During the 48thweek of 2018, (26.11.2018 – 02.12.2018) the Republic of Macedonia registered 90 influenza cases/flu-like diseases(I=4.4/100.000). Compared with the number of registered cases in the last week, are increased (21.6%))and decreased for 25.6% compared with the cases of the last season.(n=121)

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=63; 70.0% cases) and the highest incidence is registered in the age group, 0-4 years. (I=12.1 /100.000).

This week the biggest number of influenza cases is registered in Strumica(n=18, I=19,0/100,000) and the highest incidence is registered in Makedonski Brod n=7 (I = 62.5/ 100.000).

Cumulatively 15 reporting units reported low activity, and only one (RO Makedonski Brod) registered seasonal activity (Map1)

Image 1. Level of influenza activity according to the incidence of 100,000 inhabitants, 48 weeks 2018

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In the 2017/2018 season, the total number of influenza cases is 434 (I=21,0/100.000).

Compared with the same period last season (n = 646), there is a decrease in the total number of reported cases by 32.8%, and in relation to the model for the last 8 seasons (n ​​= 645) a decrease of 32.7% .

Cumulatively this season, sick persons from 21 reporting units have been reported, and in 11 reporting units the number of reported infected persons is ≥10. The highest number of patients (n=84; 19,4%; I=42,1/100.000) were registered in CPH Tetovo, and the highest cumulative incidence was registered in RO Makedonski Brod (I = 142.9 / 100.000). High incidence was registered in RO Sveti Nikole (I = 136.5 / 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 – 276 cases (63.6%), and the highest cumulative incidence of 51.6 / 100.000 was registered in elderly, over 65 years.

Chart 2. Distribution of cases of seasonal influenza per CPH / RO and an incidence of 100,000 inhabitants, season 2018/2019

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Distribution of seasonal flu patients by months (Table 1 in the Appendix):

  • October – 51 cases or 11.8%
  • November – 383 cases or 88.2%

During the week 48 of 2018, the laboratory for virology of IPH has received 9 samples, materials for laboratory diagnostics, which are all negative for the presence of influenza. Since the beginning of the season 2017/2018, the laboratory received 17 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 17780 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 19143 persons (68.4%)were vaccinated.(Table 2)

In terms of commercial vaccines, according to available data from CPH / RO, 17512 people were vaccinated. The largest number of vaccinated are over the age of 65 years – 10007 or 57.1%, aged 30-64 years – 6648 or 38.0%, while at the age of 5-29 are 150 or 0.9 %. 4 children under the age of 5 were vaccinated. From the category of health workers, 708 persons or 4.0% were vaccinated. No vaccinated pregnant women. From the total number of vaccinated patients, 12757 persons or 72.8% have a history of chronic diseases. (table 3)

During the 48th week, a report on vaccine against seasonal influenza in PZU Neuromedica was received. According to the data, in the Neuromedica Clinic, 50 people were vaccinated from a total of 200 procured vaccines (25.0%). The majority of the vaccinated (42.0%) are in the age group of 30-64 years. From the total number of vaccinated patients in PHI Neuromedica, 38.0% have a history of chronic  disease.


According to records presented in Flu News Europe (47th   week/2018), the activity of influenza virus in Europe is low, and only a few countries reported sporadic detection of influenza viral infections. 2.8% 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 88.2%, and most of the viruses are subtyped as A (H1N1)pdm09, with 64.6%