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. 2017 Aug 10;22(32):30593.
doi: 10.2807/1560-7917.ES.2017.22.32.30593.

Improving regional influenza surveillance through a combination of automated outbreak detection methods: the 2015/16 season in France

Camille Pelat  1 , Isabelle Bonmarin  1 , Marc Ruello  1 , Anne Fouillet  1 , Céline Caserio-Schönemann  1 , Daniel Levy-Bruhl  1 , Yann Le Strat  1 ; Regional Influenza study group  2
Collaborators, Affiliations

Improving regional influenza surveillance through a combination of automated outbreak detection methods: the 2015/16 season in France

Camille Pelat et al. Euro Surveill. .

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.

Keywords: ILI; automated surveillance; influenza; influenza-like illness; sentinel surveillance; statistics; syndromic surveillance.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Flow diagram of the web application MASS (Module for the Analysis of SurSaUD and Sentinelles’ data), France, 2015/16
Figure 2
Figure 2
Determination of influenza epidemic periods with the web application MASS (Module for the Analysis of SurSaUD and Sentinelles’ data), France, 2015/16
Figure 3
Figure 3
Distribution of influenza-like illness cases reported by three data source providers used in the web application MASS (Module for the Analysis of SurSaUD and Sentinelles’ data), France, 2015/16 influenza surveillance period (week 2015-W50 to 2016-W17)
Figure 4
Figure 4
Weekly influenza alarm levels (generated by statistical methods) and alert levels (resulting from epidemiological validation), 2015/16 surveillance period (week 2015-W50 to 2016-W17)
See this image and copyright information in PMC

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