Epidemiology of acute gastroenteritis in France from November 2019-August 2021, in light of reported adherence to COVID-19 barrier measures

Abstract

Since the start of the COVID-19 pandemic, French health authorities have encouraged barrier measures and implemented three lockdowns to slow SARS-CoV-2 transmission. We aimed to examine the impact of these measures on the epidemiology of acute gastroenteritis (AGE) in France, from November 2019 to August 2021. We describe trends in AGE indicators from syndromic surveillance and a sentinel surveillance network. Additionally, we describe reported AGE illness data from a community based cohort, and frequencies of adherence to COVID-19 barrier measures from repeated quantitative surveys. From week 7 in 2020, all AGE indicators reached the lowest levels observed since the last decade. During the first lockdown, the median incidence rate reported by the sentinel network was 32 per 100,000 inhabitants, 1.9 times lower than the minimum registered during the 2010-2019 period. Low activity persisted until April 2021. Reported illness from the community cohort mirrored these trends. Adherence to COVID-19 barrier measures was highest during the first lockdown, coinciding with the steep decrease in AGE incidence. Among children under 5 years, AGE incidence increased after the third lockdown in June and July 2021, but remained lower than previous winter-season peaks. Our study indicates that a reduction in adherence to COVID-19 barrier measures, and the end of the lockdowns, coincided with an increase in AGE incidence, particularly among young children. We therefore strongly recommend maintaining adherence to barrier measures in order to in order to limit the transmission of AGE related pathogens.

Figure 1

Weekly proportion of consultations for acute gastroenteritis, November 2019–August 2021 (yellow line), in (A) emergency departments (OSCOUR), (B) GP emergency house-calls (SOS Médecins), and (C) weekly incidence rate of GP consultations (Sentinel Network), compared to the minimum, median and maximum in 2010–2019 (dotted lines), all ages, France. Light blue boxes: nationwide lockdowns.

Figure 1

Weekly proportion of consultations for acute gastroenteritis, November 2019–August 2021 (yellow line), in (A) emergency departments (OSCOUR), (B) GP emergency house-calls (SOS Médecins), and (C) weekly incidence rate of GP consultations (Sentinel Network), compared to the minimum, median and maximum in 2010–2019 (dotted lines), all ages, France. Light blue boxes: nationwide lockdowns.

Figure 2

Weekly proportion of consultations for acute gastroenteritis, November 2019–August 2021 (yellow line), in (A) emergency departments (OSCOUR), (B) GP-emergency house-calls (SOS Médecins), and minimum, median and maximum of these indicators in 2010–2019 (dotted lines), children under 5 years old, France. Light blue boxes: nationwide lockdowns.

Figure 3

Weekly incidence rates (/100,000 inhabitants) of acute diarrhea from the last 4 winter’ seasons (2017–2018 to 2020–2021). Red line: from W47-2017 to W18-2018, green line: W47-2018 to W17-2019, purple line: W47-2019 to W28-2020, yellow line: W47-2020 to W22-2021, blue boxes: nationwide lockdowns. GrippeNet.fr-COVIDnet, France.

Figure 4

Frequencies of systematic adherence to barrier measures against SARS-CoV-2, CoviPrev survey, metropolitan France, week 14–2020 to week 20–2021 (only weeks with data are displayed). Light blue boxes: nationwide lockdowns.