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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
J05AF01 REVODINE G Zidovudine - 300mg 300mg Tablet, film coated 7,771,552 L.L
R03AK10 RELVAR ELLIPTA B Vilanterol (trifenatate) - 25mcg/dose, Fluticasone furoate - 200mcg/dose Inhalation powder 3,928,052 L.L
R03AK10 RELVAR ELLIPTA B Vilanterol (trifenatate) - 25mcg/dose, Fluticasone furoate - 100mcg/dose Inhalation powder 3,928,052 L.L
N05CM09 RELAXINE TRENKER G Valerian extract - 500mg 500mg Tablet, coated 1,134,203 L.L
L04AA44 RINVOQ B Upadacitinib - 15mg 15mg Tablet, prolonged release L.L
L04AA44 RINVOQ B Upadacitinib - 15mg 15mg Tablet, prolonged release 45,469,094 L.L
R01AD11 RINEX G Triamcinolone acetonide - 55mcg/actuation 55mcg/actuation Spray, suspension 470,985 L.L
D10AD01 RETACNYL - 0.05 % G Tretinoin - 0.05% Cream 584,571 L.L
D10AD51 RETINOMYCIN G Tretinoin - 0.025%, Erythromycin - 4% Gel 662,962 L.L
M01AC02 REUTENOX G Tenoxicam - 20mg 20mg Tablet, coated 576,508 L.L
G04BE08 RAVANA G Tadalafil - 5mg 5mg Tablet 1,501,264 L.L
G04BE08 RAVANA G Tadalafil - 20mg 20mg Tablet 500,421 L.L
L04AD02 ROLITAC XR G Tacrolimus - 5mg 5mg Capsule, hard, prolonged release 51,728,043 L.L
L04AD02 ROLITAC XR G Tacrolimus - 3mg 3mg Capsule, hard, prolonged release 34,888,503 L.L
L04AD02 ROLITAC XR G Tacrolimus - 1mg 1mg Capsule, hard, prolonged release 12,138,660 L.L
L04AD02 ROLITAC XR G Tacrolimus - 0.5mg 0.5mg Capsule, hard, prolonged release 6,329,498 L.L
V03AB35 RELANCIUM G Sugammadex - 100mg/ml 100mg/ml Injectable solution 45,660,028 L.L
J01FA02 ROVAMYCINE B Spiramycin - 3MIU 3MIU Tablet, film coated 649,076 L.L
J01FA02 ROVAMYCINE B Spiramycin - 1.5MIU 1.5MIU Tablet, film coated 256,674 L.L
V03AE01 RESINSODIO G Sodium polystyrene sulphonate - 99.75g/100g 99.75g/100g Powder for suspension 3,816,513 L.L
B05BB01 RINGER INJECTION G Sodium chloride - 0.86g/100ml, Calcium Chloride Dihydrate - 0.033g/100ml, Potassium chloride - 0.03g/100ml Injectable solution 204,554 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
L04AA10 RAPAMUNE B Sirolimus - 1mg 1mg Tablet 12,907,489 L.L
L04AA10 RAPAMUNE B Sirolimus - 1mg 1mg Tablet L.L
V03AE02 RENVELA B Sevelamer - 800mg 800mg Tablet, film coated 8,386,876 L.L
N06AB06 RESTRALINE G Sertraline HCl - 50mg 50mg Tablet, film coated 575,933 L.L
R03AC02 RONKOTOL G Salbutamol (sulfate) - 2.5mg/2.5ml 2.5mg/2.5ml Inhalation solution 470,345 L.L
D11AH09 RUXOTOP G Ruxolitinib - 1.5% 1.5% Cream 12,306,475 L.L
R06AX28 RUPATADINE BIOGARAN G Rupatadine - 10mg 10mg Tablet 341,336 L.L
J07BH01 ROTATEQ ROTAVIRUS VACCINE, LIVE, ORAL, PENTAVALENT B Rotavirus G1, live attenuated - ?2.2x106 IU, Rotavirus G2, live attenuated - ?2.8x106 IU, Rotavirus G3, live attenuated - ?2.2x106 IU, Rotavirus G4, live attenuated - ?2.0x106 IU, Rotavirus P1, live attenuated - ?2.3x106 IU Suspension 4,508,592 L.L
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