenza virus in Europe is the following: 49% 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 99.1%, and most of the viruses are subtyped as A(H3N2) and A(H1N1)pdm09