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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
A10BB12 JOSWE GLEMAX 2 G Glimepiride - 2mg 2mg Caplet 139,760 L.L
A10BB12 JOSWE GLEMAX 3 G Glimepiride - 3mg 3mg Caplet 235,172 L.L
A10BB12 JOSWE GLEMAX 4 G Glimepiride - 4mg 4mg Caplet 235,172 L.L
A10BB12 JOSWE GLEMAX 6 G Glimepiride - 6mg 6mg Caplet 663,858 L.L
C10AA05 JOSWE ATORVAST 10 G Atorvastatin - 10mg 10mg Caplet, film coated 849,308 L.L
C10AA05 JOSWE ATORVAST 20 G Atorvastatin - 20mg 20mg Caplet, film coated 956,816 L.L
C10AA05 JOSWE ATORVAST 40 G Atorvastatin - 40mg 40mg Caplet, film coated 1,327,716 L.L
C10BX03 JOSWE DUBARA 5/10 G Amlodipine - 5mg, Atorvastatin - 10mg Caplet, film coated 2,370,538 L.L
C10BX03 JOSWE DUBARA 10/10 G Amlodipine - 10mg, Atorvastatin - 10mg Caplet, film coated 2,655,433 L.L
A02BC03 JOSWE LANZOTEC 30 G Lansoprazole - 30mg 30mg Capsule 271,456 L.L
A02BC03 JOSWE LANZOTEC 30 G Lansoprazole - 30mg 30mg Capsule 514,692 L.L
A02BC03 JOSWE LANZOTEC 15 G Lansoprazole - 15mg 15mg Capsule 270,112 L.L
M01AH01 JOSWE FLAMEX 200 G Celecoxib - 200mg 200mg Capsule 225,766 L.L
M01AH01 JOSWE FLAMEX 200 G Celecoxib - 200mg 200mg Capsule 636,981 L.L
M01AH01 JOSWE FLAMEX 400 G Celecoxib - 400mg 400mg Capsule 585,915 L.L
M01AH01 JOSWE FLAMEX 400 G Celecoxib - 400mg 400mg Capsule 1,400,284 L.L
D06BB10 JEDARA G Imiquimod - 5% 5% Cream 3,850,109 L.L
D11AX11 JOLITE FORTE CREAM G Hydroquinone - 4% 4g/100g Cream 612,792 L.L
L01CD04 JEVTANA INJECTION B Cabazitaxel - 60mg/1.5ml 60mg/1.5ml Injectable dry powder for solution+diluent 75,619,931 L.L
L01CD04 JEVTANA INJECTION B Cabazitaxel - 60mg/1.5ml 60mg/1.5ml Injectable dry powder for solution+diluent 75,619,931 L.L
A10AB01 JUSLINE R BioTech Insulin (human) - 100IU/ml 100IU/ml Injectable solution 401,809 L.L
B03BA01 JECTIN-12 G Cyanocobalamin - 1000mcg/1ml 1000mcg/1ml Injectable solution 567,102 L.L
A10AD01 JUSLINE BioTech Insulin (human) - 100IU/ml 100IU/ml Injectable suspension 401,809 L.L
A10AE01 JUSLINE N BioTech Insulin human isophane - 100IU/ml 100IU/ml Injectable suspension 401,809 L.L
J01CR02 JULMENTIN 2X G Amoxicillin (trihydrate) - 400mg/5ml, Clavulanic Acid (potassium) - 57mg/5ml 457mg/5ml Powder for suspension 278,175 L.L
J01CR02 JULMENTIN ES G Amoxicillin (trihydrate) - 600mg/5ml, Clavulanic Acid (potassium) - 42.9mg/5ml 642.9mg/5ml Powder for suspension 507,972 L.L
R05CA12 JOS-PAN G Dried Ivy leaf extract (Hederacoside C) - 75mg/100ml Syrup 306,396 L.L
N05AH04 JOSWE QUZAL 25 G Quetiapine - 25mg 25mg Tablet 258,018 L.L
N05AH04 JOSWE QUZAL 25 G Quetiapine - 25mg 25mg Tablet 490,503 L.L
M03BX08 JAMP-CYCLOBENZAPRINE G Cyclobenzaprine HCl - 10mg 10mg Tablet 4,031,528 L.L
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