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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
G03FB01 PROGYLUTON B Norgestrel - 0.5mg (tablet 2), Estradiol valerate - 2mg (tablet 1, tablet 2) Tablet 193,513 L.L
G03GA06 PUREGON BioHuman Follitropin beta - 300IU/0.36ml 300IU/0.36ml Injectable solution 10,919,720 L.L
G03GA06 PUREGON BioHuman Follitropin beta - 600IU/0.72ml 600IU/0.72ml Injectable solution 21,129,178 L.L
G03GA30 PERGOVERIS BioHuman Follitropin alfa - 150IU, Lutropin Alfa - 75IU Injectable powder for solution+diluent 6,523,011 L.L
G04BE03 PLEASE G Sildenafil - 50mg 50mg Film, orally soluble 2,687,685 L.L
G04BX14 PRILIGY B Dapoxetine (hydrochloride) - 30mg 30mg Tablet, film coated 1,957,979 L.L
G04BX14 PRIXETIN 30 G Dapoxetine (hydrochloride) - 30mg 30mg Tablet, film coated 2,105,353 L.L
G04BX14 PRILIGY B Dapoxetine (hydrochloride) - 60mg 60mg Tablet, film coated 1,957,979 L.L
G04BX14 PRIXETIN 60 G Dapoxetine (hydrochloride) - 60mg Tablet, film coated 1,479,123 L.L
G04CA01 PROSTETROL G Alfuzosin HCl - 10mg 10mg Tablet, modified release 360,150 L.L
G04CA01 PROSTETROL G Alfuzosin HCl - 10mg 10mg Tablet, modified release 682,672 L.L
G04CA02 PROSTAFINE G Tamsulosin HCl - 0.4mg 0.4mg Capsule, modified release 761,511 L.L
G04CB01 PROSCAR B Finasteride - 5mg 5mg Tablet, film coated 846,621 L.L
H01BB03 PABAL RTS B Carbetocin - 100mcg/ml 100mcg/ml Injectable solution 12,185,492 L.L
H02AB06 PEDIACORT G Prednisolone sodium phosphate - 15mg/5ml 15mg/5ml Solution 417,231 L.L
H02AB06 PREDALONE G Prednisolone - 15mg/5ml 15mg/5ml Syrup 890,776 L.L
H02AB06 PREDO G Prednisolone sodium phosphate - 15mg/5ml 15mg/5ml Syrup 1,018,633 L.L
H02AB06 PREDOXONE G Prednisolone sodium phosphate - 15mg/5ml 15mg/5ml Solution 417,231 L.L
H02AB07 PREDICOR G Prednisone - 5mg 5mg Tablet, scored 174,060 L.L
H02AB07 PREDNISONE G Prednisone - 5mg 5mg Tablet, scored 176,619 L.L
H02AB07 PREDICOR G Prednisone - 20mg 20mg Tablet, scored 346,839 L.L
H02AB07 PREDNISONE G Prednisone - 20mg 20mg Tablet, scored 346,839 L.L
H02AB07 PREDICOR G Prednisone - 10mg 10mg Tablet, scored 386,515 L.L
H02AB07 PREDNISONE G Prednisone - 10mg 10mg Tablet, scored 386,515 L.L
H02AB07 PREDICOR G Prednisone - 50mg 50mg Tablet, scored 712,876 L.L
H02AB07 PREDNISONE G Prednisone - 50mg 50mg Tablet, scored 742,313 L.L
H02B PREDALONE PLUS G Prednisolone sodium phosphate - 10mg/5ml, Dexchlorpheniramine maleate - 2mg/5ml Syrup 890,776 L.L
J01CE01 PENICILLINE G PANPHARMA G Benzylpenicillin (sodium) - 1,000,000IU 1,000,000IU Injectable powder for solution 2,858,353 L.L
J01CR02 POSMOX G Amoxicillin (trihydrate) - 875mg, Clavulanic Acid (potassium) - 125mg 1g Powder 616,824 L.L
J01CR05 PIPERACILLINE/ TAZOBACTAM ARROW G Piperacillin (sodium) - 2g, Tazobactam (sodium) - 250mg Injectable powder for solution 731,050 L.L
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