France

Clinical monitoring: in metropolitan France, last week (2019w11), the incidence rate of influenza-like illness seen in general practice was estimated at 53 cases per 100,000 inhabitants (95% CI [44 ; 62]), corresponding to 35,000 new cases. The incidence rate was decreasing for the fifth consecutive week.
At the regional level, the highest incidence rates were noted in: Bretagne (96 cases per 100,000 inhabitants, 95% CI [53 ; 139]), Grand Est (74, 95% CI [37 ; 111]) and Corse (70, 95% CI [15 ; 125]).
Regarding the cases reported last week, the median age was 30 years (1 month to 89 years). Males accounted for 47% of the cases. These cases showed no particular sign of severity: the percentage of hospitalization was estimated at 1.0% (95% CI [0.0 ; 2.8]).

Vaccine effectiveness: According to the first data collected by the Sentinel physicians, the effectiveness of influenza vaccine against all influenza viruses is estimated at: 44% (IC95% [10 ; 66]) among people aged 65 and above, and 49% (IC95% [19 ; 68]) among people under 65 with complications risk factors. If we focus at the vaccine effectiveness (VE) by virus, VE among all people at risk of complications is 67% (IC95% [42 ; 81]) against the virus A(H1N1)pdm09 and 31% (IC95% [1 ; 52]) against A(H3N2) virus. These estimates will be refined in the coming weeks.

Virological monitoring: since week 2018s40, date of start of monitoring, 2,238 samples were swabbed by Sentinelles network practitioners (1,652 by general practitionners and 586 by pediatricians), and 2,235 samples have been tested.
Last week 69 samples were realized and tested. Among them, 34 (49.3%) were positive for at least one influenza virus. The positivity rate was slightly higher than the previous week.
The influenza viruses detected along the season were distributed as follows:
- 401 (17.9%) A(H1N1)pdm09 virus,
- 769 (34.4%) A(H3N2) virus,
-   25   (1.1%) A unsubtyped virus,
-     0   (0.0%) B/Victoria lineage virus,
-     0   (0.0%) B/Yamagata lineage virus,
-     0   (0.0%) B unknown lineage virus.
Two co-infections of influenza viruses A(H1N1)pdm09 and A(H3N2) were observed over the entire virological surveillance period.
Regarding the other respiratory viruses, 212 swabs were positive (9.5%) for the rhinovirus (hRV), 162 (7.2%) positive for the respiratory syncytial virus (RSV), and 74 (3.3%) positive for the metapneumovirus (hMPV). Last week, there was a low circulation of these three viruses.
The samples were analyzed by the CNR (Coordinating center: Institut Pasteur - Paris, associated center: Hospices civils de Lyon), and the laboratory of Virology at the University of Corsica.

Forecast: according to the forecast models based on historical data, and on medication deliveries (IQVIA research partnership). The ILI activity should continue its decrease this week (2019w12).
In order to have a global vision of the situation in metropolitan France, all available data on winter respiratory infections are analysed jointly by Santé publique France, the National Respiratory Viruses Reference Center and the Sentinelles network.
In view of all this information, the conclusions for the last week (2019w11) are:
- Clear decrease in all influenza indicators
- End of the epidemic in 3 regions: Bourgogne-Franche-Comté, Corsica and Ile-de-France ; the other metropolitan regions are in post-epidemic phase
- Approximately 7,200 deaths attribuable to influenza since the start of surveillance and until week 09

Santé publique France weekly influenza report (in french)
Information about the statistical methods (in french)

Clinical monitoring: in metropolitan France, last week (2019w11), the incidence rate of acute diarrhea seen in general practice was estimated at 150 cases per 100,000 inhabitants (95% CI [134 ; 166]), slightly above the epidemic threshold (147 cases per 100,000). However, the incidence rate should consolidate below the epidemic threshold once all data will be available.
At the regional level, the highest incidence rates were noted in: Grand Est (241 cases per 100,000 inhabitants, 95% CI [175 ; 307]), Hauts-de-France (182, 95% CI [124 ; 240]) and Pays de la Loire (168, 95% CI [112 ; 224]).
Regarding the cases reported last week, the median age was 20 years (1 month to 89 years). Males accounted for 47% of the cases. These cases showed no particular sign of severity: the percentage of hospitalization was estimated at 1.0% (95% CI [0.0 ; 2.2]).
Information on the statistical methods

In metropolitan France, last week (2019w11), the incidence rate of Chickenpox seen in general practice was estimated at 21 cases per 100,000 inhabitants (95% CI [15 ; 27]).
Three regional clusters were noted, high in Bretagne (59 cases per 100,000 inhabitants, 95% CI [24 ; 94]) and Occitanie (40, 95% CI [12 ; 68]) and moderate in Nouvelle-Aquitaine (24, 95% CI [0 ; 54]).