Influenza monthly update: February 2023 – Epidemiological weeks: 5-8, 2023

Country Somalia Egypt Libya Morocco Sudan Tunisia 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 2417 18365 399 1385 327 2278 2858 71023 13861 16013 2874 3215 1448 1532 5745 21662 14702 612 9399 140 190255 Number of tested cases (%) 2388 (99) 18365 (100) 384 (96) 1385 (100) 318 (97) 2278 (100) 2858 (100) 71023 (100) 13620 (98) 15967 (100) 2874 (100) 3215 (100) 1424 (98) 1532 (100) 5711 (99) 21662 (100) 13209 (90) 151 (25) 8038 (86) 105 (75) 186507 (98) Numbr of positive cases (%) 127 (5) 2135 (12) 141 (37) 397 (29) 4 (1) 584 (26) 279 (10) 11442 (16) 1691 (12) 2897 (18) 624 (22) 170 (5) 141 (10) 458 (30) 964 (17) 6462 (30) 1637 (12) 28 (19) 1420 (18) 0 (0) 31601 (17) A (H1N1)pdm09 2 (0) 542 (3) 0 (0) 101 (7) 0 (0) 264 (12) 211 (7) 997 (1) 1067 (8) 293 (2) 327 (11) 114 (4) 46 (3) 292 (19) 118 (2) 1977 (9) 279 (2) 28 (19) 365 (5) 0 (0) 7023 (4) 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) 0 (0) 0 (0) A (not subtyped) 16 (1) 0 (0) 114 (30) 54 (4) 3 (1) 0 (0) 0 (0) 4305 (6) 0 (0) 234 (1) 0 (0) 0 (0) 7 (0) 144 (9) 192 (3) 1590 (7) 392 (3) 0 (0) 0 (0) 0 (0) 7051 (4) Number of flu B cases (%) 107 (4) 218 (1) 27 (7) 215 (16) 1 (0) 183 (8) 56 (2) 1254 (2) 485 (4) 480 (3) 274 (10) 19 (1) 2 (0) 19 (1) 366 (6) 1794 (8) 943 (7) 0 (0) 361 (4) 0 (0) 6804 (4) A (H3) 2 (0) 1375 (7) 0 (0) 27 (2) 0 (0) 137 (6) 12 (0) 4886 (7) 139 (1) 1890 (12) 23 (1) 37 (1) 86 (6) 3 (0) 288 (5) 1101 (5) 23 (0) 0 (0) 694 (9) 0 (0) 10723 (6) 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 2023 Document number: WHO-EM/CSR/649/E Fig 2. Proportion of influenza types and subtypes/ lineages, EMR, February 2023 Key highlights In February 2023, 19 out of 21 countries with a functional influenza sentinel surveillance system in 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, Morocco, Oman, Pakistan, Qatar, Saudi Arabia, Somalia, Sudan, Syrian Arab Republic, Tunisia, United Arab Emirates and Yemen). The number of influenza positive cases has stabilized in the past 4 weeks after a steady decline for the greater part of the current influenza season. A similar trend is also evident for the influenza positivity rate, which is currently steady at 10% (Figure 1). In the current analytical period (epidemiological week 27, 2022 to week 8, 2023), there was a 16% increase in the number of cases enrolled (190 255 cases) compared to the previous reporting period (163 794 cases). Out of the 190 255 cases enrolled in the current reporting period, 186 507 (98%) were tested and, out of those, 31 601 (17%) were influenza positive (Table). Influenza positivity rate in the Region has consistently decreased over the past 4 months. During February 2023, 22 826 cases were enrolled, of which 21 264 specimens were tested for influenza (93%), of which 2192 specimens (10%) were positive (Figure 1). Influenza positivity rates varied across countries; from 3% in Egypt to 31% in Qatar, based on 200 or more specimens tested over the reporting month. Influenza type A remains the dominant circulating type of influenza in the EMR (63%). Of the total specimens that tested positive for influenza (2192) in February 2023, 603 (28%) were influenza B (lineage not determined), 496 (23%) were A(H3), 465 (21%) were influenza A (not sub-typed), 409 were influenza type A (H1N1) pdm09, and 219 (10%) were influenza B (Victoria lineage) (Figure 2). INFLUENZA MONTHLY UPDATE February 2023 - Epidemiological weeks: 5–8, 2023 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 8, 2023 Table. Reported cumulative cases by country in the Region during the analytical period week 27, 2022 to week 8, 2023Map. Influenza positivity rate and detected influenza types and subtypes by country, EMR, February 2023 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 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 % 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 0 500 1000 1500 2000 2500 3000 3500 2018/2019 2019/2020 2020/2021 2021/2022 2022/2023 23% 27% 19% 10% 21% For any queries about this bulletin, please contact: emrgoihp@who.int W 27 W 30 W 33 W 36 W 39 W 42 W 45 W 48 W 51 W 02 W 05 W 08 W 11 W 14 W 17 W 20 W 23 W 26 W 29 W 32 W 35 W 38 W 41 W 44 W 47 W 50 W 01 W 04 W 07 W 10 W 13 W 16 W 19 W 22 W 25 W 28 W 31 W 34 W 37 W 40 W 43 W 46 W 49 W 52 W 02 W 05 W 08 W 11 W 14 W 17 W 20 W 23 W 26 W 29 W 32 W 35 W 38 W 41 W 44 W 47 W 50 W 01 W 04 W 07 W 10 W 13 W 16 W 19 W 22 W 25 W 28 W 31 W 34 W 37 W 40 W 43 W 46 W 49 W 52 W 03 W 06