Influenza monthly update: June 2022 – Epidemiological weeks: 22-26, 2022

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 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 03 W 06 W 09 W 12 W 15 W 18 W 21 W 24 W 27 W 30 W 33 W 36 W 39 W 42 W 45 W 48 W 51 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 W 15 W 18 W 21 W 24 Country Somalia Egypt Libya Morocco Sudan Tunisia Afghanistan Iran (Islamic Republic of) Pakistan Bahrain Iraq Jordan Lebanon Oman Qatar Saudi Arabia Syrian Arab Republic United Arab Emirates Transmission zone Eastern Africa Northern Africa Southern Asia Western Asia Total Number of enrolled cases 486 11 265 160 408 17 1627 3304 42 648 25 321 124 2678 4593 7034 14 626 13 514 6298 1972 1991 138 066 Number of tested cases (%) 446 (92) 11 265 (100) 160 (100) 408 (100) 12 (71) 1627 (100) 3264 (99) 42 648 (100) 25 331 (100) 124 (100) 2676 (100) 4593 (100) 7034 (100) 14 572 (100) 13 514 (100) 5345 (85) 1879 (95) 1991 (100) 136 889 (99) Numbr of positive cases (%) 89 (20) 737 (7) 53 (33) 73 (18) 0 (0) 121 (7) 65 (2) 4945 (12) 714 (3) 10 (8) 93 (3) 118 (3) 216 (3) 1032 (7) 1438 (11) 332 (6) 75 (4) 138 (7) 10 249 (7) A (H1N1)pdm09 38 (9) 1 (0) 0 (0) 14 (3) 0 (0) 9 (1) 0 (0) 1 (0) 252 (1) 0 (0) 1 (0) 1 (0) 0 (0) 400 (3) 58 (0) 30 (1) 0 (0) 26 (1) 831 (1) 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) A (not subtyped) 0 (0) 0 (0) 21 (13) 0 (0) 0 (0) 0 (0) 0 (0) 1381 (3) 0 (0) 9 (7) 0 (0) 0 (0) 0 (0) 102 (1) 320 (2) 180 (3) 0 (0) 0 (0) 2013 (1) Number of flu B cases (%) 5 (1) 480 (4) 32 (20) 0 (0) 0 (0) 1 (0) 0 (0) 44 (0) 8 (0) 1 (1) 0 (0) 0 (0) 0 (0) 59 (0) 182 (1) 82 (2) 0 (0) 22 (1) 916 (1) A (H3) 46 (10) 256 (2) 0 (0) 59 (14) 0 (0) 111 (7) 65 (2) 3519 (8) 454 (2) 0 (0) 92 (3) 117 (3) 216 (3) 471 (3) 878 (6) 40 (1) 75 (4) 90 (5) 6489 (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 2022 Document number: WHO-EM/CSR/541/E Fig 2. Proportion of influenza types and subtypes/lineages, EMR, June 2022 Fig 3. Proportion of influenza types and subtypes/lineages, by age group, EMR, June 2022 Key highlights In June 2022, 14 of the 22 countries of the WHO Eastern Mediterranean Region (EMR) reported influenza data to FluNet and/or EMFLU (Afghanistan, Egypt, Islamic Republic of Iran, Iraq, Jordan, Lebanon, Libya, Oman, Qatar, Saudi Arabia, Somalia, Sudan, Syrian Arab Republic and United Arab Emirates) (Table). Overall, the Region witnessed a decrease in the number of tested specimens as well as a decrease in positive influenza cases with the beginning of the COVID-19 pandemic and remained below levels throughout the 2020/2021 analytical period. However, influenza activity showed increasing trend throughout the 2021/2022 analytical period, yet lower than that observed in pre-pandemic period: 2017-2019 (Fig. 1). The pattern of change in the influenza activity in the EMR is consistent with the global trend. In the current analytical period (2021/2022), a total of 138 066 cases were enrolled, of which 136 889 (99%) were tested and, out of those, 10 249 (7%) were influenza positive (Table). Influenza positivity rate has increased in the Region over the past three months from 5% in April and 9% in May to 13% in June 2022. Out of the 4032 enrolled cases in the Region during June 2022, 3801 specimens were tested for influenza, of which 489 specimens tested positive (13%). Of the 489 influenza-positive specimens in June 2022, 232 specimens (47%) were influenza A(H3), 140 (29%) were influenza B (lineage not determined), 78 specimens (16%) were influenza A (not subtyped), 32 specimens (7%) were influenza A (H1N1) pdm09, and 7 specimens (1%) were influenza B (Victoria lineage) (Fig. 2). Both influenza types A and B were detected across all age groups in June 2022. Influenza type A subtype (H3N2) was the most dominant variant affecting the very young (less than 2 years of age) and people older than 65 years. Influenza type B were reported along with influenza A (H3N2 and not subtyped) among all age groups (Fig 2). INFLUENZA MONTHLY UPDATE June 2022 - Epidemiological weeks: 22–26, 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, 2017 to week 26, 2022 Table. Reported cumulative cases by country in the Region during the analytical period week 27, 2021 to week 26, 2022Map. Influenza positivity rate and detected influenza types and subtypes by country, EMR, June 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 47% 7% 29% 1% 16% A (H1N1) pdm09 A (H3) A (H5) A (not subtyped) B (Yamagata lineage) B (Victoria lineage) B (lineage not determined) % of positive specimens 0 5 10 15 20 25 30 35 40 45 0 500 1000 1500 2000 2500 % 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 2 4 6 8 10 12 14 16 18 20 0 100 200 300 400 500 600 700 800 900 2020/2021 2021/2022 % 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 2017/2018 2018/2019 2019/2020 2020/2021 2021/2022 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Less than 2 years 2 years to less than 5 years 5 years to less than 15 years 15 years to less than 50 years 50 years to less than 65 years 65 years and above % o f su bt yp ed v ir us es Age groups