National Influenza Annual Report 2023–2024: A focus on influenza B and public health implications

The 2023-2024 influenza epidemic saw the return of typical late-season influenza B circulation. The epidemic was declared in week 45 (week ending November 11, 2023) due to the predominant circulation of influenza A(H1N1) and peaked in week 52 (week ending December 30, 2023); however, as influenza A circulation decreased, influenza B detections and the percentage of tests positive increased, reaching its peak in week 14 (week ending April 6, 2024). Influenza B/Victoria dominated this wave of activity, contributing to the ongoing discussion about the apparent disappearance of influenza B/Yamagata. With the recommendation for the removal of influenza B/Yamagata lineages from the recommended seasonal influenza vaccine components, the influenza surveillance community is preparing for the possibility of a new seasonal pattern dominated by influenza B/Victoria circulation. This season, as a result of influenza B/Victoria's overwhelming predominance, younger age groups were primarily affected by the wave of influenza B activity. Over the course of the season, among all influenza B detections, 52% occurred in children aged 0-19 years. Among all influenza B-associated hospitalizations, 46.4% were in children aged 0-19 years, and the highest cumulative hospitalization rates for influenza B were among children younger than five years (n=37 per 100,000 population) and children between the ages of 5-19 years (n=15 per 100,000 population). Continued vigilance and surveillance around influenza B trends and epidemiology is required to contribute to effective epidemic preparedness.