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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
C10BA03 PRAVAFEN B Pravastatin sodium - 40mg, Fenofibrate - 160mg Capsule, hard 1,264,556 L.L
J02AC01 PANZIMOL G Fluconazole - 100mg 100mg Capsule, hard 1,988,887 L.L
L01EF01 PAPILLIO G Palbociclib - 125mg 125mg Capsule, hard L.L
J02AC01 PANZIMOL G Fluconazole - 150mg 150mg Capsule, hard 423,310 L.L
G04CA02 PROSTAFINE G Tamsulosin HCl - 0.4mg 0.4mg Capsule, modified release 761,511 L.L
G03DA04 PROGEST 200 G Progesterone micronised - 200mg 200mg Capsule, soft gelatin 411,216 L.L
G03DA04 PROGEST 200 G Progesterone micronised - 200mg 200mg Capsule, soft gelatin 411,216 L.L
G03DA04 PROGEST G Progesterone micronised - 100mg 100mg Capsule, soft gelatin 368,213 L.L
G03DA04 PROGEST G Progesterone micronised - 100mg 100mg Capsule, soft gelatin 368,213 L.L
G01AA51 POLYGYNAX B Nystatin - 100,000IU, Polymixin B sulfate - 35,000IU, Neomycin sulfate - 35,000IU Capsule, vaginal 407,184 L.L
D07AC14 PRENIDERM G Methylprednisolone aceponate - 0.1% 0.1% Cream 312,283 L.L
D07AC18 PEITEL B Prednicarbate - 0.25% 0.25% Cream 507,972 L.L
D07CB01 PANDERM G Triamcinolone acetonide - 1mg/g, Gramicidin - 0.25mg/g, Neomycin (sulfate) - 2.5mg/g, Nystatin - 100.000IU/g Cream 180,075 L.L
D07CB01 POSITON G Triamcinolone acetonide - 100mg, Neomycin (sulfate) - 250mg, Nystatin - Cream 1,064,323 L.L
C05AX05 PROCTO GLYVENOL B Lidocaine HCl - 2g/100g, Tribenoside - 5g/100g Cream 405,840 L.L
C05AX05 PILOCIN G Tribenoside - 5%, Lidocaine HCl - 2% Cream 271,456 L.L
N01BB54 PRILA G Prilocaine - 2.5% w/w, Lidocaine - 2.5% w/w Cream 1,057,604 L.L
N01BB54 PRILA G Prilocaine - 2.5% w/w, Lidocaine - 2.5% w/w Cream 1,163,768 L.L
B03AA07 PEDIAFER G Ferrous (sulfate) - 15mg/ml 15mg/ml Drops 550,975 L.L
S01EC03 PROGLAU G Dorzolamide HCl - 20mg/ml 20mg/ml Drops solution 517,379 L.L
S01FB01 PHENYLEPHRINE/ COOPER G Phenylephrine HCl - 10% 10% Drops solution 278,175 L.L
S01GX09 PATANOL B Olopatadine (HCl) - 0.1% 0.1% Drops solution 572,477 L.L
S02CA06 POLYDEXA G Dexamethasone sodium metasulfobenzoate - 1.000.000IU/100ml, Polymyxin B sulfate - 100mg/100ml, Neomycin sulfate - 650.000IU/100ml Drops solution 208,296 L.L
S02CA07 PAROTICIN G Fludrocortisone acetate - 1mg/ml, Polymyxin B (sulfate) - 10.000IU/ml, Lidocaine - 50mg/ml Drops solution 319,835 L.L
S01BA04 PRED FORTE B Prednisolone acetate - 10mg/ml 1% Drops suspension 260,705 L.L
S01BA04 PRED FORTE B Prednisolone acetate - 10mg/ml 1% Drops suspension 260,705 L.L
N02BE01 PAINOL G Paracetamol - 120mg/5ml 120mg/5ml Elixir 85,750 L.L
N02BE01 PARACETAMOL ELIXIR G Paracetamol - 120mg/5ml 120mg/5ml Elixir 85,750 L.L
N02BE01 PAROL CHILDREN G Paracetamol - 240mg/5ml 240mg/5ml Elixir 314,843 L.L
A07EC02 PENTASA B Mesalazine - 1g 1g Enema 2,791,161 L.L
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