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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
H05AA02 BONTEO BioTech Teriparatide - 20mcg/dose 20mcg/dose 17,383,843 L.L
A07EA06 BUDENOFALK B Budesonide - 3mg 3mg Capsule 8,554,692 L.L
A11CC05 BENTA D 10.000 G Vitamin D3 - 10,000IU 10,000IU Capsule 895,895 L.L
A11CC05 BIO-D3 25000IU G Vitamin D3 - 25000IU 25000IU Capsule 1,130,108 L.L
A11CC05 BIO-D3 25000IU G Vitamin D3 - 25000IU 25000IU Capsule 2,147,588 L.L
J01DB05 BIODROXIL G Cefadroxil (monohydrate) - 500mg 500mg Capsule 496,382 L.L
J07AX BRONCHO-VAXOM CHILDREN B Lyophilized bacterial lysates of Haemophilus influenzae, Diplococcus pneumoniae, Klebsiella pneumoniae and ozaenae, Staphylococcus aureus, Streptococcus pyogenes and viridans, Neisseria catarrhalis - 3.5mg Capsule 1,988,887 L.L
J07AX BRONCHO-VAXOM ADULTS B Lyophilized bacterial lysates of Haemophilus influenzae, Diplococcus pneumoniae, Klebsiella pneumoniae and ozaenae, Staphylococcus aureus, Streptococcus pyogenes and viridans, Neisseria catarrhalis - 7mg Capsule 2,746,814 L.L
A11EX BECOZYM FORTE B Nicotinamide - 50mg, Calcium Pantothenate - 25mg, Biotin - 0.15mg, Vitamin B12 - 10mcg, Vitamin B6 - 10mg, Vitamin B2 - 15mg, Vitamin B1 - 15mg Capsule 290,270 L.L
J01DD08 BETIXIM 400 G Cefixime (trihydrate) - 400mg 400mg Capsule 1,026,696 L.L
L01EC03 BRAFTOVI BioTech Encorafenib - 50mg 50mg Capsule, hard 70,084,833 L.L
L01EC03 BRAFTOVI BioTech Encorafenib - 75mg 75mg Capsule, hard 149,227,143 L.L
D07AC01 BETNOVATE B Betamethasone (valerate) - 0.1% 0.1% w/w Cream 279,519 L.L
D07AC01 BETASONE G Betamethasone (valerate) - 1mg/g 1mg/g Cream 120,306 L.L
D07CC01 BETAFUCIN G Fusidic acid - 20mg/g, Betamethasone valerate - 1mg/1g Cream 210,983 L.L
D07CC01 BETASONE-N G Neomycin (sulfate) - 3.5mg/g, Betamethasone (valerate) - 1mg/g Cream 398,033 L.L
D07XC01 BETA-MICOTER G Betamethasone (dipropionate) - 0.5mg/g, Clotrimazole - 10mg/g Cream 415,951 L.L
D03AX BEPANTHEN PLUS B Chlorhexidine HCl - 5mg/g, Dexpanthenol - 50mg/g Cream 319,835 L.L
A11A BEBE-VIT G Vitamin A - 1500IU/ml, Vitamin D3 - 400IU/ml, Vitamin E - 5mg/ml, Vitamin C - 40mg/ml, Vitamin B1 - 0.5mg/ml, Vitamin B2 - 0.6mg/ml, Vitamin B6 - 0.6mg/ml, Nicotinamide - 8mg/ml Drops 287,582 L.L
S01EA05 BGLAU G Brimonidine tartrate - 0.2% 0.2% Drops solution 638,325 L.L
S01EA05 BRIMO G Brimonidine tartrate - 0.2% 0.2% Drops solution 658,483 L.L
S01EA05 BRIMOGAN G Brimonidine tartrate - 0.2% w/v 0.2% w/v Drops solution 483,783 L.L
S01EA05 BRIMONIDINE BIOGARAN G Brimonidine tartrate - 2mg/ml 0.2% Drops solution 412,560 L.L
S01GX08 BRUNISTILL G Ketotifen - 250mcg/ml 250mcg/ml Drops solution 940,690 L.L
M01AC01 BRUXICAM B Piroxicam - 0.5% Drops solution 530,818 L.L
R05CB02 BROMHEXINE G Bromhexine - 4mg/5ml 4mg/5ml Elixir 176,619 L.L
R05X BROMEX G Pyrilamine Maleate (Mepyramine) - 12.5mg/5ml, Bromhexine HCl - 4mg/5ml Elixir 250,851 L.L
D02AX BIAFINE B Trolamine - 0.67g/100g 0.67g/100g Emulsion 524,099 L.L
D10AE01 BENZAC AC G Benzoyl peroxide - 10g/100g 10% Gel 416,591 L.L
D10AE01 BENZAC AC G Benzoyl peroxide - 5g/100g 5% Gel 388,370 L.L
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