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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
N02BE01 PANADOL ACTIFAST B Paracetamol - 500mg 500mg Tablet, film coated 159,917 L.L
M01AG01 PANGESIC FORTE G Mefenamic acid - 500mg 500mg Tablet, film coated 327,898 L.L
N02BE01 PANADOL ADVANCE B Paracetamol - 500mg 500mg Tablet, film coated 438,093 L.L
N02BE01 PANADOL ADVANCE B Paracetamol - 500mg 500mg Tablet, film coated 137,072 L.L
B01AC04 PLAVIX B Clopidogrel (hydrogenosulfate) - 75mg 75mg Tablet, film coated 1,350,562 L.L
N02BE01 PANADOL ADVANCE B Paracetamol - 500mg 500mg Tablet, film coated 389,714 L.L
B01AC04 PLAVIX B Clopidogrel (hydrogenosulfate) - 75mg 75mg Tablet, film coated 1,350,562 L.L
N06AB10 PRAMACYT 10 G Escitalopram (oxalate) - 10mg 10mg Tablet, film coated 767,910 L.L
N06AB10 PRYLEX 10 G Escitalopram (oxalate) - 10mg 10mg Tablet, film coated 767,910 L.L
N06AB10 PRAMACYT 15 G Escitalopram (oxalate) - 15mg 15mg Tablet, film coated 921,492 L.L
N06AB10 PRYLEX 15 G Escitalopram (oxalate) - 15mg 15mg Tablet, film coated 921,492 L.L
B01AC04 PEDOVEX G Clopidogrel (Bisulfate) - 75mg 75mg Tablet, film coated 808,993 L.L
G03AD01 PURPLE LINE G Levonorgestrel - 1.5mg 1.5mg Tablet, film coated 1,071,570 L.L
N06AB10 PRAMACYT 20 G Escitalopram (oxalate) - 20mg 20mg Tablet, film coated 972,686 L.L
B01AC04 PIDOGREL MEDIS G Clopidogrel - 75mg 75mg Tablet, film coated 810,337 L.L
N06AB10 PRYLEX 20 G Escitalopram (oxalate) - 20mg 20mg Tablet, film coated 972,686 L.L
B01AC04 PLAVINOR-75 G Clopidogrel - 75mg Tablet, film coated Tablet, film coated 1,112,702 L.L
N04BB01 PK-MERZ B Amantadine (sulfate) - 100mg 100mg Tablet, film coated 1,382,814 L.L
N06AB10 PRAMACYT 5 G Escitalopram (oxalate) - 5mg 5mg Tablet, film coated 895,895 L.L
N06AB10 PRYLEX 5 G Escitalopram (oxalate) - 5mg 5mg Tablet, film coated 895,895 L.L
N02BE01 PANADOL JOINT B Paracetamol - 665mg 665mg Tablet, film coated, prolonged release 291,614 L.L
N06AB05 PAXERA G Paroxetine (HCl) - 20mg 20mg Tablet, film-scored 1,016,841 L.L
A02BC02 PANTO TAD G Pantoprazole (sodium) - 40mg 40mg Tablet, gastroresistant 470,345 L.L
A02BC02 PANTO TAD G Pantoprazole (sodium) - 20mg 20mg Tablet, gastroresistant 294,302 L.L
A02BC04 PARIET B Rabeprazole (sodium) - 20mg 20mg Tablet, gastroresistant 779,429 L.L
A02BC04 PULOROS 28 G Rabeprazole sodium - 20mg 20mg Tablet, gastroresistant 706,861 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
N05AH03 PRANZA G Olanzapine - 5mg 5mg Tablet, orodispersible 1,773,872 L.L
N05AH03 PRANZA G Olanzapine - 10mg 10mg Tablet, orodispersible 3,553,120 L.L
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