Increase of Scarlet fever in March 2017 in France: right or wrong signal?

Isabelle Pontais; Anne Fouillet; Cecile Forgeot; Annie-Claude Paty; Celine Caserio-Schonemann

doi:10.5210/ojphi.v10i1.8923

Increase of Scarlet fever in March 2017 in France: right or wrong signal?

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v10i1.8923 ◽

2018 ◽

Vol 10 (1) ◽

Author(s):

Isabelle Pontais ◽

Anne Fouillet ◽

Cecile Forgeot ◽

Annie-Claude Paty ◽

Celine Caserio-Schonemann

Keyword(s):

Santé Publique ◽

Scarlet Fever ◽

Syndromic Surveillance ◽

Regional Analysis ◽

Data Sources ◽

Syndromic Surveillance System ◽

Paris Area ◽

Paris Region ◽

Sante Publique

Objective: Describe a case study of validation of a scarlet fever outbreak using syndromic surveillance data sources.Introduction: Since 2004, the French syndromic surveillance system SurSaUD® [1] 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 Médecins. Almost 92% of the French ED attendances are recorded by the system. SOS Médecins 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 Médecins associations.These data are routinely analyzed to detect and follow-up various expected or unusual public health events all over the territory [2]. The system is also used for reassurance of decision makers. In that framework, in March 2017, the French Ministry of Health requested Santé publique France to validate a potential scarlet fever outbreak in France.Methods: ED attendances for scarlet fever were identified using the ICD10 code “A38”. SOS Médecins visits with the specific code corresponding to “scarlet fever” were considered.The weekly numbers of ED attendances and SOS Médecins visits for scarlet fever were analyzed from 02/01/2017 (week 5) to 03/31/2017 (week 13) by age group (all ages and less than 15 years old, scarlet fever affecting mainly children) and were compared to the numbers of attendances and visits registered during the same period of the two previous years.Analysis was conducted both at national and regional levels. In order to take into account the improvement of data quality during the study period, we also calculated proportion of attendances and visits for scarlet fever among the overall attendances (respectively visits) with medical coded information.Results: The number of SOS Médecins visits for scarlet fever started to increase in week 9 of 2017. Almost 95% of visits concerned children aged less than 15 years old. SOS Médecins visits for scarlet fever represented 0.24% of the overall visits for the 2 age groups for weeks 11, 13 and 14. This proportion was never reached in 2015 and was observed twice in 2016, but later in the year (weeks 25 and 26).The regional analysis showed that all French metropolitan regions contributed to the increase, even if Paris region was the most impacted. More specifically, cases were mainly located in the east part of the Paris region (in Seine-et-Marne).In the OSCOUR® network, the analysis of the number of attendances for scarlet fever at the national level shows a limited increase from week 9 to week 12. Weekly proportion of ED attendances for scarlet fever among the total coded attendances remained comparable to those observed the two previous years on the same period.The regional analysis also showed that 35% of attendances for scarlet fever during this period were observed in Paris area. But, number of attendances for scarlet fever in this region was comparable during this period to numbers observed the two previous years.Conclusions: The analysis of emergency syndromic data sources enables to confirm an increase of consultations for scarlet fever in SOS Médecins associations from weeks 9 to 14, mainly for children less than 15 years old.The large implementation of the SOS Médecins associations on the whole territory allowed us to provide a geographical location of the outbreak: mainly in the east part of Paris area. The temporal pattern of scarlet fever visits in this region may be in favor of a small cluster of cases.The availability of data collected routinely during a long period of time by the syndromic surveillance system enables to evaluate that the outbreak occurred earlier than the previous years, but the intensity of the outbreak was similar to those observed previously.Scarlet outbreak was not confirmed through the ED network, even if a limited increase was observed during the same period of time. The investigation of this outbreak in ED network revealed a miscoding practice in one ED structure, resulting locally in a larger number of attendances than in the other ED of Paris area.Finally, this case study led to improve data quality and highlighted the importance of the validation step of alarms by epidemiologists, even in an automatized system.

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Are the French SAMU data relevant for health surveillance?

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v10i1.8554 ◽

2018 ◽

Vol 10 (1) ◽

Author(s):

Isabelle Pontais ◽

Florian Franke ◽

Barbara Philippot ◽

François Valli ◽

Gilles Viudes ◽

...

Keyword(s):

Intensive Care ◽

Pilot Study ◽

Santé Publique ◽

Syndromic Surveillance ◽

Health Impact ◽

Health Surveillance ◽

Data Sources ◽

Daily Data ◽

Sante Publique

ObjectiveTo evaluate whether SAMU data could be relevant for health surveillance and proposed to be integrated into the French national syndromic surveillance SurSaUD® system.IntroductionThe syndromic surveillance SurSaUD® system developed by Santé publique France, the French National Public Health Agency collects daily data from 4 data sources: emergency departments (OSCOUR® ED network) [1], emergency general practioners (SOS Médecins network), crude mortality (civil status data) and electronic death certification including causes of death [2]. The system aims to timely identify, follow and assess the health impact of unusual or seasonal events on emergency medical activity and mortality. However some information could be missed by the system especially for non-severe (absence of ED consultation) or, in contrast, highly severe purposes (direct access to intensive care units).The French pre-hospital emergency medical service (SAMU) [3] represents a potential valuable data source to complete the SurSaUD® surveillance system, thanks to reactive pre-hospital data collection and a large geographical coverage on the whole territory. Data are still not completely standardized and computerized but a governmental project to develop a national common IT system involving all French SAMU is in progress and will be experimented in the following years.MethodsA pilot study was performed in the South of France PACA region, where data from the six local SAMU structures are centralized into an interconnected database. A minimal set of variables required for health monitoring (administrative and medical items) and modalities for data extraction and transmission to Santé publique France were defined.SAMU data were transmitted daily to Santé Publique France and the PACA regional team developed a Microsoft Access® application to import decrypted data, request database and analyze indicators.Retrospective part of the study was performed over a 2-year period (2013-2014) and the prospective part during 2015 was based on daily data collection. Completeness and quality of variables were analyzed. SAMU indicators including several level of specificity were built and compared to existing SurSaUD® indicators in different situations (for detection, seasonal follow-up and health impact assessment) using Spearman coefficient correlation.ResultsDuring the pilot study, data from five of the six SAMU structures of PACA region were structured enough to be analyzed. On the study period, almost 2,400,000 files were recorded and 89% contain medical information. Data completeness was high (87%) and stable during the whole period. The annual rate of SAMU solicitation was 16 for 100 inhabitants at the regional scale. 15% of the records were opened only for medical advice. In contrast, patients were evacuated directly in intensive care unit in 9.5% of cases without ED admission. Coding quality depended on the existence and the use of official thesauri and varied widely among SAMU structures. Despite coding variations, SAMU indicators for winter epidemics were significantly correlated with ED and SOS Médecins indicators. Respectively with ED flu, bronchiolitis and gastroenteritis indicators, the strongest correlations were found for SAMU lower respiratory infection (0.74), SAMU bronchiolitis (0.72) and SAMU gastroenteritis / diarrhea / vomiting (0.81).ConclusionsThis pilot study demonstrated the feasibility to collect daily SAMU activity data. The key strengths of SAMU data were a large geographic coverage, the subsidiarity with SurSaUD® system data sources, the follow-up of prehospital activity and for patients directly admitted into an intensive care unit. Some limitations were highlighted related to differences in coding practices especially for medical diagnosis. The generalization of this study will require the standardization of coding practices and homogenization of thesaurus. The implementation of the national SAMU information system should allow in a very next future to widely progressing on these topics.References[1] Fouillet A, Bousquet V, Pontais I, Gallay A and Caserio-Schönemann C. The French Emergency Department OSCOUR Network:Evaluation After a 10-year Existence. Online Journal of Public Health Informatics ISSN 1947-2579-7(1):e74, 2015[2] Caserio-Schönemann C, Bousquet V, Fouillet A, Henry V. Le système de surveillance syndromique SurSaUD (R). Bull Epidémiol Hebd 2014;3-4:38-44.[3] Baker, D.J.. The French prehospital emergency medicine system (SAMU): An introduction(2005) CPD Anaesthesia, 7 (1), pp. 20-25.

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Syndromic surveillance and UEFA Euro 2016 in France – Health impact assessment

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v9i1.7769 ◽

2017 ◽

Vol 9 (1) ◽

Cited By ~ 2

Author(s):

Erica Fougère ◽

Céline Caserio-Schönemann ◽

Jamel Daoudi ◽

Anne Fouillet ◽

Marc Ruello ◽

...

Keyword(s):

Public Health ◽

Impact Assessment ◽

Santé Publique ◽

Syndromic Surveillance ◽

Health Impact Assessment ◽

Health Impact ◽

Health Surveillance ◽

Syndromic Surveillance System ◽

Health Event ◽

Sante Publique

ObjectiveTo describe the surveillance indicators implemented for the healthimpact assessment of a potential health event occurring before, duringor after the UEFA Euro 2016 football matches in order to timelyimplement control and prevention measures.IntroductionFrance hosted 2016 UEFA European Football Championshipbetween June 10 and July 10. In the particular context of severalterrorist attacks occurring in France in 2015 [1], the French nationalpublic health agency « Santé publique France » (formerly FrenchInstitute for Public Health Surveillance-InVS) was mandated bythe Ministry of Health to reinforce health population surveillancesystems during the UEFA 2016 period. Six French regions and10 main stadiums hosted 51 matches and several official andnonofficial dedicated Fan Zones were implemented in many citiesacross national territory. Three types of hazard have been identified inthis context: outbreak of contagious infectious disease, environmentalexposure and terrorist attack.The objectives of health surveillance of this major sportingevent were the same as for an exceptional event including massgathering [2] : 1/ timely detection of a health event (infectiouscluster, environmental pollution, collective foodborne disease...)to investigate and timely implement counter measures (control andprevention), 2/ health impact assessment of an unexpected event.The French national syndromic surveillance system SurSaUD® wasone of the main tools for timely health impact assessment in thecontext of this event.MethodsFrench national syndromic SurSaUD® system has been setup in 2004 and supervised by Santé publique France for 12 years.It allows the daily automatic collation of individual data from over650 emergency departments (ED) involved in the OSCOUR®network and 61 emergency general practitioners’ (GPs) associations(SOS Médecins) [3]. About 60,000 attendances in ED (88% of thenational attendances) and 8,000 visits in SOS Médecins associations(95% of the national visits) are daily recorded all over the territoryand transmitted to Santé publique France.Medical information such as provisional medical diagnosiscoded according to the International Classification of Diseases, 10thRevision (ICD-10) for EDs and specific thesaurus for SOS Médecinsis routinely monitored through different syndromic indicators (SI).SI are defined by medically relevant clusters of one or severaldiagnoses, serving as proxies for conditions of public health interest.From June 10 to July 10, 19 SI were daily analyzed throughautomatic national and regional dashboards. SI were divided into3 groups of public health surveillance interest :1/ description of population health: injuries, faintness, myocardialinfarction, alcohol, asthma, heat-related symptoms, anxious troubles ;2/ infectious diseases/symptoms with epidemic potential ordiseases/symptoms linked with an environmental exposure: fever,fever associated with cutaneous rash, meningitis, pneumonia,gastroenteritis, collective foodborne disease ;3/ symptoms potentially linked with a CBRN-E exposure:influenza-like illness, burns, conjunctivitis, dyspnea/ difficultybreathing, neurological troubles, acute respiratory failure.Daily analysis were integrated into specific UEFA 2016surveillance bulletins and daily sent to the Ministry of Healthincluding week-ends.ResultsSI followed during the UEFA Euro 2016 period were nonspecificand potentially affected or influenced by several events appart fromthe championship. Between June 10 and July 10, two moderateheat-wave periods occurred on a large part of mainland France : thefirst one from June 22 to 25 (beginning in the West-South of Franceand then moving North and East of the country) and the secondone from July 8 to 11 in the East-South. An increase in heat-relatedindicators (hyperthermia/heat stroke, dehydration, hyponatremia andburns) has been observed during both periods in five French regionsincluding four hosting regions. Only minor increases in the other SIfollowed during the Euro 2016 period were observed.ConclusionsHealth surveillance implemented during 2016 UEFA EuropeanFootball Championship through a daily analysis of non-specificSI from the French syndromic surveillance system SurSaUD® didnot show any major variation associated with the sporting event.The observed variations were related with specific environmentalconditions (heat-waves). Together with the health surveillancesystem, preventive plans were set up during the event essentially byoffering flyers with information and useful tips on the main preventiveattitudes and measures to adopt in a summer festive context (risksassociated with alcohol and drug intake, injuries, heat and sunexposure, dehydration, unprotected sexual behaviour...).

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An Integrated Syndromic Surveillance System for Monitoring Scarlet Fever in Taiwan

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v5i1.4518 ◽

2013 ◽

Vol 5 (1) ◽

Cited By ~ 1

Author(s):

Wan-Jen Wu ◽

Yu-Lun Liu ◽

Hung-Wei Kuo ◽

Wan-Ting Huang ◽

Shiang-Lin Yang ◽

...

Keyword(s):

Scarlet Fever ◽

Surveillance System ◽

Syndromic Surveillance ◽

Syndromic Surveillance System

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Description of low back pain attendances in French ED

European Journal of Public Health ◽

10.1093/eurpub/ckz186.639 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

C Forgeot ◽

G Viudes ◽

G Noel ◽

A Fouillet ◽

C Caserio-Schönemann

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Santé Publique ◽

Health Agency ◽

Low Back ◽

Emergency Physicians ◽

Syndromic Surveillance System ◽

Prevention Campaign ◽

Potential Benefits ◽

Sante Publique

Abstract Background Low back pain (LBP) is one of the leading contributors to disease burden worldwide [1]. In 2018, French health care insurance launched a population awareness campaign in order to promote effective behaviour change in France. Because LBP acute episodes often lead to emergency visits, Santé publique France, the French Public Health Agency and the Federation of Observatories for Emergency Medecine, performed a pre-campaign situational analysis of LBP in the French emergency department (ED) involved in the OSCOUR® network. Methods The OSCOUR network is part of the French syndromic surveillance system SurSaUD® [2] coordinated by Santé publique France since 2004. In 2017, the system collects daily individual data from about 700 ED representing 92% of the French ED attendances. Those data contain demographic, administrative and medical information including discharge diagnosis coded according ICD-10. ED attendances with a diagnosis related to LBP were analyzed from 2014 to 2017. Temporal distribution of LBP attendances, hospitalizations after discharge and stay duration in ED services were also analyzed. Results From 2014 to 2017, 504 ED were included in the analysis and LBP represented 1.12% (N = 481,291) of ED all visits. This proportion remained stable over the period. 60% of LBP attendances concerned 18 to 50 years old adults and almost 10% were hospitalized after discharge. This proportion increased with age to reach 43% for the 85 years old and more. LBP attendances were more frequent on Monday. Median stay duration were almost 3 hours but increased with age and for hospitalized patients. Conclusions The broad coverage of the ED OSCOUR® network on the whole territory and the strong partnership between epidemiologists and clinicians enable Santé publique France to produce reliable results which are also consistent with ED physician’s perception. Finally those results can be used as a reference contributing to evaluate potential benefits of this campaign. Key messages This description of low back pain ED attendances is consistent with emergency physicians perception on field and can be used as a reference to evaluate potential benefits of the prevention campaign. The national coverage of the ED OSCOUR® network and the strong partnership with emergency physicians enable Santé publique France to produce relevant description on the main causes of ED attendances.

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User-friendly Rshiny web applications for supporting syndromic surveillance analysis

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v9i1.7628 ◽

2017 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Anne Fouillet ◽

Marc Ruello ◽

Lucie Leon ◽

Cecile Sommen ◽

Laurent Marie ◽

...

Keyword(s):

Public Health ◽

Surveillance System ◽

Syndromic Surveillance ◽

Web Applications ◽

Age Groups ◽

Data Sources ◽

Mortality Data ◽

Syndromic Surveillance System ◽

R Shiny ◽

User Friendly

ObjectiveThe presentation describes the design and the main functionalitiesof two user-friendly applications developed using R-shiny to supportthe statistical analysis of morbidity and mortality data from the Frenchsyndromic surveillance system SurSaUD.IntroductionThe French syndromic surveillance system SursaUD® has beenset up by Santé publique France, the national public health agency(formerly French institute for public health - InVS) in 2004. In 2016,the system is based on three main data sources: the attendancesin about 650 emergency departments (ED), the consultations to62 emergency general practitioners’ (GPs) associations SOSMédecins and the mortality data from 3,000 civil status offices [1].Daily, about 60,000 attendances in ED (88% of the nationalattendances), 8,000 visits in SOS Médecins associations (95% ofthe national visits) and 1,200 deaths (80% of the national mortality)are recorded all over the territory and transmitted to Santé publiqueFrance.About 100 syndromic groupings of interest are constructed fromthe reported diagnostic codes, and monitored daily or weekly, fordifferent age groups and geographical scales, to characterize trends,detect expected or unexpected events (outbreaks) and assess potentialimpact of both environmental and infectious events. All-causesmortality is also monitored in similar objectives.Two user-friendly interactive web applications have beendeveloped using the R shiny package [2] to provide a homogeneousframework for all the epidemiologists involved in the syndromicsurveillance at the national and the regional levels.MethodsThe first application, named MASS-SurSaUD, is dedicated to theanalysis of the two morbidity data sources in Sursaud, along with dataprovided by a network of Sentinel GPs [3]. Based on pre-aggregateddata availaible daily at 10:30 am, R programs create daily, weeklyand monthly time series of the proportion of each syndromic groupingamong all visits/attendances with a valid code at the national andregional levels. Twelve syndromic groupings (mainly infectious andrespiratory groups, like ILI, gastroenteritis, bronchiolitis, pulmonarydiseases) and 13 age groups have been chosen for this application.For ILI, 3 statistical methods (periodic regression, robust periodicregression and Hidden Markov model) have been implementedto identify outbreaks. The results of the 3 methods applied to the3 data sources are combined with a voting algorithm to compilethe influenza alarm level for each region each week: non-epidemic,pre/post epidemic or epidemic.The second application, named MASS-Euromomo, allowsconsulting results provided by the model developed by the Europeanproject EuroMomo for the common analysis of mortality in theEuropean countries (www.euromomo.eu). The Euromomo model,initially developed using Stata software, has been transcripted inR. The model has been adapted to run in France both at a national,regional and other geographical administrative levels, and for 7 agegroups.ResultsThe two applications, accessible on a web-portal, are similarlydesigned, with:- a dropdown menu and radio buttons on the left hand side to selectthe data to display (e.g. filter by data source, age group, geographicallevels, syndromic grouping and/or time period),- several tab panels allowing to consult data and statistical resultsthrough tables, static and dynamic charts, statistical alarm matrix,geographical maps,... (Figure 1),- a “help” tab panel, including documentations and guidelines,links, contact details.The MASS-SurSaUD application has been deployed in December2015 and used during the 2015-2016 influenza season. MASS-Euromomo application has been deployed in July 2016 for the heat-wave surveillance period. Positive feedbacks from several users havebeen reported.ConclusionsBusiness Intelligence tools are generally focused on datavisualisation and are not generally tailored for providing advancedstatistical analysis. Web applications built with the R-shiny packagecombining user-friendly visualisations and advanced statistics can berapidly built to support timely epidemiological analyses and outbreakdetection.Figure 1: screen-shots of a page of the two applications

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Early evaluation of impacts of cold waves and floods during winter 2018 in France

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v11i1.9747 ◽

2019 ◽

Vol 11 (1) ◽

Author(s):

Anne Fouillet ◽

Cecile Forgeot ◽

Marie-Michele Thiam ◽

Celine Caserio-Schonemann

Keyword(s):

Public Health ◽

Surveillance System ◽

Syndromic Surveillance ◽

Health Agency ◽

Health Impact ◽

Cold Weather ◽

Cold Wave ◽

Seine River ◽

Syndromic Surveillance System ◽

Paris Area

ObjectiveThe 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.IntroductionThe 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 [1], 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 [2]. Such situations may be particularly associated to direct impact like hypothermia, frostbite and selected bone/joint injuries).MethodsSince 2004, the French Public Health Agency (Santé publique France) set up a national syndromic surveillance system SurSaUD, enabling to ensure morbidity and mortality surveillance [3]. In 2018, morbidity data were daily collected from a network involving about 700 emergency departments (ED) and 58 emergency general practitioners’ associations SOS Médecins. 92% of the national ED attendances and 95% of national SOS Médecins visits are caught by the system.Both demographic (age and gender), administrative (date and location of consultation, transport) and medical information (chief complaint, medical diagnosis using ICD10 codes in ED and specific thesauri in SOS Médecins associations, severity, hospitalization after discharge) are recorded for each patient.The daily and weekly evolution of the number of all-cause ED attendances and SOS Médecins consultations during the flooding period were compared to the evolution on the two previous years. The number of hospitalisations after ED discharge was also monitored. The immediate health impact of floods and cold waves was assessed by monitoring eight syndromic indicators: gastroenteritis, carbon monoxide poisoning, burnt, stress, faintness, drowning, injuries and hypothermia.Analyses were performed by age group (<15 years, 15-64 years, more than 65 years) and at different geographical levels (national, Paris region and districts located in the Basin of Seine River).ResultsIn 2018, syndromic surveillance did not show any major impact on all-cause ED attendances and SOS Médecins consultations from week 4 to week 6, neither in Paris area nor in other areas along the Seine River. The recorded numbers were comparable to the two precedent years in all age groups.A decrease of the all-cause ED attendances was observed during the 1st day with ice conditions in Normandy and Paris, mainly in children and adults aged 15-64 years.During week 6 in Paris area, an increase of ED attendances was observed for injuries (+4% compared to the past weeks – figure 1) and to a lesser extent for hypothermia and frostbite (16 attendances compared to less than 9 for the past weeks). Similar increase in injuries were observed in Normandy during the second cold wave (Figure 1).ConclusionsDuring the flood episode, the rising water level was slow with foreseeable evolution, compared to other sudden flood events occurring in south of France in 2010 due to violent thunderstorms. This progressive evolution allows French authority to deploy wide specific organization in order to mitigate impact on concerned populations. That may explain the absence impact observed in ED at regional and national levels during the flood disaster. The evolution of injuries during 2018 episode is attributable to the cold wave that occurred simultaneously.As the French syndromic surveillance system is implemented on the whole territory and collects emergency data routinely since several years, it constitutes a reactive tool to assess the potential public health impact of both sudden and predictable disasters. It can either contribute to adapt management action or reassure decision makers if no major impact is observed.References[1] Ahern M, Kovats S. The health impacts of floods. In: Few R, Matthies F, eds. Flood hazards and health: responding to present and future risks. London, Earthscan, 2006:28–53.[2] Hughes H, Morbey R, Hughes T. et al. Using an Emergency Department Syndromic Surveillance System to investigate the impact of extreme cold weather events Public Health. 2014 Jul;128(7):628-35.[3] Caserio-Schönemann C, Bousquet V, Fouillet A, Henry V. The French syndromic surveillance system SurSaUD (R). Bull Epidémiol Hebd 2014;3-4:38-44.

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Determinants of Daily Attendances in Emergency Departments for Asthma in the Paris Area

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v7i1.5780 ◽

2015 ◽

Vol 7 (1) ◽

Author(s):

Céline Caserio-Schönemann ◽

Alice Sanna ◽

Vanina Bousquet ◽

Sylvia Medina ◽

Mathilde Pascal ◽

...

Keyword(s):

Air Pollution ◽

Emergency Departments ◽

Surveillance System ◽

Syndromic Surveillance ◽

Age Group ◽

Short Term ◽

Syndromic Surveillance System ◽

Intrinsic Factors ◽

Societal Factors ◽

Paris Area

Asthma is one of the numerous syndromic indicators daily monitored at the regional and national levels by the French syndromic surveillance system based on the emergency departments Oscour network. This indicator presents important daily fluctuations and can be influenced by several environmental, infectious and societal factors. Particularly the short-term impact on asthma of episodes like the air pollution peak experienced in March 2014 and the thunderstorm occurred in July 2014 has been analysed by age group on the Paris area, as well as the effect intrinsic factors (day-of-week, seasonal period, holidays).

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