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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
L01CB01 ETOPOSIDE VIATRIS 20MG/ML G Etoposide - 100mg/5ml 100mg/5ml Injectable concentrated solution 1,544,466 L.L
L01CD01 EBETAXEL G Paclitaxel - 30mg/5ml 30mg/5ml Injectable concentrated solution 2,983,330 L.L
L01CD01 EBETAXEL G Paclitaxel - 150mg/25ml 150mg/25ml Injectable concentrated solution 15,457,059 L.L
L01XA03 ELOXATIN B Oxaliplatin - 50mg/10ml 50mg/10ml Injectable concentrated solution 4,930,558 L.L
L01CB01 ETOPOSIDE VIATRIS 20MG/ML G Etoposide - 100mg/5ml 100mg/5ml Injectable concentrated solution L.L
L01CA04 EBERELBIN G Vinorelbine (tartrate) - 50mg/5ml 50mg/5ml Injectable concentrated solution L.L
A02BC01 ESELAN G Omeprazole (sodium) - 40mg 40mg Injectable lyophilised powder for solution 2,073,549 L.L
L01XX02 ERWINASE BioTech Erwinia L-asparaginase - 10,000IU 10,000IU Injectable lyophilised powder for solution 444,434,845 L.L
J01DH03 ERTANZ G Ertapenem - 1g 1g Injectable powder 2,521,049 L.L
L01FD04 ENHERTU BioTech Trastuzumab deruxtecan - 100mg 100mg Injectable powder for concentrate for solution L.L
L04AA33 ENTYVIO BioTech Vedolizumab - 300mg 300mg Injectable powder for concentrate for solution 152,492,033 L.L
L01FD04 ENHERTU BioTech Trastuzumab deruxtecan - 100mg 100mg Injectable powder for concentrate for solution 178,517,964 L.L
L01AA01 ENDOXAN B Cyclophosphamide (monohydrate) - 500mg 500mg Injectable powder for solution L.L
A02BC05 ESAC G Esomeprazole sodium - 40mg 40mg Injectable powder for solution 430,030 L.L
A02BC05 ESOMEPRAZOLE NORMON G Esomeprazole - 40mg 40mg Injectable powder for solution 430,030 L.L
A02BC05 ESSIUM G Esomeprazole - 40mg 40mg Injectable powder for solution 314,459 L.L
L01AA01 ENDOXAN B Cyclophosphamide (monohydrate) - 500mg 500mg Injectable powder for solution 764,646 L.L
L01AA01 ENDOXAN B Cyclophosphamide (monohydrate) - 500mg 500mg Injectable powder for solution 764,646 L.L
B02BD02 ESPEROCT BioTech Turoctocog Alfa pegol (recombinant coagulation factor VIII) - 500IU/Vial 500IU/Vial Injectable powder for solution+diluent 38,126,657 L.L
B02BD02 ESPEROCT BioTech Turoctocog Alfa pegol (recombinant coagulation factor VIII) - 1000IU/Vial 1000IU/Vial Injectable powder for solution+diluent 75,761,363 L.L
C01CA26 EPHEDRINE AGUETTANT G Ephedrine HCl - 30mg/ml 30mg/ml Injectable solution 614,136 L.L
C01CA26 EPHEDRINE RENAUDIN G Ephedrine HCl - 30mg/ml 3% Injectable solution 693,423 L.L
C01CA26 EPHEDRINE AGUETTANT G Ephedrine HCl - 3mg/ml 3mg/ml Injectable solution 7,827,491 L.L
B05BB02 ELECTROLYE 67 G Calcium gluconate - 0.10g/100ml, Potassium chloride - 0.075g/100ml, Sodium chloride - 0.30g/100ml, Dextrose, H2O - 5.0g/100ml Injectable solution 165,727 L.L
G03GA09 ELONVA BioHuman Corifollitropin alfa - 100mcg/0.5ml 100mcg/0.5ml Injectable solution 35,131,802 L.L
G03GA09 ELONVA BioTech Corifollitropin alfa - 150mcg/0.5ml 150mcg/0.5ml Injectable solution 44,141,610 L.L
L04AX03 EBETREXAT G Methotrexate - 15mg/1.5ml 15mg/1.5ml Injectable solution 2,135,366 L.L
B02AA02 EXACYL B Tranexamic acid - 500mg/5ml 500mg/5ml Injectable solution 748,520 L.L
L01DB03 EPIRUBICINE VIATRIS 2MG/ML G Epirubicin HCl - 10mg/5ml 10mg/5ml Injectable solution 855,212 L.L
L01DB03 EPIRUBICINE VIATRIS 2MG/ML G Epirubicin HCl - 50mg/25ml 50mg/25ml Injectable solution 3,914,242 L.L
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