Influenza monthly update: June 2023 – Epidemiological weeks: 23-26, 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 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 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 3778 28449 576 1902 383 3072 4159 100380 16518 18130 3829 4770 2179 2739 7931 29709 25570 751 20538 213 275576 Number of tested cases (%) 3776 (100) 28449 (100) 560 (97) 1872 (98) 379 (99) 3072 (100) 3756 (90) 100380 (100) 16277 (99) 18118 (100) 3829 (100) 4770 (100) 2155 (99) 2739 (100) 7895 (100) 29673 (100) 23486 (92) 286 (38) 19177 (93) 163 (77) 270812 (98) Numbr of positive cases (%) 250 (7) 2667 (9) 163 (29) 422 (23) 5 (1) 610 (20) 305 (8) 12772 (13) 1771 (11) 3105 (17) 637 (17) 310 (6) 151 (7) 603 (22) 1021 (13) 7590 (26) 2741 (12) 44 (15) 1948 (10) 0 (0) 37115 (14) A (H1N1)pdm09 103 (3) 696 (2) 0 (0) 103 (6) 1 (0) 266 (9) 215 (6) 1022 (1) 1117 (7) 390 (2) 329 (9) 128 (3) 47 (2) 300 (11) 145 (2) 2079 (7) 666 (3) 28 (10) 513 (3) 0 (0) 8148 (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) 38 (1) 0 (0) 117 (21) 73 (4) 3 (1) 0 (0) 0 (0) 4513 (4) 0 (0) 235 (1) 0 (0) 0 (0) 7 (0) 151 (6) 212 (3) 1923 (6) 598 (3) 0 (0) 25 (0) 0 (0) 7895 (3) Number of flu B cases (%) 107 (3) 562 (2) 46 (8) 219 (12) 1 (0) 205 (7) 78 (2) 2174 (2) 497 (3) 570 (3) 284 (7) 129 (3) 11 (1) 148 (5) 373 (5) 2117 (7) 1387 (6) 16 (6) 653 (3) 0 (0) 9577 (4) A (H3) 2 (0) 1409 (5) 0 (0) 27 (1) 0 (0) 139 (5) 12 (0) 5063 (5) 157 (1) 1910 (11) 24 (1) 53 (1) 86 (4) 4 (0) 291 (4) 1471 (5) 90 (0) 0 (0) 757 (4) 0 (0) 11495 (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/664/E Fig 2. Proportion of influenza types and subtypes/ lineages, EMR, June 2023 Key highlights In June 2023, 18 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, Islamic Republic of Iran, Iraq, Jordan, Lebanon, Libya, Morocco, occupied Palestinian territory, Oman, Pakistan, Qatar, Saudi Arabia, Somalia, Syrian Arab Republic, United Arab Emirates, and Yemen). The trend of influenza-positive cases in the EMR remains downward after an initial sharp rise early in the influenza season 2022–2023 (Figure 1). In the current analytical period (epidemiological week 27,2022 to week 26,2023), there was a 5% increase in the number of cases enrolled (275,576) compared to the previous reporting period (262,143 cases in epidemiological week 27,2022 to week 22, 2023). Out of the 275,576 cases, 270,812 (98%) were tested and, out of those, 37,115 (14%) were influenza-positive (Table). In June 2023, 10,653 cases were enrolled of which, 10,132 specimens were tested for influenza (95%). Of the specimens tested, 522 (5%) were positive. Influenza positivity rates varied across countries; from 1.7% in Oman to 9.5% in Saudi Arabia, based on 200 or more specimens tested during June 2023. The rate of influenza type A was similar to that of type B (49% and 51% respectively). Of the total 522 specimens that tested positive for influenza, 204 (39%) were influenza B (lineage not determined), 164 (31%) were A (H1N1) pdm09, 60 (12%) were influenza B (Victoria lineage), 50 (10%) were influenza A (not subtyped), and 44 (8%) were type A(H3) (Figure 2 and Map). INFLUENZA MONTHLY UPDATE June 2023 - Epidemiological weeks: 23–26, 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 26, 2023 Table. Reported cumulative cases by country in the Region during the analytical period week 27, 2022 to week 26, 2023Map. Influenza positivity rate and detected influenza types and subtypes by country, EMR, June 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 10% 39% 31% 8% 12% For any queries about this bulletin, please contact: emrgoihp@who.int