Search

Summary: Little information is available on the characteristics of infants hospitalized for acute bronchiolitis in France. An analysis of hospital records (PMSI) was conducted at the national level to describe the cases of bronchiolitis that require hospitalization among infants under 1year of age and the factors associated with death. The analysis of all admissions that occurred during 2009, for which the diagnosis of acute bronchiolitis was recorded in the PMSI database for infants aged less than 1year, was performed. Cases were described according to age, sex, underlying conditions (including bronchopulmonary dysplasia, cystic fibrosis, and congenital heart disease), length of hospital stay, recurrent admissions, admission to an intensive care unit (ICU), and use of assisted ventilation. Factors associated with death during hospitalization were studied by logistic regression. The hospitalization rate was 35.8 per 1000 infants under 1year in 2009 in France. Approximately 10% of hospitalized infants required ICU admission. Twenty-two infants died. The estimated case-fatality rate was 0.08% among hospitalized infants and 0.56% for those hospitalized in the ICU. Mortality among all infants under 1 year was 2.6/105 in France. Factors associated with death were bronchopulmonary dysplasia (OR=6.7, 95% CI [1.5–29.8]), hospitalization in an ICU (OR=6.46, 95% CI [2.4–17.4]), and the use of assisted ventilation (OR=6.2, 95% CI [2.2–17.1]). This study has enabled the quantification of the rate of hospitalization and mortality, and a better description of infants who need hospitalization. The results are consistent with international literature, but further prospective analysis will be needed to better describe the cases at higher risk, aiming to improve their management. [ABSTRACT FROM AUTHOR]

Abstract: A total of 5,758 tuberculosis cases were notified in France in 2008, giving a rate of nine cases per 100,000 inhabitants. The median age was 45years and 59% of cases were male patients. Île-de-France (Paris and greater Paris area) and French Guiana had the highest notification rate in 2008 (17.9/105 and 22.6/105 respectively). The rate of tuberculosis was higher in individuals born abroad (43.2/105 vs. 5.0/105 for individuals born in France), especially those recently arrived in France. Pulmonary tuberculosis accounted for 72% of notified cases, 76% of which were potentially contagious (positive sputum smear, or culture). Compared to 2007, the number of notified tuberculosis cases increased by 3.3% in 2008. This increase was not accompanied by a rise of severe cases (meningitis and miliary TB); this seemed to be due partly to improvement in identification and notification of cases. However this trend could require specific monitoring in future years. A national tuberculosis control program was launched in France in 2007, aiming at reducing epidemiological disparities. Clinical and public health expertise needs to be maintained on all the territory to ensure that implemented measures can have the expected impact on the epidemiology of the disease. [Copyright &y& Elsevier]

Abstract: Immigrants, and especially those recently arrived in host countries, are a high-risk group for tuberculosis. In 2006 in France, nearly half of the new cases of tuberculosis were reported in this group. The incidence rate among people born abroad was about seven times higher than that observed in people born in France (38.9/105 vs 5.2/105). The incidence was also the highest in districts with a high proportion of socioeconomically vulnerable population, such as Paris and greater Paris area. The characteristics of French born and non-French born cases differed. Patients born abroad were less likely to have pulmonary tuberculosis (68.2% vs 78.2; p <0.001) and were more likely to live in institutions (such as migrant shelters) and to harbor multiresistant tuberculosis strains. A national tuberculosis control program was launched in France in 2007, to decrease the prevalence of tuberculosis in targeted populations. [Copyright &y& Elsevier]

Abstract: This article presents results on cases of tuberculosis disease notified in France in 2005 by mandatory notification. In 2005, a total of 5,374 cases were notified in France, representing a rate of 8.9 cases per 100,000. The notification rate per 100,000 was below 10 in all French regions, except the Île-de-France and French Guyana (with respective rates of 19.7/105 and 44.0/105). Notification rates were higher in some population groups such as people born abroad (41.5/105), especially those born in sub-Saharan Africa (160/105), and those recently (<2 years) arrived in France (251/105), in homeless people (214/105), and in persons aged 80 years and over (21.7/105). Pulmonary tuberculosis accounted for 73% of notified cases, 79% of which were contagious (positive direct examination of sputum, positive culture). Results from the notification of tuberculosis disease in 2005 indicate a continuing decrease of incidence in France. However, the high incidence in some population groups requires adapting public health actions to the needs of population groups more exposed to tuberculosis. [Copyright &y& Elsevier]

In France,  Infectious diseases represent a major public health burden, because of their impact in terms of morbidity and mortality. Epidemiological surveillance should supply data to improve our knowledge about trends, clinical and microbiological evolution of infectious diseases, in order to identify and implement appropriate control and prevention measures. Epidemiological surveillance should also enable the detection of any new or abnormal phenomenon (outbreak, emerging disease, new syndrome…). In France, the surveillance of infectious disease is based on a national network involving clinicians, microbiologists and laboratories. This network is coordinated by the national public health institute (institut de veille sanitaire) that is responsible for the collection and analysis of health data. This article describes the French surveillance system, recalls the objectives and the organisation of this surveillance. Finally, the need for an early detection and warning mechanism is described and illustrated by different examples of recent events. [Copyright &y& Elsevier]

Objective In France, tuberculosis surveillance is based on mandatory notification (MN) of cases. However, the MN does not allow the full description of cases, and underreporting limits data interpretation. Aiming at better describing the cases of tuberculosis, the hospital record database (PMSI) was analyzed. Patients and method Incident cases of active pulmonary tuberculosis identified in 2010 in France in the PMSI were included and their characteristics were compared with those of the cases identified through the MN. Results In 2010, 5158 incident cases of pulmonary tuberculosis were identified in the PMSI. The mean duration of hospitalization was higher for cases considered contagious — at least one positive test result on pulmonary sample — (22 vs 13 days, P < 0.001). Among all cases, 5% were infected by HIV. Death was reported for 4% of cases. The number of pulmonary TB cases reported in the MN was 3781 in 2010. PMSI data by sex, region of residence and month of diagnosis were similar with those of the MN but patients were older in the PMSI (52 vs 47 years, P < 0.001). Considering the PMSI as exhaustive, sensitivity of the MN was estimated at 73.3% in 2010. Conclusion PMSI data were compatible with those of the MN and the estimation of the sensitivity was close to other French studies. PMSI can be considered as an interesting tool aiming at improving our knowledge about tuberculosis (TB) cases and strengthening awareness where the sensitivity of the MN is low. [ABSTRACT FROM AUTHOR]

Abstract: Legionnaire''s disease is a recently described infection and surveillance in France was implemented in 1987. In 2005, 1,527 cases were notified corresponding to a population incidence rate of 2.5 per 100,000. The median age of cases was 61 years [5–100] and the male to female sex ratio was 3.0. The case fatality rate was 11%. One or more risk factors were identified for 1,084 (71%) cases. The majority of cases (91%) was diagnosed by urinary antigen detection and a strain was identified in 276 cases (18%). Legionella pneumophila serogroup 1 infection was confirmed in 95% of cases. A specific exposure during the incubation period was reported for 39% of cases. Travel exposure was reported for 17% and hospital exposure for 7%. Multiple clusters and outbreaks were investigated. The largest one reported was identified in the north Lyon with 34 cases. Since 1997 the incidence of LD has steadily increased. This probably suggests a better detection of cases and an improvement in the surveillance system. In recent years, several new measures concerning prevention and control were implemented. However these efforts must continue particularly in the research domain to improve knowledge of the disease, in order to limit its impact on exposed populations. [Copyright &y& Elsevier]

The aim of this review was to describe the current knowledge of Legionnaires’ disease (LD) illustrated by the epidemiological situation in France in 2013. LD is a severe pneumonia commonly caused by Legionella pneumophila serogroup 1. The diagnosis is usually based on the urinary antigen test. This rapid method reduces the delay between clinical suspicion and initiation of an appropriate treatment. However, the availability of a clinical strain is important to improve knowledge of circulating bacteria, to document case clusters, and to identify the sources of contamination. The source of contamination is unknown in most cases. The main contamination sources generating aerosols are water network systems and cooling towers. Thanks to the strengthening of clinical and environmental monitoring and to several guidelines, no epidemic has been reported in France since 2006. Despite these efforts, the number of LD cases has not decreased in recent years. It is essential that applied research continue to better understand the spatial and temporal dynamics of the disease and its characteristics (impact of environmental factors, sources of exposure, strains, host, etc.). Fundamental knowledge has been greatly improved (pathogenesis, immune mechanisms, etc.). The results of this research should help define new strategies for the diagnosis, prevention, and control to decrease the number of LD cases diagnosed every year. [ABSTRACT FROM AUTHOR]