During the 46thweek of 2018, (12.12018 – 18.11.2018) the Republic of Macedonia registered 87 influenza cases/flu-like diseases(I=4.2/100.000). Compared with the number of registered cases in the last week, are increased (3.6%))and increased for 29.9% compared with the cases of the last season.(n=67)

Chart 1. Distribution of cases of seasonal influenza by week, typical epidemic curve of the seasons 2010-2018, 2017/2018 and 2018/2019

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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 (n=53; 60,9% cases) and the highest incidence is registered in the age group, 0-4 years. (I=6.9 /100.000).

This week the biggest number of influenza cases is registered in Kumanovo, n= 21 and Tetovo (n=13)

In the 2017/2018 season, the total number of influenza cases is 270 (I = 13.0 / 100.000).

Compared with the same period last season (n = 367), there is a decrease in the total number of reported cases by 26.4%, and in relation to the model for the last 8 seasons (n ​​= 438) a decrease of 38.3% .

Cumulatively this season, sick persons from 19 reporting units have been reported, and in 7 reporting units the number of reported infected persons is ≥10. The highest number of patients (n = 66; 24.4%,  I = 46.3 / 100.000) were registered in CPH Kumanovo, and the highest cumulative incidence was registered in RO Sveti Nikole (I = 68.3 / 100.000).

Regarding the distribution of the diseased by age groups, the cumulative number of cases was reported in the age group of 15-64 years – 166 cases (61.5%), and the highest cumulative incidence of 31.0 / 100.000 was registered in the youngest, children 0-4 years old

 

During the week 46 of 2018, the laboratory for virology of IPH has no received samples, materials for laboratory diagnostics. Since the beginning of the season 2017/2018, the laboratory received 6 materials which were negative for the presence of influenza virus.

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):

  • Pregnant women at any stage of pregnancy
  • children aged 6 months to 5 years
  • elderly people aged 65 years and over,
  • People with chronic diseases and conditions of weaken immunity
  • Health workers.

For the first time, since this season of influenza, Macedonia launched a free influenza vaccination for a particular category of population. For that purpose, the Ministry of Health has purchased 28,000 doses for people over 65 years of age with an average, under-average pension or no income. Additional 18,167 doses were procured by the Public Health Centers as commercial vaccines for the rest of the population.

Vaccination with free and commercial influenza vaccines is carried out by CPH / RO, as well as the previous seasons, and for the first time this season, the appointment for free vaccines is through a family doctor in the My Term system.

According to the data from the Department of E-health, from the beginning of the vaccination on 05.11.2018, and as of the closing of this report, a total of 15654 persons (55.9%)were vaccinated.

Table 1. Vaccinated persons with a free vaccine, by CPH / RO, R. of Macedonia, season 2018/2019

 

CPH/RO Week1 Week2 Week3 Total
CENTRE OF PUBLIC HEALTH BITOLA 1062 822 7 1891
Seasonal Flu Vaccine Service  – RO Demir Hisar 51 56 0 107
Seasonal Flu Vaccine Service  – RO Kicevo 292 211 0 503
Seasonal Flu Vaccine Service – RO Resen 202 25 4 231
Seasonal Flu Vaccine Service – CHP Bitola 517 530 3 1050
CENTRE OF PUBLIC HEALTH VELES 1738 548 0 2286
Seasonal Flu Vaccine Service  – RO Gevgelija 382 48 0 430
Seasonal Flu Vaccine Service – RO Kavadarci 377 138 0 515
Seasonal Flu Vaccine Service – RO Negotino 294 0 0 294
Seasonal Flu Vaccine Service – RO Nikole 278 0 0 278
Seasonal Flu Vaccine Service – CPH Veles 407 362 0 769
CENTRE OF PUBLIC HEALTH KOCANI 1334 455 0 1789
Seasonal Flu Vaccine Service – RO Berovo 112 111 0 223
Seasonal Flu Vaccine Service  – RO Vinica 362 0 0 362
Seasonal Flu Vaccine Service  -RO Delchevo 374 33 0 407
Seasonal Flu Vaccine Service  – RO Pehcevo 97 13 0 110
Seasonal Flu Vaccine Service – RO Kochani 389 298 0 687
CENTRE OF PUBLIC HEALTH KUMANOVO 584 358 33 975
Seasonal Flu Vaccination Service – RO Kratovo 62 0 0 62
Seasonal Flu Vaccine Service  – RO Kriva Palanka 202 20 0 222
Seasonal Flu Vaccine Service  – CPH Kumanovo 320 338 33 691
CENTRE OF PUBLIC HEALTH OHRID 824 582 56 1462
Seasonal Flu Vaccine Service – RO Debar 250 0 0 250
Seasonal Flu Vaccination Service – RO Struga 276 284 21 581
Seasonal Flu Vaccination Service – CPH Ohrid 298 298 35 631
CENTRE OF PUBLIC HEALTH PRILEP 628 663 226 1517
Seasonal Flu Vaccine Service  – RO Krushevo 58 58 0 116
Seasonal Flu Vaccine Service  – RO Makedonski Brod 52 55 0 107
Seasonal Flu Vaccination Service CPH Prilep Team 1 353 347 226 926
Seasonal Flu Vaccination Service CPH Prilep Team 2 165 203 0 368
CENTRE OF PUBLIC HEALTH SKOPJE 1080 878 8 1966
Seasonal Flu Vaccine Service  – CPH Skopje n.1 559 445 0 1004
Seasonal Flu Vaccine Service  – CPH Skopje n.2 521 433 8 962
CENTRE OF PUBLIC HEALTH STRUMICA 389 325 231 945
Seasonal Flu Vaccination Service – RO Valandovo 105 38 0 143
Seasonal flu vaccination service – CPH Strumica 284 287 231 802
CENTRE OF PUBLIC HEALTH TETOVO 636 656 302 1594
Seasonal Flu Vaccination Service – RO Gostivar 283 294 57 634
Seasonal Flu Vaccine Service – CPH Tetovo 353 362 245 960
CENTRE OF PUBLIC HEALTH SHTIP 818 358 53 1229
Seasonal Flu Vaccine Service  – RO Probistip 118 3 0 121
Seasonal Flu Vaccine Service  – RO Radovis 351 11 0 362
Seasonal Flu Vaccine Service  – CPH Shtip 349 344 53 561
TOTAL 9093 5645 916 15654

In terms of commercial vaccines, according to available data from CPH / RO, 16073 people were vaccinated. The largest number of vaccinated are over the age of 65 years – 9111 or 56.7%, aged 30-64 years – 6134 or 38.2%, while at the age of 5-29 are 137 or 0.9 %. 4 children under the age of 5 were vaccinated. From the category of health workers, 687 persons or 4.3% were vaccinated. No vaccinated pregnant women. From the total number of vaccinated patients, 11688 persons or 72.7% have a history of chronic diseases.

Of the total number of reporting units (31), two – CPH Skopje and RO Negotino did not submit a vaccination report in week 46, while two reporting units – Delcevo and Sveti Nikole have not sent a report at all for purchased and spent commercial vaccines from the beginning of the vaccination.

During the 46th week, a report on vaccine against seasonal influenza in PZU Neuromedica was received. According to the data, in the Neuromedica Clinic, 35 people were vaccinated from a total of 200 procured vaccines (17.5%). The majority of the vaccinated (42.9%) are in the age group of 30-64 years. From the total number of vaccinated patients in PHI Neuromedica, 40.0% have a history of chronic  disease.

EUROPE

According to records presented in Flu News Europe (45th   week/2018), the activity of influenza virus in Europe is low, and only a few countries reported sporadic detection of influenza viral infections. 1% 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 85%, and most of the viruses are subtyped as A (H1N1)pdm09, with 64.3%