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1. COVID-19 hotspots through clusters analysis in France (may–October 2020): where should we track the virus to mitigate the spread?

Author

Guillaume Spaccaferri, Clémentine Calba, Pascal Vilain, Loïc Garras, Cécile Durand, Corinne Pilorget, Nahida Atiki, Pascale Bernillon, Laëtitia Bosc, Erica Fougère, Jean-Baptiste Hanon, Valérie Henry, Caroline Huchet-Kervella, Mélanie Martel, Valérie Pontiès, Damien Mouly, Enguerrand Rolland du Roscoat, Stéphane Le Vu, Jean-Claude Desenclos, Anne Laporte, Regional MONIC group, and Patrick Rolland

Subjects
COVID-19, Hotspots, Clusters, Descriptive analysis, Criticality, Public health, Public aspects of medicine, RA1-1270
Abstract

Abstract Background In France, the lifting of the lockdown implemented to control the COVID-19 first wave in 2020 was followed by a reinforced contact-tracing (CT) strategy for the early detection of cases and transmission chains. We developed a reporting system of clusters defined as at least three COVID-19 cases, within seven days and belonging to the same community or having participated in the same gathering, whether they know each other or not. The aim of this study was to describe the typology and criticality of clusters reported between the two lockdowns in France to guide future action prioritisation. Methods In this study we describe the typology and criticality of COVID-19 clusters between the two lockdowns implemented in France (between May and end of October 2020). Clusters were registered in a national database named “MONIC” (MONItoring des Clusters), established in May 2020. This surveillance system identified the most affected communities in a timely manner. A level of criticality was defined for each cluster to take into consideration the risk of spreading within and outside the community of occurrence, and the health impact within the community. We compared the level of criticality according to the type of community in which the cluster occurred using Pearson’s chi-square tests. Results A total of 7236 clusters were reported over the study period, particularly in occupational environment (25.1%, n = 1813), elderly care structures (21.9%, n = 1586), and educational establishments (15.9%, n = 1154). We show a shift over time of the most affected communities in terms of number of clusters. Clusters reported in occupational environment and the personal sphere had increased during summer while clusters reported in educational environment increased after the start of the school year. This trend mirrors change of transmission pattern overtime according to social contacts. Among all reported clusters, 43.1% had a high level of criticality with significant differences between communities (p

Published
2021
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3. Lockdown impact on COVID-19 epidemics in regions across metropolitan France

Author

Patrick Rolland, Simon Cauchemez, Juliette Paireau, Cécile Tran Kiem, Arnaud Fontanet, Modélisation mathématique des maladies infectieuses - Mathematical modelling of Infectious Diseases, Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Collège Doctoral, Sorbonne Université (SU), Santé publique France - French National Public Health Agency [Saint-Maurice, France], Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), We acknowledge financial support from the Investissement d'Avenir programme, the Laboratoire d'Excellence Integrative Biology of Emerging Infectious Diseases programme (grant ANR-10-LABX-62-IBEID), the INCEPTION project (PIA/ANR-16-CONV-0005), and the European Union's Horizon 2020 research and innovation programme under grant 101003589 (RECOVER)., ANR-10-LABX-0062,IBEID,Integrative Biology of Emerging Infectious Diseases(2010), ANR-16-CONV-0005,INCEPTION,Institut Convergences pour l'étude de l'Emergence des Pathologies au Travers des Individus et des populatiONs(2016), European Project: 101003589, H2020-SC1-PHE-CORONAVIRUS-2020,RECOVER(2020), Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Collège doctoral [Sorbonne universités], and Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM)

Subjects
MESH: Social Isolation, MESH: Pandemics, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), MESH: Coronavirus Infections, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Pneumonia, Viral, 030204 cardiovascular system & hematology, Betacoronavirus, MESH: Communicable Disease Control, 03 medical and health sciences, 0302 clinical medicine, [MATH.MATH-ST]Mathematics [math]/Statistics [math.ST], Pandemic, Correspondence, Humans, MESH: COVID-19, MESH: SARS-CoV-2, 030212 general & internal medicine, Socioeconomics, Pandemics, ComputingMilieux_MISCELLANEOUS, MESH: Humans, SARS-CoV-2, COVID-19, General Medicine, Metropolitan area, 3. Good health, MESH: France, Metropolitan France, Geography, Social Isolation, MESH: Pneumonia, Viral, Communicable Disease Control, MESH: Betacoronavirus, France, Coronavirus Infections
Abstract

Lockdowns have been used by most European countries in response to the COVID-19 pandemic. In France, a national lockdown was implemented on March 17, 2020. Some have questioned the need for a nationwide implementation given that most hospital admissions were concentrated in two of 13 regions; others have even questioned the impact of the lockdown on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread, arguing that the natural epidemic peak was about to be reached. Here we discuss the impact of lockdown on COVID-19 epidemics in regions across metropolitan France.

Published
2020
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4. Choice of rating method for assessing occupational asbestos exposure: study for compensation purposes in France.: Method for occupational exposure assessment

Author

Celine, Gramond, Patrick, Rolland, Aude, Lacourt, Stephane, Ducamp, Soizick, Chamming's, Yvon, Creau, Michel, Hery, Jacques, Laureillard, Brahim, Mohammed-Brahim, Ewa, Orlowski, Christophe, Paris, Jean-Claude, Pairon, Marcel, Goldberg, Patrick, Brochard, S, Chamming's, Epidémiologie et Biostatistique [Bordeaux], Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Université Bordeaux Segalen - Bordeaux 2, Département santé travail (DST-InVS), Institut de Veille Sanitaire (INVS), Institut Interuniversitaire de Médecine du Travail de Paris Ile de France, Laboratoire de chimie, Caisse Régionale d'Assurance Maladie Normandie, Institut national de recherche et de sécurité (Vandoeuvre lès Nancy) (INRS ( Vandoeuvre lès Nancy)), Caisse Régionale d'Assurance Maladie Ile de France, Association de Médecine et de Santé au travail, Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de médecine du travail (LSTE), CHU Bordeaux [Bordeaux], The PNSM is supported by the National Institute for Public Health Surveillance (InVS), the Ministries of Labour and Health, and the Foundation for Medical Research (one-time grant)., Members of the PNSM Study Group are listed in the acknowledgment section, Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10

Subjects
Male, Mesothelioma, Cumulative Exposure, MESH: Risk Assessment, medicine.disease_cause, MESH: Occupational Exposure, 0302 clinical medicine, Cohen's kappa, Surveys and Questionnaires, Medicine, 030212 general & internal medicine, MESH: Compensation and Redress, MESH: Case-Control Studies, 030210 environmental & occupational health, rating method, Occupational Diseases, MESH: Reproducibility of Results, Compensation and Redress, MESH: Asbestos, Female, France, Occupational exposure, MESH: Occupational Diseases, Validation study, MESH: Probability, Risk Assessment, Asbestos, 03 medical and health sciences, kappa coefficient, Environmental health, Humans, Occupations, Probability, MESH: Occupations, MESH: Humans, MESH: Mesothelioma, business.industry, MESH: Questionnaires, experts, Public Health, Environmental and Occupational Health, Reproducibility of Results, occupational exposure, asbestos, MESH: Male, MESH: France, Case-Control Studies, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female, Kappa
Abstract

Background In the course of setting up the National Mesothelioma Surveillance Program (PNSM), established in France in 1998, the question arose as to the most suitable method of assessing occupational exposure. The aim of this study was to define the most suitable rating method for assessing occupational asbestos exposure in order to assess medico-social care. Method The study included 100 subjects—50 cases of mesothelioma and 50 controls—randomly selected and representing 457 jobs held. Job asbestos exposure was assessed by a six-expert panel using two methods: “by job” rating, where all the jobs in were assessed regardless of the subjects; and “by subject” rating, where all the jobs of a subject were assessed at the same time. Consensus was obtained and subjects' exposure was calculated for each rating. Then, two internal experts assessed job asbestos exposure with the “by subject” rating. Kappa coefficients were used to measure agreement between the ratings. Results Agreement between “by job” and “by subject” ratings was very good for subject probability of exposure (kappa = 0.84) and cumulative exposure index (kappa = 0.80). Agreement between the six-expert panel and the two internal experts was good for subject exposure (kappa for probability = 0.71; kappa for cumulative exposure index= 0.68). Conclusion This study shows that the two rating systems have good or very good agreement. These results validate the routine use in the PNSM of the “by subject” rating, with the advantage of being convenient and quick to provide feedback on occupational asbestos exposure to mesothelioma cases for compensation. Am. J. Ind. Med. 55:440–449, 2012. © 2012 Wiley Periodicals, Inc.

Published
2012
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7. Cluster of two cases of botulism due to Clostridium baratii type F in France, November 2014

Author

M Durand, Christelle Mazuet, Michel R. Popoff, C Castor, J Coutureau, M Saint-Leger, S Vygen, N Jourdan Da Silva, Agence Régionale de la Santé (ARS), Centre National de Référence des Bactéries Anaérobies et Botulisme - National Reference Center Anaerobic Bacteria and Botulism (CNR), Institut Pasteur [Paris] (IP), Hopital de Périgueux (CH Périgueux), Hopital de Périgueux, European Centre for Disease Prevention and Control [Stockholm, Sweden] (ECDC), We thank Martine Vivier-Darrigol (ARS Aquitaine), Emmanuel Bongrain (Direction Départementale de la Cohésion Sociale et de la Protection des Populations Dordogne), and Marie-Pierre Donguy (Direction Générale de l’alimentation) for their collaboration and Patrick Rolland and Jet De Valk for their comments on the manuscript., Institut Pasteur [Paris], and European Centre for Disease Prevention and Control (ECDC)

Subjects
Adult, Epidemiology, Bacterial Toxins, Neurotoxins, [SDV.TOX.TCA]Life Sciences [q-bio]/Toxicology/Toxicology and food chain, Disease cluster, Artificial respiration, Microbiology, 03 medical and health sciences, 0302 clinical medicine, Blood serum, Bacterial Proteins, Virology, Paralysis, medicine, Humans, Botulism, 030212 general & internal medicine, Clostridium, 0303 health sciences, Food poisoning, biology, 030306 microbiology, business.industry, Public Health, Environmental and Occupational Health, Middle Aged, biology.organism_classification, medicine.disease, 3. Good health, [SDV.TOX]Life Sciences [q-bio]/Toxicology, Clostridium baratii, Food Microbiology, Female, medicine.symptom, business, Food contaminant
Abstract

International audience; The first two cases in France of botulism due to Clostridium baratii type F were identified in November 2014, in the same family. Both cases required prolonged respiratory assistance. One of the cases had extremely high toxin serum levels and remained paralysed for two weeks. Investigations strongly supported the hypothesis of a common exposure during a family meal with high level contamination of the source. However, all analyses of leftover food remained negative.

Published
2015
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