Fouillet Anne

LBP is one of the leading contributors to disease burden worldwide [1]. In France, LBP is a frequent reason of general practice consultations. According to a study published in 2017 and based on 2014 data issued of the National Health Insurance Cross-Schemes Information System (Sniiram) [2], this pathology stands for 30% of thickness leave and 4 of 5 people will suffer of low back pain during their own life. Most often, LBP is a chronic pathology with acute episodes which most often require emergency care. In order to prevent chronicity, French health care insurance launched into a mainstream national prevention campaign during spring 2018. This campaign was also targeted for health professional to inform them of the best recommendations to provide to their patients. Then the French society of emergency medicine (SFMU) has been asked to relay this campaign to emergency departments (ED) where LBP is a frequent reason of attendance. Since 2004, the French syndromic surveillance system SurSaUD® [3] coordinated by the French Public Health Agency (Santé publique France) daily collects morbidity data from the emergency departments (ED) network Oscour®. Almost 92% of the French ED attendances were recorded by the system in 2017. The availability of this large ED dataset on the whole territory since several years gives the opportunity to describe LBP attendances before the potential fallout of the national prevention campaign.

Objective: The study describes the characteristics of attendances for low back pain (LBP) in the French emergency departments (ED) network Oscour®, in order to give an overview of this disease before launching a prevention campaign.

Mortality is an indicator of the severity of the impact of an event on the population. In France mortality surveillance is part of the syndromic surveillance system SurSaUD and is carried out by Santé publique France, the French public health agency. The set-up of an Electronic Death Registration System (EDRS) in 2007 enabled to receive in real-time medical causes of death in free-text format. This data source was considered as reactive and valuable to implement a reactive mortality surveillance system using medical causes of death (1). The reactive mortality surveillance system is based on the monitoring of Mortality Syndromic Groups (MSGs). An MSG is defined as a cluster of medical causes of death (pathologies, syndromes, symptoms) that meet the objectives of early detection and impact assessment of events (2). Since causes of death are entered in free-text format, their automatic classifications into MSGs require the use of natural language processing methods. We observe a constant increase in the use of these methods to classify medical information and for health surveillance over the last two decades (3).

Objective: This study aims to implement and evaluate two automatic classification methods of free-text medical causes of death into Mortality Syndromic Groups (MSGs) in order to be used for reactive mortality surveillance.

As part of the French syndromic surveillance system SurSaUDî, the French Public Health Agency (Sant© publique France) collects daily data from the emergency department (ED) network OSCOUR®. The system aims to timely identify, follow and assess the health impact of unusual or seasonal events on emergency medical activity. Individual ED data contain demographic (age, gender, residence zip code), administrative (dates of attendances and discharge, ED, etc.) and medical information (chief complaint, main and associated medical diagnoses, severity). Medical diagnoses are encoded using the ICD10 classification. Then syndromic groups are built based on these ICD10 codes for ensuring syndromic surveillance in routine. Even if ICD10 is recommended on the national guidelines for coding ED attendances, this thesaurus offers a too large variety of codes. Particularly, it includes lots of diseases that may never be observed or confirmed in ED. This variety let selection of the appropriate codes difficult for physicians in a reactive use and could discourage them to code diagnoses. In order to encourage appropriate and reactive coding practice, we decided in 2017 to produce a new diagnoses thesaurus with a limited list of ICD10 codes. Then a committee of medical and epidemiological experts was created by the Federation of regional emergency observatories (FedORU), to propose an operational thesaurus that includes relevant codes for both ED in a daily routine practice and syndromic surveillance.

Objective: The study aims to evaluate the potential impact of the revision of the thesaurus used by ED physicians to code medical diagnoses, on the syndromic indicators used daily to achieve the detection objective of the French syndromic surveillance system.

In Reunion Island, a French overseas territory located in the southwestern of Indian Ocean, the dengue virus circulation is sporadic. Since 2004, between 10 and 221 probable and confirmed autochthonous dengue fever cases have been reported annually. Since January 2018, the island has experienced a large epidemic of DENV serotype 2. As of 4 September 2018, 6,538 confirmed and probable autochthonous cases have been notified1. From the beginning of the epidemic, the regional office of National Public Health Agency (ANSP) in Indian Ocean enhanced the syndromic surveillance system in order to monitor the outbreak and to provide hospital morbidity data to public health authorities.

Objective: To describe the characteristics of ED vitis related to dengue fever and to show how the syndromic surveillance system can be flexible for the monitoring of this outbreak.

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.

In 2004, Sante publique France, the French Public Health Agency set up a reactive all-cause mortality surveillance based on the administrative part of the death certificate, in the final objectives 1/ to detect unexpected or usual variations in mortality and 2/ to provide a first evaluation of mortality impact of events. In 2007, an Electronic Death Registration System (EDRS) was implemented, enabling electronic transmission of the medical causes of death to the agency in real-time. To date, 12% of the mortality is registered electronically. A pilot study demonstrated that these data were valuable for a reactive mortality surveillance system based on causes of death. A strategy has thus been developed for the analysis in routine of the medical causes of death with the objectives of early detection of expected and unexpected outbreaks and reactive evaluation of their impact. This system will allow approaching the cause accountability when an excess death will be observed.

Objective: The aim of this study is to present the syndromic groups that will be routinely monitored for the reactive mortality surveillance based on free-text medical causes of death.

Triple-S (Syndromic Surveillance Survey, Assessment towards Guidelines for Europe) was launched in 2010 for a 3-year period. Co-financed by the European Commission through the Executive Agency for Health and Consumers, the project is coordinated by the French Institute for Public Health Surveillance and involves 24 organisations from 13 countries. Both human and veterinary syndromic surveillance are considered.

Objective

The first results of the inventory of syndromic surveillance systems in Europe, conducted in the framework of the European project Triple-S, are presented.

Co-financed by the European Commission through the Executive Agency for Health and Consumers, the European Triple-S project (Syndromic Surveillance Survey, Assessment towards Guidelines for Europe) was launched in 2010 for a 3-year period [1]. It involves 24 organisations from 13 countries. The project's final purpose is to increase the European capacity for real-time surveillance and monitoring of the health burden of expected and unexpected health-related events. Based on inventories of European SyS systems [2;3], eight country visits [4] and experts advice, the project has developed scientific guidelines that aim at providing scientific and technical guidance for the development and implementation of SyS systems for both human and animal health.

Objective

To present the Guidelines for implementing syndromic surveillance (SyS) systems at a national, regional or local level.

This paper assesses the possible interest of using of a syndromic surveillance system based on emergency departments (ED) and crude mortality for monitoring health effects of climate changes (CC).