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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
L01CE02 IRINOTECAN GP PHARM G Irinotecan HCl trihydrate - 100mg/5ml 100mg/5ml Injectable concentrated solution L.L
N05CD08 IPNODIS MEDIS G Midazolam - 5mg/ml 5mg/ml Injectable solution 565,758 L.L
N05CF04 INDUCTAL G Eszopiclone - 2mg 2mg Tablet, film coated 1,411,035 L.L
N05CF04 INDUCTAL G Eszopiclone - 3mg 3mg Tablet, film coated 1,693,242 L.L
P02CF01 IVERMECTINE BIOGARAN G Ivermectin - 3mg 3mg Tablet 1,075,074 L.L
P02CF01 IVER G Ivermectin - 6mg 6mg Tablet 431,373 L.L
C09DA04 IRBAVEL PLUS 150/12.5 G Irbesartan - 150mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 559,294 L.L
P02CF01 IVERMECTIN BENTA G Ivermectin - 6mg 6mg Tablet 784,548 L.L
P02CF01 IVERMECTIN BENTA G Ivermectin - 6mg 6mg Tablet 470,985 L.L
M01AE01 IBUSOL G Ibuprofen - 100mg/5ml 100mg/5ml Suspension 309,724 L.L
C09DA04 IRBAVEL PLUS 300/12.5 G Irbesartan - 300mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 559,294 L.L
C09DA04 IRBAVEL PLUS 300/25 G Irbesartan - 300mg, Hydrochlorothiazide - 25mg Tablet, film coated 624,567 L.L
L04AA06 IMUNOCELL G Mycophenolate mofetil - 500mg 500mg Tablet, film coated 3,791,428 L.L
C09DA04 IRTAN PLUS G Irbesartan - 300mg, Hydrochlorothiazide - 25mg 300mg Tablet 601,530 L.L
M01AE01 IBUPROFEN B. BRAUN G Ibuprofen - 400mg/100ml 400mg/100ml Injectable solution 231,141 L.L
M01AE01 IBUPROFEN B. BRAUN G Ibuprofen - 200mg/50ml 200mg/50ml Injectable solution 161,261 L.L
M01AE01 IBUPROFEN B. BRAUN G Ibuprofen - 600mg/100ml 600mg/100ml Injectable solution 550,975 L.L
G01AF05 IFENEC G Econazole nitrate - 150mg 150mg Ovule 546,944 L.L
M01AE51 IBUGESIC COLD AND SINUS G Ibuprofen - 200mg, Pseudoephedrine HCl - 30mg Tablet, film coated 154,542 L.L
R01AX ISOTONIC SODIUM CHLORIDE G Sodium chloride - 0.9% 0.9% Solution 153,582 L.L
D05AA ICHTAMMOL OINTMENT G Tars - 10% 10% Ointment 90,869 L.L
D05AA ICHTAMMOL OINTMENT G Tars - 10% 10% Ointment 174,060 L.L
A10BD11 INAGLIMET G Metformin - 1000mg, Linagliptin - 2.5mg Tablet, film coated 1,670,844 L.L
A10BD11 INAGLIMET G Metformin - 850mg, Linagliptin - 2.5mg Tablet, film coated 1,670,844 L.L
L01FF03 IMFINZI BioTech Durvalumab - 500mg/10ml 500mg/10ml Injectable solution L.L
A10AE01 INSULATARD BioTech Insulin (human) - 100IU/ml 100IU/ml Injectable suspension 752,552 L.L
A10AE01 INSULATARD BioTech Insulin (human) - 100IU/ml 100IU/ml Injectable suspension 752,552 L.L
L03AB03 IMUKIN BioTech Interferon gamma - 100mcg/0.5ml 100mcg/0.5ml Injectable suspension 6,348,312 L.L
L01FF03 IMFINZI BioTech Durvalumab - 500mg/10ml 500mg/10ml Injectable solution L.L
L04AB02 IXIFI BioTech Infliximab - 100mg 100mg Injectable powder for concentrate for solution L.L
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