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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
A02AF02 MAALOX PLUS B Dimethicone - 25mg, Aluminium hydroxide - 200mg, Magnesium hydroxide - 200mg Tablet, chewable 166,636 L.L
A02AF02 MAALOX PLUS B Simethicone - 25mg/5ml, Aluminium hydroxide - 175mg/5ml, Magnesium hydroxide - 200mg/5ml Suspension 438,093 L.L
A06AD65 MOVICOL B Potassium chloride - 0.0466g, Sodium chloride - 0.3507g, Sodium bicarbonate - 0.1785g, Macrogol 3350 - 13.125g Powder for solution 853,340 L.L
A06AD65 MOVICOL PEDIATRIC PLAIN B Potassium chloride - 23.3mg, Sodium chloride - 175.4mg, Sodium bicarbonate - 89.3mg, Macrogol 3350 - 6.563g Powder for solution 624,887 L.L
A06AG11 MINILAX G Sodium citrate (dihydrate) - 900mg/10ml, Sodium lauryl sulfate - 150mg/10ml, Glycerol - 1200mg/10ml, Sorbic acid - 10mg/10ml, Sorbitol - 9.96mg/10ml Solution 474,824 L.L
M03BA53 METHOFEN PLATINUM G Ibuprofen - 200mg, Methocarbamol - 500mg Tablet 668,082 L.L
N02BE51 MAXIFEN G Paracetamol - 325mg, Ibuprofen - 400mg Tablet, scored 225,254 L.L
M03BC51 MUSCEROL 2 G Paracetamol - 450mg, Orphenadrine (citrate) - 35mg Tablet, scored 177,899 L.L
N06CA02 MELIXITE G Flupentixol (dihydrochloride) - 0.5mg, Melitracen (HCl) - 10mg Tablet, film coated 600,250 L.L
M03BC51 MUSCEROL EXTRA G Caffeine - 15mg, Paracetamol - 450mg, Orphenadrine citrate - 35mg Tablet, scored 267,489 L.L
M03BC51 MUSCEROL 3 G Paracetamol - 450mg, Orphenadrine citrate - 35mg, Ibuprofen - 200mg Tablet, film coated 593,850 L.L
D07CA01 MYCICORT G Neomycin sulfate - 5mg/g, Hydrocortisone acetate - 10mg/g Ointment 485,063 L.L
N06DA52 MEXAZIL XR 28/10 G Memantine HCl - 28mg, Donepezil HCl - 10mg Capsule 4,333,444 L.L
N06DA52 MEXAZIL XR 14/10 G Memantine HCl - 14mg, Donepezil HCl - 10mg Capsule 3,432,174 L.L
L04AX07 MAROVAREX G Dimethyl Fumarate - 240mg Capsule, hard, gastro-resistant 60,848,734 L.L
J01CR02 MEDIMOX-CV G Amoxicillin - 875mg, Clavulanic Acid - 125mg Tablet 430,030 L.L
N02CC04 MAXALT B Rizatriptan (benzoate) - 10mg Tablet 439,436 L.L
C03EA01 MODURETIC B Hydrochlorothiazide - 50mg, Amiloride HCl - 5mg Tablet 798,398 L.L
D10AD51 MEDCLINIDERM-T G Tretinoin - 0.025%, Clindamycin (phosphate) - 1% Gel 801,186 L.L
D10AD51 MEDCLINIDERM-T G Tretinoin - 0.05%, Clindamycin (phosphate) - 1% Gel 890,776 L.L
B03AD MALTOFER FOL B Folic acid - 0.35mg, Iron trivalent (hydroxide polymaltose) - 100mg Tablet, chewable 854,684 L.L
J07AH MENFIVE G Meningococcal (serogroups A, C, Y, W, X) Polysaccharide conjugate vaccine - Injectable freeze dried powder + diluent 3,527,587 L.L
J07AH08 MENACTRA MENINGOCOCCAL POLYSACCHARIDE DIPHTERIA TOXOID CONJUGATE VACCINE B Meningococcal Polysaccharides (serogroups A, C, Y and W-135) - 4mcg/0.5ml each, Diphteria Toxoid Protein - 48mcg/0.5ml Injectable solution 6,144,048 L.L
J07AH08 MENQUADFI G Meningococcal (serogroups A, C, W and Y) conjugate vaccine - Injectable solution 4,859,334 L.L
A11DB MED-PRINCO-B FORT G Vitamin B12 - 200mcg, Vitamin B6 - 200mg, Vitamin B1 - 100mg Tablet, coated 386,515 L.L
S03CA04 MYCICORT G Hydrocortisone acetate - 5mg, Neomycin sulfate - 5mg Drops suspension 166,381 L.L
R05FB02 MUCUS RELIEF DM G Dextromethorphan HBr - 20mg, Guaifenesin - 400mg Tablet 413,903 L.L
R05X MUCOTAL PROMETHAZINE G Promethazine HCl - 2.5mg/5ml, Carbocysteine - 100mg/5ml Syrup 243,172 L.L
J07BD52 M-M-R II (MEASLES, MUMPS AND RUBELLA VIRUS VACCINE LIVE) B Rubella virus live attenuated - , Mumps virus live attenuated - , Measles virus live attenuated - Injectable solution+diluent 12,924,401 L.L
J07BD52 MEASLES, MUMPS AND RUBELLA VACCINE LIVE ATTENUATED (FREEZE-DRIED) MMR G Rubella virus live attenuated - ?1000CCID50 /0.5ml, Mumps virus live attenuated - ?5000CCID50 /0.5ml, Measles virus live attenuated - ?1000CCID50 /0.5ml Injectable freeze dried powder + diluent 739,113 L.L
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