The ongoing structuring of human papillomavirus (HPV) vaccination in middle schools in Nouvelle-Aquitaine, France.

CONTEXT: As is the case throughout France, vaccination coverage against human papillomavirus (HPV) infections in the Nouvelle-Aquitaine region is too low to limit viral circulation and to have an impact on the incidence of virus-induced pathologies. INTERVENTION METHODOLOGY: The Nouvelle-Aquitaine Regional Health Agency (ARS) has decided to set up a large-scale vaccination action in the 7th-grade classes of all 643 Nouvelle-Aquitaine middle schools during the 2023-2024 school year. This public health intervention targeting 11-to-13-year-olds shall bring together national education, health Insurance, the regional center for pharmaco-vigilance, and private health professionals. A call for applications (January 2023) led to the recruitment of vaccination centers tasked with the deployment of mobile teams. A tool for dematerialization of parental authorization was devised. A communication agency was recruited (March 2023) to set up targeted social marketing actions and increase the rate of adherence. EXPECTED RESULTS: Close to 25% of parents are likely to respond favorably to the vaccination offer. The project should help not only to increase vaccination coverage of adolescents through intervention in middle schools, but also have an impact on the demand for vaccination among city-based healthcare professionals. CONCLUSION: Increased vaccination coverage should ultimately reduce the incidence of HPV-induced pathologies. A catch-up campaign could be carried out in high schools from the 2027/2028 school year.

Assessment of vaccination coverage of adolescents aged 16-18 years with an innovative electronic immunization record system.

OBJECTIVES: To measure vaccine coverage among adolescents aged 16-18 years who participated in the National Defense Preparation Day in the Aquitaine region using the free electronic immunization record. PATIENTS AND METHODS: We considered adolescents aged 16-18 years who participated in the National Defense Preparation Day in the Aquitaine region from April to October 2013. All participants received a letter explaining how to create an electronic immunization record. Those records were then validated by checking data against the copies of the vaccination cards brought by participants on the day they attended. Vaccination coverage was estimated for eight vaccinations according to the cumulative number of doses registered and vaccines recommended during childhood. RESULTS: Among the 18,714 participants, 9636 agreed to create an electronic immunization record of which 2781 were validated. Vaccination coverage was˃90% for tuberculosis, diphtheria-tetanus-poliomyelitis, measles-mumps-rubella, and Haemophilus influenzae type B, and˂90% for pertussis, hepatitis B, meningococcal C disease, and human papillomavirus. These coverage rates were close to those reported in other available sources. CONCLUSION: Our study calls attention to the insufficient vaccination of adolescents for pertussis, HBV, meningococcal C disease, and HPV. The absence of a system that routinely provides the vaccination status of this population is a major public health issue in France. The use of an electronic immunization record was innovative, but this tool is not extensively used in the general population and has been evaluated by Santé publique France (the French national public health agency).

Shopper cards data and storage practices for the investigation of an outbreak of Shiga-toxin producing Escherichia coli O157 infections.

INTRODUCTION: An outbreak of shiga-toxin producing Escherichia coli infections occurred in southwest France in June 2012. The outbreak was investigated to identify the source of infection, and guide control measures. METHODS: Confirmed outbreak cases were patients who developed bloody diarrhoea or haemolytic uremic syndrome (HUS) between 28 May and 6 July 2012, with E. coli O157 isolates showing indistinguishable patterns on pulse field gel electrophoresis (PFGE). A standardized questionnaire was administered to patients to document food consumption and other risk exposures. Their purchase was checked through their supermarket shopper card data. RESULTS: Six patients (four with HUS and two with bloody diarrhea) were confirmed outbreak cases. Fresh ground beef burgers from one supermarket were the only common food exposure, identified by interviews and shopper card data. The PFGE profile of shiga toxin-producing E. coli O157 isolated from the suspected beef burgers was identical to those from the human cases. The suspected beef burgers were no longer on sale at the time of investigation but three patients confirmed as outbreak cases had deep-frozen some at home. CONCLUSION: Shopper card data was particularly useful to obtain precise and reliable information on the traceability of consumed food. Despite the expired use-by date, a recall was issued for the beef burgers. This contributed to preventing other cases among consumers who had deep-frozen the beef burgers.

Household transmission of haemolytic uraemic syndrome associated with Escherichia coli O104:H4, south-western France, June 2011.

Following the outbreak of haemolytic uraemic syndrome (HUS) on June 2011 in south-western France, household transmission due to Escherichia coli O104:H4 was suspected for two cases who developed symptoms 9 and 10 days after onset of symptoms of the index case. The analysis of exposures and of the incubation period is in favour of a secondary transmission within the family. Recommendations should be reinforced to prevent person-to-person transmission within households.

Performance of a syndromic system for influenza based on the activity of general practitioners, France.

BACKGROUND: In France, as in other industrialized countries, syndromic surveillance systems for the early detection of illnesses have proliferated, but few validation studies on these systems performances exist. In Bordeaux, a south-western city in France, a system using a network of general practitioners house calls, such as SOS Médecins, provided local health data used to guide health service response, in particular in case of flu-like pandemic. We explored the capacity of SOS Médecins system to identify and follow influenza outbreaks using data from the Sentinel network, considered as being a gold standard for tracking seasonal influenza in France. METHODS: Data from SOS Médecins were analysed and compared with data from the Sentinel network. The sensitivity and specificity of SOS Médecins system were evaluated for different simulated thresholds. RESULTS: A relationship between the number of visits for influenza from SOS Médecins and the number of influenza cases from the Sentinel network was observed; data from the two systems were highly correlated. We showed the capacity of SOS Médecins system to identify outbreaks with a sensitivity and specificity of 93%. CONCLUSION: The sensitivity and specificity of SOS Médecins for early outbreak detection showed the value of these data in monitoring influenza activity.