Cent Eur J Public Health 2017, 25(3):228-234

National Laboratory Surveillance of Influenza in Macedonia During Four Seasons

Golubinka Bosevska1, Vladimir Mikik1, Irena Topuzovska Kondova2, Nikola Panovski3, E. Dokic Trajkovska3, Z. Milenkovic2, K. Stavridis1, E. Janceska1, G. Kuzmanovska1, Shaban Memeti1
1 Institute of Public Health, Skopje, Republic of Macedonia
2 University Clinic for Infectious Diseases, Skopje, Republic of Macedonia
3 Institute of Microbiology and Parasitology, Medical Faculty, Saints Cyril and Methodius University, Skopje, Republic of Macedonia

Objective: The aim of the study is to comprehend results of the influenza lab surveillance system in the Republic of Macedonia after the 2009 pandemic and to determine the main characteristics of four consecutive epidemic seasons (from 2010/2011 until 2013/2014).

Methods: As part of the universal surveillance system, nasal and throat specimens were collected from patients. After extraction of RNA, the CDC real-time RT-PCR assays for the detection of influenza types and subtypes were performed.

Results: Out of 920 tested samples, 406 (44.1%) laboratory confirmed cases of influenza were found. Influenza activity begins as early as December and continues until the end of April with peaks in January or February with predominant influenza A and A/H1N1pdm. Influenza A viruses start their activity at week 49 to 52 and subside at week 17. Usually two peaks appear, the first one between week 2 and 4 and the second one between week 6 and 9. Subtype A/H1N1pdm was dominant among influenza A types in the 2010/2011 and 2012/2013 seasons. A/H3N2 was the only circulating influenza virus in the 2011/2012 season. Influenza B season is shorter and has only one peak, between weeks 2-5. Usually the influenza B viruses emerge in later stages than influenza A viruses, except for the first post-pandemic season.

Conclusion: Results revealed that post-pandemic influenza seasons in Macedonia were rather different. Although the influenza season pattern is similar to patterns in some countries of the WHO European region, some unique characteristics were observed.

Keywords: influenza, laboratory surveillance, post-pandemic, influenza subtypes

Received: January 21, 2015; Revised: June 15, 2017; Published: October 10, 2017  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Bosevska G, Mikik V, Topuzovska Kondova I, Panovski N, Dokic Trajkovska E, Milenkovic Z, et al.. National Laboratory Surveillance of Influenza in Macedonia During Four Seasons. Cent Eur J Public Health. 2017;25(3):228-234. PubMed PMID: 29022683.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Stöhr K. The global agenda on influenza surveillance and control. Vaccine. 2003 May 1;21(16):1744-8. Go to original source... Go to PubMed...
    2. World Health Organization. International Health Regulations 2005 [Internet]. Geneva: WHO; 2008 [cited 2017 Feb 8]. Available from: http://www.who.int/ihr/9789241596664/en/index.html.
    3. World Health Organization. WHO Regional Office for Europe Guidance for influenza surveillance in humans. Copenhagen: WHO Regional Office for Europe; 2009.
    4. Law on protection of the population against communicable diseases. Official gazette of Republic of Macedonia. 2004;(66). (In Macedonian.)
    5. Rulebook for reporting communicable diseases. Official gazette of Republic of Macedonia. 2009;(46). (In Macedonian.)
    6. Rulebook for criteria used for case definition of communicable diseases. Official gazette of Republic of Macedonia. 2011;(10). (In Macedonian.)
    7. CDC Protocol of realtime RTPCR for swine influenza A (H1N1) [Internet]. Atlanta: WHO Collaborating Centre for influenza at CDC; 2009 [cited 2015 Jan 1]. Available from: http://www.who.int/csr/resources/publications/swineflu/CDCrealtimeRTPCRprotocol_20090428.pdf.
    8. Bosevska G, Janceska E, Memeti S, Kuzmanovska G, Mikik V, Kondova Topuzovska I, et al. Laboratory surveillance during pandemic influenza season 2009/2010 in Republic of Macedonia. Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2013;34(2):51-8. Go to PubMed...
    9. Centers for Disease Control and Prevention (CDC). Update: influenza activity - United States, 2011-12 season and composition of the 2012-13 influenza vaccine. MMWR Morb Mortal Wkly Rep. 2012 Jun 8;61(22):414-20.
    10. National Institute for Medical Research, WHO Influenza Centre London. Report prepared for the WHO annual consultation on the composition of influenza vaccine for the Northern Hemisphere, 14th - 17 th February 2011. London: NIMR; 2011.
    11. National Institute for Medical Research, WHO Influenza Centre London. Report prepared for the WHO annual consultation on the composition of influenza vaccine for the Northern Hemisphere, 20th - 22nd February 2012. London: NIMR; 2012.
    12. National Institute for Medical Research, WHO Influenza Centre London. Report prepared for the WHO annual consultation on the composition of influenza vaccine for the Northern Hemisphere 2013/14, 18 th - 20th February 2013. London: NIMR; 2013.
    13. National Institute for Medical Research, WHO Influenza Centre London. Report prepared for the WHO annual consultation on the composition of influenza vaccine for the Northern Hemisphere 2014/15, 17th - 19th February 2014. London: NIMR; 2014.
    14. Centers for Disease Control and Prevention. Influenza (Flu). 2010-2011 Influenza (Flu) Season [Internet]. Atlanta CDC; 2011 [cited 2017 Feb 8]. Available from: http://www.cdc.gov/flu/pastseasons/1011season.htm.
    15. Plata F. Regional overview 2010/2011 Primary care surveillance. In: Joint ECDC/WHO Regional Office for Europe Meeting on Influenza Surveillance; 2011 Jun 7-9; Ljubljana, Slovenia.
    16. Prosenc K, Sočan M. Epidemiological and virological surveillance of influenza-like illness in Slovenia. In: Joint ECDC/WHO Regional Office for Europe Meeting on Influenza Surveillance; 2011 Jun 7-9; Ljubljana, Slovenia.
    17. Centers for Disease Control and Prevention (CDC). Update: influenza activity - United States, 2010-11 season, and composition of the 2011-12 influenza vaccine. MMWR Morb Mortal Wkly Rep. 2011 Jun 3;60(21):705-12.
    18. Global Virological Surveillance (Focus on Europe): 2010/11 Influenza Season. In: Joint ECDC/WHO Regional Office for Europe Meeting on Influenza Surveillance; 2011 Jun 7-9; Ljubljana, Slovenia.
    19. Centers for Disease Control and Prevention. Influenza (Flu). 2011-2012 Influenza Season [Internet]. Atlanta CDC; 2012 [cited 2015 Jan 4]. Available from: https://www.cdc.gov/flu/pastseasons/1112season.htm.
    20. Gross D. Season report 2013-14. In: Fourth Joint WHO Regional Office for Europe/ECDC Meeting on Influenza Surveillance; 2014 Jun 11-13; Vienna, Austria.
    21. Centers for Disease Control and Prevention. Influenza (Flu). 2013-2014 Influenza Season [Internet]. Atlanta CDC; 2014 [cited 2015 Jan 4]. Available from: http://www.cdc.gov/flu/pastseasons/1314season.htm.
    22. Popow-Kraupp T. Influenza surveillance in Austria. In: Fourth Joint WHO Regional Office for Europe/ECDC Meeting on Influenza Surveillance; 2014 Jun 11-13; Vienna, Austria.

    Return to the content