Abstract
The 2014/15 influenza epidemic caused a work overload for healthcare facilities in France. The French national public health agency announced the start of the epidemic – based on indicators aggregated at the national level – too late for many hospitals to prepare. It was therefore decided to improve the influenza alert procedure through (i) the introduction of a pre-epidemic alert level to better anticipate future outbreaks, (ii) the regionalisation of surveillance so that healthcare structures can be informed of the arrival of epidemics in their region, (iii) the standardised use of data sources and statistical methods across regions. A web application was developed to deliver statistical results of three outbreak detection methods applied to three surveillance data sources: emergency departments, emergency general practitioners and sentinel general practitioners. This application was used throughout the 2015/16 influenza season by the epidemiologists of the headquarters and regional units of the French national public health agency. It allowed them to signal the first influenza epidemic alert in week 2016-W03, in Brittany, with 11 other regions in pre-epidemic alert. This application received positive feedback from users and was pivotal for coordinating surveillance across the agency’s regional units.
Highlights
The influenza A(H3N2) strain that circulated in France during the winter 2014/15 caused an overload of patients in hospitals’ emergency departments (ED), with more than 30,000 visits, and in intensive care units, with at least 1,600 severe cases [1]
Among the 2,144 viruses isolated in that season in ambulatory medicine through random sampling of influenza-like illness (ILI) cases, 70% were influenza B viruses, and 27% belonged to the subtype A(H1N1) pdm09 [21]
MASS was used every week throughout this period by the epidemiologists involved in influenza surveillance at the national public health agency’s regional and national levels
Summary
The influenza A(H3N2) strain that circulated in France during the winter 2014/15 caused an overload of patients in hospitals’ emergency departments (ED), with more than 30,000 visits, and in intensive care units, with at least 1,600 severe cases [1]. Santé publique France, the French national public health agency, announced the start of the epidemic at the national level when the national incidence rate of influenza-like illness (ILI) cases who consulted general practitioners belonging to a surveillance sentinel network crossed the epidemic threshold (determined using a periodic regression model) [2,3]. This was too late for many hospitals to prepare. Influenza reports were produced in the national public health agency’s regional units, based on a variety of data and statistical methods, with no inter-regional comparison
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