During the 6th week of 2019, (04.02-10.02.2019) the Republic of Macedonia registered 2246 influenza cases/flu-like diseases(I=108,6/100.000). Compared with the number of registered cases in the last week, are increased  for 80% (n=1252) and decreased for 24.2 % compared with the cases of the last season.(n=2964). (chart1)

The registered incidence this week is above the weekly limit of the seasonal activity of the influenza virus (35.1 / 100.000), according to the MEM model for determining the intensity of seasonal influenza activity (Chart 1).

During this week, 2 deaths associated with influenza have been reported, people aged 5 and 25 years from Skopje and Ohrid who were hospitalized at the Clinic for Pediatric Diseases – Skopje and KARIL-Anesthesia, Resuscitation and Intensive Care Clinic. The presence of comorbidities has been reported in the deceased.

This week, the laboratory for virology of IPH received 67 influenza test materials, of which 35 (52.2%) were positive for the influenza virus – 28 Influenza A (H1) pdm, 2 Influenza A (H3) and 5 Influenza A are non-subtyped.

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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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=1351; 60.2% cases) and the highest incidence is registered in the age group, 0-4 years. (I=217.7 /100.000).(Chart2)

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 27 reporting units. Most of the cases have been registered in Strumica (n=427), and the highest incidence is registered in Resen, I=489.2/100 000. (chart 1).

Cumulatively 4 RU registered very high and high activity. In 16 is seasonal, in 4-average, 3-very low and 4 did not register any activity. (map 1)

Image 1. Level of influenza activity according to the incidence of 100,000 inhabitants, 6 week 2019

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In the 2018/2019 season, the total number of influenza cases is 6371 (I=307.9/100.000).

Compared with the same period last season (n = 8443), there is a decrease in the total number of reported cases by 24.5%, and in relation to the model for the last 8 seasons (n ​​= 15823) a decrease of 59.7% .

Cumulatively this season, most of the cases have been reported from Strumica (n=845), Gostivar (n=812), Skopje (n=725), Tetovo (n=553) and Bitola (n=537)  (chart 3; 1)

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

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The highest cumulative incidence of 904,3/100.000 habitants was registered in Debar (n=251) and also high incidence over 700/100 000h. was registered in Kavadarci, Kratovo, Strumica (chart 3;1)

Regarding the distribution of the diseased by age groups, the cumulative number of cases was reported in the age group of 15-64 years – 4225 cases (69.7%), and the highest cumulative incidence of 522.4 / 100.000 was registered in 0-4 years. (chart  1)

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

  • October – 51 cases or 0.8%
  • November – 383 cases or 6.0%
  • December – 784 cases or 12.3%
  • January – 2907 cases or 45.6%
  • February – 2246 or 35.3%


From the beginning of the season, the laboratory for virology of IPH has received 216 samples, materials for laboratory diagnostics, of which 84 (38.9%) are positive for the presence of influenza virus, all are Influenza A: 67 (79,8%) are Influenza A(H1N1)pdm, 8 (9.5%) are Influenza A(H3), аnd 9 (10.7%) are Influenza А non-subtyped(chart 4)

Chart 4. Weekly distribution of number and percentage of Influenza positive samples 2018/2019

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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):

According to the data from the Department of E-health, from the beginning of the vaccination, and as of the closing of this report, a total of 19979 persons (71.4%)were vaccinated.

In terms of commercial vaccines, according to available data from CPH / RO, 19348 people were vaccinated. The largest number of vaccinated are over the age of 65 years – 10977 or 56.7%, aged 30-64 years – 7370 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, 14111 persons or 72.9% have a history of chronic diseases.

During the 6th  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. The majority of the vaccinated are in the age group of 30-64 years. Also, 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.


According to records presented in Flu News Europe (5th week/2019), the activity of influenza virus in Europe is the following: 54.7% 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 98.8%, and most of the viruses are subtyped as A(H3N2) and A(H1N1)pdm09