Influenza monthly update: January 2023 – Epidemiological weeks: 1-4, 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 1629 16995 304 1101 276 1753 2175 61945 12405 15982 2470 2861 1300 1532 5055 18453 10389 150 6922 97 163794 Number of tested cases (%) 1628 (100) 16995 (100) 289 (95) 1094 (99) 276 (100) 1753 (100) 1960 (90) 61945 (100) 12130 (98) 15964 (100) 2470 (100) 2861 (100) 1293 (99) 1532 (100) 5023 (99) 18453 (100) 9072 (87) 150 (100) 6922 (100) 87 (90) 161897 (99) Numbr of positive cases (%) 80 (5) 2068 (12) 123 (43) 347 (32) 3 (1) 494 (28) 210 (11) 10979 (18) 1503 (12) 2897 (18) 591 (24) 143 (5) 141 (11) 458 (30) 937 (19) 5453 (30) 1380 (15) 0 (0) 1352 (20) 0 (0) 29159 (18) A (H1N1)pdm09 1 (0) 511 (3) 0 (0) 80 (7) 0 (0) 252 (14) 171 (9) 979 (2) 954 (8) 293 (2) 326 (13) 110 (4) 47 (4) 292 (19) 112 (2) 1870 (10) 167 (2) 0 (0) 350 (5) 0 (0) 6515 (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) 110 (38) 45 (4) 3 (1) 0 (0) 0 (0) 4251 (7) 0 (0) 234 (1) 0 (0) 0 (0) 8 (1) 144 (9) 175 (3) 1289 (7) 276 (3) 0 (0) 0 (0) 0 (0) 6535 (4) Number of flu B cases (%) 78 (5) 207 (1) 13 (4) 200 (18) 0 (0) 116 (7) 29 (1) 918 (1) 426 (4) 480 (3) 245 (10) 12 (0) 1 (0) 19 (1) 362 (7) 1588 (9) 923 (10) 0 (0) 310 (4) 0 (0) 5927 (4) A (H3) 1 (0) 1350 (8) 0 (0) 22 (2) 0 (0) 126 (7) 10 (1) 4831 (8) 123 (1) 1890 (12) 20 (1) 21 (1) 85 (7) 3 (0) 288 (6) 706 (4) 14 (0) 0 (0) 692 (10) 0 (0) 10182 (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 2023 Document number: WHO-EM/CSR/642/E Fig 2. Proportion of influenza types and subtypes/ lineages, EMR, January 2023 Key highlights In January 2023, 17 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, Bahrain, Egypt, Islamic Republic of Iran, Iraq, Jordan, Lebanon, Libya, Morocco, Oman, Pakistan, Qatar, Saudi Arabia, Somalia, Tunisia, United Arab Emirates and Yemen). The number of influenza positive cases in the EMR has been consistently decreasing over the past 12 weeks after the initial spike early in the current influenza season (weeks 43 and 44). In the current analytical period (epidemiological week 27, 2022 to week 4, 2023), there was a 29% increase in the number of cases enrolled (163 794 cases) compared to the previous reporting period (126 945 cases). Out of the 163 794 cases enrolled in the current reporting period, 161 897 (99%) were tested and, out of those, 29 159 (18%) were influenza positive (Table). Influenza positivity rate in the Region has decreased over the past two months (20% in December and 26% in November 2022). During January 2023, 24 446 cases were enrolled, of which 23 896 specimens were tested for influenza (98%), of which 2725 specimens (11%) were positive. Of the total specimens tested positive for influenza (2725) in January 2023, 62% (1703) were influenza type A. Of the influenza-positive specimens, 796 (29%) were influenza A (H1N1) pdm09, 674 (25%) were influenza B (lineage not determined), 507 (19%) were A(H3), 400 specimens (15%) were influenza A (not subtyped), and 348 (13%) were influenza B (Victoria lineage) (Fig. 2). The positivity rate for influenza B (Victoria lineage) has nearly doubled, from 7% in December 2022 to 13% in January 2023, while the positivity rate for type B has jumped from 25% in December to 38% in January (a 52% increase). INFLUENZA MONTHLY UPDATE January 2023 - Epidemiological weeks: 1–4, 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 4, 2023 Table. Reported cumulative cases by country in the Region during the analytical period week 27, 2022 to week 4, 2023Map. Influenza positivity rate and detected influenza types and subtypes by country, EMR, January 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 25% 29% 15% 13% 18% 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