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Am J Epidemiol . Using the near real-time effective reproduction number rt as an early-warning tool for seasonal bronchiolitis and influenza-like il

tetano

Editor, Senior Moderator
Am J Epidemiol


. 2024 Jul 30:kwae195.
doi: 10.1093/aje/kwae195. Online ahead of print. Using the near real-time effective reproduction number rt as an early-warning tool for seasonal bronchiolitis and influenza-like illness epidemics

Yves Gallien[SUP] 1 [/SUP], Juliette Paireau[SUP] 2 3 [/SUP], Annie-Claude Paty[SUP] 1 [/SUP], Berenice Villegas-Ramirez[SUP] 1 [/SUP], Mohamed Hamidouche[SUP] 1 [/SUP], Gabriela Modenesi[SUP] 1 [/SUP], Aurélien Zhu-Soubise, Christophe Bonaldi[SUP] 4 [/SUP], Anne Fouillet[SUP] 4 [/SUP], Sophie Vaux[SUP] 4 [/SUP], Sibylle Bernard-Stoecklin[SUP] 4 [/SUP], Arnaud Tarantola[SUP] 4 [/SUP]



Affiliations
Abstract

Background: Yearly bronchiolitis and influenza-like illness epidemics in France often involve high morbidity and mortality, which severely impacts healthcare. Epidemics are declared by the French National Institute of Public Health based on syndromic surveillance of primary care and emergency departments (ED), using statistics-based alarms. Although the effective reproduction number (Rt) is used to monitor the dynamics of epidemics, it has never been used as an early warning tool for bronchiolitis or influenza-like illness epidemics in France.We assessed whether Rt is useful for detecting seasonal epidemics by comparing it to the tool currently used (MASS) by epidemiologists to declare epidemic phases.
Methods: We used anonymized ED syndromic data from the Île-de-France region in France from 2010 to 2022. We estimated Rt and compared the indication of accelerated transmission (Rt >1) to the MASS epidemic alarm time points. We computed the difference between those two time points, time to epidemic peak, and the daily cases documented at first indication and peak.
Results: Rt provided alarms for influenza-like illness and bronchiolitis epidemics that were, respectively, 6 days (IQR[4;8]) and 64 days (IQR[52;80]) - in median - earlier than the alarms provided by MASS.
Conclusion: Rt detected earlier signals of bronchiolitis and influenza-like illness epidemics. Using this early-warning indicator in combination with others to declare an annual epidemic could provide opportunities to improve healthcare system readiness.

Keywords: bronchiolitis; early warning; epidemic; influenza; reproduction number.

 
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