During the 9th week of 2018 (26.02.2018 – 04.03.2018), the Republic of Macedonia registered 2781  influenza cases/flu-like diseases(I=134.4/100.000).

Compared with the number of registered cases in the last week, are decreased for 35%(chart 1)and increased for 8 times compared with the cases of the last season.

Chart 1. Distribution of cases of seasonal influenza by week, typical epidemic curve of the seasons 2010-2017, 2016/2017 and 2017/2018

1

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 (1651 cases) and the highest incidence is registered in the age group, from 0-4 years. (I=247.9/100.000 )

This week the biggest number of influenza cases is registered in Skopje, n= 544 and also, the highest incidence is registered in Kavadarci (I = 680.9/ 100.000).

From 31 reporting units, Sveti Nikole, Strumica and Kavadarci registered very high activity of the influenza virus, also- high activity, in other units- registered seasonal activity,3 units didn’t registered ant cases

Chart 2. Level of influenza activity according to the incidence of 100,000 inhabitants, week 9 2018

 kartogram

In the 2017/2018 season, the total number of influenza like illness (ILI) cases is 19210 (I = 928.4/ 100.000).Compared with the previous season (34481 cases), the number has decreased for 44%.

This season the biggest number of influenza cases is registered in Gostivar-2072, Skopje-2386, Kumanovo-1787, with the highest incindence in Debar(I=3022.9 /100 000).

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, 11558 cases (60%) and the highest incidence is registered in the age group of 5-14 years. (I=1750.3/100 000).

 

The analysis of the number of seasonal flu cases per month indicates a gradual increase in the number of patients in January (2,396 patients or 12.5%) and a peak in February (12,951 or 67.4%). In march, for 1 week are registered 2781 or 14.5%

 

During this week the laboratory for virology of IPH has received 48 samples, materials for laboratory diagnostics. 26 samples(54.2%) are positive for the presence of influenza virus, subtyped as 83% Influenza B (90% Yamagata, 10% Victoria) and 17% Influenza A (of which 50% are A(H1N1)pdm09 and 50% are Influenza A non-subtyped (chart 2)

Since the beginning of the season 2017/2018, the laboratory received 364 materials, of which, 180 are positive (49.5%) for the presence of the influenza virus, 69% are Influenza B (96.8% Yamagata, 1.6% Victoria and 1.6% non-subtyped), and 31% are Influenza A of which (75 are А(H1N1)pdm09 –and 25% Influenza A non-subtyped),

Chart 2. Weekly distribution of number and percentage of positive samples of influenza 2017/2018

2

Vaccination with the seasonal flu vaccine started from October 17, 2017. The total number of 3-type vaccines (Influvac, produced in Abbot Biologicals Olst, Netherlands) for this season is 27997 doses.  According to reports received by CPH / RO, 27997 people were vaccinated, or 100% of total purchased vaccines. The majority of the vaccinated are aged over 65 years – 60.5%, From the total number of the vaccinated  75.2% have a history of chronic diseases.

 

EUROPE

According to records presented in Flu News Europe, the activity of influenza virus in Europe is widespread, The situation is common for this time of year.

This week, 49% samples were confirmed as positive, Influenza А (36%) and Influenza B (64%).

So far, influenza type A is predominant with 33%, and most of the viruses are subtyped as А (H1N1)pdm09 with 65% and  influenza type B with 67% (97% – B/Yamagata).

B / Yamagata type is dominated by the registered Influenza B viruses, but this type is not included in the trivalent vaccine for this season. Based on the data provided to EuroMOMO, mortality among older people has increased over the past weeks, especially in the countries of the southwestern part from Europe.

For the 2018-2019 season of the Northern Hemisphere WHO recommends a four-valent vaccine containing:

  • A / Michigan / 45/2015 (H1N1) pdm09-like virus;
  • A / Singapore / INFIMH-16-0019 / 2016 (H3N2) -like virus;
  • B / Colorado / 06/2017-like virus (B / Victoria / 2/87 lineage);
  • B / Phuket / 3073/2013-like virus (B / Yamagata / 16/88 lineage).