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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
G04BE03 PLEASE G Sildenafil - 50mg 50mg Film, orally soluble 2,687,685 L.L
M02AA07 PIROXICALM G Piroxicam - 0.5% 0.5% Gel 207,336 L.L
G03DA04 PROGESTOGEL B Progesterone - 1% 1% Gel 542,912 L.L
G03DA04 PROGESTOGEL B Progesterone - 1% 1% Gel 542,912 L.L
A07EC02 PENTASA XTEND B Mesalazine - 2g 2g Granules for suspension 8,550,789 L.L
A07EC02 PENTASA B Mesalazine - 4g 4g Granules, prolonged release 8,513,063 L.L
N02BG09 PENTHROX INHALER B Methoxyflurane - Inhalation 21,080,096 L.L
R03AK06 PROPIONATE DE FLUTICASONE/ SALMETEROL ARROW G Salmeterol - 50mcg/dose, Fluticasone propionate - 100mcg/dose Inhalation powder 1,593,797 L.L
R03AK06 PROPIONATE DE FLUTICASONE/ SALMETEROL ARROW G Salmeterol - 50mcg/dose, Fluticasone propionate - 250mcg/dose Inhalation powder 1,980,824 L.L
R03AK06 PROPIONATE DE FLUTICASONE/ SALMETEROL ARROW G Salmeterol - 50mcg/dose, Fluticasone propionate - 500mcg/dose Inhalation powder 2,605,711 L.L
R05CB13 PULMOZYME BioTech Dornase alfa (desoxyribonuclease) - 2.5mg/2.5ml 2.5mg/2.5ml Inhalation solution L.L
R05CB13 PULMOZYME BioTech Dornase alfa (desoxyribonuclease) - 2.5mg/2.5ml 2.5mg/2.5ml Inhalation solution 54,658,804 L.L
R03BA02 PULMICORT B Budesonide - 0.5mg/ml 0.5mg/ml Inhalation suspension for nebuliser 2,015,764 L.L
L01FD02 PERJETA 420MG BioTech Pertuzumab - 420mg/14ml 420mg/14ml Injectable concentrate for solution L.L
L01CD01 PATAXEL G Paclitaxel - 300mg/50ml 300mg/50ml Injectable concentrate for solution 17,809,220 L.L
L01CD01 PACLITAXEL NEAPOLIS G Paclitaxel - 30mg 30mg Injectable concentrate for solution 3,514,148 L.L
L01CD01 PATAXEL G Paclitaxel - 30mg/5ml 30mg/5ml Injectable concentrate for solution 2,447,137 L.L
L01CD01 PATAXEL G Paclitaxel - 100mg/16.7ml 100mg/16.7ml Injectable concentrate for solution 8,500,054 L.L
L01CD01 PACLITAXEL NEAPOLIS G Paclitaxel - 150mg/25ml 150mg/25ml Injectable concentrate for solution 15,665,972 L.L
J05AX18 PREVYMIS B Letermovir - 240mg/12ml 240mg/12ml Injectable concentrate for solution 23,599,640 L.L
L01FD02 PERTUVIA BioTech Pertuzumab - 420mg/14ml 420mg/14ml Injectable concentrate for solution L.L
N05CM18 PROXIDA G Dexmedetomidine HCl - 200mcg/2ml 200mcg/2ml Injectable concentrate for solution 1,771,184 L.L
L01BA04 PEMETREXED EVER PHARMA G Pemetrexed (disodium) - 500mg/20ml 500mg/20ml Injectable concentrate for solution 38,284,701 L.L
L01BA04 PEMETREXED STRAGEN G Pemetrexed (disodium) - 500mg/20ml 500mg/20ml Injectable concentrate for solution 24,037,602 L.L
L01BA04 PEMETREXED STRAGEN G Pemetrexed (disodium) - 1000mg/40ml 1000mg/40ml Injectable concentrate for solution 40,480,209 L.L
L01BA04 PEMETREXED EVER PHARMA G Pemetrexed (disodium) - 100mg/4ml 100mg/4ml Injectable concentrate for solution 12,185,492 L.L
L01BA04 PEMETREXED STRAGEN G Pemetrexed (disodium) - 100mg/4ml 100mg/4ml Injectable concentrate for solution 12,759,187 L.L
L01FD02 PECTUNA BioTech Pertuzumab - 420mg/14ml 420mg/14ml Injectable concentrate for solution 132,032,880 L.L
L01FD02 PERJETA 420MG BioTech Pertuzumab - 420mg/14ml 420mg/14ml Injectable concentrate for solution 220,054,714 L.L
L01FD02 PERTUVIA BioTech Pertuzumab - 420mg/14ml 420mg/14ml Injectable concentrate for solution 147,592,404 L.L
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