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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
D11AX01 ALOPEXY G Minoxidil - 5% 5% Solution 896,343 L.L
A04AA05 ALOXI B Palonosetron HCl - 0.25mg/5ml 0.25mg/5ml Injectable solution 3,656,595 L.L
B03XA01 ALPEEN BioTech Erythropoietin recombinant human (Epoetin alfa) - 10,000IU 10000IU Injectable solution 4,036,903 L.L
B03XA01 ALPEEN BioTech Erythropoietin recombinant human (Epoetin alfa) - 10,000IU 10,000IU Injectable solution 10,661,285 L.L
B03XA01 ALPEEN BioTech Erythropoietin recombinant human (Epoetin alfa) - 4000IU 4000IU Injectable solution 8,728,144 L.L
B03XA01 ALPEEN BioTech Erythropoietin recombinant human (Epoetin alfa) - 4000IU 4000IU Injectable solution 1,127,036 L.L
B03XA01 ALPEEN BioTech Erythropoietin recombinant human (Epoetin alfa) - 4000IU 4000IU Injectable solution 4,748,244 L.L
B03XA01 ALPEEN BioTech Erythropoietin recombinant human (Epoetin alfa) - 40,000IU 40,000IU Injectable solution 11,210,836 L.L
S01EA05 ALPHAGAN P B Brimonidine tartrate - 1.5mg/ml 0.15% Drops solution 999,819 L.L
S01EA05 ALPHAGAN P B Brimonidine tartrate - 1.5mg/ml 0.15% Drops solution 999,819 L.L
S01EA05 ALPHAGAN P B Brimonidine tartrate - 0.1% 0.15% Drops solution 999,819 L.L
S01EA05 ALPHANOVA G Brimonidine tartrate - 0.15% 0.15% Drops solution 599,354 L.L
N05BA12 ALPRAZOLAM BIOGARAN G Alprazolam - 0.5mg 0.5mg Tablet, scored 169,324 L.L
N05BA12 ALPRAZOLAM BIOGARAN G Alprazolam - 0.25mg 0.25mg Tablet, scored 115,570 L.L
N05BA12 ALPROX G Alprazolam - 0.5mg 0.5mg Tablet 383,955 L.L
N05BA12 ALPROX G Alprazolam - 1mg 1mg Tablet 895,895 L.L
L04AB01 ALTEBREL BioTech Etanercept - 50mg/1ml 50mg/1ml Injectable solution 14,833,767 L.L
L04AB01 ALTEBREL BioTech Etanercept - 25mg/0.5ml 25mg/0.5ml Injectable solution 27,383,989 L.L
L04AB01 ALTEBREL BioTech Etanercept - 50mg/1ml 50mg/1ml Injectable solution L.L
A11CC05 ALTO D 10.000 G Vitamin D3 - 10,000IU 10,000IU Capsule 895,895 L.L
A11CC05 ALTUM G Vitamin D3 - 50,000IU 50,000IU Capsule, hard 712,620 L.L
A11CC05 ALTUM-D3 G Vitamin D3 - 10,000IU 10,000IU Capsule 561,342 L.L
A11CC05 ALTUM-D3 G Vitamin D3 - 50,000IU 50,000IU Capsule, hard 712,620 L.L
L01ED04 ALUNBRIG B Brigatinib - 30mg 30mg Tablet, film coated 87,227,357 L.L
L01ED04 ALUNBRIG B Brigatinib - 90mg 90mg Tablet, film coated 261,678,963 L.L
L01ED04 ALUNBRIG B Brigatinib - 180mg 180mg Tablet, film coated 409,120,926 L.L
M04AA01 ALURIC G Allopurinol - 300mg 300mg Tablet, scored 175,339 L.L
N07CA01 ALVIGO G Betahistine dihydrochloride - 16mg 16mg Tablet, scored 1,204,339 L.L
L01XG01 ALVOCADE G Bortezomib - 3.5mg 3.5mg Injectable powder for solution 14,169,600 L.L
N06DA02 ALZEPIL G Donepezil HCl - 5mg 5mg Tablet 1,406,555 L.L
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