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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
B01AB05 LOVENOX BioTech Enoxaparin sodium - 8000UI (80mg)/0.8ml 8000UI (80mg)/0.8ml Injectable solution 1,206,771 L.L
A11CC05 PEDIAVIT D 800 G Vitamin D3 - 800IU 800IU Liquid 580,540 L.L
B01AC27 UPTRAVI B Selexipag - 800mcg 800mcg Tablet, film coated 242,569,645 L.L
J05AB01 VICLORIX 800 G Aciclovir - 800mg 800mg Tablet 4,321,797 L.L
N06BX03 CEBROTONIN G Piracetam - 800mg 800mg Tablet, film coated 577,852 L.L
A07EC02 ASACOL B Mesalazine - 800mg 800mg Tablet 6,396,690 L.L
B03AB09 FERPLEX B Iron trivalent (ferric proteinsuccinylate) - 800mg 800mg Solution 1,202,739 L.L
N03AF04 ZEBINIX B Eslicarbazepine acetate - 800mg 800mg Tablet 10,075,439 L.L
V03AE02 SEVELAMER CARBONATE ARROW G Sevelamer carbonate - 800mg 800mg Tablet, film coated L.L
V03AE02 RENVELA B Sevelamer - 800mg 800mg Tablet, film coated 8,386,876 L.L
V03AE02 FOSEAL-800 G Sevelamer HCl - 800mg 800mg Tablet, film coated 470,345 L.L
V03AE02 FOSEAL-800 G Sevelamer HCl - 800mg 800mg Tablet, film coated 7,977,094 L.L
V03AE02 SEVELAMER CARBONATE ARROW G Sevelamer carbonate - 800mg 800mg Tablet, film coated 8,645,754 L.L
C08DA01 ISOPTIN B Verapamil (HCl) - 80mg 80mg Tablet, film coated 397,704 L.L
N05AE05 LAROZA G Lurasidone - 80mg 80mg Tablet, film coated 5,548,726 L.L
N05AE05 LURABIL G Lurasidone - 80mg 80mg Tablet, film coated 2,535,831 L.L
J01AA08 VULGA XR G Minocycline - 80mg 80mg Tablet, film coated 1,983,512 L.L
L01EB04 TAGRISSO B Osimertinib - 80mg 80mg Tablet, film coated L.L
M04AA03 ADENURIC B Febuxostat - 80mg 80mg Tablet, film-scored 2,127,111 L.L
M04AA03 FEBUXOSTAT ARROW G Febuxostat - 80mg 80mg Tablet, film coated 1,084,481 L.L
M04AA03 FEBUXOSTAT BIOGARAN G Febuxostat - 80mg 80mg Tablet, film coated 1,182,581 L.L
M04AA03 OXUBAT 80 G Febuxostat - 80mg 80mg Tablet, film coated 1,549,002 L.L
M04AA03 STABURIC G Febuxostat - 80mg 80mg Tablet, film coated 1,355,489 L.L
M04AA03 UROSTAT G Febuxostat - 80mg 80mg Tablet, film coated 1,402,972 L.L
C09CA03 DIOVAN B Valsartan - 80mg 80mg Tablet, film coated 602,041 L.L
C09CA03 ANGINET G Valsartan - 80mg 80mg Tablet, film coated 387,027 L.L
C09CA03 ARBITEN 80 G Valsartan - 80mg 80mg Tablet 387,027 L.L
C09CA03 TABUVAN G Valsartan - 80mg 80mg Tablet, film coated 387,027 L.L
C09CA03 VALSANET G Valsartan - 80mg 80mg Tablet, film coated 479,944 L.L
C09CA03 VALSARTAN ARROW LAB G Valsartan - 80mg 80mg Tablet, film coated, breakable 387,027 L.L
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