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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
A03AX12 PHLOROGLUCINOL/TRIMETHYLPHLOROGLUCINOL ARROW G Phloroglucinol - 40mg/4ml, Trimethylphloroglucinol - 0.04mg/4ml Injectable solution 940,690 L.L
A03AX13 OVOL B Simethicone - 40mg/ml 40mg/ml Drops 233,829 L.L
A03AX13 SIMETHICONE G Dimethicone - 2g/100ml 2g/100ml Emulsion 212,327 L.L
A03AX13 MOSAR PLUS B Mosapride citrate - 5mg, Simethicone - 200mg Tablet, coated 865,435 L.L
A03AX13 OVOL FOR GAZ B Simethicone - 180mg 180mg Capsule, liquid gel 241,892 L.L
A03AX58 METEOSPASMYL B Alverine citrate - 60mg, Simethicone - 300mg Capsule 474,376 L.L
A03BA01 ATROPINE G Atropine sulfate - 1mg/ml 1mg/ml Injectable solution 702,149 L.L
A03BA01 ATROPINE SULFATE RENAUDIN G Atropine sulfate - 1mg/ml 0.1% Injectable solution 397,777 L.L
A03BA01 ATROPINE I.V. 0.25 MG. G Atropine - 0.25mg/ml 0.25mg/ml Injectable solution 2,412,129 L.L
A03BA01 ATROPINE G Atropine sulfate - 0.5mg/ml 0.5mg/ml Injectable solution 680,315 L.L
A03BA01 ATROPINE SULFATE RENAUDIN G Atropine sulfate - 0.5mg/ml 0.5mg Injectable solution 385,683 L.L
A03BA01 ATROPINE SULFATEAGUETTANT G Atropine - 0.1mg/ml 0.1mg/ml Injectable solution 7,805,376 L.L
A03BB01 BUSCOPAN B Butylscopolamine bromide - 10mg 10mg Tablet, sugar coated 692,079 L.L
A03BB01 BUSCOPAN B Butylscopolamine bromide - 10mg 10mg Tablet, sugar coated 291,614 L.L
A03BB01 SCOPINAL G Butylscopolamine bromide - 10mg 10mg Tablet, film coated 162,605 L.L
A03BB01 SCOPINAL G Butylscopolamine bromide - 5mg/5ml 5mg/5ml Syrup 210,983 L.L
A03BB01 ANTIPAN G Hyoscine N butylbromide - 20mg/ml Injectable solution 355,798 L.L
A03BB01 ANTIPAN G Hyoscine N butylbromide - 20mg/ml Injectable solution 2,557,140 L.L
A03BB01 HISCOPINE (HYOSCINE BUTYL BROMIDE INJECTION) G Hyoscine butylbromide - 20mg/ml 20mg/ml Injectable solution 3,217,159 L.L
A03BB01 SCOBUREN G Butylscopolamine bromide - 20mg/ml 20mg/ml Injectable solution 370,901 L.L
A03BB01 SCOPINAL G Butylscopolamine bromide - 20mg/ml 20mg/ml Injectable solution 178,731 L.L
A03BB01 ? HYOSCINE BUTYLBROMIDE G Hyoscine butylbromide - 20mg/ml 20mg/ml Injectable solution 70,392 L.L
A03CA02 FLUDINIUM G Clidinium bromide - 2.5mg, Trifluoperazine HCl - 1mg Capsule 386,515 L.L
A03CA02 LIBRAX DRAGEES B Clidinium bromide - 2.5mg, Chlordiazepoxide - 5mg Tablet, sugar coated 435,405 L.L
A03CA02 BIPAX G Clidinium bromide - 2.5mg, Chlordiazepoxide - 5mg Tablet, sugar coated 363,477 L.L
A03CA02 LIBROCOL G Chlordiazepoxide - 5mg, Clidinium bromide - 2.5mg Tablet 338,648 L.L
A03CA02 PRIMAX G Clidinium bromide - 2.5mg, Chlordiazepoxide - 5mg Tablet 222,694 L.L
A03CA02 ULCEDEX G Clidinium bromide - 2.5mg, Chlordiazepoxide - 5mg Tablet 222,694 L.L
A03CB01 RESTROPINAL PEDIATRIC B Butobarbital - 2mg/ml, Methyl hyoscine nitrate - 0.1mg/ml Drops 197,097 L.L
A03DB04 PANADOL WOMAN B Paracetamol - 500mg, Hyoscine butylbromide - 10mg Tablet, coated 436,749 L.L
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