Ten years experience of syndromic surveillance for civil and military public health, France, 2004-2014

Difficulties by France to identify and properly estimate the impact and consequences of the intensive 2003 heatwave, and the identification of a need for an interoperable real time medical surveillance system in the French military deployed forces, has prompted France to establish two syndromic surveillance systems. These systems, a civil syndromic surveillance system 'Surveillance sanitaire des urgences et des deces' (SurSaUD) [1] and a military syndromic surveillance system, `Le Systeme d'Alerte et de Surveillance en Temps Reel' (ASTER) [2] were set up in 2004. The aim of these systems is to reinforce the early warning capacity of public health events. Syndromic surveillance, defined as the (near) real time collection, analysis, interpretation and dissemination of health-related data aims at detecting, monitoring and evaluating unexpected, emerging or expected public health threats and contributes to the monitoring and assessment of the impact of these [3]. After a 10-year existence, the two systems SurSaUD and ASTER are pillars of the national and international public health surveillance. In November 2014, a joint meeting was organised in Paris by the French Institute for Public Health Surveillance (InVS) and the French Center for Epidemiology and Public Health for the French Armed Forces (Centre d'Epidemiologie et de Sante Publique des Armees, CESPA), including all stakeholders of the two systems. This meeting aimed at sharing the experiences and keys to success of the two systems and to promote the exchange and discussion between the different actors towards a collaborative future. All the presentations are available on the InVS website [4]. This meeting report summarises the key points of the 10-year experience, the feedback and expectations of the different stakeholders, in particular data providers and decision makers, and presents the outlook and future collaborations at a national and international level for the two systems.