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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
H02AB04 METHYLPREDNISOLONE ORBUCELL INJ. G Methylprednisolone sodium succinate - 40mg 40mg Injectable powder for solution 2,143,749 L.L
H02AB04 MP 40 G Methylprednisolone - 40mg 40mg Injectable powder for solution 219,046 L.L
H02AB04 METHYLPREDNISOLONE ORBUCELL INJ. G Methylprednisolone sodium succinate - 125mg 125mg Injectable powder for solution 5,784,922 L.L
H02AB04 MP 500 G Methylprednisolone - 500mg 500mg Injectable powder for solution 5,316,241 L.L
L01FD01 MABTIN 440 BioTech Trastuzumab (r-DNA origin) - 440mg 440mg Injectable powder for solution 70,042,700 L.L
G03GA02 MENO-CLAIR HP-HMG BioHuman Human Menopausal Gonadotrophin, Highly purified - 75IU 75IU Injectable powder for solution + solution 1,045,509 L.L
G03GA02 MENO-CLAIR HP-HMG BioHuman Human Menopausal Gonadotrophin, Highly purified - 150IU 150IU Injectable powder for solution + solution 2,005,013 L.L
B01AD11 METALYSE BioTech Tenecteplase - 10,000IU 10,000IU Injectable powder for solution+diluent 77,816,093 L.L
G03GA02 MENOPUR BioHuman Menotropin - 1,200IU 1,200IU Injectable powder for solution+diluent 27,815,659 L.L
G03GA02 MENOPUR BioHuman Menotropin - 600IU 600IU Injectable powder for solution+diluent 13,907,829 L.L
J01DD04 MEDAXONUM G Ceftriaxone (disodium) (Vial) - 500mg, Lidocaine (ampoule) - 500mg Injectable powder for solution+diluent 307,740 L.L
J01DD04 MEDAXONUM G Ceftriaxone (disodium) - 1g 1g Injectable powder for solution+diluent 438,093 L.L
J01DD04 MESPORIN-1000 IM G Ceftriaxone (sodium) - 1g 1,000mg Injectable powder for solution+diluent 417,935 L.L
J01DD04 MESPORIN-1000 IV G Ceftriaxone (sodium) - 1g 1,000mg Injectable powder for solution+diluent 417,935 L.L
S01EB09 MIOVISIN G Acetylcholine chloride - 20mg/2ml 20mg/2ml Injectable powder for solution+solvent 6,449,100 L.L
H05BA01 MIACALCIC B Calcitonin (salmon synthetic) - 100IU/ml 100IU/ml Injectable solution 1,720,118 L.L
N02BE01 MAKOACHE G Paracetamol - 1000mg/100ml 10mg/ml Injectable solution 1,403,867 L.L
B05BC01 MANNITOL G Mannitol - 20g/100ml 20g/100ml Injectable solution 406,810 L.L
B05BC01 MANNITOL G Mannitol - 20g/100ml 20g/100ml Injectable solution 579,064 L.L
B05BC01 MANNITOL G Mannitol - 20g/100ml 20g/100ml Injectable solution 613,662 L.L
B05BC01 MANNITOL 20% INJECTION USP G Mannitol - 20% 20% Injectable solution 374,633 L.L
B05BC01 MANNITOL 20% INJECTION USP G Mannitol - 20% 20% Injectable solution 613,662 L.L
B05BC01 MANNITOL 20% INJECTION USP G Mannitol - 20% 20% Injectable solution 344,754 L.L
B05BC01 MANNITOL 20% INJECTION, USP G Mannitol - 20g/100ml 20g/100ml Injectable solution 402,213 L.L
B05BC01 MANNITOL 20% INJECTION, USP G Mannitol - 20g/100ml 20g/100ml Injectable solution 402,213 L.L
B05BC01 MANNITOL G Mannitol - 10g/100ml 10g/100ml Injectable solution 329,815 L.L
B05BC01 MANNITOL G Mannitol - 10g/100ml 10g/100ml Injectable solution 494,147 L.L
B05BC01 MANNITOL 10% USP INJECTION G Mannitol - 10% 10% Injectable solution 430,943 L.L
B05BC01 MANNITOL 10% USP INJECTION G Mannitol - 10% 10% Injectable solution 326,367 L.L
L04AX03 METOJECT G Methotrexate disodium - 10mg/0.2ml 10mg/0.2ml Injectable solution 1,553,482 L.L
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