During the 11th week of 2019, (18.03-24.03.2019) the Republic of Macedonia registered 975 influenza cases/flu-like diseases(I=47.1/100.000). Compared with the number of registered cases in the last week, are decreased for 38% (n=1573) and increased for 40.7 % compared with the cases of the last season.. (chart1) and compared to the average for the 12th week of the last 8 seasons, there is an increase of 2 times (Chart 1).

The incidence this week is above the weekly limit of seasonal activity of the influenza virus (Chart 1).

Over the past week, there has been 1 death associated with influenza. The deceased is a 63 years old person from Kavadarci, with the pre-chronic disease ie co-morbidity. and confirmed A (H1pdm) influenza virus.

This week, the virological laboratory of the IPH received 51 influenza testing materials, of which 23 (45.1%) were positive for the presence of the influenza virus – 10 Influenza A (H1) pdm, 7 Influenza A (H3) and 6 Influenza A is non-subtyped (Chart 5).

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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This week most of the cases have been registered in a group 15-64 years (n=619; 63.5%)and the highest incidence is registered in children 0-4 years, I=94.7/100 000. (chart 2).

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 23 reporting units. Most of the cases have been registered in Skopje (n=206)and the highest incidence is registered in Resen (I=159,0/100.000) and Kavadarci (I=151,0/100.000). (chart 1).

Image 1. Level of influenza activity according to the incidence of 100,000 inhabitants, 12 week 2019

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In the 2018/2019 season, the total number of influenza cases is 20179 (I=975.2/100.000).

Compared with the same period last season(n=23.097), 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=25.275) a decrease of 20.2% .

Cumulatively this season, most of the cases have been reported from Skopje (n=3.499; 17,3%),            Strumica (n=2.408; 11,9%), Kavadarci (n=1.816; 9%) and Gostivar (n=1.403; 7%) (chart 3; 1)

The highest cumulative incidence of 4219.9/100.000 habitants was registered in Kavadarci  and also high incidence over 1500,0/100 000h. was registered in Strumica, Debar, Sveti Nikole, Kratovo, \Resen,Prilep (chart 3;1)

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


Over the season, have been registered 23 deaths associated with influenza. 12 people from Skopje, 3 from Ohrid, 2 from Kicevo and 2 from Kavadarci, and 1 case from Delcevo, Tetovo, Resen, Valandovo.  In 18 people (78.3%), pre-chronic disease has been identified, ie co-morbidity.The age of the deceased ranges from 5-86 years.

Regarding the distribution of the diseased by age groups, the cumulative number of cases was reported in the age group of 15-64 years – 12803 cases (63.4%), and the highest cumulative incidence of 1921.8 / 100.000 was registered in 0-4 years. (chart 1)

Most of the cases are reported in February – 11076 (54.9%) and in March- 4978 (24,7%)  (chart 4; 1)

Chart 4. Distribution of cases of seasonal flu by month, season 2018/201


From the beginning of the season, the laboratory for virology of IPH has received 763 samples, materials for laboratory diagnostics, of which 410 (53.7%) are positive for the presence of influenza virus, all are Influenza A: 316 (77.0%) are Influenza A(H1N1)pdm, 47 (11.5%) are Influenza A(H3), аnd 47(11.5%) are Influenza А 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):

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 19992 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%, From the category of health workers, 801 persons were vaccinated. From the total number of vaccinated patients, 14111 persons or 72.9% have a history of chronic diseases.

According to the data a report on vaccine against seasonal influenza in (Private healthcare clinics) 50 people were vaccinated. The largest number of vaccinated are in the age group 30-64. 38.0% have a history of chronic disease.




According to records presented in Flu News Europe (11th week/2019), the activity of influenza virus in Europe is the following: 34.1% samples were confirmed as positive.(from the sentinel surveillance tests in countries reporting to the TESSy system of the ECDC).

From the beginning of the 40th week, over 90% of influenza A viruses detected by SARI (severe acute respiratory infection) cases were subtyped, and 80% of them were A (H1N1) pdm09.

In general, current influenza vaccines tend to act better against influenza A (H1N1) pdm09 and influenza virus B than against influenza A (H3N2).

Preliminary assessments of the effectiveness of the vaccine continue to support the use of vaccines. Initial data suggest that vaccines are effective, but estimates vary depending on the population surveyed and the proportions of subtypes of circulating viruses.

The data from Member States reporting to EuroMOMO show that increased mortality in persons continues to decline.

Increased mortality is noticed in the age group over 65 years and less in the age group of 15-64 years.