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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
C03DA04 EPLERENONE BIOGARAN G Eplerenone - 50mg 50mg Tablet, coated 1,849,127 L.L
L02BG06 EXEMESTANE BGR G Exemestane - 25mg 25mg Tablet, coated 4,479,027 L.L
J05AF10 ENTECAVIR ARROW G Entecavir - 1mg 1mg Tablet, coated L.L
J05AF10 ENTECAVIR ARROW G Entecavir - 0.5mg 0.5mg Tablet, coated L.L
R06AX22 EBASTINE ARROW G Ebastine - 10mg 10mg Tablet, coated 524,099 L.L
N06AB10 ESCITALOPRAM BIOGARAN G Escitalopram (oxalate) - 10mg 10mg Tablet, coated, scored 678,640 L.L
N06AB10 ESCITALOPRAM BIOGARAN G Escitalopram (oxalate) - 15mg 15mg Tablet, coated, scored 678,640 L.L
N06AB10 ESCITALOPRAM BIOGARAN G Escitalopram (oxalate) - 20mg 20mg Tablet, coated, scored 678,640 L.L
M01AB05 EMIFENAC 50 G Diclofenac sodium - 50mg 50mg Tablet, dispersible 387,027 L.L
V03AC03 ENFEROX G Deferasirox - 500mg 500mg Tablet, dispersible 37,720,158 L.L
N02BE01 EFFERALGAN B Paracetamol - 1g 1g Tablet, effervescent 129,009 L.L
N02AJ06 EFFERALGAN CODEINE B Paracetamol - 500mg, Codeine phosphate - 30mg Tablet, effervescent scored 215,015 L.L
N02BE01 EFFERALGAN B Paracetamol - 500mg 500mg Tablet, effervescent scored 129,009 L.L
M01AB05 EPARDEX G Diclofenac sodium - 50mg 50mg Tablet, enteric coated 223,974 L.L
M01AB05 EPARDEX G Diclofenac sodium - 50mg 50mg Tablet, enteric coated 3,246,979 L.L
C09DX04 ENTRESTO B Valsartan - 26mg, Sacubitril - 24mg Tablet, film coated 6,029,821 L.L
C09DX04 ENTRESTO B Valsartan - 51mg, Sacubitril - 49mg Tablet, film coated 6,029,821 L.L
A10BD19 EMPAGLINE G Empagliflozin - 10mg, Linagliptin - 5mg Tablet, film coated 2,237,050 L.L
A10BD19 EMPALYN G Empagliflozin - 10mg, Linagliptin - 5mg Tablet, film coated 2,237,050 L.L
C09DX04 ENTRESTO B Valsartan - 103mg, Sacubitril - 97mg Tablet, film coated 11,674,240 L.L
A10BD19 EMPAGLINE G Empagliflozin - 25mg, Linagliptin - 5mg Tablet, film coated 2,237,050 L.L
A10BD19 EMPALYN G Empagliflozin - 25mg, Linagliptin - 5mg Tablet, film coated 2,237,050 L.L
A10BD20 EMPAZIMET G Metformin HCl - 1000mg, Empagliflozin - 12.5mg Tablet, film coated 1,840,168 L.L
A10BD20 EMPAZIMET G Metformin HCl - 1000mg, Empagliflozin - 5mg Tablet, film coated 1,840,168 L.L
A10BD21 ENFORZA B Saxagliptin HCl - 5mg, Dapagliflozin - 10mg Tablet, film coated 6,072,824 L.L
B01AF02 ELIQUIS B Apixaban - 5mg 5mg Tablet, film coated 4,183,603 L.L
B01AF02 ELAPIX 5 G Apixaban - 5mg 5mg Tablet, film coated 1,970,969 L.L
B01AF02 ELIQUIS B Apixaban - 2.5mg 2.5mg Tablet, film coated 4,183,603 L.L
B01AF02 ELAPIX 2.5 G Apixaban - 2.5mg 2.5mg Tablet, film coated 1,970,969 L.L
J05AF10 ENTRILIV G Entecavir - 1mg 1mg Tablet, film coated 11,475,203 L.L
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