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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
J01CR05 PIPERACILLIN/TAZOBACTAM PANPHARMA G Piperacillin (sodium) - 4g, Tazobactam (sodium) - 0.5g Injectable powder for solution 7,461,939 L.L
J01CR05 PIPERACILLIN/TAZOBACTAM SANDOZ G Piperacillin (sodium) - 4g, Tazobactam (sodium) - 0.5g Injectable powder for solution 913,813 L.L
J01CR05 PIPERACILLIN/TAZOBACTAM SANDOZ G Piperacillin (sodium) - 4g, Tazobactam (sodium) - 0.5g Injectable powder for solution 7,961,483 L.L
J01CR05 PIPERACILLIN/TAZOBACTAM STRAGEN G Piperacillin (sodium) - 4g, Tazobactam (sodium) - 0.5g Injectable powder for solution 897,687 L.L
J01CR05 PIPERACILLIN/TAZOBACTAM STRAGEN G Piperacillin (sodium) - 4g, Tazobactam (sodium) - 0.5g Injectable powder for solution 7,820,986 L.L
J01CR05 PIPERACILLINE/ TAZOBACTAM ARROW G Piperacillin (sodium) - 4g, Tazobactam (sodium) - 500mg Injectable powder for solution 7,378,682 L.L
J01CR05 PIPTAZ-ORBUCELL G Piperacillin (sodium) - 4g, Tazobactam (sodium) - 0.5g Injectable powder for solution 1,087,873 L.L
J01CR05 PRIZMA G Piperacillin (sodium) - 4g, Tazobactam (sodium) - 0.5g Injectable powder for solution 913,813 L.L
G03GA30 PERGOVERIS BioHuman Follitropin alfa - 150IU, Lutropin Alfa - 75IU Injectable powder for solution+diluent 6,523,011 L.L
C01CA06 PHENYLEPHRINE HYDROCHLORIDE G Phenylephrine HCl - 10mg/ml 1% Injectable solution 10,282,281 L.L
C01CA06 PHENYLEPHRINE RENAUDIN G Phenylephrine - 100mcg/ml 100mcg/ml Injectable solution 5,955,910 L.L
C01CA06 PHENYLEPHRINE AGUETTANT G Phenylephrine - 500mcg/10ml 500mcg/10ml Injectable solution 11,464,796 L.L
N02BE01 PARACETAMOL PANPHARMA G Paracetamol - 10mg/ml 10mg/ml Injectable solution 1,959,322 L.L
G03DA04 PROLUTEX B Progesterone - 25mg 25mg Injectable solution 5,570,227 L.L
N02BE01 PARACETAMOL S.A.L.F G Paracetamol - 1000mg/100ml 10mg/ml Injectable solution 5,542,006 L.L
N02BE01 PARACETAMOL B.BRAUN G Paracetamol - 1000mg/100ml 1000mg/100ml Injectable solution 129,009 L.L
N02BE01 PARACETAMOL MACOPHARMA G Paracetamol - 1000mg/100ml 10mg/ml Injectable solution 9,350,840 L.L
N02BE01 PARACETAMOL NORMON G Paracetamol - 1000mg/100ml 10mg/ml Injectable solution 9,633,134 L.L
N02BE01 PARACETAMOL PANPHARMA G Paracetamol - 1000mg/100ml 10mg/ml Injectable solution 8,675,675 L.L
N02BE01 PARACETAMOL PANPHARMA G Paracetamol - 1000mg/100ml 10mg/ml Injectable solution 2,215,996 L.L
N02BE01 PARAMED G Paracetamol - 10mg/ml 10mg/ml Injectable solution 814,369 L.L
N02BE01 PARACEROL G Paracetamol - 10mg/ml 10mg/ml Injectable solution 1,536,012 L.L
N02BE01 PARA-SOLUTIONS G Paracetamol - 1g/100ml 500mg/100ml Injectable solution 179,179 L.L
N02BE01 PARASWISS G Paracetamol - 1g/100ml 1g/100ml Injectable solution 130,353 L.L
G03GA06 PUREGON BioHuman Follitropin beta - 300IU/0.36ml 300IU/0.36ml Injectable solution 10,919,720 L.L
G03GA06 PUREGON BioHuman Follitropin beta - 600IU/0.72ml 600IU/0.72ml Injectable solution 21,129,178 L.L
L03AB11 PEGASYS BioTech Peginterferon alfa-2a - 180mcg/0.5ml 180mcg/0.5ml Injectable solution L.L
L01BA04 PEMETREXED NEAPOLIS G Pemetrexed (disodium) - 100mg 100mg Injectable solution L.L
L01XY02 PHESGO BioTech Pertuzumab - 600mg, Trastuzumab - 600mg Injectable solution 326,054,156 L.L
L01XY02 PHESGO BioTech Pertuzumab - 1200mg, Trastuzumab - 600mg Injectable solution 591,417,874 L.L
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