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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
A02BC01 OMEPRAL G Omeprazole - 20mg 20mg Capsule, delayed release 213,735 L.L
A02BC01 OMEPRAZOLE PHARMADEX G Omeprazole - 20mg 20mg Capsule 415,951 L.L
A02BC01 OMEPRAZOLE PHARMADEX G Omeprazole - 20mg 20mg Capsule 15,757,784 L.L
A02BC01 OMEZOL BENTA G Omeprazole - 20mg 20mg Capsule 550,336 L.L
A02BC01 OMEZOL BENTA G Omeprazole - 20mg 20mg Capsule 317,403 L.L
A02BC01 OMEPRAL G Omeprazole - 40mg 40mg Capsule, delayed release 499,142 L.L
A02BC01 OMEPRAZOLE ARROW G Omeprazole - 40mg 40mg Injectable powder for solution 454,219 L.L
A02BC01 OMEPRAZOLE VIANEX G Omeprazole (sodium) - 40mg 40mg Injectable powder for solution+diluent 467,657 L.L
A02BC01 OMEPRAZOLE-ORBUCELL G Omeprazole (sodium) - 40mg 40mg Injectable solution 3,839,550 L.L
A02BC01 OMEPREFUL G Omeprazole - 40mg 40mg Injectable powder for solution+solvent 20,218,110 L.L
A02BC01 OMEPRAL G Omeprazole - 20mg 20mg Powder for suspension 712,876 L.L
A02BC01 OMEPRAL G Omeprazole - 10mg 10mg Powder for suspension 890,776 L.L
A03AX13 OVOL B Simethicone - 40mg/ml 40mg/ml Drops 233,829 L.L
A03AX13 OVOL FOR GAZ B Simethicone - 180mg 180mg Capsule, liquid gel 241,892 L.L
A04AA01 ONDAKEY G Ondansetron (HCl dihydrate) - 8mg 8mg Tablet, film coated 4,489,778 L.L
A04AA01 ONDANSETRON BIOGARAN G Ondansetron - 8mg 8mg Tablet, coated 1,307,559 L.L
A04AA01 ONDANSETRON MEDIS G Ondansetron (HCl dihydrate) - 8mg 8mg Tablet, film coated 748,520 L.L
A04AA01 ODNATRON G Ondansetron (HCl dihydrate) - 4mg/2ml 4mg/2ml Injectable solution 880,217 L.L
A04AA01 ONDANSETRON HIKMA G Ondansetron (HCl dihydrate) - 4mg/2ml 4mg/2ml Injectable solution 2,228,091 L.L
A04AA01 ONDANSETRON MEDIS G Ondansetron - 4mg/2ml 4mg/2ml Injectable solution 978,317 L.L
A04AA01 ONDANSETRON RENAUDIN G Ondansetron (HCl dihydrate) - 4mg/2ml 4mg/2ml Injectable solution 1,791,342 L.L
A04AA01 ONDANSETRON VIANEX G Ondansetron (HCl) - 4mg/2ml 4mg/2ml Injectable solution 197,545 L.L
A04AA01 ODNATRON G Ondansetron (HCl dihydrate) - 8mg/4ml 8mg/4ml Injectable solution 952,784 L.L
A04AA01 ONDANSETRON HIKMA G Ondansetron (HCl dihydrate) - 8mg/4ml 8mg/4ml Injectable solution 4,018,089 L.L
A04AA01 ONDANSETRON MEDIS G Ondansetron - 8mg/4ml 8mg/4ml Injectable solution 1,919,007 L.L
A04AA01 ONDANSETRON RENAUDIN G Ondansetron (HCl dihydrate) - 8mg/4ml 8mg/4ml Injectable solution 2,433,699 L.L
A04AA01 ONDANSETRON VIANEX G Ondansetron (HCl) - 8mg/4ml 8mg/4ml Injectable solution 387,027 L.L
A04AA01 ONDANSETRON ARROW G Ondansetron - 8mg 8mg Tablet, orodispersible 1,280,682 L.L
A04AA01 ONZETRAN OD G Ondansetron - 8mg 8mg Tablet, orodispersible 1,023,880 L.L
A04AA01 ONDEMED G Ondansetron (HCl) - 4mg/5ml 4mg/5ml Solution 858,779 L.L
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