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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
D07AC13 ELICA G Mometasone furoate micronized - 1mg/g 0.1% Ointment 399,121 L.L
D07XC03 ELICASAL G Mometasone furoate - 1mg/g, Salicylic acid - 50mg/g Ointment 462,282 L.L
G01AF05 ECONAZ G Econazole nitrate - 150mg 150mg Ovule 415,951 L.L
G01AF05 ECOREX 150 G Econazole nitrate - 150mg 150mg Ovule 280,863 L.L
N06DA03 EXELON TRANSDERMAL PATCH 10 B Rivastigmine - 9.5mg/24h 9.5mg/24h Patch 2,457,888 L.L
N06DA03 EXELON TRANSDERMAL PATCH 5 B Rivastigmine - 4.6mg/24h 4.6mg/24h Patch 2,457,888 L.L
N06DA03 EXELON TRANSDERMAL PATCH 15 B Rivastigmine - 13.3mg/24h 13.3mg/24h Patch 7,582,922 L.L
G01AF05 ECOGYN G Econazole nitrate - 150mg 150mg Pessary 447,948 L.L
M09AX10 EVRYSDI B Risdiplam - 0.75mg/ml 0.75mg/ml Powder L.L
M09AX10 EVRYSDI B Risdiplam - 0.75mg/ml 0.75mg/ml Powder 865,644,067 L.L
G01AX ENTEROGERMINA B Bacillus clausii spores - 6 Billions/2g 6 billions/2g Powder for suspension 1,493,009 L.L
G01AX ENTEROGERMINA B Bacillus clausii spores - 6 Billions/2g 6 billions/2g Powder for suspension 1,343,843 L.L
N02BE01 EFFERALGAN B Paracetamol - 3% 3% Solution 163,949 L.L
D08AX01 EAU OXYGENEE 10/120 G Hydrogen peroxide - 10V 10V Solution 119,026 L.L
D08AX02 EOSIN ALCOHOLIC G Eosin - 2% 2% Solution 115,187 L.L
D08AX02 EOSIN AQUEUSE G Eosin - 2% 2% Solution 98,548 L.L
D08AX02 EOSIN ALCOHOLIC G Eosin - 1% 1% Solution 108,787 L.L
D08AX02 EOSIN AQUEUSE G Eosin - 1% 1% Solution 84,470 L.L
D10AF02 ERYTHROMYCIN 1.5 % G Erythromycin - 15mg/ml 1.5 % Solution 501,701 L.L
D01AE22 EXODERIL B Naftifine HCl - 10ml/ml 1% Solution 159,917 L.L
G01AX ENTEROGERMINA B Bacillus clausii spores - 2 Billions/5ml Suspension 1,131,515 L.L
G01AX ENTEROGERMINA B Bacillus clausii spores - 2 Billions/5ml Suspension 595,322 L.L
R05 EXALL FORTE G Chlorpheniramine maleate - 2.5mg, Guaifenesin - 100mg, Acetaminophen - 100mg, Diprophylline - 25mg Syrup 501,701 L.L
B03AB ENRICH N G Iron trivalent (hydroxide polymaltose complex) - 156.25mg/5ml Syrup 279,519 L.L
G03DA04 ENDOMETRIN B Progesterone - 100mg 100mg Tablet 2,776,379 L.L
A07BA51 EUCARBON B Rhubarbe - 25mg, Sulfur - 50mg, Senna - 105mg, Vegetal charcoal - 180mg Tablet 795,555 L.L
G03XC01 EVA TABLET G Raloxifene HCl - 60mg 60mg Tablet 1,354,081 L.L
N02BE51 EXTRA STRENGTH HEADACHE RELIEF G Acetaminophen - 250mg, Acetylsalicylic acid - 250mg, Caffeine - 65mg Tablet 353,431 L.L
C09BB06 ENEAS G Enalapril maleate - 10mg, Nitrendipine - 20mg Tablet 2,009,045 L.L
C03AA03 ESIDREX B Hydrochlorothiazide - 25mg 25mg Tablet 380,115 L.L
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