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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
N05BA12 TRANQUINAL 0.5 G Alprazolam - 0.5mg 0.5mg Tablet 267,425 L.L
P02DA01 TAENIASAN G Niclosamide - 500mg 500mg Tablet 94,709 L.L
P02DA01 TENIADEX G Niclosamide - 500mg 500mg Tablet 70,392 L.L
G01AA51 TERGYNAN G Nystatin - 100000IU, Neomycin (sulfate) - 65000IU, Metronidazole - 500mg Tablet 348,055 L.L
C09DA07 TELMICARD 80 PLUS G Telmisartan - 80mg, Hydrochlorothiazide - 12.5mg Tablet 954,768 L.L
L04AA31 TERAGIO G Teriflunomide - 14mg 14mg Tablet 24,725,612 L.L
L04AA31 TERAGIO G Teriflunomide - 14mg 14mg Tablet 23,076,914 L.L
N02AX02 TRAMAL RAPIDE B Tramadol HCl - 50mg 50mg Tablet 388,370 L.L
D01BA02 TERMINUS G Terbinafine HCl - 250mg 250mg Tablet 483,783 L.L
C09DB04 TWYNSTA B Telmisartan - 80mg, Amlodipine - 10mg Tablet 991,756 L.L
C09DB04 TWINCARD 80/10 G Telmisartan - 80mg, Amlodipine - 10mg Tablet 1,460,309 L.L
C09DB04 TWYNSTA B Telmisartan - 80mg, Amlodipine - 5mg Tablet 991,756 L.L
C09DB04 TWINCARD 80/5 G Telmisartan - 80mg, Amlodipine - 5mg Tablet 1,131,387 L.L
C08CA01 TORANS G Amlodipine (besylate) - 5mg 5mg Tablet 518,339 L.L
C08CA01 TORANS G Amlodipine (besylate) - 10mg 10mg Tablet 716,716 L.L
A02AC10 TUMS EXTRA STRENGTH 750 ASSORTED FRUIT B Calcium carbonate - 750mg Tablet, chewable 421,967 L.L
C10AA05 TORVACOL 10 G Atorvastatin (calcium) - 10mg 10mg Tablet, coated 1,128,828 L.L
C10AA05 TORVACOL 20 G Atorvastatin (calcium) - 20mg 20mg Tablet, coated 1,128,828 L.L
C10AA05 TORVACOL 40 G Atorvastatin (calcium) - 40mg 40mg Tablet, coated 2,363,819 L.L
G04BE08 TADALAFIL BIOGARAN G Tadalafil - 5mg 5mg Tablet, coated 3,369,013 L.L
G04BE08 TADALAFIL BIOGARAN G Tadalafil - 10mg 10mg Tablet, coated 1,397,596 L.L
N06AA09 TRYPTIZOL B Amitryptiline (HCl) - 10mg 10mg Tablet, coated 695,234 L.L
N06AA09 TRYPTIZOL B Amitryptiline (HCl) - 25mg 25mg Tablet, coated 716,716 L.L
N02AJ13 TRAMADOL/PARACETAMOL ARROW LAB G Tramadol - 37.5mg, Paracetamol - 325mg Tablet, coated 205,608 L.L
N02AX02 TRAMADOL DENK 50 G Tramadol HCl - 50mg 50mg Tablet, effervescent 256,674 L.L
H03BB02 THYROZOL B Methimazole (Thiamazole) - 5mg 5mg Tablet, film coated 233,829 L.L
H03BB02 THYROZOL B Methimazole (Thiamazole) - 10mg 10mg Tablet, film coated 326,554 L.L
A10BH05 TRAJENTA B Linagliptin - 5mg 5mg Tablet, film coated 3,213,127 L.L
C10AA05 TARDELIP G Atorvastatin - 10mg 10mg Tablet, film coated 688,559 L.L
J05AF07 TENOFOVIR DISOPROXIL ARROW G Tenofovir disoproxil - 245mg 245mg Tablet, film coated 9,747,613 L.L
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