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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
L01CD04 CABAZITAXEL EVER PHARMA G Cabazitaxel - 60mg/6ml 10mg/ml Injectable concentrate for solution 56,690,955 L.L
L01CD04 CABAZITAXEL EVER PHARMA G Cabazitaxel - 60mg/6ml 10mg/ml Injectable concentrate for solution L.L
L01EX07 CABOMETYX B Cabozantinib - 20mg 20mg Tablet, film coated 440,893,501 L.L
L01EX07 CABOMETYX B Cabozantinib - 40mg 40mg Tablet, film coated 440,893,501 L.L
L01EX07 CABOMETYX B Cabozantinib - 60mg 60mg Tablet, film coated 440,893,501 L.L
L01CD04 CABOTAX G Cabazitaxel - 60mg/1.5ml 60mg/1.5ml Injectable concentrated powder for solution+diluent 45,371,506 L.L
G02CB03 CABRGOL G Cabergoline - 0.5mg 0.5mg Tablet, scored 976,973 L.L
L01DB01 CAELYX B Doxorubicin HCl pegylated liposomes - 20mg/10ml 20mg/10ml Injectable concentrated solution 34,821,487 L.L
L01DB01 CAELYX B Doxorubicin HCl pegylated liposomes - 20mg/10ml 20mg/10ml Injectable concentrated solution L.L
A11GB CAL-C-VITA EFFERVESCENT B Vitamin B6 - 15mg, Vitamin D - 300IU, Calcium carbonate - 625mg, Ascorbic acid - 1000mg Tablet, effervescent 494,534 L.L
A11AA CAL-VIT G Riboflavine - 9mg/100ml, Cyanocobalamine - 570mcg/100ml, Pyridoxine HCl - 35mg/100ml, Thiamine HCl - 190mg/100ml, Inositol - 150mg/100ml, Nicotinamide - 120mg/100ml, Calcium Pantothenate - 27mg/100ml, Sodium hypophosphite - 70mg/100ml Syrup 163,821 L.L
A11EA CAL-VIT G Riboflavine - 3mg, Cyanocobalamine - 60mcg, Pyridoxine HCl - 5mg, Thiamine mononitrate - 10mg, Inositol - 3mg, Calcium pantothenate - 3mg Tablet 142,063 L.L
A11EA CAL-VIT G Riboflavine - 3mg, Cyanocobalamine - 60mcg, Pyridoxine HCl - 5mg, Thiamine mononitrate - 10mg, Inositol - 3mg, Calcium Pantothenate - 3mg Tablet 4,025,128 L.L
D04AX CALAMINE PLUS B Diphenhydramine HCl - 0.25/100ml, Tetracaine HCl - 0.025/100ml, Zinc oxide - 8g/100ml, Calamine - 8g/100ml Lotion 177,899 L.L
B05XA07 CALCIUM CHLORIDE G Calcium chloride - 10g/100ml 10g/100ml Injectable solution 5,436,771 L.L
A12AA03 CALCIUM GLUCONATE G Calcium gluconate - 10g/100ml 10g/100ml Injectable solution 763,056 L.L
A12AA03 CALCIUM GLUCONATE G Calcium gluconate - 10g/100ml 10g/100ml Injectable solution 6,867,500 L.L
A12AA03 CALCIUM GLUCONATE S.A.L.F G Calcium gluconate monohydrate - 10% 10% Injectable solution 389,714 L.L
V03AE01 CALCIUM RESONIUM B Calcium Polystyrene Sulphonate - 15g 15g Powder 2,053,391 L.L
V03AF03 CALCIUMFOLINAT EBEWE G Calcium folinate - 100mg/10ml 100mg/10ml Injectable solution 1,289,872 L.L
R06AE09 CALIVIDA G Levocetirizine dihydrochloride - 5mg 5mg Tablet, film coated 447,948 L.L
R06AE09 CALIVIDA G Levocetirizine dihydrochloride - 0.5mg/ml 0.5mg/ml Solution 1,158,264 L.L
A12AA04 CALPEROS G Calcium (carbonate) - 500mg 500mg Tablet 622,199 L.L
A12AX CALPEROS D3 A SUCER B Vitamin D3 - 400IU, Calcium - 500mg Tablet, chewable 658,483 L.L
L01EL02 CALQUENCE B Acalabrutinib - 100mg 100mg Tablet, film coated 650,653,454 L.L
A12AA04 CALTRATE 600 B Calcium (carbonate) - 600mg 600mg Tablet 618,168 L.L
R03DA55 CAMPHO-PNEUMINE AMINOPHYLLINE ADULTES G Amyleine HCl - 0.01g, Eucalyptol - 0.05g, Camphre - 0.1g, Gaiacol ethyl glycolate - 0.26g, Aminophylline - 0.15g Suppository 326,362 L.L
R03DA55 CAMPHO-PNEUMINE AMINOPHYLLINE ADULTES G Amyleine HCl - 0.01g, Eucalyptol - 0.05g, Camphre - 0.1g, Gaiacol ethyl glycolate - 0.26g, Aminophylline - 0.15g Suppository 490,183 L.L
R03DA55 CAMPHO-PNEUMINE AMINOPHYLLINE ENFANTS G Eucalyptol - 0.03g, Camphre - 0.04g, Gaiacol ethyl glycolate - 0.12g, Aminophylline - 0.06g Suppository 284,127 L.L
R03DA55 CAMPHO-PNEUMINE AMINOPHYLLINE ENFANTS G Eucalyptol - 0.03g, Camphre - 0.04g, Gaiacol ethyl glycolate - 0.12g, Aminophylline - 0.06g Suppository 426,190 L.L
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