In the WHO Eastern Mediterranean Region, influenza activity is high in the month of December in many countries reporting data to FluNet and EMFLU namely, Afghanistan, Bahrain, Egypt, Iran (Islamic Republic of), Iraq, Jordan, Kuwait, Lebanon, Morocco, Oman, occupied Palestinian territories (oPt), Pakistan, Qatar, Syrian Arab Republic, Saudi Arabia, and Tunisia (Fig. 1). All seasonal influenza subtypes were detected in the Region.

Fig. 1. Influenza activity in Eastern Mediterranean Region, December 2017

Influenza activity by sub-type

• In December 2017, no new cases of influenza A(H5N1) were reported in Egypt.
• In the northern Africa influenza transmission zone, Morocco reported co-circulation of influenza A(H1N1)pdm09, A(H3N2) and influenza B (Yamagata lineage) while Egypt and Tunisia reported predominant circulation of influenza A(H1N1)pdm09.
• In the Western Asia influenza transmission zone, influenza A(H1N1)pdm09 were detected predominantly with A(H3N2) in Jordan and Bahrain, while Kuwait, Oman, Qatar and Saudi Arabia reported predominant circulation of influenza A(H1N1)pdm09 with A(H3N2) and influenza B virus.
• In southern Asia transmission zone, Afghanistan and Pakistan reported predominant circulation of influenza A(H1N1)pdm09 virus with influenza A(H3N2) while Iran (Islamic Republic of) reported co-circulation of all seasonal influenza viruses.

Source of transmission zones 

Fig. 2 shows the weekly distribution of influenza subtypes.

Fig. 2. Weekly positive cases of influenza by subtype, Epi week 52/2016–2017

Circulating influenza viruses by subtype

• During December 2017, regional national influenza centres and influenza laboratories tested a total of 15 315 specimens for influenza viruses of which 5297 tested positive (35%).
• The average percentage of positivity rates is 32%, with highest positivity rate recorded in Jordan, oPt, Qatar, Saudi Arabia and Tunisia.
• Of the viruses tested, 4271 (81%) were influenza A viruses, including 3582 (67%) influenza A/H1N1pdm09 viruses and 651 (12%) were influenza A/H3 viruses; 1026 (19%) were influenza B viruses  (Fig. 3).

Fig. 3. Circulating influenza viruses in the Region by subtype, Epi week 48-52, 2017

Related link

Influenza update, December 2017