Influenza monthly update: March 2023 – Epidemiological weeks: 9-13, 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 2681 20818 506 1574 383 2730 3262 83920 15202 16013 3301 3998 1711 2325 6642 25670 18000 675 10509 162 220082 Number of tested cases (%) 2679 (100) 20818 (100) 491 (97) 1574 (100) 379 (99) 2730 (100) 3262 (100) 83920 (100) 15202 (100) 15978 (100) 3301 (100) 3998 (100) 1711 (100) 2325 (100) 6642 (100) 25670 (100) 16260 (90) 220 (33) 9322 (89) 126 (78) 216608 (98) Numbr of positive cases (%) 150 (6) 2263 (11) 160 (33) 469 (30) 5 (1) 609 (22) 315 (10) 12077 (14) 1754 (12) 2897 (18) 637 (19) 253 (6) 143 (8) 593 (26) 990 (15) 7330 (29) 2138 (13) 40 (18) 1540 (17) 0 (0) 34363 (16) A (H1N1)pdm09 8 (0) 603 (3) 0 (0) 102 (6) 1 (0) 266 (10) 213 (7) 1010 (1) 1111 (7) 293 (2) 329 (10) 120 (3) 46 (3) 300 (13) 128 (2) 2045 (8) 416 (3) 28 (13) 400 (4) 0 (0) 7419 (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) 31 (1) 0 (0) 117 (24) 64 (4) 3 (1) 0 (0) 0 (0) 4414 (5) 0 (0) 234 (1) 0 (0) 0 (0) 7 (0) 151 (6) 204 (3) 1858 (7) 482 (3) 0 (0) 0 (0) 0 (0) 7565 (3) Number of flu B cases (%) 109 (4) 270 (1) 43 (9) 276 (18) 1 (0) 205 (8) 90 (3) 1657 (2) 492 (3) 480 (3) 284 (9) 93 (2) 4 (0) 138 (6) 369 (6) 1993 (8) 1205 (7) 12 (5) 433 (5) 0 (0) 8154 (4) A (H3) 2 (0) 1390 (7) 0 (0) 27 (2) 0 (0) 138 (5) 12 (0) 4996 (6) 151 (1) 1890 (12) 24 (1) 40 (1) 86 (5) 4 (0) 289 (4) 1434 (6) 35 (0) 0 (0) 707 (8) 0 (0) 11225 (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 2023 Document number: WHO-EM/CSR/650/E Figure 2. Proportion of influenza types and subtypes/lineages, EMR, March 2023 Key highlights In March 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, Egypt, Islamic Republic of Iran, Iraq, Jordan, Lebanon, Libya, Morocco, occupied Palestinian territory, Oman, Pakistan, Qatar, Saudi Arabia, Somalia, Sudan, Syrian Arab Republic, Tunisia, United Arab Emirates, and Yemen). The number of influenza-positive cases in the EMR has declined in the current influenza season (2022–2023), after an initial spike in the number of cases early in the current influenza season (Figure 1). In the current analytical period (epidemiological week 27, 2022 to week 13, 2023), there was a 16% increase in the number of cases enrolled (220 082) compared to the previous reporting period (190 255 cases- in epidemiological week 27, 2022 to week 8, 2023). Out of the 220 082 cases enrolled in the current reporting period, 216 608 (98%) were tested and, out of those, 34 363 (16%) were influenza positive (Table). There has been a consistent decline in the influenza positivity rate in the Region over the past four months. In March 2023, 27 368 cases were enrolled, of which 27 099 specimens were tested for influenza (99%), of which 2227 specimens (8%) were positive (Figure 1). Influenza positivity rates varied across countries; from <1% in Lebanon to 22% in Qatar, based on 200 or more specimens tested over the reporting month. In March 2023, influenza type A remained the dominant circulating type of influenza in the EMR (56%). Of the total specimens tested positive for influenza (2227), 801 (36%) were influenza B (lineage not determined), 490 (22%) were A(H3), 464 (21%) were influenza A (not subtyped), 302 (14%) were influenza type A (H1N1) pdm09, and 170 (8%) were influenza B (Victoria lineage) (Figure 2). INFLUENZA MONTHLY UPDATE March 2023 - Epidemiological weeks: 9–13, 2023 Figure 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 13, 2023 Table. Reported cumulative cases by country in the Region during the analytical period week 27, 2022 to week 13, 2023Map. Influenza positivity rate and detected influenza types and subtypes by country, EMR, March 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 22% 36%13% 8% 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 W 09 W 12