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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
L01EF01 IBRANCE B Palbociclib - 125mg 125mg Capsule 172,164,216 L.L
L01EF01 IBRANCE B Palbociclib - 125mg 125mg Tablet, film coated 172,164,216 L.L
L01EK01 INLYTA B Axitinib - 5mg 5mg Tablet, film coated 136,632,514 L.L
L01EK01 INLYTA B Axitinib - 1mg 1mg Tablet, film coated 33,373,253 L.L
L01EL01 IMBRUVICA B Ibrutinib - 140mg 140mg Tablet, film coated 194,761,649 L.L
L01EL01 IMBRUVICA B Ibrutinib - 420mg 420mg Tablet, film coated 584,282,877 L.L
L01EL01 IMBRUVICA B Ibrutinib - 420mg 420mg Tablet, film coated L.L
L01FF03 IMFINZI BioTech Durvalumab - 500mg/10ml 500mg/10ml Injectable solution L.L
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L01FF03 IMFINZI BioTech Durvalumab - 500mg/10ml 500mg/10ml Injectable solution 227,939,689 L.L
L01FF03 IMFINZI BioTech Durvalumab - 120mg/2.4ml 120mg/2.4ml Injectable solution 59,776,110 L.L
L03AB03 IMUKIN BioTech Interferon gamma - 100mcg/0.5ml 100mcg/0.5ml Injectable suspension 6,348,312 L.L
L04AA06 IMUNOCELL G Mycophenolate mofetil - 500mg 500mg Tablet, film coated L.L
L04AA06 IMUNOCELL G Mycophenolate mofetil - 500mg 500mg Tablet, film coated 3,791,428 L.L
L04AB02 INFLIXIREL BioTech Infliximab - 100mg 100mg Injectable concentrate for solution L.L
L04AB02 IXIFI BioTech Infliximab - 100mg 100mg Injectable powder for concentrate for solution L.L
L04AB02 INFLIXIREL BioTech Infliximab - 100mg 100mg Injectable concentrate for solution 18,065,957 L.L
L04AB02 IXIFI BioTech Infliximab - 100mg 100mg Injectable powder for concentrate for solution 23,911,751 L.L
L04AX01 IMURAN B Azathioprine - 50mg 50mg Tablet 2,030,546 L.L
L04AX01 IMURAN B Azathioprine - 50mg 50mg Tablet 2,030,546 L.L
L04AX06 IMNOVID B Pomalidomide - 2mg 2mg Capsule, hard 290,515,206 L.L
L04AX06 IMNOVID B Pomalidomide - 4mg 4mg Capsule, hard 290,515,206 L.L
L04AX06 IMNOVID B Pomalidomide - 4mg 4mg Capsule, hard L.L
M01AB01 INDOMEL G Indometacin - 25mg 25mg Capsule 170,220 L.L
M01AB01 INDOCID B Indometacin - 100mg 100mg Suppository 424,910 L.L
M01AB01 INDOMEL G Indometacin - 100mg 100mg Suppository 222,694 L.L
M01AC01 INFLACAM G Piroxicam - 20mg/ml 20mg/ml Injectable solution 193,513 L.L
M01AC01 INFLACAM G Piroxicam - 20mg/ml 20mg/ml Injectable solution 190,826 L.L
M01AE01 IBUSOL G Ibuprofen - 100mg/5ml 100mg/5ml Suspension 309,724 L.L
M01AE01 IBUPROFEN B. BRAUN G Ibuprofen - 400mg/100ml 400mg/100ml Injectable solution 231,141 L.L
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