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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
S01ED51 XALACOM B Timolol (maleate) - 6.8mg/ml, Latanoprost - 50?g/ml Drops solution 510,660 L.L
S01EE01 XALAPROST G Latanoprost - 0.005% w/v 0.005% w/v Drops solution 421,967 L.L
S01EE01 XALATAN B Latanoprost - 50mcg/ml 50mcg/ml Drops solution 704,173 L.L
N05AX12 XALIPRO G Aripiprazole - 10mg 10mg Tablet 2,123,271 L.L
N05AX12 XALIPRO G Aripiprazole - 15mg 15mg Tablet 2,418,917 L.L
N05AX12 XALIPRO G Aripiprazole - 5mg 5mg Tablet 1,746,995 L.L
L01ED01 XALKORI B Crizotinib - 250mg 250mg Capsule L.L
L01ED01 XALKORI B Crizotinib - 250mg 250mg Capsule 347,644,061 L.L
L01ED01 XALKORI B Crizotinib - 200mg 200mg Capsule 347,644,061 L.L
N05BA12 XANAX B Alprazolam - 0.5mg 0.5mg Tablet 477,064 L.L
B01AF01 XARELTO B Rivaroxaban - 2.5mg 2.5mg Tablet, film coated 4,045,168 L.L
B01AF01 XARELTO B Rivaroxaban - 15mg 15mg Tablet, film coated 4,440,862 L.L
B01AF01 XARELTO B Rivaroxaban - 20mg 20mg Tablet, film coated 4,440,862 L.L
B01AF01 XARELTO B Rivaroxaban - 10mg 10mg Tablet, film coated 1,588,892 L.L
G04CA01 XATRAL XL B Alfuzosin HCl - 10mg 10mg Tablet, prolonged release 1,061,636 L.L
B01AF01 XAVIRAN G Rivaroxaban - 15mg 15mg Tablet, film coated 952,208 L.L
B01AF01 XAVIRAN G Rivaroxaban - 20mg 20mg Tablet, film coated 952,208 L.L
B01AF01 XAVIRAN G Rivaroxaban - 10mg 10mg Tablet, film coated 606,649 L.L
L04AA29 XELJANZ B Tofacitinib - 5mg 5mg Tablet L.L
L04AA29 XELJANZ B Tofacitinib - 5mg 5mg Tablet 80,685,473 L.L
L04AA29 XELJANZ XR B Tofacitinib - 11mg 11mg Tablet, extended release 78,687,316 L.L
L01BC06 XELODA B Capecitabine - 500mg 500mg Tablet, film coated 17,946,398 L.L
D07AC13 XEMADERM G Mometasone furoate - 0.1% 0.1% Cream 335,961 L.L
A08AB01 XENICAL B Orlistat - 120mg 120mg Capsule 4,036,903 L.L
M03AX01 XEOMIN BioTech Clostridium botulinum type A neurotoxin complex - 100 units LD50 100 units LD50 Injectable powder for solution 20,517,541 L.L
M03AX01 XEOMIN BioTech Clostridium botulinum type A neurotoxin complex - 50 units LD50 50 units LD50 Injectable powder for solution 11,920,109 L.L
J01DD15 XEVANEER G Cefdinir - 125mg/5ml 125mg/5ml Powder for suspension 1,308,903 L.L
J01DD15 XEVANEER G Cefdinir - 125mg/5ml 125mg/5ml Powder for suspension 686,704 L.L
J01DD15 XEVANEER G Cefdinir - 300mg 300mg Capsule 1,350,562 L.L
M05BX04 XGEVA BioTech Denosumab - 120mg 120mg Injectable solution 33,545,669 L.L
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