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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
B05D PERITONEAL DIALYSIS SOLUTION WITH 4 1/4% DEXTROSE G Sodium lactate - 0.392g%, Calcium chloride, 2H2O - 0.0257g%, Magnesium chloride, 6H2O - 0.0153g%, Sodium chloride - 0.567g%, Dextrose, H2O - 4.25g% Injectable solution 498,744 L.L
B05D PERITONEAL DIALYSIS SOLUTION WITH 1 1/2% DEXTROSE G Sodium lactate - 0.392g%, Calcium chloride, 2H2O - 0.0257g%, Magnesium chloride, 6H2O - 0.0153g%, Sodium chloride - 0.567g%, Dextrose, H2O - 1.5g% Injectable solution 490,807 L.L
B05XA PEDITRACE B Sodium selenite 5H2O (anhydrous) - 6.66mcg/ml, Sodium fluoride - 126mcg/ml, Potassium iodide - 1.31mcg/ml, Zinc chloride - 521mcg/ml, Copper chloride - 53.7mcg/ml, Manganese chloride 4H2O - 3.6mcg/ml Injectable concentrated solution 4,749,139 L.L
B05XA01 POTASSIUM CHLORIDE G Potassium chloride - 7.46g/100ml 7.46g/100ml Injectable solution 2,822,386 L.L
B05XA01 POTASSIUM CHLORIDE G Potassium chloride - 7.46g/100ml 7.46g/100ml Injectable solution 663,077 L.L
B05XA01 POTASSIUM CHLORIDE G Potassium chloride - 10g/100ml 10g/100ml Injectable solution 3,023,493 L.L
B05XA01 POTASSIUM CHLORIDE G Potassium chloride - 15g/100ml 15g/100ml Injectable solution 5,688,441 L.L
B05XA01 POTASSIUM CHLORIDE G Potassium chloride - 11.2g/100ml 11.2g/100ml Injectable solution 789,487 L.L
C01CA06 PHENYLEPHRINE HYDROCHLORIDE G Phenylephrine HCl - 10mg/ml 1% Injectable solution 10,282,281 L.L
C01CA06 PHENYLEPHRINE RENAUDIN G Phenylephrine - 100mcg/ml 100mcg/ml Injectable solution 5,955,910 L.L
C01CA06 PHENYLEPHRINE AGUETTANT G Phenylephrine - 500mcg/10ml 500mcg/10ml Injectable solution 11,464,796 L.L
C01EA01 PROSTIN VR B Alprostadil - 500mcg/ml 500mcg/ml Injectable concentrated solution 19,894,577 L.L
C01EB17 PROCORALAN B Ivabradin (HCl) - 5mg 5mg Tablet, film coated 1,890,786 L.L
C01EB17 PROCORALAN B Ivabradin (HCl) - 7.5mg 7.5mg Tablet, film coated 1,890,786 L.L
C02KX01 PMS-BOSENTAN G Bosentan (monohydrate) - 125mg 125mg Tablet 77,539,821 L.L
C02KX01 PMS-BOSENTAN G Bosentan (monohydrate) - 62.5mg 62.5mg Tablet 77,539,821 L.L
C04AD03 PENTOXIFYLLINE SR G Pentoxifylline - 1160 400mg Tablet, sustained release 1,478,227 L.L
C05AX05 PROCTO GLYVENOL B Lidocaine - 40mg, Tribenoside - 400mg Suppository 399,121 L.L
C05AX05 PROCTO GLYVENOL B Lidocaine HCl - 2g/100g, Tribenoside - 5g/100g Cream 405,840 L.L
C05AX05 PILOCIN G Tribenoside - 5%, Lidocaine HCl - 2% Cream 271,456 L.L
C07AA05 PROBETOL G Propranolol HCl - 10mg 10mg Tablet 126,705 L.L
C07AA05 PROBETOL G Propranolol HCl - 40mg 40mg Tablet 159,981 L.L
C09BA04 PRETERAX ARGININE B Perindopril arginine - 2.5mg, Indapamide - 0.625mg Tablet, film coated 452,875 L.L
C09BB04 PRESORYL PLUS G Perindopril arginine - 5mg, Amlodipine (besylate) - 5mg Tablet 557,695 L.L
C09BB04 PRESORYL PLUS G Perindopril arginine - 10mg, Amlodipine (besylate) - 5mg Tablet 770,022 L.L
C09BB04 PRESORYL PLUS G Perindopril arginine - 10mg, Amlodipine (besylate) - 10mg Tablet 770,022 L.L
C09DB01 POVAM G Amlodipine (besylate) - 5mg, Valsartan - 160mg Tablet, film coated 857,372 L.L
C09DB01 POVAM G Amlodipine (besylate) - 10mg, Valsartan - 160mg Tablet, film coated 857,372 L.L
C10AA03 PRAVASTATINE ARROW G Pravastatin - 40mg 40mg Tablet, breakable 526,786 L.L
C10AA03 PRAVASTATINE ARROW G Pravastatin - 20mg 20mg Tablet, breakable 526,786 L.L
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