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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
J01DD15 SEFARIN G Cefdinir - 300mg 300mg Capsule 1,490,321 L.L
L04AA27 SCLEMOD G Fingolimod Hydrochloride - 0.5mg 0.5mg Capsule L.L
A02BC01 SANAMIDOL G Omeprazole - 20mg 20mg Capsule 456,906 L.L
A02BC01 STOMAZOLE G Omeprazole - 20mg 20mg Capsule 593,850 L.L
A02BC01 STOMAZOLE G Omeprazole - 20mg 20mg Capsule 15,757,784 L.L
L04AX04 SOTIRA G Lenalidomide - 5mg 5mg Capsule 68,908,116 L.L
L04AX04 SOTIRA G Lenalidomide - 10mg 10mg Capsule 72,248,183 L.L
L04AX04 SOTIRA G Lenalidomide - 15mg 15mg Capsule 76,208,289 L.L
L04AX04 SOTIRA G Lenalidomide - 25mg 25mg Capsule 76,719,234 L.L
R05CB06 SOLVAMUC SR G Ambroxol - 75mg 75mg Capsule 276,448 L.L
G04CA04 SILOSIN B Silodosine - 4mg 4mg Capsule 1,251,693 L.L
G04CA04 SILODOSINE ARROW G Silodosine - 4mg 4mg Capsule 732,394 L.L
G04CA04 SILODOSINE BIOGARAN G Silodosine - 4mg 4mg Capsule 555,007 L.L
G04CA04 SILOSIN B Silodosine - 8mg 8mg Capsule 1,927,454 L.L
G04CA04 SILODOSINE ARROW G Silodosine - 8mg 8mg Capsule 732,394 L.L
G04CA04 SILODOSINE BIOGARAN G Silodosine - 8mg 8mg Capsule 555,007 L.L
L01EX01 SUTENT B Sunitinib maleate - 12.5mg 12.5mg Capsule 54,006,801 L.L
L01EX01 SOVIDEX G Sunitinib maleate - 12.5mg 12.5mg Capsule 36,042,560 L.L
L01EX01 SUTENT B Sunitinib maleate - 25mg 25mg Capsule 98,852,769 L.L
L01EX01 SOVIDEX G Sunitinib maleate - 25mg 25mg Capsule 64,804,314 L.L
L01EX01 SUTENT B Sunitinib maleate - 50mg 50mg Capsule 197,706,574 L.L
L01EX01 SOVIDEX G Sunitinib maleate - 50mg 50mg Capsule 118,623,323 L.L
L04AA27 SCLEMOD G Fingolimod Hydrochloride - 0.5mg 0.5mg Capsule 18,264,981 L.L
L04AA27 SCLEMOD G Fingolimod Hydrochloride - 0.5mg 0.5mg Capsule 17,079,643 L.L
N06AB06 SERTRALINE BIOGARAN G Sertraline HCl - 50mg 50mg Capsule 520,067 L.L
N06AB06 SERTRALINE BIOGARAN G Sertraline HCl - 25mg 25mg Capsule 130,353 L.L
L01EX01 SUTENT B Sunitinib maleate - 12.5mg 12.5mg Capsule L.L
L01EX01 SUTENT B Sunitinib maleate - 50mg 50mg Capsule L.L
J01DD08 SUPRAX B Cefixime (trihydrate) - 200mg 200mg Capsule 1,067,011 L.L
J01DD08 SUPRAX B Cefixime (trihydrate) - 200mg 200mg Capsule 1,067,011 L.L
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