Influenza monthly update: September 2022 – Epidemiological weeks: 35–39, 2022

W 27 W 29 W 31 W 33 W 35 W 37 W 39 W 41 W 43 W 45 W 47 W 49 W 51 W 01 W 03 W 05 W 07 W 09 W 11 W 13 W 15 W 17 W 19 W 21 W 23 W 25 W 27 W 29 W 31 W 33 W 35 W 37 W 39 W 41 W 43 W 45 W 47 W 49 W 51 W 01 W 03 W 05 W 07 W 09 W 11 W 13 W 15 W 17 W 19 W 21 W 23 W 25 W 27 W 29 W 31 W 33 W 35 W 37 W 39 W 41 W 43 W 45 W 47 W 49 W 51 W 53 W 02 W 04 W 06 W 08 W 10 W 12 W 14 W 16 W 18 W 20 W 22 W 24 W 26 W 28 W 30 W 32 W 34 W 36 W 38 W 40 W 42 W 44 W 46 W 48 W 50 W 52 W 02 W 04 W 06 W 08 W 10 W 12 W 14 W 16 W 18 W 20 W 22 W 24 W 26 W 28 W 30 W 32 W 34 W 36 W 38 2022/2023 Country Somalia Egypt Libya Sudan Afghanistan Iran (Islamic Republic of) Pakistan Bahrain Iraq Jordan Lebanon occupied Palestinian territory Oman Qatar Saudi Arabia Syrian Arab Republic United Arab Emirates Yemen Transmission zone Eastern Africa Northern Africa Southern Asia Western Asia Total Number of enrolled cases 905 3530 59 170 449 3929 3209 10997 366 1015 576 25 1356 4795 2404 150 2012 15 35962 Number of tested cases (%) 853 (94) 3530 (100) 59 (100) 170 (100) 449 (100) 3929 (100) 3209 (100) 10987 (100) 366 (100) 1015 (100) 569 (99) 25 (100) 1347 (99) 4795 (100) 2103 (87) 150 (100) 2012 (100) 15 (100) 35583 (99) Numbr of positive cases (%) 60 (7) 144 (4) 6 (10) 2 (1) 1 (0) 119 (3) 197 (6) 1834 (17) 1 (0) 3 (0) 93 (16) 0 (0) 193 (14) 789 (16) 191 (9) 0 (0) 176 (9) 0 (0) 3809 (11) A (H1N1)pdm09 0 (0) 4 (0) 0 (0) 0 (0) 1 (0) 63 (2) 0 (0) 93 (1) 1 (0) 0 (0) 93 (16) 0 (0) 12 (1) 124 (3) 4 (0) 0 (0) 43 (2) 0 (0) 438 (1) A (H5) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) A (not subtyped) 0 (0) 0 (0) 2 (3) 2 (1) 0 (0) 21 (1) 0 (0) 161 (1) 0 (0) 0 (0) 0 (0) 0 (0) 36 (3) 215 (4) 21 (1) 0 (0) 0 (0) 0 (0) 458 (1) Number of flu B cases (%) 60 (7) 81 (2) 4 (7) 0 (0) 0 (0) 2 (0) 148 (5) 229 (2) 0 (0) 0 (0) 0 (0) 0 (0) 128 (10) 208 (4) 164 (8) 0 (0) 50 (2) 0 (0) 1074 (3) A (H3) 0 (0) 59 (2) 0 (0) 0 (0) 0 (0) 33 (1) 49 (2) 1351 (12) 0 (0) 3 (0) 0 (0) 0 (0) 17 (1) 242 (5) 2 (0) 0 (0) 83 (4) 0 (0) 1839 (5) Flu A (%) Published by the WHO Regional Office for the Eastern Mediterranean in Cairo, Egypt. The information in this document is gathered from the Region’s ministries of health. For more information, please contact: emrgohspoutbreak@who.int World Health Organization Regional Office for the Eastern Mediterranean Monazamet El Seha El Alamia Str,Extension of Abdel Razak El Sanhouri Street P.O. Box 7608, Nasr City Cairo 11371, Egypt www.emro.who.int © World Health Organization 2022 Document number: WHO-EM/CSR/563/E Fig 2. Proportion of influenza types and subtypes/ lineages, EMR, September 2022 Key highlights In September 2022, 16 of 22 countries of the WHO Eastern Mediterranean Region (EMR) reported influenza data to FluNet and/or EMFLU (Afghanistan, Bahrain, Egypt, Islamic Republic of Iran, Iraq, Jordan, Lebanon, Libya, Oman, Pakistan, Qatar, Saudi Arabia, Somalia, Sudan, United Arab Emirates and Yemen) (Table). Overall, there was an increased activity in the influenza season of 2021–2022, as compared to the previous two seasons at the height of the COVID-19 pandemic, which witnessed substantially lower influenza activities (Fig 1). Compared to the previous months, there was an increase in influenza activity observed in the Region in September, ahead of the influenza season, which typically starts from October. In the current analytical period (epidemiological week 27 to week 39, 2022), based on influenza data from 18 countries, a total of 35 962 cases were enrolled, of which 35 583 (99%) were tested and, out of those, 3809 (11%) were influenza positive (Table). Influenza positivity rate in the Region has been steadily increasing over the past three months; from 9% in July to 11% in August and to 12% in September 2022. Out of the 15 368 enrolled cases in the Region during September 2022, 15 176 specimens (99%) were tested for influenza, of which 1769 specimens tested positive (12%). Of the 1769 influenza-positive specimens in September 2022, 645 specimens (37%) were influenza A (H3), 371 specimens (21%) were influenza A (H1N1) pdm09, 322 (18%) were influenza B (lineage not determined), 268 (15%) were influenza B (Victoria lineage) and 163 cases (9%) were influenza A (not subtyped) (Fig. 2)." INFLUENZA MONTHLY UPDATE September 2022 - Epidemiological weeks: 35–39, 2022 Fig 1. Number of specimens by influenza virus subtypes/lineages and percentage of specimens testing positive for influenza viruses in the Region from week 27, 2018 to week 39, 2022 Table. Reported cumulative cases by country in the Region during the analytical period week 27 to week 39, 2022Map. Influenza positivity rate and detected influenza types and subtypes by country, EMR, September 2022 Source of data: FluNet and EMFLU Afghanistan Pakistan Islamic Republic of Iran Iraq Syrian Arab RepublicLebanon Jordan Egypt Libya Tunisia Morocco Sudan Occupied Palestinian territory Kuwait Qatar Saudi Arabia United Arab Emirates Oman Yemen Somalia Djibouti Bahrain 37% 21% 18% 15% 9% A (H1N1) pdm09 A (H3) A (H5) A (not subtyped) B (Yamagata lineage) B (Victoria lineage) B (lineage not determined) % of positive specimens A (H1N1) pdm09 A (H3) A (not subtyped) B (Victoria lineage) B (lineage not determined) 0 5 10 15 20 25 30 35 40 45 0 500 1000 1500 2000 2500 % o f po si ti ve s pe ci m en s N um be r of s pe ci m en s Analytical period . . . . . . 2018/2019 2019/2020 2020/2021 2021/2022