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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
A11CC05 D-CURE G Vitamin D3 - 25,000IU 25,000IU Solution 467,657 L.L
A11CC05 D-ESTER G Vitamin D3 - 10000IU 10000IU Capsule, soft gelatin 999,563 L.L
A11CC05 D-ESTER G Vitamin D3 - 50000IU 50000IU Capsule 1,187,701 L.L
A11CC05 D-VITAL G Vitamin D3 - 10,000IU 10,000IU Capsule 561,342 L.L
A11CC05 D-VITAL G Vitamin D3 - 50,000IU 50,000IU Capsule, hard 712,620 L.L
L01AX04 DACARBAZINE MEDAC G Dacarbazine - 200mg 200mg Injectable powder for solution 15,866,076 L.L
L01AX04 DACARBAZINE MEDAC G Dacarbazine - 1,000mg 1,000mg Injectable powder for solution 5,411,654 L.L
N04BC07 DACEPTON G Apomorphine HCl - 30mg/3ml 30mg/3ml Injectable solution 13,404,432 L.L
N04BC07 DACEPTON G Apomorphine HCl Hemihydrate - 100mg/20ml 100mg/20ml Injectable solution 12,678,532 L.L
L01BC08 DACOGEN B Decitabine - 50mg 50mg Injectable lyophilised powder for solution 90,496,389 L.L
L01BC08 DACOGEN B Decitabine - 50mg 50mg Injectable lyophilised powder for solution 90,495,926 L.L
C05CA53 DAFLON B Hesperidin - 50mg, Diosmin - 450mg Tablet, film coated 627,574 L.L
C05CA53 DAFLON B Hesperidin - 50mg, Diosmin - 450mg Tablet, film coated 1,191,988 L.L
C05CA53 DAFLON B Hesperidin - 100mg, Diosmin - 900mg Tablet, film coated 1,256,493 L.L
D05AX52 DAIVOBET B Calcipotriol - 50mcg/g, Betamethasone - 0.5mg/g Gel 2,100,426 L.L
D07XA01 DAKTACORT B Hydrocortisone - 10mg/g, Miconazole nitrate - 20mg/g Cream 208,296 L.L
D01AC02 DAKTARIN B Miconazole nitrate - 20mg/g 20mg/g Cream 231,141 L.L
A01AB09 DAKTARIN ORAL B Miconazole nitrate - 20mg/g 20mg/g Gel 318,491 L.L
J01FF01 DALACIN-C B Clindamycin HCl - 150mg 150mg Capsule 287,582 L.L
J01FF01 DALACIN-C B Clindamycin HCl - 300mg 300mg Capsule 478,408 L.L
L01EA02 DALEUBIN G Dasatinib - 70mg 70mg Tablet, film coated 102,415,923 L.L
L01EA02 DALEUBIN G Dasatinib - 50mg 50mg Tablet, film coated 101,548,596 L.L
L01EA02 DALEUBIN G Dasatinib - 20mg 20mg Tablet, film coated 82,387,571 L.L
J01FF01 DANALLI G Clindamycin HCl - 300mg 300mg Capsule 267,425 L.L
A02BC DANLOX QUICK G Omeprazole - 20mg, Sodium bicarbonate - 1680mg Powder 1,323,685 L.L
A10BK01 DAPALOZIN G Dapagliflozin propanediol - 10mg 10mg Tablet 1,330,404 L.L
R06AX27 DAREQ G Desloratadine - 5mg 5mg Tablet, film coated 258,018 L.L
G03DA04 DARSTIN G Progesterone - 10mg/g 10mg/g Gel 380,307 L.L
L01FC01 DARZALEX BioTech Daratumumab - 400mg/20ml 400mg/20ml Injectable concentrate for solution L.L
L01FC01 DARZALEX BioTech Daratumumab - 400mg/20ml 400mg/20ml Injectable concentrate for solution L.L
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