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Influenza Surveillance

Severe Acute Respiratory Infection Surveillance (SARI)
Rationale Severe acute respiratory infections (SARI) can be the result of several agents: viral, bacterial, and parasites, even though bacterial and parasitic agents can be less common. Among the viruses, influenza viruses are among the major causes of SARI.
Any preventive or control measure related to Influenza requires the availability of surveillance, including the seasonality pattern and the causative agents.
SARI surveillance in Lebanon was established in collaboration of the World Health Organization.
Objectives The objectives of Severe Acute Respiratory Infection (SARI) in Lebanon are:
- To estimate morbidity (incidence) of SARI in Lebanon
- To identify baseline figures and alert/outbreak thresholds
- To describe SARI cases by time, place, person, susceptibility, severity
- To identify circulating influenza strains and detect novel viruses
- To contribute to the global influenza surveillance
Sources of data Data sources are hospital sentinel sites. Sentinel surveillance focuses on collection of data from specific pre-selected health sites to carefully monitor a specific disease. The collection of the data is systemic. The sites are selected based on key criteria: willingness, activity and representativeness of the population.
The current sentinel sites are:
- In the mohafazas of Beirut and Mount Lebanon: Rafik Hariri University Governmental Hospital (RHUH), American University of Beirut Medical Center, Quarantina Governmental Hospital
- In the mohafazas of Bekaa and Baalbeck/Hermel: Baalbeck Governmental Hospital
- In the mohafazas of North and Akkar: Kheir Hospital
Case Definition An acute respiratory infection with:
- History of fever or measured fever of >=38°C and cough
- Onset within the last 10 days
- Requiring hospitalization
Case Investigation For each SARI case, data is collected including demographical and clinical data. Also, clinical specimens are collected for laboratory testing. The needed specimens are: nasopharyngeal swab (preferable one), oropharyngeal swab, bronchoalveolar lavage (if done), or tracheal aspirate (if patient intubated).
Laboratory Testing Laboratory testing for SARI patients are performed at the National Influenza Center at RHUH. The laboratory testing includes RT-PCR for Influenza viruses A and B.
SARI forms - Laboratory request form
Results - Latest weekly bulletin
- Latest weekly severity indicators
- Link to WHO database
 
Intensive Care Unit Based Surveillance (ICU)
Objectives The main objectives of ICU-based surveillance are to:
 - Measure and monitor on weekly basis morbidity indicators related to severe acute respiratory infections in Lebanon
 - Detect abnormal pattern and novel agents at an early stage, and investigate them
 - Assist decision makers on proper control measures
Data sources Data sources are both ICUs in public and private hospitals across Lebanon. The MOPH decision requested each hospital to designate a focal person from the ICU medical staff in charge of reporting to the MOPH.
Case definition - Severe Acute Respiratory Infection with fever and dyspnea
- Whatever was the etiological agent
- Admitted to ICU
Data collection Data is collected using a specific form. The form is sent every week by the hospital event if no cases were reported. The reporting form is a nominative line-listing.
Guidelines ICU-based surveillance for acute respiratory infection: Ar, En, Fr
Weekly form - ICU weekly reporting form
Results - Latest weekly summary
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ATC Name B/G Ingredients Dosage Form Price
A01AB09 DAKTARIN ORAL B Miconazole nitrate - 20mg/g 20mg/g Gel 318,491 L.L
A01AB09 MICONAZ G Miconazole nitrate - 20mg/g 20mg/g Gel 229,093 L.L
A01AB09 MICOZOLE G Miconazole - 20mg/g 20mg/g Gel 104,820 L.L
A01AB09 MYCOHEAL G Miconazole nitrate - 20mg/g 20mg/g Gel 210,983 L.L
A01AD11 DILO MOUTHWASH G Diclofenac sodium - 0.74mg/ml 0.74mg/ml 1,062,276 L.L
A02AC10 RENNIE B Magnesium carbonate - 80mg, Calcium carbonate - 680mg Tablet, chewable 240,548 L.L
A02AC10 TUMS EXTRA STRENGTH 750 ASSORTED FRUIT B Calcium carbonate - 750mg Tablet, chewable 421,967 L.L
A02AF02 MAALOX PLUS B Dimethicone - 25mg, Aluminium hydroxide - 200mg, Magnesium hydroxide - 200mg Tablet, chewable 166,636 L.L
A02AF02 ACTONORM B Aluminium hydroxide - 220mg/5ml, Magnesium hydroxide - 200mg/5ml, Simethicone - 25mg/5ml Suspension 403,153 L.L
A02AF02 MAALOX PLUS B Simethicone - 25mg/5ml, Aluminium hydroxide - 175mg/5ml, Magnesium hydroxide - 200mg/5ml Suspension 438,093 L.L
A02AH REFCON DOUBLE ACTION G Sodium alginate - 50mg/ml, Sodium bicarbonate - 21.3mg/ml, Calcium (carbonate) - 32.50mg/ml Suspension 399,121 L.L
A02BA03 FAMODAR 20 G Famotidine - 20mg 20mg Tablet, film coated 552,319 L.L
A02BA03 FAMONOR G Famotidine - 20mg 20mg Tablet, film coated 220,390 L.L
A02BA03 FAMODAR 40 G Famotidine - 40mg 40mg Tablet, film coated 552,319 L.L
A02BA03 FAMONOR G Famotidine - 40mg 40mg Tablet, film coated 439,436 L.L
A02BB01 CYTOTEC B Misoprostol - 200mcg 200mcg Tablet 737,770 L.L
A02BB01 MISOFAR G Misoprostol - 200mcg 200mcg Tablet 1,546,763 L.L
A02BB01 MISOFAR G Misoprostol - 25mcg 25mcg Tablet 1,855,846 L.L
A02BC DANLOX QUICK G Omeprazole - 20mg, Sodium bicarbonate - 1680mg Powder 1,323,685 L.L
A02BC01 ARAPRIDE G Omeprazole - 20mg 20mg Capsule, hard, gastro-resistant 427,342 L.L
A02BC01 AXIPRON G Omeprazole - 20mg 20mg Capsule 373,358 L.L
A02BC01 DIGCAP G Omeprazole - 20mg 20mg Capsule 593,850 L.L
A02BC01 EPIRAZOLE G Omeprazole - 20mg 20mg Capsule 208,296 L.L
A02BC01 GASTRAZOLE G Omeprazole - 20mg 20mg Capsule 134,384 L.L
A02BC01 GASTRAZOLE G Omeprazole - 20mg 20mg Capsule 377,620 L.L
A02BC01 GASTRIMUT G Omeprazole - 20mg 20mg Capsule, hard, gastro-resistant 427,342 L.L
A02BC01 GASTRIMUT G Omeprazole - 20mg 20mg Capsule, hard, gastro-resistant 6,720,556 L.L
A02BC01 GASTRISEC G Omeprazole - 20mg 20mg Capsule 413,903 L.L
A02BC01 HYPOSEC G Omeprazole - 20mg 20mg Capsule 659,827 L.L
A02BC01 HYPOSEC G Omeprazole - 20mg 20mg Capsule 1,478,227 L.L
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