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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
R03AK07 BUFOMIX EASYHALER G Formoterol fumarate dihydrate - 4.5mcg/inhalation, Budesonide - 160mcg/inhalation Metered dose inhaler 1,182,581 L.L
R03AK07 BUFOMIX EASYHALER G Formoterol fumarate dihydrate - 9mcg, Budesonide - 320mcg Metered dose inhaler 2,365,163 L.L
R03AK13 BUTOSOL G Salbutamol (sulfate) - 100mcg/dose, Beclometasone dipropionate - 50mcg/dose Metered dose inhaler 548,288 L.L
R03AL11 BREZTRI AEROSPHERE B Formoterol fumarate dihydrate - 5mcg, Glycopyrronium Bromide - 7.2mcg, Budesonide - 160mcg Inhalation suspension 6,705,774 L.L
C09BA04 BI-PRETERAX ARGININE B Perindopril arginine - 5mg, Indapamide - 1.25mg Tablet, film coated 452,875 L.L
J01EE01 BACTRIM FORTE B Trimethoprim - 160mg, Sulfamethoxazole - 800mg Tablet 344,024 L.L
C09BA04 BI-PRETERAX ARGININE B Perindopril arginine - 10mg, Indapamide - 2.5mg Tablet, film coated 765,990 L.L
D07CC01 BETAFUCIN G Fusidic acid - 20mg/g, Betamethasone valerate - 1mg/1g Cream 210,983 L.L
D07CC01 BETASONE-N G Neomycin (sulfate) - 3.5mg/g, Betamethasone (valerate) - 1mg/g Cream 398,033 L.L
A11A BEBE-VIT G Vitamin A - 1500IU/ml, Vitamin D3 - 400IU/ml, Vitamin E - 5mg/ml, Vitamin C - 40mg/ml, Vitamin B1 - 0.5mg/ml, Vitamin B2 - 0.6mg/ml, Vitamin B6 - 0.6mg/ml, Nicotinamide - 8mg/ml Drops 287,582 L.L
L03AX03 BCG-MEDAC G BCG seed RIVM derived from seed 1173-P2 - 2x10? to 3x10? viable units Injectable powder for suspension+diluent L.L
D07XC01 BETA-MICOTER G Betamethasone (dipropionate) - 0.5mg/g, Clotrimazole - 10mg/g Cream 415,951 L.L
J01CR02 BETAMOX ES G Amoxicillin - 600mg/5ml, Clavulanic Acid - 42.9mg/5ml Powder for suspension 592,635 L.L
J05AR20 BIKTARVY B Bictegravir - 50mg, Emtricitabine - 200mg, Tenofovir alafenamide - 25mg Tablet, film coated 76,569,138 L.L
J01CR02 BETAMOX PLUS G Amoxicillin - 875mg, Clavulanic Acid - 125mg Tablet, coated 717,661 L.L
J07AJ51 BOOSTRIX B Diphteria toxoid purified - ?2.5Lf/0.5ml, Tetanus toxoid purified - ?5Lf/0.5ml, Bordetella Pertussis Antigens: toxoid - 8mcg/0.5ml, Bordetella Pertussis Antigens: filamentous haemagglutinin - 8mcg/0.5ml, Pertactine - 2.5mcg Al3+/0.5ml, Aluminium hydroxide - 0.3mg Al3+/0.5ml, Aluminium Phosphate - 0.2mg/0.5ml Injectable suspension 1,394,909 L.L
J07AX BRONCHO-VAXOM CHILDREN B Lyophilized bacterial lysates of Haemophilus influenzae, Diplococcus pneumoniae, Klebsiella pneumoniae and ozaenae, Staphylococcus aureus, Streptococcus pyogenes and viridans, Neisseria catarrhalis - 3.5mg Capsule 1,988,887 L.L
J07AX BRONCHO-VAXOM ADULTS B Lyophilized bacterial lysates of Haemophilus influenzae, Diplococcus pneumoniae, Klebsiella pneumoniae and ozaenae, Staphylococcus aureus, Streptococcus pyogenes and viridans, Neisseria catarrhalis - 7mg Capsule 2,746,814 L.L
A11EA BECOZYME B Vitamin B5 - 6mg/2ml, Vitamin B6 - 4mg/2ml, Vitamin PP - 40mg/2ml, Vitamin B2 - 5.47mg/2ml, Vitamin B1 - 10mg/2ml Injectable solution 662,514 L.L
R05FB BRONCHOPHANE G Dextrometorphan HBr - 4.58mg/5ml, Diphenydramine HCl - 5mg/5ml, Ephedrine HCl - 7.5mg/5ml, Guaifenesin - 50mg/5ml Syrup 115,570 L.L
A11EX BECOZYM FORTE B Nicotinamide - 50mg, Calcium Pantothenate - 25mg, Biotin - 0.15mg, Vitamin B12 - 10mcg, Vitamin B6 - 10mg, Vitamin B2 - 15mg, Vitamin B1 - 15mg Capsule 290,270 L.L
R05X BROMEX G Pyrilamine Maleate (Mepyramine) - 12.5mg/5ml, Bromhexine HCl - 4mg/5ml Elixir 250,851 L.L
M01AC01 BRUXICAM B Piroxicam - 0.5% Drops solution 530,818 L.L
L03AX03 BCG-MEDAC G BCG seed RIVM derived from seed 1173-P2 - 2x10? to 3x10? viable units Injectable powder for suspension+diluent 18,750,588 L.L
A03CA02 BIPAX G Clidinium bromide - 2.5mg, Chlordiazepoxide - 5mg Tablet, sugar coated 363,477 L.L
C09DA06 BLOPRESS PLUS 16MG B Candesartan cilexetil - 16mg, Hydrochlorothiazide - 12.5mg Tablet 1,040,134 L.L
C09DA06 BLOPRESS PLUS 8MG B Candesartan cilexetil - 8mg, Hydrochlorothiazide - 12.5mg Tablet 806,306 L.L
C07AB12 BLOVEK G Nebivolol HCl - 5mg Tablet 511,940 L.L
C07BB07 BISCORDEX PLUS G Bisoprolol fumarate - 5mg, Hydrochlorothiazide - 12.5mg Tablet 723,115 L.L
C07BB07 BISOCOR 5 PLUS G Bisoprolol - 5mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 678,321 L.L
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