Forgeot Cécile

In Saint-Martin (31 949 inhabitants) and Saint-Barthelemy (9 625 inhabitants) islands in the French West Indies, the surveillance system is based on several data sources: (1) a syndromic surveillance system based on two emergency departments (ED) of Saint-Barthellemy (HL de Bruyn) and Saint-Martin (CH Fleming) and on mortality (SurSaUD® network [1])); (2) a network of sentinel general practitioners (GP'™s) based on the voluntary participation of 10 GPs in Saint-Martin and 5 in Saint-Barthelemy; (3) the notifiable diseases surveillance system (31 notifiable diseases to individual case-specific form); (4) the regional surveillance systems of leptospirosis and arboviruses based on the biological cases reported by physicians and laboratories of two islands. On September 6, 2017, Hurricane Irma struck Saint-Martin and Saint-Barthelemy islands. Both islands were massively destroyed. This storm led to major material damages, such as power outages, disturbance of drinking water systems, road closures, destruction of medical structures and evacuation or relocation of residents. In this context, the usual monitoring system did not work and life conditions were difficult. The regional unit of French National Public Health Agency set up an epidemiological surveillance by sending epidemiologists in the field in order to collect data directly from ED physicians, GP's and in dispensaries. Those data allowed to describe short-term health effects and to detect potential disease outbreaks in the aftermath of Hurricane Irma. This paper presents results of the specific syndromic surveillance.

Objective: Describe short-term health effects of the Hurricane using the syndromic surveillance system based on emergency departments, general practitioners and dispensaries in Saint-Martin and Saint-Barthelemy islands from September 11, 2017 to October 29, 2017.

The Seine River rises at the north-East of France and flows through Paris before emptying into the English Channel. On January 2018 (from 22th January to 11th February, Weeks 4 to 6), major floods occurred in the Basin of Seine River, after an important rainy period. This period was also marked by the occurrence on the same area of a first cold wave on Week 6 (from 5th to 7th February), including heavy snowfall and ice conditions from 9th to 10th February. A second similar cold wave occured from 28th February and 1st March. Floods of all magnitude are known to have potential health impacts on population, both at short, medium and long term both on physical (injuries, diarrhoeal disease, Carbon Monoxyde poisoning, vector-borne disease) and mental health. Extreme cold weather have also the potential to further impact on human health through direct exposure to lower temperatures, and associated adverse conditions, such as snow and ice. Such situations may be particularly associated to direct impact like hypothermia, frostbite and selected bone/joint injuries).

Objective: The presentation describes the results of the daily monitoring of health indicators conducted by the French public health agency during the major floods and the cold wave that occurred in January 2018 in France, in order to early identify potential impact of those climatic events on the population.

Since 2004, the French syndromic surveillance system SurSaUD® coordinated by the French Public Health Agency (Sante publique France) daily collects morbidity data from two data sources: the emergency departments (ED) network Oscour® and the emergency general practitioners associations SOS Medecins. Almost 92% of the French ED attendances are recorded by the system. SOS Medecins network is a group of 62 associations of general practitioners, dispatched all over the territory. Sante publique France received data from 61 out of 62 associations. Both data sources collect medical diagnosis, using ICD10 codes in the ED network and specific medical thesaurus in SOS Medecins associations. These data are routinely analyzed to detect and follow-up various expected or unusual public health events all over the territory. The system is also used for reassurance of decision makers. In that framework, in March 2017, the French Ministry of Health requested Sante publique France to validate a potential scarlet fever outbreak in France.

Objective:

Describe a case study of validation of a scarlet fever outbreak using syndromic surveillance data sources.