Week 12/2020 (16 – 22 March 2020)

  • The novel coronavirus disease 2019 (COVID-19) outbreak in the Region seems to be affecting healthcare presentations and testing capacities in Member States, which impact both influenza epidemiologic and virologic data, and seasonal patterns.
  • For the Region overall, influenza activity appears to be declining. High influenza intensity was reported by 1 Member State, and 7 Member States and areas reported medium influenza intensity. Widespread influenza activity was reported by less than half of the Member States and areas across the Region.
  • However, influenza-like illness (ILI) and/or acute respiratory infection (ARI) notification rates continued to increase or remain high in some Member States this week, which might reflect the community transmission of COVID-19.
  • The percentage of specimens from patients who presented with ILI or ARI to sentinel primary healthcare sites that tested positive for an influenza virus dropped from 30% last week to 14% this week.
  • Both influenza virus types A and B were co-circulating in sentinel source specimens with a higher proportion (60%) of type A viruses being detected. Of the type A detections, A(H1N1)pdm09 viruses were the most common (65%). Of the influenza B viruses, all were B/Victoria lineage.
  • Pooled estimates of all-cause mortality show, overall, normal expected levels in the participating countries; however, increased excess mortality is notable in Italy.

2019/20 season overview 

  • For the Region as a whole, influenza activity commenced earlier than in recent years and, based on sentinel sampling, first exceeded a positivity rate of 10% in week 47/2019.
  • The influenza season for the Region as a whole peaked in week 05/2020 reaching a maximum positivity rate of 55%. The peak phase with positivity levels above 50% lasted for just two weeks, 05/2020 and 06/2020, but reporting in subsequent weeks may have been adversely affected by Member State responses to the COVID-19 outbreak. In the previous influenza season, rates of influenza positivity exceeded 50% for six weeks.
  • The majority of circulating viruses were susceptible to neuraminidase inhibitors supporting early treatment or prophylactic use according to national guidelines.
  • Interim estimates of 2019–2020 seasonal influenza vaccine effectiveness in the northern hemisphere are available. Vaccination remains the best possible method for prevention of influenza and/or reducing the risk of serious complications.
  • WHO has published recommendations for the composition of influenza vaccines to be used in the 2020–2021 northern hemisphere season. Based on these recommendations the influenza A(H1N1)pdm09, A(H3N2) and B/Victoria-lineage virus components should be updated for the 2020–2021 influenza vaccine.
  • ECDC and WHO Regional Office for Europe published a joint Regional Situation Assessment for the 2019–2020 influenza season up to week 49/2019, which focused on disease severity and impact on healthcare systems to assist forward planning in Member States.

Other news

The World Health Organization categorized the COVID-19 outbreak as a pandemic on 11 March 2020. The number of COVID-19 cases being reported within the European Region has continued to increase significantly. For more information visit:

Influenza intensity, spread and dominant virus type/subtype