Influenza monthly update: September 2023 - Epidemiological weeks: 36-39, 2023

Country Somalia Egypt Libya Morocco 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 693 7077 4 82 275 701 16193 796 2150 530 505 651 149 2517 3524 10442 90 9923 23 56325 Number of tested cases (%) 660 (95) 7077 (100) 4 (100) 82 (100) 275 (100) 399 (57) 16193 (100) 790 (99) 2150 (100) 530 (100) 504 (100) 651 (100) 149 (100) 2514 (100) 3524 (100) 10207 (98) 19 (21) 9915 (100) 16 (70) 55659 (99) Numbr of positive cases (%) 43 (7) 641 (9) 0 (0) 0 (0) 0 (0) 1 (0) 2016 (12) 5 (1) 218 (10) 14 (3) 4 (1) 7 (1) 0 (0) 324 (13) 514 (15) 976 (10) 0 (0) 733 (7) 0 (0) 5496 (10) A (H1N1)pdm09 35 (5) 420 (6) 0 (0) 0 (0) 0 (0) 0 (0) 390 (2) 0 (0) 96 (4) 6 (1) 0 (0) 2 (0) 0 (0) 150 (6) 81 (2) 174 (2) 0 (0) 231 (2) 0 (0) 1585 (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) A (not subtyped) 8 (1) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 973 (6) 0 (0) 1 (0) 0 (0) 0 (0) 2 (0) 0 (0) 69 (3) 195 (6) 412 (4) 0 (0) 48 (0) 0 (0) 1708 (3) Number of flu B cases (%) 0 (0) 189 (3) 0 (0) 0 (0) 0 (0) 1 (0) 164 (1) 2 (0) 25 (1) 0 (0) 0 (0) 1 (0) 0 (0) 23 (1) 65 (2) 215 (2) 0 (0) 86 (1) 0 (0) 771 (1) A (H3) 0 (0) 32 (0) 0 (0) 0 (0) 0 (0) 0 (0) 489 (3) 3 (0) 96 (4) 8 (2) 4 (1) 2 (0) 0 (0) 82 (3) 173 (5) 175 (2) 0 (0) 368 (4) 0 (0) 1432 (3) 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/686/E Fig 2. Proportion of influenza types and subtypes/ lineages, EMR, September 2023 Key highlights In Sep 2023, 17 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, the Islamic Republic of Iran, Iraq, Jordan, Lebanon, Libya, Morocco, Oman, Pakistan, Qatar, Saudi Arabia, Somalia, Syrian Arab Republic, Tunis, and the United Arab Emirates). The influenza-positive proportion in the EMR started to increase reaching epidemic levels, signaling the beginning of the new influenza 2023-2024 season (Figure 1). In the current analytical period (epidemiological week 27 to week 39,2023), there were a total of 56,325 enrolled cases. Out of which, 55,659 (99%) were tested, and out of the tested, 5,496 (10%) were influenza-positive (Table). In Sep 2023, 23,367 cases were enrolled of which, 22,907 specimens were tested for influenza (98%). Of those specimens tested, 3,348 (15%) were positive. Influenza positivity proportions varied across countries; from 0% in Afghanistan to 20% in Qatar, based on 200 or more specimens tested during Sep 2023. In September, the positivity proportion of influenza type A was higher than that of type B (92% and 8% respectively) Figure 2. Of the total 3,348 specimens that tested positive for influenza in September, 1,030 (31%) were influenza A (not subtyped), 1,027 (31%) were type A(H3), 1,007 (30%) were A (H1N1) pdm09, 237 (7%) were influenza B (lineage not determined), and 45 (1%) were influenza B (Victoria lineage) Figure 2 and Map). INFLUENZA MONTHLY UPDATE September 2023 - Epidemiological weeks: 36–39, 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, 2019 to week 39, 2023 Table. Reported cumulative cases by country in the Region during the analytical period week 27, 2022 to week 39, 2023Map. Influenza positivity rate and detected influenza types and subtypes by country, EMR, September 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 2019/2020 2020/2021 2021/2022 2022/2023 7% 31% 31% 1% 30% For any queries about this bulletin, please contact: emrgoihp@who.int 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 01 W 03 W 05 W 07 W 09 W 11 W 13 W 15 W 17 W 19 W 21 W 23 W 25 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 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 28 W 30 W 32 W 34 W 36 W 38