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Mortality Surveillance during a Large Chikungunya Outbreak Using a Syndromic Surveillance System

Description

Following the heat wave that scorched France in August 2003 a national daily gathering of mortality data was decided in link with the National Institute for Statistics and Economic Studies (Insee). Such gathering is based on Public Records Office equipped with the appropriate software in order to transmit their data to Insee. Then data received daily are transmitted automatically to the National Institut for Health Surveillance. Data are encrypted and transmitted 7 days per week through direct FTP in a pretermined format. For each death certificate, the following information are recorded: zip code, age, sex, date of death.

A pilot test started in June, 2004 with 147 cities for one year. The good evaluation of the system pushed to enlarge it to all eligible cities in France. The enlarged system started on November 1, 2005 and concerned 1,152 Public Records Office which represents around 75% of the daily French mortality.

Reunion Island (population 770,000) is being affected by the most important outbreak of chikungunya disease ever described in the medical literature. Between March 1, 2005 and May 30, 2006, an estimated 255,000 cases have been reported in this French territory located in the Indian Ocean. The vast majority of the cases have been occurring from mid-December, with a peak of 45000 cases week 5, 2006.

The disease is a self-limiting febrile viral disease characterised by arthralgia or arthritis. The symptoms may last for several months but recovery was, until now, considered universal.

 

Objective

This paper describes the on going surveillance of mortality during the largest outbreak of chikungunya ever known. It is based on a new automatic gathering of mortality data and it is also the first opportunity to test this system in real condition.

Submitted by elamb on