Influenza monthly update: February 2022 – epidemiological weeks: 5-8, 2022

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 Country Somalia Egypt Morocco 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 295 5260 324 786 2520 36 016 14 641 87 1435 2926 6536 12 584 9437 1656 606 1426 96 535 Number of tested cases (%) 295 (100) 5260 (100) 324 (100) 786 (100) 2125 (84) 36 016 (100) 14 651 (100) 86 (99) 1433 (100) 2926 (100) 6536 (100) 12 535 (100) 9437 (100) 440 (27) 606 (100) 1426 (100) 94 882 (98) Numbr of positive cases (%) 65 (22) 224 (4) 71 (22) 68 (9) 65 (3) 4844 (13) 530 (4) 4 (5) 92 (6) 46 (2) 214 (3) 982 (8) 718 (8) 41 (9) 41 (7) 75 (5) 8080 (9) A (H1N1)pdm09 18 (6) 0 (0) 14 (4) 7 (1) 0 (0) 0 (0) 80 (1) 0 (0) 0 (0) 1 (0) 0 (0) 395 (3) 18 (0) 0 (0) 0 (0) 13 (1) 546 (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) A (not subtyped) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 1341 (4) 0 (0) 3 (3) 0 (0) 0 (0) 0 (0) 92 (1) 181 (2) 15 (3) 0 (0) 0 (0) 1632 (2) Number of flu B cases (%) 5 (2) 26 (0) 0 (0) 0 (0) 0 (0) 33 (0) 2 (0) 1 (1) 0 (0) 0 (0) 0 (0) 39 (0) 77 (1) 26 (6) 0 (0) 9 (1) 218 (0) A (H3) 42 (14) 198 (4) 57 (18) 61 (8) 65 (3) 3470 (10) 448 (3) 0 (0) 92 (6) 45 (2) 214 (3) 456 (4) 442 (5) 0 (0) 41 (7) 53 (4) 5684 (6) 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/503/E Fig 2. Proportion of influenza types and subtypes/lineages, EMR, February 2022 Fig 3. Proportion of influenza types and subtypes/lineages, by age group, EMR, February 2022 Key highlights In February 2022, 12 out of 22 countries of the Region reported data to FluNet and/or EMFLU, namely Afghanistan, Egypt, Islamic Republic of Iran, Iraq, Lebanon, Morocco, Oman, Pakistan, Qatar, Saudi Arabia, Tunisia and United Arab Emirates (Table). The Eastern Mediterranean Region (EMR) witnessed a decrease in the number of tested specimens as well as a decrease in influenza activity with the beginning of the COVID-19 pandemic and remained below levels throughout the 2020/2021 analytical period. However, influenza activity has shown increasing trends in the 2021/2022 analytical period, yet lower trends when compared to pre-pandemic periods (Fig. 1). Influenza positivity rate in the Region was 11% in January 2022 and decreased to 1.7% in February 2022. In the analytical period 2021/2022, a total of 96 535 cases were enrolled, of which 94 882 (98%) were tested and 8080 (9%) were influenza positive (Table). Out of the 19 012 enrolled cases in the Region during January 2022, 18 633 specimens were tested for influenza, of which 315 specimens tested positive (1.7%). Out of the 315 influenza-positive specimens in January 2022, 162 specimens (51%) were influenza A(H3), 90 specimens (29%) were influenza A (not subtyped), 49 specimens (15%) were influenza A (H1N1)pdm09, 9 specimens (3%) were influenza B (lineage not determined) and 5 specimens (2%) were influenza B (Victoria lineage) (Fig. 2). Both influenza A (not sub-typed) and influenza B were detected in cases aged less than 2 years. Only influenza type A (not-subtyped) was detected in cases aged 2 years to less than 15 years. Both influenza types (A with dominance of subtype H3, and B) were detected in cases aged 15 to less than 50 years. No influenza cases detected in age groups above 50 years. INFLUENZA MONTHLY UPDATE February 2022 - Epidemiological weeks: 5–8, 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 8, 2022 Table. Reported cumulative cases by country in the Region during the analytical period week 27, 2021 to week 8, 2022Map. Influenza positivity rate and detected influenza types and subtypes by country, EMR, February 2022 Source of data: FluNet and EMFLU Afghanistan Pakistan Islamic Republic of IranIraq Syrian Arab RepublicLebanon Jordan Egypt Libya Tunisia Morocco Sudan Occupied Palestinian territory Kuwait Qatar Saudi Arabia United Arab Emirates Oman Yemen Somalia Djibouti Bahrain 51% 15% 3% 2% 29% 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 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 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