N Jourdan-da Silva

Surveillance for outbreaks of gastroenteritis in elderly long-term care facilities in France, November 2010 to May 2012

This article describes outbreaks of gastroenteritis in elderly long-term care facilities (LTCF) in France from November 2010 to May 2012 reported through the surveillance system for gastroenteritis outbreaks in LTCF. A total of 1,072 outbreaks were reported, causing 26,551 episodes of illness and 60 deaths. The median attack rate (AR) among residents was 32%. Norovirus and person-to-person transmission were the most frequently reported aetiology and mode of transmission. Control measures were implemented in 1,054 (98%) outbreaks and for 928 outbreaks, the timing of such measures could be inferred. Of these, 799 (86%) had put control measures into effect within three days of the occurrence of the first case. Outbreaks of gastroenteritis in LTCF cause substantial morbidity and mortality among elderly people in France. LTCF are encouraged to develop infection prevention and control plans and to notify any gastroenteritis outbreak to health authorities to ensure rapid control.

The French human Salmonella surveillance system: evaluation of timeliness of laboratory reporting and factors associated with delays, 2007 to 2011

Given the regular occurrence of salmonellosis outbreaks in France, evaluating the timeliness of laboratory reporting is critical for maintaining an effective surveillance system. Laboratory-confirmed human cases of Salmonella infection from whom strains were isolated from 2007 to 2011 in France (n=38,413) were extracted from the surveillance database. Three delay intervals were defined: transport delay (strain isolation, transport from primary laboratory to national reference laboratory), analysis delay (serotyping, reporting) and total reporting delay. We calculated the median delay in days and generated the cumulative delay distribution for each interval. Variables were tested for an association with reporting delay using a multivariable generalised linear model. The median transport and analysis delays were 7 and 6 days respectively (interquartile range (IQR: 6-10 and 4-9 respectively), with a median total reporting delay of 14 days (IQR: 11-19). Timeliness was influenced by various external factors: decreasing serotype frequency, geographical zone of primary laboratory and strain isolation on Sundays were the variables most strongly associated with increased length of delay. The effect of season and day of the week of isolation was highly variable over the study period. Several areas for interventions to shorten delays are identified and discussed for both transport and analysis delays.

Automated early warning system for the surveillance of Salmonella isolated in the agro-food chain in France

Non-typhic Salmonella is one of the major bacterial pathogens that cause foodborne infections as well as economic losses for the food production industry. There is therefore a need to improve early detection to prevent the emergence and spread of Salmonella within the agro-food chain. The passive laboratory-based surveillance system of the Salmonella network has been integrated into the French Food Safety Agencys working plan. The objective of this study was to evaluate the ability of this network to detect unusual Salmonella contamination as early as possible in the agro-food chain. Three statistical methods were used to detect unusual events from the time-series of counts. After an experimental period of more than 1 year, this approach detected several unusual events linked to contamination in the agro-food chain that were confirmed in a timely manner at national or regional levels. This evaluation also reinforced the position of the Salmonella network as an integral part of the national public health surveillance system.

Nationwide pseudo-outbreak of Salmonella enterica ssp. diarizonae, France

To investigate an increased incidence of human cultures growing Salmonella enterica ssp. diarizonae serotype 61:k:1,5,7 in France in 2008, we reviewed medical records of case patients and identified the material used during invasive procedures and for bacterial culture. Trace-back investigations incriminated culture media containing contaminated sheep blood agar.

Les risques infectieux alimentaires et les zoonoses vus par les Français et leur médecin

L’élaboration des campagnes d’éducation pour la santé, ciblées sur des publics spécifiques, repose habituellement sur la perception des risques par la population. Or, malgré les crises sanitaires récentes liées à l’alimentation (listériose, « vache folle »...), il existe peu de données sur la perception par la population générale et les professionnels de santé du risque infectieux alimentaire ou des zoonoses en France. Des travaux ponctuels ont été menés en France pour évaluer l’évolution de la perception d’un risque lié à la consommation de viande bovine pendant et après la « crise de la vache folle » [1]. Les baromètres santé de l’Institut national de prévention et d’éducation pour la santé (Inpes) [2] et de l’Institut de radioprotection et de sureté nucléaire (IRSN) [3] sont les seules enquêtes régulières comprenant un volet sur la perception du risque alimentaire global en population générale mais elles n’explorent pas le risque infectieux. À partir de l’enquête Nicolle, menée par l’Inpes et l’Institut de veille sanitaire en 2006, l’objectif de cette étude est de décrire les connaissances, les attitudes et les pratiques des Français et de leurs médecins vis-à-vis du risque infectieux alimentaire et zoonotique. 2. Matériel et méthode