Sentinel physician's network in Reunion Island: A tool for infectious diseases surveillance

Abstract The surveillance of infectious diseases in Reunion Island is based on a sentinel network of family physicians (FPs) coordinated by the Indian Ocean regional institute for public health surveillance (French acronym OI Cire). The objectives are to identify and monitor outbreaks of influenza, gastroenteritis, and chicken pox, and to characterize circulating influenza viruses. The network can monitor other potentially epidemic diseases. Method The Reunion sentinel network ensures a continuous and permanent surveillance. Physicians send their weekly activity data to the Cire that collects, processes, and interprets it; they also collect samples for biological surveillance of influenza. Statistical thresholds, based on historical data and the estimated numbers of incident cases, are calculated to follow the trend, detect outbreaks, and quantify their impact. Results The network currently includes 56 FPs and pediatricians, accounting for 6.5% of FPs on the island. The network has clarified the seasonality of influenza during the austral winter and identified the seasonality of acute diarrhea with an epidemic peak when school starts in August. The sentinel FPs's reports allowed monitoring the epidemic trend and estimating the number of cases during the 2005 and 2006 chikungunya outbreaks and 2009 influenza A (H1N1) outbreaks. Conclusion The network has proven its contribution, responsiveness, and reliability for epidemiological surveillance during outbreak. It is an essential tool for infectious diseases surveillance in Reunion Island.