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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
A16AB04 FABRAZYME BioTech Agalsidase beta - 35mg 35mg Injectable powder for concentrate for solution 295,038,213 L.L
A16AB04 FABRAZYME BioTech Agalsidase beta - 35mg 35mg Injectable powder for concentrate for solution L.L
A02BA03 FAMODAR 20 G Famotidine - 20mg 20mg Tablet, film coated 552,319 L.L
A02BA03 FAMODAR 40 G Famotidine - 40mg 40mg Tablet, film coated 552,319 L.L
A02BA03 FAMONOR G Famotidine - 20mg 20mg Tablet, film coated 220,390 L.L
A02BA03 FAMONOR G Famotidine - 40mg 40mg Tablet, film coated 439,436 L.L
A03FA03 FARCOTILIUM G Domperidone - 10mg 10mg Capsule, soft gelatin 146,479 L.L
A03FA03 FARCOTILIUM G Domperidone - 5mg/5ml 5mg/5ml Suspension 115,570 L.L
J01AA02 FARMODOXI G Doxycycline (hyclate) - 100mg 100mg Tablet 310,428 L.L
R03DX10 FASENRA B Benralizumab - 30mg 30mg Injectable solution L.L
R03DX10 FASENRA B Benralizumab - 30mg 30mg Injectable solution 214,213,273 L.L
L02BA03 FASLODEX B Fulvestrant - 250mg/5ml 250mg/5ml Injectable solution 46,628,557 L.L
L02BA03 FASLODEX B Fulvestrant - 250mg/5ml 250mg/5ml Injectable solution L.L
M02AA10 FASTUM B Ketoprofen - 2.5g/100g 2.5% Gel 177,387 L.L
M02AA10 FASTUM B Ketoprofen - 2.5g/100g 2.5% Gel 337,304 L.L
N06AB08 FAVERIN B Fluvoxamine maleate - 100mg 100mg Tablet, film-scored 1,291,433 L.L
J02AC01 FAZOL 150 G Fluconazole - 150mg 150mg Capsule 623,468 L.L
N02BE01 FEBRADOL G Paracetamol - 500mg 500mg Tablet 327,642 L.L
N02BE01 FEBRADOL JOINT G Paracetamol - 665mg 665mg Tablet 289,246 L.L
M01AE01 FEBRIDEX ELIXIR G Ibuprofen - 100mg/5ml 100mg/5ml Elixir 262,369 L.L
M04AA03 FEBUXOSTAT ARROW G Febuxostat - 120mg 120mg Tablet, film coated 1,084,481 L.L
M04AA03 FEBUXOSTAT ARROW G Febuxostat - 80mg 80mg Tablet, film coated 1,084,481 L.L
M04AA03 FEBUXOSTAT BIOGARAN G Febuxostat - 120mg 120mg Tablet, film coated 1,182,581 L.L
M04AA03 FEBUXOSTAT BIOGARAN G Febuxostat - 80mg 80mg Tablet, film coated 1,182,581 L.L
B02BD03 FEIBA BioHuman Factor VIII Inhibitor bypassing fraction - 500IU 500U (50U/ml) Injectable powder for solution+solvent 40,480,699 L.L
B02BD03 FEIBA BioHuman Factor VIII Inhibitor bypassing fraction - 1000IU 1000U (50U/ml) Injectable powder for solution+solvent 79,869,612 L.L
L02BG04 FEMAPLEX G Letrozole - 2.5mg 2.5mg Tablet, film coated 1,583,046 L.L
L02BG04 FEMARA B Letrozole - 2.5mg 2.5mg Tablet, film coated 3,433,518 L.L
L02BG04 FEMAZOL G Letrozole - 2.5mg 2.5mg Tablet, film coated 1,433,432 L.L
R06AX26 FENADEX 120 G Fexofenadine HCl - 120mg 120mg Tablet, film coated 295,645 L.L
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