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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
C09BB07 RAMIPRIL/AMLODIPINE GENERICON G Ramipril - 10mg, Amlodipine - 5mg Capsule, hard 1,358,625 L.L
C09BB07 RAMIPRIL/AMLODIPINE GENERICON G Ramipril - 10mg, Amlodipine - 10mg Capsule, hard 1,358,625 L.L
N05AX15 REAGILA G Cariprazine HCl - 1.5mg 1.5mg Capsule, hard 6,394,003 L.L
N05AX15 REAGILA G Cariprazine HCl - 3mg 3mg Capsule, hard 6,394,003 L.L
N05AX15 REAGILA G Cariprazine HCl - 4.5mg 4.5mg Capsule, hard 6,394,003 L.L
N05AX15 REAGILA G Cariprazine - 6mg 6mg Capsule, hard 6,394,003 L.L
L04AD02 ROLITAC XR G Tacrolimus - 3mg 3mg Capsule, hard, prolonged release 34,888,503 L.L
L04AD02 ROLITAC XR G Tacrolimus - 1mg 1mg Capsule, hard, prolonged release 12,138,660 L.L
L04AD02 ROLITAC XR G Tacrolimus - 5mg 5mg Capsule, hard, prolonged release 51,728,043 L.L
L04AD02 ROLITAC XR G Tacrolimus - 0.5mg 0.5mg Capsule, hard, prolonged release 6,329,498 L.L
L01EX10 RYDAPT B Midostaurin - 25mg 25mg Capsule, soft 1,254,159,941 L.L
L01EX10 RYDAPT B Midostaurin - 25mg 25mg Capsule, soft 627,079,971 L.L
D10AD01 RETACNYL - 0.05 % G Tretinoin - 0.05% Cream 584,571 L.L
D11AH09 RUXOTOP G Ruxolitinib - 1.5% 1.5% Cream 12,306,475 L.L
A03CB01 RESTROPINAL PEDIATRIC B Butobarbital - 2mg/ml, Methyl hyoscine nitrate - 0.1mg/ml Drops 197,097 L.L
R06AE07 RINALGIT G Cetirizine (dihydrochloride) - 10mg/ml 10mg/ml Drops solution 237,860 L.L
S01XA18 RESTASIS B Ciclosporin - 0.5mg/ml 0.05% Emulsion 4,100,063 L.L
S01XA18 RESTASIS B Ciclosporin - 0.5mg/ml 0.05% Emulsion 4,100,063 L.L
D11AX01 REGAINE FOAM FOR MEN B Minoxidil - 5% Foam 1,370,719 L.L
D11AX01 REGAINE FOAM FOR MEN B Minoxidil - 5% Foam 3,090,838 L.L
D06BX01 ROZEX B Metronidazole - 0.75g/100g 0.75% Gel 584,571 L.L
D10AD04 ROACCUTANE B Isotretinoin - 0.05% 0.05% Gel 1,730,869 L.L
D10AD51 RETINOMYCIN G Tretinoin - 0.025%, Erythromycin - 4% Gel 662,962 L.L
D02AF REPARIL GEL-N B Diethylamine salicylate - 5g/100g, Ascine - 1g/100g Gel 481,096 L.L
N02BE51 REMIDOL G Paracetamol - 650mg, Dextromethorphan HBr - 20mg, Chlorphenamine maleate - 4mg Granules for solution 537,537 L.L
R03AK10 RELVAR ELLIPTA B Vilanterol (trifenatate) - 25mcg/dose, Fluticasone furoate - 200mcg/dose Inhalation powder 3,928,052 L.L
R03AK10 RELVAR ELLIPTA B Vilanterol (trifenatate) - 25mcg/dose, Fluticasone furoate - 100mcg/dose Inhalation powder 3,928,052 L.L
R03AC02 RONKOTOL G Salbutamol (sulfate) - 2.5mg/2.5ml 2.5mg/2.5ml Inhalation solution 470,345 L.L
L01FX18 RYBREVANT BioTech Amivantamab - 350mg 350mg Injectable concentrate for solution 135,818,621 L.L
L01FA01 RIXATHON BioTech Rituximab - 100mg/10ml 100mg/10ml Injectable concentrate for solution 28,438,096 L.L
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