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
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
|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|
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.
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%