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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
N02BF02 NERVAX G Pregabalin - 150mg 150mg Capsule 1,955,291 L.L
N02BF02 NEUREXAL G Pregabalin - 150mg 150mg Capsule 754,856 L.L
N02BF02 NERVAX G Pregabalin - 75mg 75mg Capsule 513,348 L.L
N02BF02 NEUREXAL G Pregabalin - 75mg 75mg Capsule 335,577 L.L
N02BF02 NEUREXAL G Pregabalin - 75mg 75mg Capsule 637,365 L.L
N02BF02 NEUREXAL G Pregabalin - 25mg 25mg Capsule 321,754 L.L
C04AX21 NAFTILUX B Naftidrofuryl oxalate acid - 200mg 200mg Capsule 533,505 L.L
M09AX NUCLEO C.M.P. FORTE G UTP+UDP+UMP - 3mg, CMP - 5mg Capsule 443,468 L.L
A02BC05 NEXICURE G Esomeprazole - 40mg 40mg Capsule 646,324 L.L
A02BC05 NEXOREST G Esomeprazole - 40mg 40mg Capsule 646,324 L.L
N03AX12 NEUROPLEX G Gabapentin - 300mg 300mg Capsule 1,107,326 L.L
N03AX12 NEUROPLEX G Gabapentin - 400mg 400mg Capsule 1,290,089 L.L
N06AB03 NEANXETIN G Fluoxetine (HCl) - 20mg 20mg Capsule 422,351 L.L
A07AX03 NIFUNAL G Nifuroxazide - 200mg 200mg Capsule, hard 217,702 L.L
L01XG03 NINLARO B Ixazomib - 4mg 4mg Capsule, hard 388,991,058 L.L
L01XG03 NINLARO B Ixazomib - 3mg 3mg Capsule, hard 348,420,676 L.L
L01XG03 NINLARO B Ixazomib - 2.3mg 2.3mg Capsule, hard 272,619,919 L.L
L01EA03 NILORA G Nilotinib - 200mg 200mg Capsule, hard 94,388,785 L.L
M01AH01 NORMOCOXIB G Celecoxib - 200mg 200mg Capsule, hard 798,242 L.L
A02BC01 NEOOPRAZOLE G Omeprazole - 20mg 20mg Capsule, hard, gastro-resistant 407,184 L.L
R03BB04 NEUMOTROPIO G Tiotropium bromide - 10mcg 10mcg Capsule, inhalation 3,115,844 L.L
L01CA04 NAVELBINE B Vinorelbine (ditartrate) - 20mg 20mg Capsule, soft gelatin 4,048,997 L.L
L01CA04 NAVELBINE B Vinorelbine (ditartrate) - 30mg 30mg Capsule, soft gelatin 6,072,824 L.L
D10AF05 NADIXA G Nadifloxacin - 1% 1% Cream 850,652 L.L
S01AE02 NAFLOX G Norfloxacin - 3mg/ml 3mg/ml Drops 370,901 L.L
S01AA23 NETTACIN B Netilmicin - 0.3% 0.3% Drops solution 681,328 L.L
S01CA01 NETILDEX B Dexamethasone - 0.1%, Netilmicin - 0.3% Drops solution 752,552 L.L
S01GA51 NAPHCON A B Naphazoline HCl - 0.025%, Pheniramine maleate - 0.3% Drops solution 369,557 L.L
A04AA01 NOZAMET G Ondansetron - 8mg 8mg Film, orodispersible 6,075,448 L.L
A04AA01 NOZAMET G Ondansetron - 4mg 4mg Film, orodispersible 3,234,181 L.L
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