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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
A10BD15 DIAFLOZIN PLUS G Metformin HCl XR - 1000mg, Dapagliflozin - 5mg Tablet, film coated 1,241,710 L.L
B05BB02 2.5% DEXTROSE 0.45% SODIUM CHLORIDE INJECTION G Dextrose,H2O - 2.5g/100ml, Sodium chloride - 0.45g/100ml Injectable solution 172,377 L.L
C09DX03 VOCADO HCT B Olmesartan medoxomil - 20mg, Amlodipine - 5mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 1,482,258 L.L
R03AK07 BUFOMIX EASYHALER G Formoterol fumarate dihydrate - 4.5mcg/inhalation, Budesonide - 160mcg/inhalation Metered dose inhaler 1,182,581 L.L
A10BD15 DIVINUSMET XR G Dapagliflozin - 5mg, Metformin HCl XR - 1000mg Tablet, extended release 2,900,012 L.L
B05BB02 2.5% DEXTROSE 0.45% SODIUM CHLORIDE INJECTION G Dextrose,H2O - 2.5g/100ml, Sodium chloride - 0.45g/100ml Injectable solution 224,090 L.L
C09DX03 OLMENOR TRIPLE G Olmesartan medoxomil - 20mg, Amlodipine (besylate) - 5mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 1,037,446 L.L
M01BX DORIXINA B1B6B12 B Lysine clonixinate - 125mg, Vitamin B1 - 50mg, Vitamin B6 - 30mg, Vitamin B12 - 50mcg Tablet, film coated 804,962 L.L
R03AK07 SYMBICORT B Formoterol fumarate dihydrate - 9mcg/Inhalation, Budesonide - 320mcg/Inhalation Inhalation powder 3,378,420 L.L
A10BD15 ZYGLOMET XR 5/1000 G Dapagliflozin - 5mg, Metformin HCl XR - 1000mg Tablet, film coated 2,578,386 L.L
B05BB02 2.5% DEXTROSE 0.45% SODIUM CHLORIDE INJECTION G Dextrose,H2O - 2.5g/100ml, Sodium chloride - 0.45g/100ml Injectable solution 150,543 L.L
C09DX03 VOCADO HCT B Olmesartan medoxomil - 40mg, Amlodipine - 5mg, Hydrochlorothiazide - 25mg Tablet, film coated 1,523,917 L.L
R03AK07 BUFOMIX EASYHALER G Formoterol fumarate dihydrate - 9mcg, Budesonide - 320mcg Metered dose inhaler 2,365,163 L.L
A10BD15 XIGDUO XR B Metformin HCl XR - 1000mg, Dapagliflozin - 10mg Tablet 3,006,579 L.L
B05BB02 DEXTROSE 2.5% & SODIUM CHLORIDE 0.45% G Sodium chloride - 0.45g/100ml, Dextrose, H2O - 2.5g/100ml Injectable solution 176,974 L.L
C09DX03 OLMENOR TRIPLE G Olmesartan medoxomil - 40mg, Amlodipine (besylate) - 5mg, Hydrochlorothiazide - 25mg Tablet, film coated 1,067,011 L.L
R03AK07 FORACORT 200 G Formoterol fumarate dihydrate - 4.5mcg/inhalation, Budesonide - 200mcg/inhalation Metered dose inhaler 2,159,555 L.L
A06AA01 HUILE DE PARAFFINE G Liquid paraffin - Liquid 207,336 L.L
A10BD15 DIAFLOZIN PLUS G Metformin HCl XR - 1000mg, Dapagliflozin - 10mg Tablet, film coated 2,483,421 L.L
B05BB02 DEXTROSE 2.5% & SODIUM CHLORIDE 0.45% G Sodium chloride - 0.45g/100ml, Dextrose, H2O - 2.5g/100ml Injectable solution 198,578 L.L
C09DX03 VOCADO HCT B Olmesartan medoxomil - 40mg, Amlodipine - 5mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 1,523,917 L.L
J01DD52 ZAVICEFTA B Ceftazidime - 2g, Avibactam - 0.5g Injectable powder for concentrate for solution 101,659,975 L.L
R03AK07 FORACORT 400 G Formoterol fumarate - 4.5mcg/inhalation, Budesonide - 400mcg/inhalation Metered dose inhaler 3,104,276 L.L
A10BD15 DIVINUSMET XR G Dapagliflozin - 10mg, Metformin HCl XR - 1000mg Tablet, extended release 2,775,035 L.L
B05BB02 DEXTROSE 2.5% & SODIUM CHLORIDE 0.45% G Sodium chloride - 0.45g/100ml, Dextrose, H2O - 2.5g/100ml Injectable solution 224,090 L.L
C08DA51 TARKA B Verapamil - 180mg, Trandolapril - 2mg Capsule, modified release 2,422,948 L.L
C09DX03 OLMENOR TRIPLE G Olmesartan medoxomil - 40mg, Amlodipine (besylate) - 5mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 1,067,011 L.L
R03AK08 INUVER B Formoterol fumarate - 6mcg/dose, Beclometasone dipropionate - 100mcg/dose Inhalation solution 3,225,222 L.L
A02AC10 RENNIE B Magnesium carbonate - 80mg, Calcium carbonate - 680mg Tablet, chewable 240,548 L.L
A10BD15 ZYGLOMET XR 10/1000 G Dapagliflozin - 10mg, Metformin HCl XR - 1000mg Tablet, film coated 2,467,295 L.L
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