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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
A02BC02 PANTO TAD G Pantoprazole (sodium) - 40mg 40mg Tablet, gastroresistant 470,345 L.L
A02BC02 PANTOMAX G Pantoprazole (sodium sesquihydrate) - 40mg 40mg Tablet, enteric coated 771,366 L.L
A02BC02 PANTOMAX G Pantoprazole (sodium sesquihydrate) - 40mg 40mg Tablet, enteric coated 1,381,470 L.L
A02BC02 PANTOVER G Pantoprazole (sodium sesquihydrate) - 40mg 40mg Tablet, enteric coated 739,113 L.L
A02BC02 PANTO TAD G Pantoprazole (sodium) - 20mg 20mg Tablet, gastroresistant 294,302 L.L
A02BC02 PANTOMAX G Pantoprazole (sodium sesquihydrate) - 20mg 20mg Tablet, enteric coated 440,780 L.L
A02BC02 PANTOMAX G Pantoprazole (sodium sesquihydrate) - 20mg 20mg Tablet, enteric coated 837,214 L.L
A02BC02 PANTONIX-JULPHAR G Pantoprazole - 40mg 40mg Injectable powder for solution 260,705 L.L
A02BC02 PANTOPRAZOL SALA G Pantoprazole (sodium) - 40mg 40mg Injectable powder for solution 503,941 L.L
A02BC03 PEPTAZOLE G Lansoprazole - 30mg 30mg Capsule 252,642 L.L
A02BC04 PARIET B Rabeprazole (sodium) - 20mg 20mg Tablet, gastroresistant 779,429 L.L
A02BC04 PRASOLAN G Rabeprazole sodium - 20mg 20mg Tablet, enteric coated 230,373 L.L
A02BC04 PULOROS 28 G Rabeprazole sodium - 20mg 20mg Tablet, gastroresistant 706,861 L.L
A02BC05 PRIMAZOL 20 G Esomeprazole (magnesium dihydrate) - 20mg 20mg Capsule, gastro-resistant 511,940 L.L
A02BC05 PROTREX G Esomeprazole - 20mg 20mg Capsule 511,940 L.L
A02BC05 PRIMAZOL 40 G Esomeprazole (magnesium dihydrate) - 40mg 40mg Capsule, gastro-resistant 639,925 L.L
A02BC05 PROTREX G Esomeprazole - 40mg 40mg Capsule 646,324 L.L
A02BC05 PUMPINOX G Esomeprazole - 40mg 40mg Tablet, enteric coated 649,076 L.L
A02BD08 PYLERA B Bismuth subcitrate potassium - 140mg, Tetracycline HCl - 125mg, Metronidazole - 125mg Capsule 6,156,142 L.L
A03AX12 PHLOROGLUCINOL/TRIMETHYLPHLOROGLUCINOL ARROW G Phloroglucinol - 40mg/4ml, Trimethylphloroglucinol - 0.04mg/4ml Injectable solution 940,690 L.L
A03CA02 PRIMAX G Clidinium bromide - 2.5mg, Chlordiazepoxide - 5mg Tablet 222,694 L.L
A03DB04 PANADOL WOMAN B Paracetamol - 500mg, Hyoscine butylbromide - 10mg Tablet, coated 436,749 L.L
A03FA03 PROKININ G Domperidone - 10mg 10mg Tablet, film coated 221,734 L.L
A04AA05 PALONAN G Palonosetron HCl - 250mcg/5ml 250mcg/5ml Injectable solution 2,194,495 L.L
A06AB58 PICOPREP B Magnesium oxide - 3.5g, Citric acid - 12g, Sodium picosulfate - 10mg Powder 694,767 L.L
A07EC02 PENTASA B Mesalazine - 1g 1g Tablet, controlled release 4,945,340 L.L
A07EC02 PENTASA XTEND B Mesalazine - 2g 2g Granules for suspension 8,550,789 L.L
A07EC02 PENTASA B Mesalazine - 1g 1g Suppository 4,153,817 L.L
A07EC02 PENTASA B Mesalazine - 1g 1g Enema 2,791,161 L.L
A07EC02 PENTASA B Mesalazine - 4g 4g Granules, prolonged release 8,513,063 L.L
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