During the 52nd week of 2018, (24.12-30.12.2018) the Republic of 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 16.2%))and increased for 57.8 % compared with the cases of the last season.(n=128)

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=136; 66.8% cases) and the highest incidence is registered in the age group, over 65 years. (I=14.5 /100.000).

This week the biggest number of influenza cases is registered in Gostivar (n=85, I=71.0/100,000), and the highest incidence is registered in Tetovo, also. (chart 1)

Cumulatively 16 reporting units reported very low activity and two reported low(seasonal) actrivity(Image1)

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

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In the 2018/2019 season, the total number of influenza cases is 1218 (I=58.9/100.000).

Compared with the same period last season (n = 1082), there is a decrease in the total number of reported cases by 12.6%, and in relation to the model for the last 8 seasons (n ​​= 1643) a decrease of 25.9% .

Cumulatively this season, sick persons from 25 reporting units have been reported, and in 15 reporting units the number of reported infected persons is ≥10. The highest number of patients is in Gostivar (n=215; 17,7%; I=179,5/100.000), Tetovo (n=200; 16,4%; I=100,1/100.000) and Kumanovo (n=146; 12,0%; I=102,3/100.000) The highest cumulative incidence was registered in RO Makedonski brod (I = 250.1/ 100.000, n=28) and in Sveti Nikole I=229.1/100.000) (chart 2)

Chart 1. Distribution of cases of seasonal influenza per CPH / RO and the incidence of 100,000 inhabitants, season 2018/2019

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Regarding the distribution of the diseased by age groups, the cumulative number of cases was reported in the age group of 15-64 years – 831 cases (68.2%), and the highest cumulative incidence of 102.4 / 100.000 was registered in 0-4 years. (chart 3)

Chart 3. Distribution of seasonal flu / influenza-like illnesses by age group – 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 4.2%

November – 383 cases or 31.4%

December – 784 cases or 64.4%

During the week 52 of 2018, the laboratory for virology of IPH has received 6 samples, materials for laboratory diagnostics, of which onlyu one is positive for the presence of influenza virus. From the beginning of the season are received 45 samples, and two are positive(4.4%). Influenza A/H3 and Influenza A non-subtyped.

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):

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 19387 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 19896 persons (71.1%)were vaccinated.

In terms of commercial vaccines, according to available data from CPH / RO, 19306 people were vaccinated. The largest number of vaccinated are over the age of 65 years – 10943 or 56.7%, aged 30-64 years – 7362 or 38.1%, while at the age of 5-29 are 196 or 1.0 %. 4 children under the age of 5 were vaccinated. From the category of health workers, 801 persons or 4.1% were vaccinated. No vaccinated pregnant women. From the total number of vaccinated patients, 14089 persons or 72.9% have a history of chronic diseases. (table 3)

During the 50th 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. One pregnant women is vaccinated and 11 health workers. From the total number of vaccinated patients in PHI Neuromedica, 38.0% have a history of chronic  disease.

EUROPE

According to records presented in Flu News Europe (51st  week/2018), the activity of influenza virus in Europe is low. 21.8% 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 97.2%, and most of the viruses are subtyped as A(H1N1)pdm09 with 55.7%