Influenza monthly update: November 2022 – Epidemiological weeks: 44-48, 2022

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 1330 6788 95 55 182 490 1134 32909 6406 14210 1209 1765 714 829 3748 13321 7286 150 5099 41 97761 Number of tested cases (%) 1297 (98) 6788 (100) 80 (84) 55 (100) 175 (96) 490 (100) 1049 (93) 32909 (100) 6406 (100) 14200 (100) 1209 (100) 1765 (100) 707 (99) 829 (100) 3719 (99) 13321 (100) 6521 (90) 150 (100) 5099 (100) 32 (78) 96801 (99) Numbr of positive cases (%) 76 (6) 551 (8) 9 (11) 17 (31) 2 (1) 50 (10) 51 (5) 9302 (28) 372 (6) 2717 (19) 307 (25) 41 (2) 13 (2) 232 (28) 893 (24) 3516 (26) 1039 (16) 0 (0) 1110 (22) 0 (0) 20298 (21) A (H1N1)pdm09 0 (0) 48 (1) 0 (0) 0 (0) 0 (0) 23 (5) 44 (4) 922 (3) 38 (1) 237 (2) 250 (21) 26 (1) 3 (0) 171 (21) 111 (3) 1378 (10) 109 (2) 0 (0) 270 (5) 0 (0) 3630 (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) 0 (0) 0 (0) 5 (6) 0 (0) 2 (1) 0 (0) 0 (0) 3674 (11) 0 (0) 212 (1) 0 (0) 1 (0) 4 (1) 57 (7) 155 (4) 717 (5) 175 (3) 0 (0) 0 (0) 0 (0) 5002 (5) Number of flu B cases (%) 76 (6) 132 (2) 4 (5) 12 (22) 0 (0) 11 (2) 1 (0) 362 (1) 269 (4) 402 (3) 48 (4) 3 (0) 0 (0) 3 (0) 344 (9) 1030 (8) 744 (11) 0 (0) 217 (4) 0 (0) 3658 (4) A (H3) 0 (0) 371 (5) 0 (0) 5 (9) 0 (0) 16 (3) 6 (1) 4344 (13) 65 (1) 1866 (13) 9 (1) 11 (1) 6 (1) 1 (0) 283 (8) 391 (3) 11 (0) 0 (0) 623 (12) 0 (0) 8008 (8) 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/585/E Fig 2. Proportion of influenza types and subtypes/ lineages, EMR, November 2022 Key highlights In November 2022, 20 out 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, Morocco, Occupied Palestinian Territory, Oman, Pakistan, Qatar, Saudi Arabia, Somalia, Sudan, Syrian Arab Republic, Tunisia, United Arab Emirates and Yemen). There has been a sustained increase in influenza activity over the past three months with a spike in weeks 43 and 44. In the current analytical period (epidemiological week 27 to week 48, 2022), there was a 61% increase in the number of cases enrolled as compared to the previous analytical period (epidemiological week 27 to 43). In the current reporting period, 97 761 cases were enrolled as compared to 60 541 cases enrolled in the previous period. Out of the 97 761 cases enrolled in the current reporting period, 96 801 (99%) were tested and, out of those, 20 298 (21%) were influenza positive (Table). With the increase in the number of influenza cases over the past months, influenza positivity rate in the Region has increased from 11% in August, to 12% in September, and to 32% in October, then it reduced to 26% in November 2022. Out of the 35 278 enrolled cases in the Region during November 2022, 34 758 specimens (99%) were tested for influenza, of which 9004 specimens (26%) were positive. Of the total specimens tested positive for influenza (9004) in November 2022, 83% (7496) were influenza type A. Of the influenza-positive specimens, 3015 (33%) were influenza A(H3), 2749 specimens (31%) were influenza A (not subtyped), 1732 specimens (19%) were influenza A (H1N1) pdm09, 1131 (13%) were influenza B (lineage not determined), and 377 (4%) were influenza B (Victoria lineage) (Fig. 2). INFLUENZA MONTHLY UPDATE November 2022 - Epidemiological weeks: 44–48, 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 48, 2022 Table. Reported cumulative cases by country in the Region during the analytical period week 27 to week 48, 2022Map. Influenza positivity rate and detected influenza types and subtypes by country, EMR, November 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 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 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 33% 19%13% 4% 31%