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Influenza monthly update, March 2018

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In the WHO Eastern Mediterranean Region, influenza activity continued to decrease in the month of March in many countries reporting data to FluNet and EMFLU namely, Afghanistan, Bahrain, Egypt, Iran (Islamic Republic of), Iraq, Jordan, Kuwait, Lebanon, Morocco, Palestine, Oman, Pakistan, Qatar, Saudi Arabia, Syrian Arab Republic and Tunisia (Fig. 1).

Figure 1. Influenza geographic spread  in the Eastern Mediterranean Region, March 2018

Fig.1. Influenza geographic spread in the Eastern Mediterranean Region, March 2018

Influenza activity by subtype

In March 2018, no new cases of human influenza A(H5N1) were reported in Egypt.

In the northern Africa influenza transmission zone, Morocco, Tunisia and Egypt reported co-circulation of influenza A(H1N1)pdm09, A(H3N2) and influenza B.

In the western Asia influenza transmission zone, influenza A(H1N1)pdm09 was detected with A(H3N2) and influenza B virus in Bahrain, Kuwait, Lebanon, Oman, Qatar and Saudi Arabia. Jordan reported A(H3N2) and influenza B; Iraq reported circulation of A(H1N1)pdm09; while Palestine reported circulation of influenza A(H1N1)pdm09 and influenza B virus.

In the southern Asia transmission zone, Afghanistan reported circulation of A(H1N1)pdm09 and influenza B; while Iran (Islamic Republic of) and Pakistan reported co-circulation of all seasonal influenza viruses.

Fig. 2 shows the weekly distribution of influenza subtypes.

Source of transmission zones

Figure 2. Positive cases of influenza by subtype, Epi week 12/2017–2018

Fig. 2. Positive cases of influenza by subtype

Circulating influenza viruses by subtype

During March 2018, national influenza centres and influenza laboratories in the Region tested a total of 9357 specimens for influenza viruses, of which 2314 tested positive (25%).

The average percentage of positivity rates is 25%, with the highest positivity rate recorded in Bahrain, Egypt, Lebanon, Palestine and Tunisia.

Of the viruses tested, 1031 (45%) were influenza A viruses, including 749 (32%) influenza A(H1N1)pdm09 virus and 242 (11%) influenza A(H3N2) virus. Influenza B virus accounted for 1282 (55%), including 1231 (53%) influenza B (lineage not determined) and 51 (2%) B (Yamagata lineage) (Fig. 3).

Figure 3. Circulating influenza viruses in the Eastern Mediterranean Region by subtype, Epi week 9-12, 2018

Fig. 3. Circulating influenza viruses in the Eastern Mediterranean Region by subtype

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Influenza monthly update, March 2018

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