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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
L01FX24 TECVAYLI BioTech Teclistamab - 10mg/ml 10mg/ml Injectable solution 95,166,436 L.L
L01FX24 TECVAYLI BioTech Teclistamab - 90mg/ml 90mg/ml Injectable solution 483,720,518 L.L
L01FX29 TALVEY B Talquetamab - 2mg/ml 3mg/1.5ml Injectable solution 45,594,403 L.L
L01FX29 TALVEY B Talquetamab - 40mg/ml 40mg/ml Injectable solution 555,916,745 L.L
A10BJ05 TRULICITY BioTech Dulaglutide - 0.75mg/0.5ml 0.75mg/0.5ml Injectable solution 10,165,201 L.L
A10BJ05 TRULICITY BioTech Dulaglutide - 1.5mg/0.5ml 1.5mg/0.5ml Injectable solution 10,165,201 L.L
C02CA06 TACHYBEN G Urapidil - 25mg/5ml 25mg/5ml Injectable solution 1,439,255 L.L
L04AC16 TREMFYA BioTech Guselkumab - 100mg/ml 100mg/ml Injectable solution L.L
M01AB05 TRATUL G Diclofenac Deanol - 90mg 90mg Injectable solution 490,503 L.L
L01FX24 TECVAYLI BioTech Teclistamab - 90mg/ml 90mg/ml Injectable solution L.L
J06BB02 TETAGAM P BioHuman Human Tetanus Immunoglobulin - 250IU/ml 250IU/ml Injectable solution 3,075,475 L.L
J06BB02 TETANUS GAMMA BioHuman Human Tetanus Immunoglobulin - 250IU/ml 250IU/ml Injectable solution 3,077,399 L.L
L01FX24 TECVAYLI BioTech Teclistamab - 10mg/ml 10mg/ml Injectable solution L.L
A10AE04 TOUJEO BioTech Insulin glargine - 300Units/ml 300Units/ml Injectable solution 4,559,658 L.L
A10AE06 TRESIBA BioTech Insulin degludec - 100IU/ml 100IU/ml Injectable solution 6,223,335 L.L
J07AP03 TYPHIM VI B Salmonella typhi polysaccharides - 0.025mg/0.5ml 0.025mg/0.5ml Injectable solution 1,118,077 L.L
J01MA12 TAVANIC 500MG B Levofloxacin - 500mg/100ml 500mg/100ml Injectable solution 1,988,887 L.L
A11DB TRILAGAVIT G Vitamin B12 - 1mg/3ml, Vitamin B6 - 100mg/3ml, Vitamin B1 - 100mg/3ml Injectable solution 579,196 L.L
B06AC05 TAKHZYRO BioTech Lanadelumab - 300mg/2ml 300mg Injectable solution L.L
N02AX02 TRAMAL 100MG B Tramadol HCl - 100mg/2ml 100mg/2ml Injectable solution 243,235 L.L
N02AX02 TRAMADOL ARROW G Tramadol HCl - 100mg/2ml 100mg/2ml Injectable solution 318,491 L.L
N02AX02 TRAMADOL NORMON G Tramadol HCl - 100mg/2ml 100mg/2ml Injectable solution 169,324 L.L
A04AA01 TRONDAMET G Ondansetron (HCl) - 4mg/2ml 4mg/2ml Injectable solution 2,027,858 L.L
N03AX18 TREPADIO G Lacosamide - 200mg/20ml 200mg/20ml Injectable solution 9,569,390 L.L
A04AA01 TRONDAMET G Ondansetron (HCl) - 8mg/4ml 2mg/ml Injectable solution 2,027,858 L.L
G02CX01 TRACTOCILE B Atosiban acetate - 7.5mg/ml 7.5mg/ml Injectable solution 2,592,272 L.L
G02CX01 TRACTOCILE B Atosiban acetate - 7.5mg/ml 7.5mg/ml Injectable solution 8,282,804 L.L
B06AC05 TAKHZYRO BioTech Lanadelumab - 300mg/2ml 300mg Injectable solution 1,202,366,121 L.L
B06AC05 TAKHZYRO BioTech Lanadelumab - 300mg/2ml Injectable solution 1,204,227,927 L.L
G03BA03 TESTOVIRON DEPOT B Testosterone Enantate - 250mg/ml 250mg/ml Injectable solution 467,657 L.L
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