Improving regional influenza surveillance through a combination of automated outbreak detection methods: the 2015/16 season in France.
Camille Pelat, Isabelle Bonmarin, Marc Ruello, Anne Fouillet, Céline Caserio-Schönemann, Daniel Levy-Bruhl, Yann Le Strat, Regional Influenza study group
Author Information
Camille Pelat: Santé publique France, French national public health agency. Saint-Maurice, France.
Isabelle Bonmarin: Santé publique France, French national public health agency. Saint-Maurice, France.
Marc Ruello: Santé publique France, French national public health agency. Saint-Maurice, France.
Anne Fouillet: Santé publique France, French national public health agency. Saint-Maurice, France.
Céline Caserio-Schönemann: Santé publique France, French national public health agency. Saint-Maurice, France.
Daniel Levy-Bruhl: Santé publique France, French national public health agency. Saint-Maurice, France.
Yann Le Strat: Santé publique France, French national public health agency. Saint-Maurice, France.
: Members of the regional influenza study group are mentioned at the end of the article.
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.
