VOLUME 2, NUMBER 14 (PUBLISHED ON Apr 11, 2024)

COVID-19 & F LU E XPRESSCOVID-19 & Flu Express is a weekly report produced by Surveillance Division of the Communicable Disease Branch of theCentre for Health Protection. It monitors and summarizes the latest local and global COVID-19 and influenza activities.

Local Situation of COVID-19 Activity (as of Apr 10, 2024)
Reporting period: Mar 31 – Apr 6, 2024 (Week 14)
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The latest surveillance data showed that the overall COVID-19 activity has been eased.
Concerning the monitoring of SARS-CoV-2 variants, the latest surveillance data showedthat JN.1 is the most prevalent variant. However, the current evidence does not suggest
JN.1 will cause a more severe disease than the previous prevalent XBB and its descendantlineages.
Members of the public are advised to maintain strict personal and environmental hygiene
at all times for personal protection against COVID-19 infection and prevention of the
spread of the disease in the community. High risk people (e.g. persons with underlying
medical conditions or persons who are immunocompromised) should adopt additional
measures to protect themselves such as wearing mask properly when going to public
places.
For other details, please visit the COVID-19 information page(https://www.chp.gov.hk/en/healthtopics/content/24/102466.html).
Members of the public are advised to take note of the latest recommendations on the useof COVID-19 vaccines in Hong Kong to protect themselves from serious outcomes of
COVID-19. High-risk priority groups are recommended to receive a dose of COVID-19
vaccine at least six months since the last dose or infection, regardless of the number ofdoses received previously. For more details, please visit(https://www.chp.gov.hk/files/pdf/consensus_interim_recommendations_on_the_use_of_covid19_vaccines_in_hong_kong_11oct.pdf).

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For the latest information on COVID-19 and prevention measures, please visit the thematic
website of COVID-19 (https://www.coronavirus.gov.hk/eng/index.html).

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VOLUME 2, NUMBER 14 (PUBLISHED ON Apr 11, 2024)

Laboratory surveillance for COVID-19 cases
Positive nucleic acid test laboratory detections for severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) virus
In week 14, the weekly number of newly recorded positive nucleic acid test laboratory detections for
SARS-CoV-2 virus was 696 as compared to 804 in the preceding week. (Figure 1.1)
In the first 4 days of week 15 (Apr 7 – Apr 10), the daily number of newly recorded positive nucleic
acid test laboratory detections for SARS-CoV-2 virus ranged from 87 to 126.
Since Jan 30, 2023, the cumulative number of positive nucleic acid test laboratory detections was
61,707 (as of Apr 10, 2024).

Figure 1.1 Weekly number of positive nucleic acid test laboratory detections for SARS-CoV-2 virus

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VOLUME 2, NUMBER 14 (PUBLISHED ON Apr 11, 2024)

Positive detection rate of specimens tested positive for SARS-CoV-2 virus at the Public
Health Laboratory Services Branch

Among the 7,983 respiratory specimens received by the Public Health Laboratory Services Branch(PHLSB) in week 14, 685 (8.58%) were tested positive for SARS-CoV-2 virus as compared to 797 (9.96%)
in the preceding week. (Figure 1.2)

Figure 1.2 Percentage of specimens tested positive for SARS-CoV-2 virus at PHLSB

3VOLUME 2, NUMBER 14 (PUBLISHED ON Apr 11, 2024)

COVID-19 outbreak surveillance
In week 14, 4 COVID-19 outbreaks occurring in schools/institutions were recorded (affecting 20
persons), as compared to 6 outbreaks recorded in the previous week (affecting 36 persons). (Figure
1.3)
In the first 4 days of week 15 (Apr 7 – Apr 10), 3 COVID-19 outbreak occurring in schools/institutions
was recorded (affecting 27 persons).

Figure 1.3 COVID-19 outbreaks in schools/institutions

Week 13

Week 14

Child care centre/ kindergarten (CCC/KG)
Primary school (PS)

0
0

0
0

First 4 days of week 15(Apr 7 – Apr 10)
00

Secondary school (SS)

0

0

0

Residential care home for the elderly

2

3

3

Residential care home for persons with disabilities

2

1

0

Others200Total number of outbreaks

6

4

3

Total number of persons affected

36

20

27

Type of institutions

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VOLUME 2, NUMBER 14 (PUBLISHED ON Apr 11, 2024)

Surveillance of severe and fatal COVID-19 cases(Note: The data reported are provisional figures and subject to further revision.)

In week 14, the weekly number of severe COVID-19 cases including deaths with cause of death
preliminarily assessed to be related to COVID-19 was 34 as compared to 36 in the preceding week.
(Figure 1.4)
Since Jan 30, 2023, the cumulative number of fatal cases with cause of death preliminarily assessed tobe related to COVID-19 was 1,220 (as of Apr 6, 2024).

Figure 1.4 Weekly number of severe COVID-19 cases including deaths

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VOLUME 2, NUMBER 14 (PUBLISHED ON Apr 11, 2024)

Sewage surveillance of SARS-CoV-2 virus
In week 14, the 7-day geometric mean per capita viral load of SARS-CoV-2 virus from sewage
surveillance was around 290,000 copy/L as compared to around 359,000 copy/L in the preceding
week. (Figure 1.5)

Figure 1.5 7-day geometric mean per capita viral load of SARS-CoV-2 virus from sewage surveillance since May 1, 2022

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VOLUME 2, NUMBER 14 (PUBLISHED ON Apr 11, 2024)

COVID-19 surveillance among sentinel general out-patient clinics andsentinel private medical practitioner clinics
In week 14, the average consultation rate for COVID-19 among sentinel general out-patient clinics(GOPC) and sentinel private medical practitioner clinics were 48.3 (Figure 1.6) and 22.2 (Figure 1.7)
COVID-19 cases per 1,000 consultations, respectively.

Figure 1.6 Average consultation rate of COVID-19 cases in GOPC

Figure 1.7 Average consultation rate of COVID-19 cases in private medical practitioner clinics

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VOLUME 2, NUMBER 14 (PUBLISHED ON Apr 11, 2024)

Surveillance on SARS-CoV-2 variants
The Centre for Health Protection (CHP) conducts surveillance on SARS-CoV-2 variants from sewage
samples. The latest surveillance data (as of Mar 27, 2024) showed that JN.1 and its descendantlineages remained the most prevalent variant, comprising around 77.1% of all characterised
specimens. At the same time, the prevalence of XBB.1.9.2^ comprised about 11.1% of all specimens.
(Figure 1.8)

Figure 1.8 Estimated proportion of variants among sewage samples^ Including EG.5, HV.1 and their descendant lineages
Those SARS-CoV-2 variants not classified as VOIs/ Variants Under Monitoring (VUMs) by World Health Organization
(WHO)
#

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VOLUME 2, NUMBER 14 (PUBLISHED ON Apr 11, 2024)

CHP also conducted genetic characterisation of 35 specimens obtained from reported severe and fatal
cases of COVID-19 between Mar 27 and Apr 09, 2024. The results showed that JN.1 and its
descendant lineages remained the most prevalent variant, comprising 100% of all characterised
specimens (35 cases). (Figure 1.9)

Figure 1.9 Proportion of variants among specimens obtained from reported severe and death cases for COVID-19^ Including EG.5, HV.1 and their descendant lineages#
Those SARS-CoV-2 variants not classified as VOIs/ Variants Under Monitoring (VUMs) by WHO

Besides, CHP conducted genetic characterisation for the specimens obtained from some non-severecases of COVID-19 during the same period. The results showed that JN.1 and its descendant lineages
are the most prevalent variant, comprising 100% of all characterised specimens.

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VOLUME 2, NUMBER 14 (PUBLISHED ON Apr 11, 2024)

Global situation of COVID-19 activity

Globally, as of Mar 24, 2024, there have been 775,132,086 confirmed cases of COVID-19,
including 7,042,222 deaths, reported to WHO.
According to WHO COVID-19 epidemiological update last published on Mar 15, 2024,
Over 0.29 million new cases and over 6,200 deaths were reported in the last 28 days (Feb 5
to Mar 3, 2024) globally.

The highest numbers of new 28-day cases were reported from Russia, Australia, Chile, New
Zealand and Argentina. The highest numbers of new 28-day deaths were reported from theUSA, Russia, Australia, Italy and Chile.

WHO commented that current trends in reported COVID-19 cases were underestimates of
the true number due to the reduction in testing and delays in reporting in many countries.
Therefore, related data should be interpreted with caution.

Currently, WHO is monitoring five VOIs, which are BA.2.86, EG.5, JN.1, XBB.1.5 and
XBB.1.16, and three VUMs, which are XBB, XBB.1.9.1 and XBB.2.3.



Between Feb 26 and Mar 3, 2024, JN.1 is the most prevalent variant globally, accounting for
90.3% compared to 89.4% between Feb 5 and 11, 2024. The updated risk evaluation for
JN.1 suggested an overall evaluation of low public health risk at the global level based on
available evidence. During the same period, the prevalence of BA.2.86, EG.5, XBB.1.5 and
XBB.1.16 decreased from 3.0%, 2.7%, 0.6% and 0.2% to 2.2%, 2.2%, 0.6% and <0.1%
respectively. All VUMs showed decreasing trends over the reporting period.

Sources:1.

WHO COVID-19 dashboard, accessed on Apr 11, 2024

2.

World Health Organization COVID-19 epidemiological update

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VOLUME 2, NUMBER 14 (PUBLISHED ON Apr 11, 2024)

Local Situation of Influenza Activity (as of Apr 10, 2024)
Reporting period: Mar 31 – Apr 6, 2024 (Week 14)
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Hong Kong has entered winter influenza season since early January. The latest surveillance data
show that local influenza activity remains active with the influenza-associated admission rate
higher than the baseline threshold.
Influenza can cause serious illnesses in high-risk individuals and even healthy persons. Given thatseasonal influenza vaccines are safe and effective, all persons aged 6 months or above except
those with known contraindications are recommended to receive influenza vaccine to protect
themselves against seasonal influenza and its complications, as well as related hospitalisations
and deaths.
The Seasonal Influenza Vaccination Subsidy Scheme (VSS) 2023/24 has been launched since
September 28, 2023, whereas the Government Vaccination Programme (GVP), Seasonal Influenza
Vaccination School Outreach (Free of Charge) Programme and the Residential Care Home
Vaccination Programme have been launched since October 5, 2023. The public may visit the CHP's
Vaccination Schemes page for more details of the vaccination programmes(https://www.chp.gov.hk/en/features/17980.html).
Apart from getting influenza vaccination, members of the public should always maintain good
personal and environmental hygiene.
For the latest information on seasonal influenza and its prevention, please visit the Centre for
Health Protection's Seasonal Influenza page(http://www.chp.gov.hk/en/view_content/14843.html).

Influenza-like-illness surveillance among sentinel general out-patient clinics andsentinel private medical practitioner clinics, 2020-24
In week 14, the average consultation rate for influenza-like illness (ILI) among sentinel general
outpatient clinics (GOPC) was 7.1 ILI cases per 1,000 consultations, which was higher than 6.7
recorded in the previous week (Figure 2.1, left). The average consultation rate for ILI among sentinel
private medical practitioner (PMP) clinics was 49.7 ILI cases per 1,000 consultations, which was
higher than 44.9 recorded in the previous week (Figure 2.1, right).

Figure 2.1 ILI consultation rates at sentinel GOPC (left) and PMP clinics (right), 2020-24
Note: The CHP has started to use electronic data on diagnosis coding of patients of the Hospital Authority's GOPC for
sentinel surveillance since January 2020, replacing manual data collection in the past.

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VOLUME 2, NUMBER 14 (PUBLISHED ON Apr 11, 2024)

Laboratory surveillance, 2020-24
Among the 9,334 respiratory specimens received in week 14*, 548 (5.87%) were tested positive forseasonal influenza A or B viruses. Among the subtyped influenza detections, there were 351 (67%)
influenza A(H1), 120 (23%) influenza A(H3) and 56 (11%) influenza B viruses. The positive percentage(5.87%) was below the baseline threshold of 9.21% but was higher than 5.63% recorded in theprevious week (Figure 2.2).

Figure 2.2 Percentage of respiratory specimens tested positive for influenza viruses, 2020-24 (upper: overall positive
percentage, lower: positive percentage by subtypes)[Note: The baseline threshold is 1.96 standard deviation above the average weekly positive percentage during non-season periods from2014 week 49 to 2019 week 48.]
Remarks: Some specimens may contain vaccine strains from people with recent history of receiving live-attenuated influenza vaccine

Surveillance of oseltamivir resistant influenza A and B virusesIn February 2024, there were no new reports of oseltamivir (Tamiflu) resistant influenza A and B
viruses.
For the results of previous months, please refer to the following webpage:https://www.chp.gov.hk/en/statistics/data/10/641/695/7068.html* Including 7,983 specimens received by Public Health Laboratory Services Branch, Centre for Health Protection and 1,351
specimens received by the Hospital Authority

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VOLUME 2, NUMBER 14 (PUBLISHED ON Apr 11, 2024)

Influenza-like illness outbreak surveillance, 2020-24

In week 14, 9 ILI outbreaks occurring in schools/institutions were recorded (affecting 64 persons), as
compared to 14 outbreaks recorded in the previous week (affecting 66 persons) (Figure 2.3). The
overall number was at the low intensity level currently (Figure 2.4*). In the first 4 days of week 15(Apr 7 – 10), 5 ILI outbreaks occurring in schools/institutions were recorded (affecting 23 persons).
Since the start of 2023-24 winter influenza season in week 2, 259 outbreaks were recorded (as of Apr
10).

Figure 2.3 ILI outbreaks in schools/institutions, 2020-24

Type of institutions
Child care centre/ kindergarten (CCC/KG)
Primary school (PS)
Secondary school (SS)
Residential care home for the elderly
Residential care home for persons with disabilities
OthersTotal number of outbreaks
Total number of persons affected

Week 13

Week 14

1
4
1
5
1
2

0
0
0
7
0
2

Cumulative number ofoutbreaks since week 2(as of Apr 10)
24
124
31
36
24
20

14
66

9
64

259
1611

In comparison, 850 outbreaks were recorded in the same duration of surveillance (13 complete
weeks) in the 2018/19 winter season, as compared with 254 outbreaks in the current season (Figure
2.5).

Figure 2.4 ILI outbreaks in schools/institutions, 2023-24

Figure 2.5 Cumulative numbers of ILI outbreaks reported
during major influenza seasons, 2018–19 and 2023–24
Note: The predominating virus was shown in bracket.
* Various intensity levels applicable for this year were calculated with the moving epidemic method (MEM) based on therelevant historical data recorded from 2010 week 49 to 2019 week 48. For details, please refer to this webpage:https://www.chp.gov.hk/files/pdf/explanatory_note_for_flux_mem_eng.pdf
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VOLUME 2, NUMBER 14 (PUBLISHED ON Apr 11, 2024)

Influenza-associated hospital admission rates in public hospitals based ondischarge coding, 2020-24
In week 14, the overall admission rate in public hospitals with principal diagnosis of influenza was
0.36 (per 10,000 population) as compared to 0.45 recorded in the previous week (Figure 2.6). It wasabove the baseline threshold of 0.25 but at the low intensity level (Figure 2.7*). The
influenza-associated admission rates for persons aged 0-5 years, 6-11 years, 12-17 years, 18-49 years,
50-64 years and 65 years or above were 1.47, 0.43, 0.14, 0.12, 0.24 and 0.80 cases (per 10,000 people
in the age group) respectively, as compared to 1.39, 0.69, 0.36, 0.15, 0.25 and 1.06 cases in theprevious week (Figure 2.6).

Figure 2.6 Influenza-associated hospital admission rates, 2020-24 (upper: overall rate, lower: rates by age groups)[Note: The baseline threshold is 1.96 standard deviation above the average weekly admission rate during non-season periods from 2014
week 49 to 2019 week 48.]

*Various intensity levels applicable for this year were
calculated with the moving epidemic method (MEM) basedon the relevant historical data recorded from 2010 week 49
to 2019 week 48. For details, please refer to this webpage:https://www.chp.gov.hk/files/pdf/explanatory_note_for_fl
Figure 2.7 Influenza-associated hospital admission rates, ux_mem_eng.pdf
2023-24

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VOLUME 2, NUMBER 14 (PUBLISHED ON Apr 11, 2024)

Rate of ILI syndrome group in accident Fever surveillance at sentinel child careand emergency departments,
centres/ kindergartens, 2020-24#
2020-24
In week 14, the rate of the ILI syndrome group in
the accident and emergency departments (AEDs)
was 187.0 (per 1,000 coded cases), which was
lower than the rate of 197.4 in the previous week
(Figure 2.8).

The surveillance for week 14 was suspended due toEaster holidays. In week 13, 0.79% of children in thesentinel child care centres / kindergartens(CCCs/KGs) had fever (38°C or above) (Figure 2.9).

#Note: This syndrome group includes codes related to ILI
such as influenza, upper respiratory tract infection, fever,cough, throat pain, and pneumonia.

Figure 2.8 Rate of ILI syndrome group in AEDs, 2020-24

Figure 2.9 Percentage of children with fever at sentinel
CCCs/KGs, 2020-24

Fever surveillance at sentinel
Influenza-like illness surveillance
residential care homes for the elderly, among sentinel Chinese medicine
2020-24practitioners, 2020-24
In week 14, 0.18% of residents in the sentinel
residential care homes for the elderly (RCHEs) had
fever (38°C or above), compared to 0.14%
recorded in the previous week (Figure 2.10).

In week 14, the average consultation rate for ILI
among Chinese medicine practitioners (CMPs) was
0.32 ILI cases per 1,000 consultations as comparedto 1.32 recorded in the previous week (Figure 2.11).

Figure 2.10 Percentage of residents with fever at sentinel
RCHEs, 2020-24

Figure 2.11 ILI consultation rate at sentinel CMPs, 2020-24

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VOLUME 2, NUMBER 14 (PUBLISHED ON Apr 11, 2024)

Surveillance of severe influenza cases(Note: The data reported are provisional figures and subject to further revision.)

Surveillance for intensive care unit (ICU) admission/death with laboratory
confirmation of influenza among adult patients (Aged 18 years or above)
Since 2018, the Centre for Health Protection (CHP) has collaborated with the Hospital Authority andprivate hospitals to monitor ICU admissions and deaths with laboratory confirmation of influenza
among adult patients regularly. For surveillance purpose, the cases refer to laboratory-confirmed
influenza patients who required ICU admission or died within the same admission of influenza
infection. Their causes of ICU admission or death may be due to other acute medical conditions orunderlying diseases.
In week 14, 32 adult cases of ICU admission/death with laboratory confirmation of influenza wererecorded, in which 21 of them were fatal. Among the 32 adult cases, 11 were known to havereceived the 2023/24 seasonal influenza vaccine (SIV). In the first 4 days of week 15 (Apr 7 – 10),26 cases were recorded, in which 12 of them were fatal.
Influenza type

Week
Week 14First 4 days of week 15(Apr 7 – 10)




A(H1)
14

A(H3)
5

A(H1) and A(H3)0A (pending subtype)
10

B
3

C
0

18

2

0

4

2

0

Since the start of 2023-24 winter influenza season in week 2, 446 adult cases of ICU
admission/death with laboratory confirmation of influenza were recorded, in which 274 of themwere fatal. Among them, 123 patients had influenza A(H1) infection, 198 patients with influenza
A(H3), 1 patient with influenza A(H1) and A(H3), 60 patients with influenza A (pending subtype),
61 patients with influenza B and 3 patients with influenza C.
In comparison, 594 adult cases were recorded in the same duration of surveillance (13 complete
weeks) in the 2018/19 winter season, as compared with 420 cases in the current season (Figure
2.12, left). The corresponding figure for deaths was 350 in the above season, as compared with
262 deaths in the current season (Figure 2.12, right).

Figure 2.12 Cumulative numbers of adult severe influenza cases reported during major influenza seasons, 2018–19 and
2023–24 (left: ICU admission/death cases; right: deaths)
Note: The predominating virus was shown in bracket.

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VOLUME 2, NUMBER 14 (PUBLISHED ON Apr 11, 2024)

Surveillance of severe paediatric influenza-associated complication/death (Agedbelow 18 years)
In week 14 and the first 4 days of week 15 (Apr 7 – 10), there was one case of severe paediatricinfluenza-associated complication/death.
Reporting
week
14





Age

Sex

5 months Female

Complication

Severe pneumonia

Fatal Influenza subtype
case?
No

Influenza A (H1)

History of receiving
influenza vaccine
for this season
No

Since the start of 2023-24 winter influenza season in week 2, 16 paediatric cases ofinfluenza-associated complication/death were reported, in which none of them were fatal. Eightcases had infections with influenza A(H3), five with influenza A(H1) and three with influenza B.
Four of them received the 2023/24 SIV. In 2024, 17 paediatric cases of influenza-associatedcomplication/death were recorded, in which none of them were fatal (as of Apr 10).
In comparison, 22 paediatric cases of influenza-associated complication/death were recorded in
the same duration of surveillance (13 complete weeks) in the 2018/19 winter season, as
compared with 16 cases in the current season (Figure 2.13, left). The corresponding figure fordeath was 1 in the above season, as compared with 0 death in current season (Figure 2.13, right).

Figure 2.13 Cumulative numbers of cases of paediatric influenza-associated complication/death reported during major
influenza seasons, 2018–19 and 2023–24 (left: complication/death cases; right: deaths)
Note: The predominating virus was shown in bracket.

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VOLUME 2, NUMBER 14 (PUBLISHED ON Apr 11, 2024)

Severe influenza cases of all ages•

Since the start of 2023-24 winter influenza season in week 2, 462 severe influenza cases among
all ages have been reported, including 274 deaths (as of Apr 10).
Age group
0-5
6-11
12-17
18-49
50-64
>=65

Cumulative number of cases (death)
8 (0)
6 (0)
2 (0)
52 (6)
88 (32)306 (236)•

Among the adult fatal cases with available clinical information, about 84% had chronic diseases.

•

Among patients with laboratory confirmation of influenza admitted to public hospitals in thisseason (from Jan 7 to Apr 10), 3.3% of admitted cases died during the same episode ofadmission. So far, it was within the historical range between 1.9% (2015/16 winter season) and3.3% (2015 summer season).

Figure 2.14 Weekly number of severe influenza cases by age groups, 2020-24 (the percentage positive for influenza virusesin Figure 2.2 is also shown in this graph)18

VOLUME 2, NUMBER 14 (PUBLISHED ON Apr 11, 2024)

Global Situation of Influenza Activity
Influenza activity continued to decline in most countries in the Northern hemisphere. Influenza A(H1N1)pdm09
and B viruses predominated, with differences by geographical area. In the Southern Hemisphere, influenza
activity is generally low (data up to Mar 24, 2024).


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







In the United States (week ending Mar 30, 2024), influenza activity remained elevated nationally but was
decreasing. The percentage of specimens tested positive for influenza decreased to 9.1% from 10.5% in
the preceding week. The percentage of out-patient visits for ILI was 3.0%, which was above the national
baseline of 2.9%. Influenza A(H1N1)pdm09, A(H3N2) and B viruses co-circulated in week 13.
In Canada (week ending Mar 30, 2024), most indicators of influenza activity are generally decreasing. The
weekly percentage of tests positive for influenza was 9.2% in week 13. Influenza A and B virusesco-circulated.
In the United Kingdom (week ending Mar 31, 2024), influenza activity decreased. Influenza positivity was
3.6% in week 13 as compared to 4.5% in the preceding week. The weekly ILI consultation rate in Englanddecreased to 3.4 from 4.9 per 100,000 population in preceding week, and remained within baseline
activity levels.
In Europe (week ending Mar 31, 2024), influenza activity remained widespread, but continued to decrease
towards the 10% positivity epidemic threshold. The percentage of sentinel specimens tested positive for
influenza was 10%, as compared to 12% in the preceding week. Majority of detections were influenza B
viruses in week 13.
In Mainland China (week ending Mar 31, 2024), influenza surveillance data showed the percentage of
specimens tested positive for influenza in both southern and northern provinces continued to decrease,with 16.9% and 7.9% in week 13 respectively. Influenza B(Victoria) viruses predominated, followed byinfluenza A(H3N2) and A(H1N1)pdm09 viruses. .
In Taiwan (week ending Apr 6, 2024), influenza-like illness consultation showed a decreasing trend. The
percentage of specimens tested positive for influenza in week 12 was 13.8%. Most of the influenza
detections in the 4 weeks from week 9 to week 12 were influenza A(H3N2) (46.8%), followed by influenza
B (40.5%) and influenza A(H1) (12.6%) viruses.
In Japan (week ending Mar 31, 2024), the average number of reported ILI cases per sentinel site decreased
to 11.18 from 14.08 in the preceding week. Most of the influenza detections in recent weeks were
influenza B viruses.
In South Korea (week ending Mar 30, 2024), the weekly ILI rate remained elevated. The rate in week 13
was 14.0 per 1,000 out-patient visits, which was above the season epidemic threshold of 6.5. In week 13,
7.9% of tests were positive for influenza (including 5.9% influenza B, 1.8% influenza A(H3N2) and 0.2%
influenza A(H1N1)pdm09).

Sources:

Information have been extracted from the following sources when updates are available: World Health Organization, United States
Centers for Disease Control and Prevention, Public Health Agency of Canada, UK Health Security Agency, European Centre for Disease
Prevention and Control (ECDC) and WHO Regional Office for Europe (WHO Euro), Chinese National Influenza Center, Taiwan Centers
for Disease Control, Japan Ministry of Health, Labour and Welfare and Korean Disease Control and Prevention Agency.

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