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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
A11CC05 ALTO D 10.000 G Vitamin D3 - 10,000IU 10,000IU Capsule 895,895 L.L
A11CC05 ALTUM-D3 G Vitamin D3 - 10,000IU 10,000IU Capsule 561,342 L.L
N03AX12 APO-GABAPENTIN G Gabapentin - 300mg 300mg Capsule 2,260,343 L.L
M01AE01 ADVIL LIQUI-GELS B Ibuprofen - 200mg 200mg Capsule 464,970 L.L
G04CB02 AVODART B Dutasteride - 0.5mg 0.5mg Capsule 2,660,787 L.L
M01AE01 ADVIL LIQUI-GELS EXTRA STRENGTH B Ibuprofen - 400mg 400mg Capsule 575,165 L.L
N02AJ13 ALGODOL G Paracetamol - 325mg, Tramadol HCl - 37.5mg Capsule 317,403 L.L
C08CA01 AMLOR B Amlodipine besylate - 5mg 5mg Capsule 560,382 L.L
C08CA01 AMLOR B Amlodipine besylate - 5mg 5mg Capsule 560,382 L.L
C08CA01 AMLODAR 5 G Amlodipine (besylate) - 5mg 5mg Capsule 362,837 L.L
C08CA01 AMLODIPINE ARROW G Amlodipine (besylate) - 5mg 5mg Capsule 462,282 L.L
C08CA01 AMLODIPINE BIOGARAN G Amlodipine (besylate) - 5mg 5mg Capsule 462,282 L.L
C08CA01 AMLOPHAR G Amlodipine (besylate) - 5mg 5mg Capsule 388,370 L.L
C08CA01 AMOPRO G Amlodipine (besylate) - 5mg 5mg Capsule 362,837 L.L
C08CA01 AMLODAR 10 G Amlodipine (besylate) - 10mg 10mg Capsule 671,921 L.L
C08CA01 AMLODIPINE ARROW G Amlodipine (besylate) - 10mg 10mg Capsule 462,282 L.L
C08CA01 AMLODIPINE BIOGARAN G Amlodipine (besylate) - 10mg 10mg Capsule 462,282 L.L
A04AD12 APREPITANT BIOGARAN G Aprepitant - 80mg 80mg Capsule 1,986,199 L.L
L01ED03 ALECENSA B Alectinib - 150mg 150mg Capsule, hard L.L
A11CC05 ALTUM G Vitamin D3 - 50,000IU 50,000IU Capsule, hard 712,620 L.L
A11CC05 ALTUM-D3 G Vitamin D3 - 50,000IU 50,000IU Capsule, hard 712,620 L.L
L01ED03 ALECENSA B Alectinib - 150mg 150mg Capsule, hard 490,837,809 L.L
D10BA01 ABSORICA LIDOSE G Isotretinoin - 16mg 16mg Capsule, hard 1,827,045 L.L
A04AA55 AKYNZEO B Palonosetron - 0.5mg, Netupitant - 300mg Capsule, hard 7,364,372 L.L
A02BC01 ARAPRIDE G Omeprazole - 20mg 20mg Capsule, hard, gastro-resistant 427,342 L.L
N02AA01 ACTISKENAN G Morphine sulfate - 30mg 30mg Capsule, immediate release 763,303 L.L
N02AA01 ACTISKENAN G Morphine sulfate - 20mg 20mg Capsule, immediate release 512,004 L.L
N02AA01 ACTISKENAN G Morphine sulfate - 10mg 10mg Capsule, immediate release 310,428 L.L
N02AA01 ACTISKENAN G Morphine sulfate - 5mg 5mg Capsule, immediate release 233,829 L.L
R03BA02 AERONIDE G Budesonide - 200mcg 200mcg Capsule, inhalation 1,150,329 L.L
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