In the WHO Eastern Mediterranean Region, influenza activity continues to increase in the month of April in many countries reporting data to FluNet and EMFLU namely, Afghanistan, Bahrain, Egypt, Iran (Islamic Republic of), Iraq, Jordan, Kuwait, Lebanon, Morocco, occupied Palestinian territory (oPt), Oman, Pakistan, Qatar, Saudi Arabia, Sudan, Syrian Arab Republic, Tunisia and United Arab Emirates.
In April 2019, the proportion of tested cases for influenza in EMR is 85% out of 6,775 enrolled cases, 16% of the tested cases is positive and 84% is negative.
Figure 1: Influenza geographic spread by type and subtypes, April 2019
Influenza activity by sub-type
• In April 2019, no new cases of human influenza A(H5N1) were reported in Egypt.
• In the northern Africa influenza transmission zone, Egypt continued reporting low influenza activity with all seasonal subtypes co-circulating. Morocco and Tunisia reported no activity.
• In the western Asia influenza transmission zone, Oman, Saudi Arabia, Qatar and Kuwait continued reporting co-circulation of influenza types A and B with influenza B virus predominating in Qatar. Jordan, Iraq, reported sporadic circulation of A(H1N1)pdm09 while Lebanon and oPt reported circulation of Influenza A(H1N1)pdm09 and A(H3N2) viruses. Syria and Sudan reported no activity.
• In southern Asia transmission zone, influenza activity continued to decrease with all seasonal influenza subtypes co-circulating in Afghanistan and Iran (Islamic Republic of); Pakistan reported no activity.
Source of transmission zones: http://www.who.int/csr/disease/swineflu/transmission_zones/en/
Circulating influenza viruses by subtype
• During April 2019, national influenza centres and influenza laboratories in the Region tested a total of 5,753 specimens for influenza viruses of which 896 tested positive (16%).
• The average percentage of positivity rates is 16%, with highest positivity rate recorded in Lebanon and Saudi Arabia.
• Of the viruses tested; 504 (57%) were influenza A viruses, including 277 (31%) influenza A(H1N1)pdm09 virus, 84 (10%) were influenza A(H3) virus and 143 (16%) were influenza A(not subtyped) virus. Influenza B (Lineage Not determined) virus accounted for 351 (39%).
Figure 3: Circulating influenza viruses in the EMR by subtype, April 2019