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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
R06AE09 ZOLICIN G Levocetirizine dihydrochloride - 5mg 5mg Tablet, film coated 228,453 L.L
R06AE09 ZOLICIN G Levocetirizine dihydrochloride - 0.5mg/ml 0.5mg/ml Solution 663,858 L.L
N02CC03 ZOLMITRIPTAN ARROW GENERIGUES G Zolmitriptan - 2.5mg 2.5mg Tablet, film coated 1,726,838 L.L
N02CC03 ZOLMITRIPTAN ARROW GENERIGUES G Zolmitriptan - 2.5mg 2.5mg Tablet, film coated 857,372 L.L
N02CC03 ZOLMITRIPTAN BIOGARAN G Zolmitriptan - 2.5mg 2.5mg Tablet, orodispersible 921,876 L.L
N02CC03 ZOLMITRIPTAN BIOGARAN G Zolmitriptan - 2.5mg 2.5mg Tablet, orodispersible 1,683,835 L.L
N06AB06 ZOLOFT B Sertraline HCl - 50mg 50mg Tablet, scored 596,666 L.L
N06AB06 ZOLOFT B Sertraline HCl - 50mg 50mg Tablet, scored 596,666 L.L
J01FA10 ZOMAX G Azithromycin (dihydrate) - 200mg/5ml 200mg/5ml Powder for suspension 258,018 L.L
J01FA10 ZOMAX G Azithromycin (dihydrate) - 200mg/5ml 200mg/5ml Powder for suspension 258,018 L.L
J01FA10 ZOMAX G Azithromycin (dihydrate) - 250mg 250mg Capsule 360,150 L.L
A04AA01 ZONETRON ODT G Ondansetron - 8mg 8mg Tablet, orodispersible 998,283 L.L
A04AA01 ZONETRON ODT G Ondansetron - 4mg 4mg Tablet, orodispersible 972,686 L.L
L02BG03 ZORTEX G Anastrozole - 1mg 1mg Tablet, film coated 1,944,092 L.L
J05AB01 ZOVIRAX B Aciclovir - 200mg/5ml 200mg/5ml Suspension 487,815 L.L
J05AB01 ZOVIRAX IV B Aciclovir - 250mg 250mg Injectable freeze dried substance 2,146,116 L.L
L01BC07 ZYDROME G Azacitidine - 100mg 100mg Injectable lyophilised powder 10,967,854 L.L
A10BD15 ZYGLOMET XR 10/1000 G Dapagliflozin - 10mg, Metformin HCl XR - 1000mg Tablet, film coated 2,467,295 L.L
A10BD15 ZYGLOMET XR 5/1000 G Dapagliflozin - 5mg, Metformin HCl XR - 1000mg Tablet, film coated 2,578,386 L.L
A10BK01 ZYGLOR 10 G Dapagliflozin - 10mg 10mg Tablet, film coated 2,039,953 L.L
M04AA01 ZYLORIC B Allopurinol - 100mg 100mg Tablet 278,175 L.L
M04AA01 ZYLORIC B Allopurinol - 300mg 300mg Tablet 302,365 L.L
C10BA06 ZYMPASS B Rosuvastatin (calcium) - 10mg, Ezetimibe - 10mg Tablet, film coated 2,138,053 L.L
C10BA06 ZYMPASS B Rosuvastatin (calcium) - 20mg, Ezetimibe - 10mg Tablet, film coated 2,482,077 L.L
C10BA06 ZYMPASS B Rosuvastatin (calcium) - 40mg, Ezetimibe - 10mg Tablet, film coated 2,482,077 L.L
N05AH03 ZYPREXA B Olanzapine - 5mg 5mg Tablet 1,197,364 L.L
N05AH03 ZYPREXA B Olanzapine - 5mg 5mg Tablet 1,197,364 L.L
N05AH03 ZYPREXA B Olanzapine - 10mg 10mg Tablet 1,468,820 L.L
N05AH03 ZYPREXA B Olanzapine - 10mg 10mg Tablet 1,468,820 L.L
N05AH03 ZYPREXA VELOTAB B Olanzapine - 5mg 5mg Tablet, dispersible 2,607,054 L.L
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