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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
N02BF02 PLENICA G Pregabalin - 25mg 25mg Capsule 697,454 L.L
N02BF02 PMS-PREGABALIN G Pregabalin - 25mg 25mg Capsule 770,022 L.L
A02BC05 PROTREX G Esomeprazole - 20mg 20mg Capsule 511,940 L.L
A02BC05 PROTREX G Esomeprazole - 40mg 40mg Capsule 646,324 L.L
A02BD08 PYLERA B Bismuth subcitrate potassium - 140mg, Tetracycline HCl - 125mg, Metronidazole - 125mg Capsule 6,156,142 L.L
L01EF01 PALBRANCE 75 G Palbociclib - 75mg 75mg Capsule 168,011,222 L.L
L01EF01 PALBOMED G Palbociclib - 100mg 100mg Capsule 23,911,751 L.L
L01EF01 PALBRANCE 100 G Palbociclib - 100mg 100mg Capsule 168,011,222 L.L
M01AC01 PIROXICAM G Piroxicam - 10mg 10mg Capsule 353,239 L.L
L01EF01 PALBOMED G Palbociclib - 125mg 125mg Capsule 25,799,521 L.L
L01EF01 PALBRANCE 125 G Palbociclib - 125mg 125mg Capsule 69,032,469 L.L
N03AX12 PMS-GABAPENTIN G Gabapentin - 300mg 300mg Capsule 869,466 L.L
N03AX12 PMS-GABAPENTIN G Gabapentin - 400mg 400mg Capsule 1,071,042 L.L
N06AB03 PMS-FLUOXETINE G Fluoxetine (HCl) - 20mg 20mg Capsule 592,635 L.L
N06AB03 PROXETIN G Fluoxetine (HCl) - 20mg 20mg Capsule 374,996 L.L
L04AA27 PMS-FINGOLIMOD G Fingolimod Hydrochloride - 0.5mg 0.5mg Capsule 19,694,724 L.L
N06AB06 PMS-SERTRALINE G Sertraline HCl - 100mg 100mg Capsule 2,015,764 L.L
N06AX21 PMS-DULOXETINE G Duloxetine HCl - 60mg 60mg Capsule, delayed release 976,973 L.L
N06AX21 PMS-DULOXETINE G Duloxetine HCl - 30mg 30mg Capsule, delayed release 642,357 L.L
A02BC05 PRIMAZOL 20 G Esomeprazole (magnesium dihydrate) - 20mg 20mg Capsule, gastro-resistant 511,940 L.L
A02BC05 PRIMAZOL 40 G Esomeprazole (magnesium dihydrate) - 40mg 40mg Capsule, gastro-resistant 639,925 L.L
B01AE07 PRADAXA B Dabigatran etexilate (mesilate) - 110mg 110mg Capsule, hard 1,603,204 L.L
B01AE07 PRADAXA B Dabigatran etexilate (mesilate) - 110mg 110mg Capsule, hard 3,205,064 L.L
B01AE07 PRADAXA B Dabigatran etexilate (mesilate) - 150mg 150mg Capsule, hard 3,031,709 L.L
L01EF01 PAPILLIO G Palbociclib - 100mg 100mg Capsule, hard L.L
N02BF02 PREGABADOR G Pregabalin - 75mg 75mg Capsule, hard 364,181 L.L
N02BF02 PREGASTAR G Pregabalin - 75mg 75mg Capsule, hard 653,370 L.L
L01EF01 PAPILLIO G Palbociclib - 75mg 75mg Capsule, hard 147,883,080 L.L
L01EF01 PAPILLIO G Palbociclib - 100mg 100mg Capsule, hard 147,883,080 L.L
L01EF01 PAPILLIO G Palbociclib - 125mg 125mg Capsule, hard 147,883,080 L.L
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