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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
N05AX13 INVEGA SUSTENNA B Paliperidone palmitate - 75mg 75mg Injectable suspension, prolonged release 15,240,595 L.L
R05CB06 MUCOSOLVAN LA B Ambroxol HCl - 75mg 75mg Capsule 345,368 L.L
R05CB06 MUCOCURE SR G Ambroxol - 75mg 75mg Capsule 276,448 L.L
R05CB06 MUCOXELLIN LA G Ambroxol - 75mg 75mg Capsule 276,448 L.L
R05CB06 SOLVAMUC SR G Ambroxol - 75mg 75mg Capsule 276,448 L.L
L01EC03 BRAFTOVI BioTech Encorafenib - 75mg 75mg Capsule, hard 149,227,143 L.L
L01EF01 IBRANCE B Palbociclib - 75mg 75mg Capsule 172,164,216 L.L
L01EF01 IBRANCE B Palbociclib - 75mg 75mg Tablet, film coated 172,164,216 L.L
L01EF01 PALBRANCE 75 G Palbociclib - 75mg 75mg Capsule 168,011,222 L.L
L01EF01 PAPILLIO G Palbociclib - 75mg 75mg Capsule, hard 147,883,080 L.L
B03XA06 REBLOZYL BioTech Luspatercept - 75mg 75mg Injectable powder for solution 377,881,318 L.L
N06AA21 MEFIDIOMIL B Maprotiline - 75mg 75mg Tablet, sugar coated 958,608 L.L
B01AC04 PLAVIX B Clopidogrel (hydrogenosulfate) - 75mg 75mg Tablet, film coated 1,350,562 L.L
B01AC04 PLAVIX B Clopidogrel (hydrogenosulfate) - 75mg 75mg Tablet, film coated 1,350,562 L.L
B01AC04 AGGRIX 75 G Clopidogrel besylate - 75mg 75mg Tablet, film coated 1,204,083 L.L
B01AC04 ANTIPLEX G Clopidogrel (Bisulfate) - 75mg 75mg Tablet, film coated 1,295,464 L.L
B01AC04 APO-CLOPIDOGREL G Clopidogrel (Bisulfate), - 75mg 75mg Tablet 911,125 L.L
B01AC04 CERUVIN G Clopidogrel (Bisulfate) - 75mg 75mg Tablet 240,548 L.L
B01AC04 CLODOR G Clopidogrel (Bisulfate) - 75mg 75mg Tablet 1,148,025 L.L
B01AC04 CLOPI TAD G Clopidogrel (Bisulfate) - 75mg 75mg Tablet, film coated 911,125 L.L
B01AC04 CLOPIDOGREL ARROW G Clopidogrel besylate - 75mg 75mg Tablet, film coated 658,483 L.L
B01AC04 CLOPIKEY G Clopidogrel (Bisulfate) - 75mg 75mg Tablet 748,520 L.L
B01AC04 CLOPISTOP G Clopidogrel - 75mg 75mg Tablet, film coated 1,081,473 L.L
B01AC04 CLOTRIX 75 G Clopidogrel (hydrogenosulfate) - 75mg 75mg Tablet, film coated 958,608 L.L
B01AC04 CLOTRIX 75 G Clopidogrel (hydrogenosulfate) - 75mg 75mg Tablet, film coated 895,895 L.L
B01AC04 GREPID G Clopidogrel (Bisulfate) - 75mg 75mg Tablet, film coated 1,297,770 L.L
B01AC04 NORMIGORE G Clopidogrel (Bisulfate) - 75mg 75mg Tablet, film coated 1,184,117 L.L
B01AC04 PEDOVEX G Clopidogrel (Bisulfate) - 75mg 75mg Tablet, film coated 808,993 L.L
B01AC04 PIDOGREL MEDIS G Clopidogrel - 75mg 75mg Tablet, film coated 810,337 L.L
B01AC04 THROMBO G Clopidogrel - 75mg 75mg Tablet, film coated 764,646 L.L
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