During the 15th week of 2019, (08.04-15.04.2019) the Republic of North Macedonia registered 202 influenza cases/flu-like diseases(I=9.8/100.000). Compared with the number of registered cases in the last week, are decreased for 28.6% (n=283) and increased for 47.4 % compared with the cases of the last season.(n=137). (chart1) and compared to the average for the 15th week of the last 8 seasons, there is an increase for 2 times (Chart 1).

The incidence this week is below the weekly limit of seasonal (low) activity of the influenza virus (Chart 1).

Over the past week, there have been no deaths associated with influenza. This week, the virological laboratory of the IPH received 17 influenza testing materials, of which 2 (11.8%) were positive for the presence of the influenza virus –  Influenza A (H3) (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

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This week most of the cases have been registered in a group 15-64 years (n=141; 69.8%)and the highest incidence is registered in children from 0-4 years years, I=13.8/100 000. (chart 2).

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

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This week were reported cases from 18 reporting units. Most of the cases have been registered in Gostivar (n=39)and the highest incidence is registered in Negotino, I=38.4/100 000. (chart 1).

Image 1. Level of influenza activity according to the incidence of 100,000 inhabitants, 15 week 2019

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In the 2018/2019 season, the total number of influenza cases is 21142 (I=1021.8/100.000).

Compared with the same period last season , there is a decrease in the total number of reported cases by 11.5%, and in relation to the model for the last 8 seasons (n=26046) a decrease of 38.6% .

Cumulatively this season, most of the cases have been reported from Strumica(n=2467), Kavadarci n=1878 Skopje (n=3679), Prilep (n=1573), Gostivar (n=1579) (chart 3; 1)

The highest cumulative incidence of 4364.0/100.000 habitants was registered in Kavadarci and also in Strumica(2604.6/100,000).  and also high incidence over 1500,0/100 000h. was registered in Debar, Resen, Sveti Nikole, Kratovo, Prilep(chart 3;1)

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

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Over the season, have been registered 28 deaths associated with influenza. 13 people from Skopje, 4 from Ohrid, 2 from Kicevo, Kavadarci, Delcevo, Tetovo, and 1 from  Resen, Valandovo and Kriva Palanka.  In 20 people (71,4%), pre-chronic disease has been identified, ie co-morbidity.The age of the deceased ranges from 5-86 years.

Regarding the distribution of the diseased by age groups, the cumulative number of cases was reported in the age group of 15-64 years – 13438 cases (63.6%), and the highest cumulative incidence of 2004.4 / 100.000 was registered in 0-4 years. (chart 1)

Most of the cases are reported in February – 11076 (52.4%) (chart 4; 1)

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

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From the beginning of the season, the laboratory for virology of IPH has received 822 samples, materials for laboratory diagnostics, of which 428 (52.1%) are positive for the presence of influenza virus, all are Influenza A: 323 (75.5%) are Influenza A(H1N1)pdm, 55 (12.9%) are Influenza A(H3), аnd 50 (11.6%) are Influenza А non-subtyped(chart 5)

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

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According to records presented in Flu News Europe (14th week/2019), the activity of influenza virus in Europe is the following: 23% samples were confirmed as positive.(from the sentinel surveillance tests in countries reporting to the TESSy system of the ECDC).

From the beginning of the 40th week, over 99% of influenza A viruses detected by SARI (severe acute respiratory infection) cases were subtyped, and 80% of them were A (H1N1) pdm09.

In general, current influenza vaccines tend to act better against influenza A (H1N1) pdm09 and influenza virus B than against influenza A (H3N2).

Preliminary assessments of the effectiveness of the vaccine continue to support the use of vaccines. Initial data suggest that vaccines are effective, but estimates vary depending on the population surveyed and the proportions of subtypes of circulating viruses.

The data from Member States reporting to EuroMOMO show that increased mortality in persons has returned to normal.