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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
L01CD01 PANATAXEL G Paclitaxel - 150mg/25ml 150mg/25ml Injectable concentrated solution 16,521,761 L.L
L01CD01 PANATAXEL G Paclitaxel - 100mg/16.7ml 100mg/16.7ml Injectable concentrated solution L.L
L01BB02 PURI-NETHOL B Mercaptopurine - 50mg 50mg Tablet 830,495 L.L
L01BA04 PEMETREXED NEAPOLIS G Pemetrexed (disodium) - 100mg 100mg Injectable solution L.L
L01BA04 PEMETREXED ACCORD G Pemetrexed (disodium) - 500mg 500mg Injectable powder for concentrate for solution 20,000,292 L.L
L01BA04 PEMETREXED EVER PHARMA G Pemetrexed (disodium) - 500mg/20ml 500mg/20ml Injectable concentrate for solution 38,284,701 L.L
L01BA04 PEMETREXED GP PHARM G Pemetrexed (disodium) - 500mg 500mg Injectable lyophilised powder 46,641,484 L.L
L01BA04 PEMETREXED NEAPOLIS G Pemetrexed (disodium) - 500mg Injectable powder 41,289,202 L.L
L01BA04 PEMETREXED SPC G Pemetrexed (disodium) - 500mg 500mg Injectable concentrated powder for solution 43,746,515 L.L
L01BA04 PEMETREXED STRAGEN G Pemetrexed (disodium) - 500mg/20ml 500mg/20ml Injectable concentrate for solution 24,037,602 L.L
L01BA04 PEMETREXED STRAGEN G Pemetrexed (disodium) - 1000mg/40ml 1000mg/40ml Injectable concentrate for solution 40,480,209 L.L
L01BA04 PEMITRA G Pemetrexed (disodium) - 500mg 500mg Injectable powder for concentrate for solution 47,161,032 L.L
L01BA04 PEMETREXED EVER PHARMA G Pemetrexed (disodium) - 100mg/4ml 100mg/4ml Injectable concentrate for solution 12,185,492 L.L
L01BA04 PEMETREXED NEAPOLIS G Pemetrexed (disodium) - 100mg 100mg Injectable solution 10,554,169 L.L
L01BA04 PEMETREXED STRAGEN G Pemetrexed (disodium) - 100mg/4ml 100mg/4ml Injectable concentrate for solution 12,759,187 L.L
L01BA04 PEMETREXED NEAPOLIS G Pemetrexed (disodium) - 500mg Injectable powder L.L
J07CA06 PENTAXIM B Poliomyelitis virus type 3 inactivated(Prefilled syringe) - 32D.U., Poliomyelitis virus type 2 inactivated(Prefilled syringe) - 8D.U., Poliomyelitis virus type 1 inactivated(Prefilled syringe) - 40D.U., Bordetella pertussis antigen (Prefilled syringe) - toxoid 25mcg+filamentous haemaglutinin 25mcg, Tetanus toxoid (Prefilled syringe) - ?40IU, Diphtheria toxoid (Prefilled syringe) - ?30IU, H. Influenza type b polysaccharide(Vial) - 10mcg Injectable dry powder+suspension 2,558,676 L.L
J07BF03 POLIOMYELITIS VACCINE INACTIVATED B Poliomyelitis virus type 1 inactivated - 40D.U, Poliomyelitis virus type 2 inactivated - 8D.U, Poliomyelitis virus type 3 inactivated - 32D.U Injectable suspension 1,206,771 L.L
J07BD52 PRIORIX B Rubella virus live attenuated - ?10³ CCID50, Mumps virus live attenuated - ?103.7 CCID50, Measles virus live attenuated - ?10³ CCID50 Injectable lyophilised powder for solution+diluent 1,142,266 L.L
J07AL02 PREVENAR 13 B Polysaccharide for serotypes 1, 3, 4, 5 , 6A, 7F, 9V,14, 18C, 19A, 19F, 23F (2.2mcg)Polysaccharide for serotypes 6B (4.4mcg)Conjugated to CRM197 carrier protein and adsorbed on aluminium phosphate (0.125mg aluminium) - Injectable suspension 6,352,343 L.L
J07AL02 PNEUMOSIL (10-VALENT) G Pneumococcal polysaccharide conjugate vaccine (adsorbed) - Injectable suspension 3,386,483 L.L
J07AL02 PREVENAR 20 B Pneumococcal polysaccharide for serotypes 1, 3, 4, 5 , 6A, 7F,8, 9V,10A, 11A, 12F, 14, 15B, 18C, 19A, 19F,22F, 23F, 33F (2.2mcg) Pneumococcal polysaccharide for serotypes 6B (4.4mcg)Conjugated to CRM197 carrier protein (approximately 51mcg) adsorbed on aluminium phosphate (0.125mg aluminium) - Injectable suspension 7,415,107 L.L
J07AL01 PNEUMOVAX 23 B Polysaccharides from each of 23 capsular types of Streptococcus pneumoniae - 25mcgx23serotypes/0.5ml Injectable solution 2,378,601 L.L
J06BA02 PRIVIGEN BioHuman Immunoglobulin human - 5g/50ml 10% Injectable solution 45,903,895 L.L
J05AX18 PREVYMIS B Letermovir - 240mg 240mg Tablet, film coated 460,943,945 L.L
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J05AX18 PREVYMIS B Letermovir - 240mg/12ml 240mg/12ml Injectable concentrate for solution 23,599,640 L.L
J05AG06 PIFELTRO B Doravirine - 100mg 100mg Tablet, film coated 27,819,434 L.L
J02AC01 PANZIMOL G Fluconazole - 100mg 100mg Capsule, hard 1,988,887 L.L
J02AC01 PANZIMOL G Fluconazole - 150mg 150mg Capsule, hard 423,310 L.L
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