Eastern Mediterranean Regional (EMR) respiratory virus activity – weekly update: week 25/2025

KEY HIGHLIGHTS The WHO Eastern Mediterranean Region (EMR) continues to monitor influenza and SARS-CoV-2 trends through data reported to FluNet and EMFLU 2.0. In week 25/2025 of the 2024-2025 influenza season 15 out of 22 member states and territory in the EMR reported influenza data to FluNet and/or EMFLU. This bulletin provides an analysis of the current season’s data (2024-2025) compared to same period in the previous season (2023-2024), highlighting key epidemiological trends and observations. Kuwait re-activated the sentinel influenza and ORVs surveillance and started continuously reporting to the regional platform since week 40, 2024. REGIONAL SARS-COV-2 TRENDS (Figure 1) Influenza proportion positive in week 25/2025 of the 2024-2025 influenza season have a weekly mean positivity of 3%, compared to 5.9% in the previous week which is lower. SARS-CoV-2 activity with a weekly mean positivity rate of 8.4%. In the last season same period, influenza virus circulation was predominant with SARS-CoV-2 positive proportions being at very low levels. However, the current season SARS-CoV-2 is predominant. REGIONAL INFLUENZA TRENDS (Figure 2, Figure 3, and Map) There are variations in influenza activity across countries in the region, reflecting different epidemiological patterns. Circulating Viruses: of the influenza viruses detected in week 25/2025 of the 2024-2025 influenza season in the Region, influenza type A viruses (59%) were predominant compared with influenza type B viruses (41%). In the current week, influenza types A and B are circulating in all countries reporting positive influenza except for Oman, were only influenza type A is circulating and Afghanistan were only type B is circulating. EASTERN MEDITERRANEAN REGIONAL (EMR) RESPIRATORY VIRUS ACTIVITY - WEEKLY UPDATE Figure 1. Influenza and SARS-CoV-2 tested specimens and percent positivity in the Region from week 27, 2021 to week 25, 2025 Figure 2. Number of specimens by influenza virus subtypes/lineages and percentage of specimens testing positive for influenza viruses in the Region from week 27, 2021 to week 25, 2025 . . . . . . . . . . COUNTRY-SPECIFIC TRENDS (Figure 4) Iraq, Lebanon, Morocco, KSA, Somalia, Syria, Tunisia, UAE, Yemen: These countries reported comparable influenza positivity trends in 2024-2025 season compared to the same period in the 2023-2024 season. . Week 25/2025 Comparable Trends: Oman :This country reported decreasing and/or lower influenza positivity trends in 2024-2025 season compared to the same period in the 2023-2024 season. Decreasing and/or lower trends: Afghanistan, Bahrain, Egypt, Iran : These countries reported a positive trend in 2024-2025 season compared to the same period in the 2023-2024 season. . Increasing and/or higher trends: . 0 10 20 30 40 50 60 70 80 90 100 0 5000 10000 15000 20000 25000 30000 35000 W 2 7 W 3 2 W 3 7 W 4 2 W 4 7 W 5 2 W 0 5 W 1 0 W 1 5 W 2 0 W 2 5 W 3 0 W 3 5 W 4 0 W 4 5 W 5 0 W 0 3 W 0 8 W 1 3 W 1 8 W 2 3 W 2 8 W 3 3 W 3 8 W 4 3 W 4 8 W 0 1 W 0 6 W 1 1 W 1 6 W 2 1 W 2 6 W 3 1 W 3 6 W 4 1 W 4 6 W 5 1 W 0 4 W 0 9 W 1 4 W 1 9 W 2 4 2021-2022 2022-2023 2023-2024 2024-2025 % p o si ti ve Sp e ci m e n t e st e d Specimen tested for influenza Specimen tested for SARS-COV2 % influenza positive % COVID-19 positve 0 10 20 30 40 50 60 70 80 90 100 0 500 1000 1500 2000 2500 3000 3500 4000 W 27 W 32 W 37 W 42 W 47 W 52 W 05 W 10 W 15 W 20 W 25 W 30 W 35 W 40 W 45 W 50 W 03 W 08 W 13 W 18 W 23 W 28 W 33 W 38 W 43 W 48 W 01 W 06 W 11 W 16 W 21 W 26 W 31 W 36 W 41 W 46 W 51 W 04 W 09 W 14 W 19 W 24 2021-2022 2022-2023 2023-2024 2024-2025 % p os iti ve Nu m be r o f s pe cim en s Seasons A (H1N1) pdm09 A (H3) A (not subtyped) B (lineage not determined) B (Yamagata lineage) B (Victoria lineage) % influenza positive Figure 4. Percent positivity trends among EMR member states for two seasons: from week 27, 2023 till week 26, 2024 and from week 27, 2024 till week 25, 2025 Map. Influenza positivity rate by country, EMR, week 25,2025 Figure 3. Percentage of influenza virus types and subtypes by country, week 25, 2025 Afghanistan Pakistan Islamic Republic of IranIraq Syrian Arab Republic Lebanon Jordan Egypt Libya Tunisia Morocco Sudan Occupied Palestinian territory Kuwait Qatar Saudi Arabia United Arab Emirates Oman Yemen Somalia Djibouti Bahrain Season 2023/2024 Season 2024/2025 *Kuwait: re-activation of sentinel influenza and ORVs surveillance in week 40, 2024 **Sudan: disruption of surveillance system in 2023-2024 season due to emergency conflicts ***oPt: delay in reporting for current season 2024-2025 due to emergency conflicts Afghanistan Bahrain Egypt Iran (Islamic Republic of) Iraq Jordan Kuwait* Lebanon Libya Morocco occupied Palestinian territory*** Oman Pakistan Qatar Saudi Arabia Somalia Sudan** Syrian Arab Republic Tunisia United Arab Emirates Yemen 0 10 20 30 40 50 60 70 80 90 100 Afghanistan Bahrain Egypt Iran (Islamic Republic of) Iraq Kuwait Lebanon Morocco Oman Saudi Arabia Somalia Syrian Arab Republic Tunisia United Arab Emirates Yemen % p os iti ve A (H1N1) pdm09% A (H3)% A (not subtyped)% Flu B% 0 10 20 30 40 50 60 70 80 90 100 0 20 40 60 80 100 0 20 40 60 80 100 0 20 40 60 80 100 0 20 40 60 80 100 0 20 40 60 80 100 0 20 40 60 80 100 0 20 40 60 80 100 0 20 40 60 80 100 0 20 40 60 80 100 0 20 40 60 80 100 0 20 40 60 80 100 0 20 40 60 80 100 0 20 40 60 80 100 0 20 40 60 80 100 0 20 40 60 80 100 0 20 40 60 80 100 0 20 40 60 80 100 0 20 40 60 80 100 -20 0 20 40 60 80 100 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 2025 Regional and Global WHO platforms for Influenza: EMFLU is a regional WHO platform that facilitates sharing of epidemiological and virological data on influenza from EMR countries to EMRO. Since its launch in 2016, the platform has been used at national and regional levels to monitor trends of circulating influenza viruses. Following the COVID-19 pandemic, WHO global and regional guidance has advocated for the integration of SARS-CoV-2 and other respiratory viruses (ORVs) with epidemic and pandemic potential into the influenza sentinel surveillance system, a well-established system in the Region. To support this, EMRO upgraded the regional platform to EMFLU 2.0, which now includes advanced data capturing functionalities for multi-pathogen surveillance. This upgrade strengthened the Region’s integrated surveillance efforts. RespiMart, developed from FluMart, is a global platform to facilitate exchange, harmonization, consolidation and storage of surveillance data for respiratory viruses with epidemic and pandemic potential, including influenza, respiratory syncytial virus (RSV) and SARS-CoV-2. It provides one single platform for sharing aggregated and case-based data from different applications and/or data sources and allows for integrated analysis and reporting. Alongside the regional platform, countries’ NICs are encouraged to maintain reporting to FluNet for both sentinel and non-sentinel data. The ongoing synchronization between EMFLU and RespiMart platforms ensures timely data complementarity and streamlined reporting. WHO support to EMR countries: WHO/EMRO has made significant progress in strengthening the sustainability of influenza surveillance systems across the region. These efforts have enhanced national core capacities to detect and respond to influenza and other respiratory pathogens with epidemic and pandemic potential, such as SARS-CoV-2, MERS-CoV, H5N1, and others. This support yielded the following current regional status: 21 out of 22 countries have existing influenza surveillance systems, National Influenza Centers/National Influenza Labs, and capacity to conduct genomic sequencing 21 countries in the region share viruses through their NICs and influenza labs to WHO Collaborating Centers that feed into GISRS 18 countries report influenza data to WHO global and/or regional platforms (FluNet/EMFLU) 12 countries in EMR benefit from PIP Partnership Contribution, with Pakistan and Tunisia selected to benefit from outputs 1 and 4 under HLIP III 2024-2030 14 countries have national seasonal influenza vaccination policy 3 newly PIVI supported countries (Jordan, Lebanon, Egypt) and 2 countries have previous direct support from PIVI (Morocco and Tunisia) . . . . . . SUPPLEMENTAL INFORMATION Document number: WHO-EM/CSR/828/E Last update: 29 June 2025 Source of data: FluNet and EMFLU