During the 5th week of 2017, the Republic of Macedonia registered 563 influenza cases/flu-like diseases, (I=27.2/100.000). Compared with the registered cases in the last week  (1199), the number has decreased by 53.0%.

The total number of reported cases this week, exceed below the limit of 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

Графикон 1

The highest number of patients (n = 90) was registered on the territory of CPH Ohrid, then CPH Prilep-n=62, Strumica-45, Kumanovo-41. The highest incidence of 160.4 / 100,000, was registered on the territory of Ohrid, and Pehcevo (I=140.2/100 000) where is registered average activity of Influenza. 10 CPH/RO show low activity, 15 CPH / RO show very low activity of influenza, and no cases registered in Pehcevo, Kriva Palanka, Negotino, Demir Hisar Picture 1-

Picture 1. Activity level of flu by the incidence of 100,000, week 5, 2017

Картограм 1

This week, the highest number of patients (n = 415, 73.7%) have been reported in the largest age group of 15-64 years, children aged 5-14 with 8,4% (n=55),  elderly 65+ with 12,6% (n=71), and children aged 0-4 with (3,9%;  n=22). The highest incidence of  28.4/ 100,000 was registered in age group 15-64, in elderly (65+),  (I=27.1/100.000), in children  aged 0-4; 18.9/100.000,  and  in children aged 5-14 was 23.8/100 000 (Chart 2).

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

Графикон 2

The total number of flu cases is 33497 (I = 1618.9/ 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=4.511; 13,5%), Strumica (n=3.166; 9,5%) and Kavadarci (n=2.937; 8,8%) (Chart 3).

The highest incidence is registered on the territory of Kavadarci -(I=6824.8/100.000), Sveti Nikole- -(I=5660.1/100.000), and Strumica (I=3342.5/100.000) (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

Графикон 3

From the total number of cases of flu/flu-like illnesses, 15073 or 45.0% were reported in December, 1.6%(532) in November and 0.5%.(171) in October. 17158, or 51.2% are reported in January, 563 or 1.7% in February

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=23025 or 68.7%) and the highest incidence (1939.9 / 100,000) is registered in the age groups 5-14 with 4490 cases and in the age group of 0-4. (1885.7/100.000) with 2191 cases. 3791 cases and incidence of (1446.2 / 100,000) is registered in the age group over 65. (Chart 4)

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

Графикон 4

During the week 5 of 2017, the laboratory for virology of IPH has received  9 samples, (material for laboratory diagnostics), of which, 1 (or 11.1% is positive to the presence of the influenza virus (Influenza A/H3). Since the beginning of the season 2016/2017, the laboratory received 142 materials, from the routine and sentinel and 57 (40.1%)  were positive for the presence of influenza virus, of which 54- Influenza A/H3, 2 non-typed Influenza A virus, 1 Influenza B.

chart 5

Графикон 5

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

Epidemiological data on the number of reported cases of influenza / influenza like illness and laboratory confirmed cases of influenza suggest an early start to the season and the weekly number is exceeding the limit of average activity (first time, after the pandemic in 2009/2010). This week, on the territory of Macedonia, only 2 CPH / RO registered very high activity, 3 with high activity, the other regions are average or low activity.


According to records presented in Flu News Europe (week 4/2017), the activity of influenza virus in Europe is with stable activity, and the countries reported detection of 51% 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 97%, while last year, the subtype A(H1N1)pdm09 was predominant