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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
D10BA01 CURACNE G Isotretinoin - 40mg 40mg Capsule, soft gelatin 3,553,120 L.L
D10BA01 CURACNE G Isotretinoin - 40mg 40mg Capsule, soft gelatin 3,553,120 L.L
D10BA01 CURACNE G Isotretinoin - 40mg 40mg Capsule, soft gelatin 3,553,120 L.L
D10BA01 CURACNE G Isotretinoin - 40mg 40mg Capsule, soft gelatin 3,553,120 L.L
L01EX07 CABOMETYX B Cabozantinib - 40mg 40mg Tablet, film coated 440,893,501 L.L
L04AB04 CINNORA BioTech Adalimumab - 40mg/0.8ml 40mg/0.8ml Injectable solution 14,817,734 L.L
G03GA05 CINNAL-f BioHuman Follitropin alfa - 450IU/0.75ml 450IU/0.75ml Injectable solution 7,372,177 L.L
C01DX12 CORVASAL 4MG B Molsidomine - 4mg 4mg Tablet 492,742 L.L
C02CA04 CARDULAR B Doxazosin (mesylate) - 4mg 4mg Tablet 755,239 L.L
C02CA04 CURCARD G Doxazosin (mesylate) - 4mg 4mg Tablet 452,875 L.L
D06BA02 CREM-O-SULFA G Sulfathiazole - 5% 5% Cream 202,216 L.L
D06BB03 CIVAR G Aciclovir - 5% 5% Cream 507,972 L.L
G03GA01 CHORIOMON BioHuman Human Chorionic Gonadotrophin - 5,000IU 5,000IU Injectable lyophilised powder for solution+diluent 6,306,653 L.L
B01AD12 CEPROTIN BioHuman Protein C Human - 500IU 500IU Injectable powder for solution+diluent 86,314,057 L.L
B03BA01 COBAL G Vitamin B12 - 500mcg 500mcg Tablet, coated 486,471 L.L
B03BA05 COBAL G Mecobalamine - 500mcg/ml 500mcg/ml Injectable solution 1,128,828 L.L
L01BC06 CAPECITABINE SHILPA G Capecitabine - 500mg 500mg Tablet, film coated 7,396,894 L.L
L01BC06 CAPECITABINE SPC G Capecitabine - 500mg 500mg Tablet, film coated 12,665,771 L.L
L01BC06 CAPEDA G Capecitabine - 500mg 500mg Tablet, film coated 4,927,423 L.L
J01DE01 CEFIPEX 500 BENTA G Cefepime (hydrochloride) - 500mg 500mg Injectable solution 545,216 L.L
J05AB06 CYMEVENE B Ganciclovir (sodium) - 500mg 500mg Injectable solution 1,726,838 L.L
J01FA09 CLAREM 500 G Clarithromycin - 500mg 500mg Tablet, film coated 686,704 L.L
L01XX05 CUREAML G Hydroxycarbamide (or Hydroxyurea) - 500mg 500mg Capsule 1,228,272 L.L
L01XX05 CYTODROX G Hydroxycarbamide (or Hydroxyurea) - 500mg 500mg Capsule 3,301,821 L.L
J01MA02 CIPROBAY B Ciprofloxacine (HCl) - 500mg 500mg Tablet, film coated 654,451 L.L
J01MA02 CIFLOSIN G Ciprofloxacin - 500mg 500mg Tablet, film coated 327,898 L.L
J01MA02 CIPRO G Ciprofloxacin - 500mg 500mg Tablet, film coated 436,749 L.L
J01MA02 CIPRO MEDIS 500 G Ciprofloxacin - 500mg 500mg Tablet, coated 479,752 L.L
J01MA02 CIPROCIN G Ciprofloxacine (HCl) - 500mg 500mg Tablet, film-scored 240,548 L.L
J01MA02 CIPRODAR G Ciprofloxacine (HCl) - 500mg 500mg Tablet, film coated 392,402 L.L
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