# Patterns of the Circulation of Influenza in a Targeted Jordanian Subpopulation from November 2021 to April 2023

## TL;DR

This study tracks influenza patterns in Jordan from 2021 to 2023, identifying key strains and coinfections to guide public health strategies.

## Contribution

The study provides detailed strain-specific influenza data and coinfection patterns in a Jordanian subpopulation.

## Key findings

- IAV (H1N1) pdm09 was the most common influenza strain detected (55.8%).
- IBV Victoria lineage dominated among IBV cases (98.4%).
- Frequent coinfections were observed between IAV and IBV, as well as other pathogens.

## Abstract

Background: Influenza remains a global health challenge, causing significant morbidity and mortality. This study explores the epidemiology of influenza A (IAV) and B (IBV) during the 2021–2023 winter seasons within a targeted Jordanian subpopulation to inform public health strategies. Methods: Nasopharyngeal swabs from patients with acute respiratory tract infections (ARTIs) in three major Jordanian cities were analyzed. RT-PCR was utilized to detect common respiratory pathogens, and specific primers identified IAV (H1N1) pdm09, H3N2, and IBV subtypes. Statistical analyses examined influenza subtype frequencies and their association with demographics and coinfection patterns. Results: IAV, IBV, and ICV were detected in 9.4%, 13.5%, and 5.5% of cases, respectively. Predominant strains were IAV (H1N1) pdm09 (55.8%), H3N2 (30.2%), and IBV Victoria lineage (98.4%). Coinfections with IAV frequently involved Bordetella spp., Staphylococcus aureus, and IBV, while IBV also showed coinfections with Haemophilus influenzae type B and IAV. Conclusions: The predominance of IAV (H1N1) pdm09 and IBV Victoria lineage highlights the need for strain-specific vaccination. Frequent coinfections underscore the importance of comprehensive diagnostics. Local public health strategies should focus on increasing vaccine coverage and preventive education, especially for adults and urban populations.