Influenza monthly update: August 2023 – Epidemiological weeks: 31-35, 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 4340 31456 286 1913 383 3072 4261 108940 17147 19279 4275 5130 2581 3084 8927 32493 31968 790 25798 186 306309 Number of tested cases (%) 4192 (97) 31456 (100) 286 (100) 1883 (98) 379 (99) 3072 (100) 4259 (100) 108940 (100) 16904 (99) 19267 (100) 4275 (100) 5130 (100) 2557 (99) 3084 (100) 8890 (100) 32493 (100) 29755 (93) 314 (40) 24436 (95) 166 (89) 301738 (99) Numbr of positive cases (%) 265 (6) 2845 (9) 92 (32) 422 (22) 5 (1) 610 (20) 306 (7) 13343 (12) 1776 (11) 3159 (16) 640 (15) 313 (6) 153 (6) 602 (20) 1082 (12) 7859 (24) 3200 (11) 44 (14) 2223 (9) 0 (0) 38939 (13) A (H1N1)pdm09 106 (3) 778 (2) 0 (0) 103 (5) 1 (0) 266 (9) 215 (5) 1073 (1) 1117 (7) 407 (2) 330 (8) 128 (2) 49 (2) 300 (10) 186 (2) 2114 (7) 744 (3) 28 (9) 615 (3) 0 (0) 8560 (3) 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) 46 (1) 0 (0) 59 (21) 73 (4) 3 (1) 0 (0) 0 (0) 4812 (4) 0 (0) 235 (1) 0 (0) 0 (0) 7 (0) 151 (5) 215 (2) 2027 (6) 800 (3) 0 (0) 35 (0) 0 (0) 8463 (3) Number of flu B cases (%) 110 (3) 647 (2) 33 (12) 219 (12) 1 (0) 205 (7) 79 (2) 2300 (2) 499 (3) 586 (3) 284 (7) 129 (3) 11 (0) 147 (5) 379 (4) 2177 (7) 1496 (5) 16 (5) 695 (3) 0 (0) 10013 (3) A (H3) 3 (0) 1420 (5) 0 (0) 27 (1) 0 (0) 139 (5) 12 (0) 5158 (5) 160 (1) 1931 (10) 26 (1) 56 (1) 86 (3) 4 (0) 302 (3) 1541 (5) 160 (1) 0 (0) 878 (4) 0 (0) 11903 (4) 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/676/E Fig 2. Proportion of influenza types and subtypes/ lineages, EMR, August 2023 Key highlights In August 2023, 16 out of 21 Member States with a functional influenza surveillance system in the WHO Eastern Mediterranean Region (EMR) reported influenza data to FluNet and/or EMFLU (Afghanistan, Bahrain, Egypt, the Islamic Republic of Iran, Iraq, Jordan, Lebanon, occupied Palestinian territory, Oman, Pakistan, Qatar, Saudi Arabia, Somalia, Syrian Arab Republic, the United Arab Emirates, and Yemen). The trend of influenza-positive proportion in the EMR remains below epidemic levels, not yet signaling the beginning of the new influenza 2023-2024 season (Figure 1). In the current analytical period (epidemiological week 27,2022 to week 35,2023), there was a 6% increase in the number of cases enrolled (306,309 compared to the previous reporting period with 288,263 cases in epidemiological week 27,2022 to week 30, 2023). Out of the 306,309 enrolled cases, 301,738 (99%) were tested and, out of those, 38,939 (13%) were influenza-positive (Table). In Aug 2023, 14,693 cases were enrolled of which, 14,402 specimens were tested for influenza (98%). Of those specimens tested, 943 (6.5%) were positive. Influenza positivity rates varied across the countries; from 0% in Afghanistan, Lebanon, and Pakistan to 12% in Qatar, based on 200 or more specimens tested during August 2023. In August, the positivity rate of influenza type A was higher than that of type B (80% and 20% respectively) Figure 2. Of the total 943 specimens that tested positive for influenza, 296 (31.4%) were influenza A (not subtyped), 239 (25.3%) were type A(H3), 222 (23.5%) were A (H1N1) pdm09, 154 (16.4%) were influenza B (lineage is not determined), and 32 (3.4%) were influenza B (Victoria lineage) Figure 2 and Map). INFLUENZA MONTHLY UPDATE August 2023 - Epidemiological weeks: 31–35, 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, 2019 to week 35, 2023 Table. Reported cumulative cases by country in the Region during the analytical period week 27, 2022 to week 35, 2023Map. Influenza positivity rate and detected influenza types and subtypes by country, EMR, August 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 2019/2020 2020/2021 2021/2022 2022/2023 16.4% 31.4% 25.3% 3.4% 23.5% For any queries about this bulletin, please contact: emrgoihp@who.int 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 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