During the 15th week of 2017, the Republic of Macedonia registered 17 influenza cases/flu-like diseases ( I=0.8/100.000). Compared with the registered cases in the last week  (50), the number has decreased by 66.0%. The total number of reported cases this week, exceed below the limit of  very low activity, according to MEM model to determine the intensity of the activity of seasonal flu (chart 1).

Chart 1. Intensity level and weekly distribution of influenza / influenza like illness, by the expected epidemic curve of 2010-2016, the season 2015/2016 and 2016/2017

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The highest number of patients (n = 9) was registered on the territory of CPH Ohrid and isolated cases/no cases in other regions. The highest incidence of 18.0/ 100,000, was registered on the territory of Debar, where was detected low activity of the influenza virus. Also, a very low seasonal activity was detected in 3 CPH/RO, and no cases in 27 CPH / RO. (chart 1)

Picture 1. Activity level of flu by the incidence of 100,000, week 15, 2017

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This week, the highest number of patients  (n = 15,  88.2%) have been reported in the largest age group of 15-64 years, elderly 65+ with (n=1), and children aged  5-14 with (n=1). The highest incidence of 1.0/100,000 was registered in age group 15-64, then in the age group over 65 and children aged 5-14 with (I=0.4/100.000), (Chart 2).  

Chart 2. Distribution of seasonal flu by age groups and incidence per 100,000 inhabitants, season 2016/2017

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The total number of flu cases is 34916 (I = 1687.4/ 100.000). This season have been reported infected people from all reporting units. The most of the cases which have been reported are from Skopje (n=4.562; 13,1%), Strumica (n=3.280; 9,4%), Gostivar (n=3.004; 8,6%), Kavadarci (n=2.988; 8,6%) and Bitola (n=2.828; 8,1%) (chart 3).

The highest incidence is registered on the territory of  Kavadarci (I=6.943.3/100.000), Sveti Nikole (I=5.864.9/100.000), Strumica (I=3.462.9/100.000), Ohrid (I=3.348.8/100.000) and Veles (3.226.8/100.000) (Chart 3). During this season were registered 2 deaths associated with influenza,

Chart 3. Distribution of seasonal flu by CPH/RO and incidence per 100,000 inhabitants, season 2016/2017

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From the total number of cases of flu/flu-like illnesses, in December were reported 15073 or 43.2 %, 1.5%(532) in November and 0.5%.(171) in October.  17158, or 49.1% are reported in January, 1396 or 4.0% in February, and in March- 519 cases or 1.5%, in april- 67 cases or 0.2%. Regarding the distribution of patients by age groups, the largest number of cases this season have been reported in the age group of 15-64 years –n=24115 or 69.1% and the highest incidence (1997.4 / 100,000, n=4623) is registered in the age groups 5-14 and in the age group of 0-4. (1938.2/100.000, n=2254). 3924 cases and incidence of (1496.9/ 100,000) is registered in the age group over 65. (Chart 4)

Chart 4. Distribution of seasonal flu by age groups, season 2016/2017

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During the week 15 of 2017, the laboratory for virology of IPH has 1 received  sample, (material for laboratory diagnostics) which is negative. Since the beginning of the season 2016/2017, the laboratory received 170 materials, from the routine and sentinel and 63 (37.1%)  were positive for the presence of influenza virus, of which 60- Influenza A/H3, 2 non-typed Influenza A virus, 1 Influenza B. (chart 5)

Chart 5. Weekly distribution of number and percentage of positive samples of influenza 2016/2017

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According to reports received by CPH / RO, 99.9% of total purchased vaccines are used, or 26665 persons are vaccinated.. The majority of the vaccinated are aged over 64 years – 15324 cases or 57.5%, 30-64 years – 10001 cases or 37,5%, and  5-29 – 661 cases or 2.5%. In the age group 0-4 years- 10 cases, and 613 health workers (2,3%). There are no vaccinated pregnant women. From the total number of the vaccinated, 17908 persons or 67.2% have a history of chronic diseases. The vaccination has finished in every CPH/RO

EUROPE

According to records presented in Flu News Europe (week 14/2017), the activity of influenza virus in Europe is with low activity, and the countries reported detection of 17% positive samples. The pandemic reached its peak in week 46 in the season 2009/2010, and week 48-51, in the previous 5 seasons. So far, this year, most of the viruses are subtyped as A (H3N2) with 99%, while last year, the subtype A(H1N1)pdm09 was predominant