Where have the flu and gastroenteritis gone?

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In recent weeks, government and health officials’ statements have focused their speeches on Covid-19. However, there are seasonal ailments that we usually hear about and which have been forgotten… as if they no longer existed.

Influenza, a reminder in December for vaccination

The seasonal flu is generally talked about in September, with its share of advice and especially an incentive to be vaccinated for the most sensitive people. Even recently, several testimonies told us about the difficulty of obtaining the famous vaccine, which was out of stock in several pharmacies. It was, therefore, necessary to register on a waiting list to be able to obtain his vaccine.

In a statement dated December 8, social security indicated that “The 2020 seasonal flu vaccination campaign began on October 13, 2020, and will continue until January 31, 2021, in mainland France, Martinique, Guadeloupe and Guyana. “.

Where are the indicators for influenza this year?

First, Santé Publique France indicates: “In the context of the pandemic linked to SARS-CoV-2, the epidemiological indicators of influenza for the 2020-21 season and more particularly the surveillance of influenza syndromes are impacted by the surveillance linked to COVID-19.

In the current situation, influenza surveillance is based only on confirmed influenza diagnoses: virologic data, severe cases of influenza admitted to intensive care, and reports of acute respiratory infection episodes related to influenza in elderly communities. . This bulletin will evolve according to the epidemiological situation. “

The takeaway from the numbers is that seasonal flu seems to be slipping away this year.

Since week 40

Number of severe influenza cases admitted to intensive care: 0

Number of acute respiratory infection episodes associated with influenza in elderly communities: 0

Number of positive influenza samples identified as part of the outpatient medical surveillance of the Sentinelles network: 1

Number of positive samples for influenza identified by hospital laboratories notified to the National Reference Center (CNR) for respiratory viruses (including influenza): 10

Since October 5, 2020, no serious cases of influenza have been reported by the services participating in this surveillance (Figure 1).

Since week 40, for around 10,000 elderly communities identified in France, 13 episodes of grouped cases of acute respiratory infection (ARI) 2 unrelated to SARS-CoV-2 have been reported to Public Health France (Figure 2). No confirmed influenza cases were identified among these reported episodes.

At the same time, data from city doctors confirm the low presence of seasonal influenza. The samples are taken as part of the surveillance of the Sentinel Network for Acute Respiratory Infections (ARI) observed in general medicine in mainland France.

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Since week 40, among the 436 nasopharyngeal swabs analyzed, 1 influenza virus type B / Victoria has been detected (Figure 3).

The different figures provided by Santé Publiques France make it possible to compare several seasons and to note the absence of circulation of the flu this season.

Finally, in a hospital environment (RENAL network), since week 40, among the 20,073 results transmitted to the CNR (National Reference Center), 10 samples have been found to be positive for an influenza virus (Figure 4):

► 6 type B viruses detected, including 1 in a patient returning from a trip to West Africa;

► 3 type A (H3N2) viruses detected, including 1 in a patient also returning from a trip to West Africa and 1 non-subtyped type A virus.

More generally, in Europe, from the start of surveillance in week 40 until week 51, the various health agencies have identified:

– 7 influenza viruses (2 unsubtyped A viruses and 5 B viruses with no known lineage) were detected among the 11,060 samples taken in general medicine tested for influenza, reported by sentinel networks;

– 390 influenza viruses were detected among the 148,868 samples taken in institutional settings (hospitals, establishments for the elderly, etc.) tested for influenza (29 A (H3N2), 9 A (H1N1) pdm09, 158 viruses A not under -typed, 3 B / Victoria, 1 B / Yamagata and 190 B viruses with no known lineage).

Influenza surveillance that has evolved

Influenza
Influenza

Until the beginning of 2020, the surveillance of seasonal influenza epidemics by the Sentinelles network was based on the follow-up of cases of “influenza syndromes” (defined by a fever above 39 ° C, of ​​sudden onset, accompanied by myalgia and respiratory signs), seen in general medicine and pediatric consultations.

In March 2020, following the appearance of SARS-CoV-2 (COVID-19), Sentinels surveillance evolved. The indicator monitored is now that of “acute respiratory infections” (ARI) (defined by the sudden onset of fever (or sensation of fever) and respiratory signs), seen in general medicine and pediatric consultations.

This surveillance of ARIs not only makes it possible to follow the evolution of the seasonal flu but also that of COVID-19 and other viral infections responsible for ARI (RSV, rhinovirus and metapneumovirus in particular), thanks to the coupling of virological monitoring also carried out by Sentinels doctors. All the data collected thus makes it possible to estimate the number of cases of COVID-19 or influenza among these cases of AKI seen in general medicine and paediatrics in mainland France.

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We will thus retain the very low presence of influenza at the national level as at the level of Burgundy.

What about gastroenteritis? She is almost absent this year! Blame it on health care! According to several health professionals interviewed in recent weeks.

In mainland France, last week (2020s52), the incidence rate of cases of acute diarrhoea seen in general practice was estimated at 39 cases per 100,000 inhabitants. This rate is slightly lower compared to week 2020s51 (consolidated data: 62]), and lower than those usually observed during this period.

At the regional level , the highest incidence rates were observed in: Pays de la Loire (166), Provence-Alpes-Côte d’Azur (84) and Corsica (65). The incidence rate in Bourgogne Franche-Comté is 14 per 100,000.

This season’s surprise guest: chickenpox

This season, the numbers for chickenpox are more telling than those for the flu or gastroenteritis.

Thus in metropolitan France, last week (2020s52), the incidence rate of cases of chickenpox seen in general medicine consultation was estimated at 18 cases per 100,000 inhabitants. This rate has been increasing in recent weeks (consolidated data for week 2020s51: 16), with a level approaching those usually observed in this period.

There is very clearly a certain territorial inequality in the course of chickenpox. At the regional level, the highest incidence rates were observed in Corsica (60), Hauts-de-France (51), Normandy (43) and Center-Val de Loire (43).

In Bourgogne Franche-Comté, the incidence rate is 11.

The Agence Santé Publique France and Social Security recommend continuing to apply hygiene and sanitary procedures by washing your hands regularly and using disposable tissues.

If chickenpox seems to return to customary rates of previous seasons, the data collected would show a notable drop in the presence of influenza viruses and gastroenteritis, the origin of which may be the health measures implemented now for several months.

As for the seasonal flu vaccine, it is still possible to have it done until the end of the month, either by your city doctor, your pharmacist or a private nurse at your home.