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Adedire O, Love NK, Hughes HE, Buchan I, Vivancos R, Elliot AJ. Early Detection and Monitoring of Gastrointestinal Infections Using Syndromic Surveillance: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:489. [PMID: 38673400 PMCID: PMC11050429 DOI: 10.3390/ijerph21040489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/08/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024]
Abstract
The underreporting of laboratory-reported cases of community-based gastrointestinal (GI) infections poses a challenge for epidemiologists understanding the burden and seasonal patterns of GI pathogens. Syndromic surveillance has the potential to overcome the limitations of laboratory reporting through real-time data and more representative population coverage. This systematic review summarizes the utility of syndromic surveillance for early detection and surveillance of GI infections. Relevant articles were identified using the following keyword combinations: 'early warning', 'detection', 'gastrointestinal activity', 'gastrointestinal infections', 'syndrome monitoring', 'real-time monitoring', 'syndromic surveillance'. In total, 1820 studies were identified, 126 duplicates were removed, and 1694 studies were reviewed. Data extraction focused on studies reporting the routine use and effectiveness of syndromic surveillance for GI infections using relevant GI symptoms. Eligible studies (n = 29) were included in the narrative synthesis. Syndromic surveillance for GI infections has been implemented and validated for routine use in ten countries, with emergency department attendances being the most common source. Evidence suggests that syndromic surveillance can be effective in the early detection and routine monitoring of GI infections; however, 24% of the included studies did not provide conclusive findings. Further investigation is necessary to comprehensively understand the strengths and limitations associated with each type of syndromic surveillance system.
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Affiliation(s)
- Olubusola Adedire
- Institute of Population Health, University of Liverpool, Liverpool L69 3GF, UK;
- Real-Time Syndromic Surveillance Team, Field Services, Health Protection Operations, UK Health Security Agency, Birmingham B2 4BH, UK; (H.E.H.); (A.J.E.)
- National Institute for Health Research Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool L69 7BE, UK; (N.K.L.); (R.V.)
| | - Nicola K. Love
- National Institute for Health Research Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool L69 7BE, UK; (N.K.L.); (R.V.)
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Wirral CH64 7TE, UK
| | - Helen E. Hughes
- Real-Time Syndromic Surveillance Team, Field Services, Health Protection Operations, UK Health Security Agency, Birmingham B2 4BH, UK; (H.E.H.); (A.J.E.)
- National Institute for Health Research Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool L69 7BE, UK; (N.K.L.); (R.V.)
| | - Iain Buchan
- Institute of Population Health, University of Liverpool, Liverpool L69 3GF, UK;
- National Institute for Health Research Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool L69 7BE, UK; (N.K.L.); (R.V.)
| | - Roberto Vivancos
- National Institute for Health Research Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool L69 7BE, UK; (N.K.L.); (R.V.)
- Field Services North-West, Health Protection Operations, UK Health Security Agency, Liverpool L3 1DS, UK
| | - Alex J. Elliot
- Real-Time Syndromic Surveillance Team, Field Services, Health Protection Operations, UK Health Security Agency, Birmingham B2 4BH, UK; (H.E.H.); (A.J.E.)
- National Institute for Health Research Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool L69 7BE, UK; (N.K.L.); (R.V.)
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Vincent M, Larrieu S, Vilain P, Etienne A, Solet JL, François C, Roquebert B, Jaffar Bandjee MC, Filleul L, Menudier L. From the threat to the large outbreak: dengue on Reunion Island, 2015 to 2018. ACTA ACUST UNITED AC 2020; 24. [PMID: 31771702 PMCID: PMC6885751 DOI: 10.2807/1560-7917.es.2019.24.47.1900346] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background With more than 300 million infections estimated annually worldwide, dengue is the most prevalent arboviral infection. On Reunion Island, after a large outbreak in 1977–78, only limited episodes of viral circulation or sporadic cases were reported till 2015. Aim Our objective was to document and report on the circulation of dengue virus after the occurrence of a small outbreak during austral summer 2015/16 and until the large outbreak of 2018. Methods Beside the mandatory notification of biologically confirmed dengue cases, additional systems of surveillance were set up: estimation of dengue-like syndrome in people seeking care by their family doctor, surveillance of emergency department visits related to dengue, surveillance of hospitalised dengue patients and deaths classifications. Results After a moderate outbreak during summer 2015/16 with 231 cases, 2017 was characterised by limited viral circulation (97 cases) which, however, persisted during the austral winter. By February 2018, the number of cases had increased and led to a peak at the beginning of May 2018. More than 6,000 cases were reported this year (dengue virus type 2 only). In addition, six deaths of dengue patients were notified. Conclusion In 2017, the persistence of transmission during winter created favourable conditions for the emergence of an epidemic during summer 2018. After this moderate epidemic wave, the viral circulation persisted during winter 2018 for the second year, opening the door for the second wave in 2019 and for potential endemisation of the disease on Reunion Island in the near future.
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Filleul L, Pagès F, Wan GNC, Brottet E, Vilain P. Costs of Conjunctivitis Outbreak, Réunion Island, France. Emerg Infect Dis 2017; 24:168-170. [PMID: 29260662 PMCID: PMC5749441 DOI: 10.3201/eid2401.170916] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
During January–April 2015, a major outbreak of conjunctivitis on Réunion Island caused a large public health impact. On the basis of general practitioner consultations, emergency department visits, and eye medication sales during the 13-week epidemic, we estimated a total healthcare cost of €3,341,191 from the outbreak.
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Marguerite N, Brottet E, Pagès F, Jaffar-Bandjee MC, Schuffenecker I, Josset L, Vilain P, Filleul L. A major outbreak of conjunctivitis caused by coxsackievirus A24, Réunion, January to April 2015. ACTA ACUST UNITED AC 2017; 21:30271. [PMID: 27387200 DOI: 10.2807/1560-7917.es.2016.21.26.30271] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 04/17/2016] [Indexed: 11/20/2022]
Abstract
From January to April 2015, Réunion experienced a major outbreak of acute haemorrhagic conjunctivitis (AHC) caused by coxsackievirus A24, which heavily impacted the healthcare system. According to the general practitioners' (GP) sentinel network, the number of medical consultations due to conjunctivitis during this period was estimated at ca 100,000. This report describes the characteristics of the outbreak, which were obtained through several different yet complementary surveillance systems on the island. These included the network of hospital emergency departments (OSCOUR network), the GPs' sentinel network, an Internet-based population cohort ('Koman i lé') participating in a survey on distinct symptoms including 'red eyes' and the monitoring of eye drop sales. Overall the results of the different surveillance approaches were in good agreement regarding the outbreak dynamic. A peak of patients with conjunctivitis was detected in the first 15 days of March (week 10 and 11), coinciding with increased eye drop sales on the island. Strains recovered from outbreak cases belonged to genotype IV and were most closely related to strains identified in AHC outbreaks in China, Egypt and Japan since 2010. Continued surveillance of AHC in Réunion remains important not only locally, but also because frequent exchanges between the island and mainland France may lead to introduction of this virus in Europe.
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Affiliation(s)
- Nadège Marguerite
- Santé publique France, French national public health agency, Regional unit (Cire océan Indien), Saint-Denis, Réunion, France
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Giry C, Roquebert B, Li-Pat-Yuen G, Gasque P, Jaffar-Bandjee MC. Simultaneous detection of chikungunya virus, dengue virus and human pathogenic Leptospira genomes using a multiplex TaqMan® assay. BMC Microbiol 2017; 17:105. [PMID: 28468604 PMCID: PMC5415735 DOI: 10.1186/s12866-017-1019-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 04/28/2017] [Indexed: 11/13/2022] Open
Abstract
Background In 2005–2006 a major epidemics of Chikungunya disease occurred in South-West Indian Ocean islands. In Reunion Island, the magnitude of Chikungunya infection related symptoms was high and with over 38% of serological prevalence in the population. This epidemics illustrated the potential threat of emerging arboviral diseases for inhabitants of Reunion Island and elsewhere since vectors are worldwide distributed. A sentinel surveillance network was set-up to detect emerging pathogens associated with fever over 38 °C and in the absence of known etiologic causes. Leptospirosis is caused by a pathogenic spirochete of the Leptospira genus and is an endemic and recurrent seasonal disease of great concern in Reunion Island. To accurately diagnose potentially infected patients and to advise Health authorities on the presence of emerging pathogens, a rapid diagnostic test was needed that could differentiate between these 3 pathogens. Methods A one-step multiplex real-time PCR assay was developed that can simultaneously detect RNA of Chikungunya and Dengue viruses and leptospiral DNA with good performance for a routine diagnostic use. Results Simplex protocols already published were used with key modifications to implement a triplex assay which was set-up with a small reaction volume to improve cost efficiency. Conclusions This approach has enabled greater diagnostic capacity in our laboratory. We established a multiplex approach validated and valuable for cost savings, and with the concurrent detection of 3 pathogens of public health concern.
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Affiliation(s)
- Claude Giry
- Centre National Arbovirus Associé, CHU de la Réunion-Site Nord, Saint-Denis, Réunion, France. .,Laboratoire de microbiologie et, CHU de la Réunion-Site Nord, Saint-Denis, Réunion, France.
| | - Bénédicte Roquebert
- Centre National Arbovirus Associé, CHU de la Réunion-Site Nord, Saint-Denis, Réunion, France.,Laboratoire de microbiologie et, CHU de la Réunion-Site Nord, Saint-Denis, Réunion, France.,UMR PIMIT, Processus Infectieux en Milieu Insulaire Tropical, Université de la Réunion, INSERM 1187, CNRS 9192, IRD 249, Saint-Denis, Réunion, France
| | - Ghislaine Li-Pat-Yuen
- Centre National Arbovirus Associé, CHU de la Réunion-Site Nord, Saint-Denis, Réunion, France.,Laboratoire de microbiologie et, CHU de la Réunion-Site Nord, Saint-Denis, Réunion, France
| | - Philippe Gasque
- Laboratoire d'immunologie clinique et expérimentale ZOI (LICE-OI), CHU de la Réunion-Site Nord, Saint-Denis, Réunion, France.,UMR PIMIT, Processus Infectieux en Milieu Insulaire Tropical, Université de la Réunion, INSERM 1187, CNRS 9192, IRD 249, Saint-Denis, Réunion, France
| | - Marie-Christine Jaffar-Bandjee
- Centre National Arbovirus Associé, CHU de la Réunion-Site Nord, Saint-Denis, Réunion, France.,Laboratoire de microbiologie et, CHU de la Réunion-Site Nord, Saint-Denis, Réunion, France.,Laboratoire d'immunologie clinique et expérimentale ZOI (LICE-OI), CHU de la Réunion-Site Nord, Saint-Denis, Réunion, France.,UMR PIMIT, Processus Infectieux en Milieu Insulaire Tropical, Université de la Réunion, INSERM 1187, CNRS 9192, IRD 249, Saint-Denis, Réunion, France
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Larrieu S, Filleul L, Reilhes O, Jaffar-Bandjee MC, Dumont C, Abossolo T, Thebault H, Brottet E, Pagès F, Vilain P, Leparc-Goffart I, Antok E, Vandroux D, Poubeau P, Moiton MP, Von Theobald P, Chieze F, Gallay A, De Valk H, Bourdillon F. Réunion Island prepared for possible Zika virus emergence, 2016. ACTA ACUST UNITED AC 2017; 21:30281. [PMID: 27546187 DOI: 10.2807/1560-7917.es.2016.21.28.30281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 07/05/2016] [Indexed: 11/20/2022]
Abstract
Zika virus (ZIKV) has recently spread widely and turned into a major international public health threat. Réunion appears to offer conditions particularly favourable to its emergence and therefore prepared to face possible introduction of the virus. We designed a scaled surveillance and response system with specific objectives, methods and measures for various epidemiological phases including a potential epidemic. Several tools were developed in order to (i) detect individual cases (including a large information campaign on the disease and suspicion criteria), (ii) monitor an outbreak through several complementary systems allowing to monitor trends in disease occurrence and geographic spread and (iii) detect severe forms of the disease in collaboration with hospital clinicians. We put the emphasis on detecting the first cases in order to contain the spread of the virus as much as possible and try to avoid progress towards an epidemic. Our two main strengths are a powerful vector control team, and a close collaboration between clinicians, virologists, epidemiologists, entomologists and public health authorities. Our planned surveillance system could be relevant to Europe and island settings threatened by Zika virus all over the world.
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Affiliation(s)
- Sophie Larrieu
- Santé publique France, French national public health agency, Regional unit (Cire) Océan Indien, Réunion, France
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Filleul L, Ranoaritiana DB, Balleydier E, Vandroux D, Ferlay C, Jaffar-Bandjee MC, Jaubert J, Roquebert B, Lina B, Valette M, Hubert B, Larrieu S, Brottet E. A major impact of the influenza seasonal epidemic on intensive care units, Réunion, April to August 2016. Euro Surveill 2016; 21:30405. [PMID: 27918264 PMCID: PMC5291144 DOI: 10.2807/1560-7917.es.2016.21.47.30405] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 11/23/2016] [Indexed: 11/20/2022] Open
Abstract
The 2016 seasonal influenza in Réunion in the southern hemisphere, was dominated by influenza A(H1N1)pdm09 (possibly genogroup 6B.1). An estimated 100,500 patients with acute respiratory infection (ARI) consulted a physician (cumulative attack rate 11.9%). Sixty-six laboratory-confirmed cases (65.7/100,000 ARI consultations) were hospitalised in an intensive care unit, the highest number since 2009. Impact on intensive care units was major. Correlation between severe cases was 0.83 between Réunion and France and good for 2009 to 2015.
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Affiliation(s)
- Laurent Filleul
- Santé publique France, French national public health agency, Regional unit (Cire) Océan Indien, Réunion, France
| | - Dany Bakoly Ranoaritiana
- Indian Ocean Field Epidemiology Training Programme, Surveillance des Epidémies et Gestion des Alertes (SEGA) One Health Network, Indian Ocean Commission, Mauritius
- Epidemiological Surveillance Department, Ministry of Health, Madagascar
| | - Elsa Balleydier
- Santé publique France, French national public health agency, Regional unit (Cire) Océan Indien, Réunion, France
| | - David Vandroux
- Intensive Care Unit, Centre Hospitalier Universitaire, Saint-Denis, Réunion, France
| | - Clémence Ferlay
- Intensive Care Unit, Centre Hospitalier Universitaire, Saint-Pierre, Réunion, France
| | | | - Julien Jaubert
- Laboratory of biology, Centre Hospitalier Universitaire, Saint-Pierre, Réunion, France
| | - Bénédicte Roquebert
- Laboratory of virology, Centre Hospitalier Universitaire, Saint-Denis, Réunion, France
| | - Bruno Lina
- Hospices Civils de Lyon, National Influenza Centre, Laboratory of Virology & Virpath, CIRI, Inserm U1111, CNRS UMR5308, ENS Lyon, UCBL, Lyon, France
| | - Martine Valette
- Hospices Civils de Lyon, National Influenza Centre, Laboratory of Virology & Virpath, CIRI, Inserm U1111, CNRS UMR5308, ENS Lyon, UCBL, Lyon, France
| | - Bruno Hubert
- Santé publique France, French national public health agency, Regional unit (Cire) Pays de la Loire, Nantes, France
| | - Sophie Larrieu
- Santé publique France, French national public health agency, Regional unit (Cire) Océan Indien, Réunion, France
| | - Elise Brottet
- Santé publique France, French national public health agency, Regional unit (Cire) Océan Indien, Réunion, France
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Brottet E, Jaffar-Bandjee MC, Li-Pat-Yuen G, Filleul L. Etiology of Influenza-Like Illnesses from Sentinel Network Practitioners in Réunion Island, 2011-2012. PLoS One 2016; 11:e0163377. [PMID: 27654509 PMCID: PMC5031398 DOI: 10.1371/journal.pone.0163377] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 09/06/2016] [Indexed: 11/23/2022] Open
Abstract
In Réunion Island, despite an influenza surveillance established since 1996 by the sentinel general practitioner’s network, little is known about the etiology of Influenza like-illness (ILI) that differs from influenza viruses in a tropical area. We set up a retrospective study using nasal swabs collected by sentinel GPs from ILI patients in 2011 and 2012. A total of 250 swabs were randomly selected and analyzed by multiplex reverse transcriptase polymerase chain reaction (RT-PCR) including research of 18 viruses and 4 bacteria. We detected respiratory viruses in 169/222 (76.1%) samples, mostly rhinovirus (23.4%), influenza A virus (21.2%), influenza B virus (12.6%), coronavirus (4.9%) and Human metapneumovirus (3.6%). Nine swabs (5.3% of positive swabs) revealed co-infections with two viruses identified, among which six concerned co-infections with influenza viruses. We observed important seasonal differences, with circulation of Human Metapneumoviruses, RSV A and B and coronavirus only during summer; whereas parainfluenza viruses were identified only during winter. In conclusion, this study highlights a substantial circulation of multiple respiratory pathogens in Réunion Island throughout the year. It shows that ILI are not only attributable to influenza and underlines the need for biological surveillance. As the use of multiplex RT-PCR showed its efficacy, it is now used routinely in the surveillance of ILI.
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Affiliation(s)
- Elise Brottet
- Santé publique France, French national public health agency, Regional unit (Cire) Océan Indien, Réunion, France
- * E-mail:
| | | | - Ghislaine Li-Pat-Yuen
- Laboratory of virology, Centre Hospitalier Universitaire, Saint-Denis, Réunion, France
| | - Laurent Filleul
- Santé publique France, French national public health agency, Regional unit (Cire) Océan Indien, Réunion, France
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