During the 6th  week of 2020 (from 03.02–09.02.2020), 3614 (I = 174.6/ 100,000) cases of influenza / flu-like illnesses were reported in the Republic of North Macedonia.

Compared to the number of reported cases registered this week to the 6th week of last season (n = 2246) is increased by 60.9% and compared to the 6th week of the typical epidemic curve (modeled from the last 9 seasons) ( n = 3190) is registered an increase of 13.3% (Chart 1).
The reported incidence is over the weekly limit of seasonal activity (average) of the influenza virus (I = 161.2 / 100,000).

This week, 108 materials were available for laboratory testing of influenza in the IPH laboratory for virology. From the tested materials, 69 (63.9%) were positive for the presence of influenza virus – 35 were detected type A (16 A / H1pdm, 17 A / H3 and 2 non typed) and 34 were influenza type B (23 Victoria). and 11 Underemined line ).

Chart 1. Intensity levels and weekly distribution of influenza / influenza-like illness by expected epidemic curve 2010-2019, season 2018/2019 and 2019/2020

grip 6 .1

Regarding the distribution of the diseases by age groups, the highest number of cases was reported in the age group that covers the largest part of the population (15-64 years) – 1557 cases (43.1%) and the highest incidence (593.2 / 100,000) is registered in children aged 5-14. (chart 2)

Chart 2. Weekly distribution of seasonal influenza / influenza-like illnesses by age groups – incidence per 100,000 population, 2019/2020 season

grip 6.2


This week, 27 reporting units reported cases. Most of the cases were reported from Skopje (n = 739). The highest weekly incidence (I = 1010.8 / 100,000) is registered in Kavadarci, with 435 cases.

6 reporting units reported very low activity during this week, 12 reported seasonal (low), 4– high and 5 – Debar, Kavadarci, Srtumica, Sveti nikole r,Stip registered very high activity of the influenza virus ( Chart 1).

Chart 1. Level of influenza activity according to the incidence of 100,000 inhabitants, 6 weeks 2020

grip 6.3

Cumulative data

In the 2019/2020 season, the total number of influenza cases was 10757 (I = 519.9 / 100,000).

Compared to the same period last season (n = 6468), there is a increase in the total number of reported cases by 66.3%, while compared to the model for the last 9 seasons (n ​​= 13051) there is a increase of 17.6% .

Cumulatively this season, from cases have been reported from 30 reporting units,

The highest number of infected persons  are registered in Strumica (n = 1793), Kavadarci (n=948), Gostivar (n = 938) and Skopje (n = 1953) (chart 3)

The highest cumulative incidence (I = 2316.7 / 100,000) were registered in Debar, with 643 cases.
Cumulative incidence of over 500.0 / 100,000 inhabitants is registered in Sveti Nikole, Kavadarci, Kratovo, Strumica, Gostivar,Stip and Radovis (chart 3).

Chart 3. Distribution of cases of seasonal influenza by CPH / RO and incidence per 100,000 population, season 2019/2020

grip 6.4


Regarding the distribution of the diseases by age groups, the highest number of cases was reported in the age group that covers the largest part of the population (15-64 years) – 5673 cases (52.7%) and the highest incidence (1269.4 / 100,000) is registered in children aged 5-14. (chart 4)

Chart 4. Distribution of seasonal influenza cases by age group, season 2019/2020

 grip 6.5

The distribution of cases of seasonal influenza / flu-like illnesses by months is given in Chart 5. The highest number (6315) and percentage (58.7%) of the cases were registered in January.

Chart 5. Distribution of cases of seasonal influenza by reporting month, season 2019/2020

 grip 6.6

Since the start of the 2019/2020 season, a total of 391 materials from health facilities – from outpatient and hospital treated patients to regular and sentinel surveillance – have been received at the IPH Laboratory for Virology, of which 178 (45.5%) are positive of the influenza virus (chart 6).From the positive, 104 (58.4%) are Influenza A, while 74 (41.6%) are Influenza B. According to the Influenza A subtype, 59 (56.7%) were A / H1pdm, 34 (32.7%) A / H3, and 11 were non-subtyped. According to Influenza B line, 55 (74.3%) are B / Victoria and 19 are indefinite.

Chart 6. Weekly and cumulative distribution of number and percentage of positive samples of influenza 2019/2020

grip 6.7

grip 6.8



Vaccination against seasonal influenza is the most effective protection against this disease, which is why the Institute of Public Health recommends vaccination of the whole population, especially for people who are part of the so-called “influenza.” risk groups (according to WHO recommendations):

Elderly people (over 65 years)•       Pregnant women• • Health workers • Children aged 6-59 months.

According to data from the EHS, since the start of the vaccination on 15.11.2018, and as of the close of this report, a total of 28630 people from the at-risk population have been vaccinated. .

Regarding to commercial vaccines, as of 19/01/2020, and according to available data from the PH / RO reports, 14,627 persons have been vaccinated. Most of those vaccinated are over 65 years of age – 7,262 or 49.6%, 30-64 years old – 6,487 or 44.3%, while aged 5-29 are 461 or 3.2 %. 10 children younger than 5 years of age are vaccinated. From the category of health care workers, 404 persons or 2.8% were vaccinated. Three pregnant women have been vaccinated. From the total number of vaccinated, 7,891 (53.9%) have a history of chronic illness. Most of the remaining commercial vaccines are redistributed, and will be given free of charge, to the at-risk population categories listed above, which will be reported on a monthly basis.



According to a report by Flu News Europe released in week 5 of 2020, influenza virus activity is increasing.

In the reporting countries, 4 country reported very high, 5 high and most countries reporting widespread activity.

Detection of influenza virus in sentinel system samples is above 10% by week 47 of 2019. In most countries, the Influenza A virus is predominant, although there are countries dominated by Influenza B or co-circulation of both viruses.

During the 5th week, the percentage of positive sentinel surveillance patients was 54.1%. Since the beginning of the season sentinel surveillance, 32.9% of tested positive for the presence of influenza viruses. Of these, 68.9% are Influenza A and 31.1% are Influenza B. Among Influenza A viruses, co-circulate A (H1N1) pdm09 and A (H3N2), and among Influenza B, the Victoria line dominates.