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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
M01AB05 REMETHAN G Diclofenac sodium - 50mg 50mg Tablet 196,201 L.L
C10AA07 ROVASTIN G Rosuvastatin (calcium) - 10mg 10mg Tablet 560,574 L.L
G04BE08 RAVANA G Tadalafil - 5mg 5mg Tablet 1,501,264 L.L
C10AA07 ROVASTIN G Rosuvastatin (calcium) - 20mg 20mg Tablet 560,574 L.L
P01AB01 RAMAZOL G Metronidazole - 500mg 500mg Tablet 216,359 L.L
L04AA10 RAPAMUNE B Sirolimus - 1mg 1mg Tablet 12,907,489 L.L
L04AA10 RAPAMUNE B Sirolimus - 1mg 1mg Tablet L.L
N04BD02 RASAGILINE BIOGARAN G Rasagiline - 1mg 1mg Tablet 5,214,109 L.L
R06AX28 RUPATADINE BIOGARAN G Rupatadine - 10mg 10mg Tablet 341,336 L.L
N04BD02 RAZYLECT 1 G Rasagiline mesylate - 1mg 1mg Tablet 3,532,514 L.L
A02AC10 RENNIE B Magnesium carbonate - 80mg, Calcium carbonate - 680mg Tablet, chewable 240,548 L.L
R03DC03 RELIEFAST G Montelukast (sodium) - 5mg 5mg Tablet, chewable 1,034,119 L.L
R03DC03 RELIEFAST G Montelukast (sodium) - 4mg 4mg Tablet, chewable 1,034,119 L.L
G03XC01 RALOXIFENE ARROW G Raloxifene HCl - 60mg 60mg Tablet, coated 1,425,817 L.L
M01AB05 RAPIDUS G Diclofenac potassium - 50mg 50mg Tablet, coated 287,582 L.L
M01AC02 REUTENOX G Tenoxicam - 20mg 20mg Tablet, coated 576,508 L.L
N05CM09 RELAXINE TRENKER G Valerian extract - 500mg 500mg Tablet, coated 1,134,203 L.L
N05AX08 RISPERIDONE BIOGARAN G Risperidone - 1mg 1mg Tablet, coated, scored 643,701 L.L
N05AX08 RISPERIDONE BIOGARAN G Risperidone - 2mg 2mg Tablet, coated, scored 1,488,977 L.L
N05AX08 RISPERIDONE BIOGARAN G Risperidone - 4mg 4mg Tablet, coated, scored 1,105,982 L.L
M01AB05 ROFENAC D G Diclofenac free acid - 50mg 50mg Tablet, dispersible 408,528 L.L
A11GA01 REDOXON EFF.ORANGE B Ascorbic acid (vit C) - 1g 1g Tablet, effervescent 366,869 L.L
A02BC02 RAZON 40 G Pantoprazole (sodium) - 40mg 40mg Tablet, enteric coated 727,019 L.L
A02BC02 RAZON 40 G Pantoprazole (sodium) - 40mg 40mg Tablet, enteric coated 1,252,461 L.L
A02BC02 RAZON 20 G Pantoprazole (sodium) - 20mg 20mg Tablet, enteric coated 747,176 L.L
A02BC04 RABEZOL 20 G Rabeprazole sodium - 20mg 20mg Tablet, enteric coated 282,847 L.L
A02BC04 RABEZOL 20 G Rabeprazole sodium - 20mg 20mg Tablet, enteric coated 639,925 L.L
A02BC04 RAZOLE 20 G Rabeprazole sodium - 20mg 20mg Tablet, enteric coated 282,847 L.L
A02BC04 RAZOLE 20 G Rabeprazole sodium - 20mg 20mg Tablet, enteric coated 639,925 L.L
N05AH04 REZAL XR G Quetiapine fumarate - 200mg 200mg Tablet, extended release 2,116,552 L.L
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