Diarrhoea-related morbidity and rotavirus infection in France

To assess the importance of diarrhoea in France and, specifically, rotaviru s-related diarrhoea among children, we reviewed data obtained from three co mplementary sources: (1) general practitioner (GP) sentinel surveillance; ( 2) hospital discharge data from paediatric hospitals; and (3) laboratory ba sed surveillance. The GP sentinel network is based on 500 physicians who el ectronically notify new cases of eight illnesses, including diarrhoea, each week. It was estimated that about 3.3 million patients seek medical attent ion for diarrhoea from their GP each year, with a winter outbreak associate d with an increased rate of isolation of rotavirus. A national system of ho spital discharge diagnosis was used to estimate the burden of diarrhoeal mo rbidity in two paediatric wards in Tours, France. Between 1994 and 1996, 11 64 patients under 15 y of age (9.7% of all admissions) were admitted for di arrhoea, of whom 83% were reported as having viral gastroenteritis; 14.3% w ere dehydrated and 52% were under 1 y old. Hospital admissions had a season al pattern similar to notifications from sentinel GP for children under 5 y old. A centralized laboratory surveillance network representing 17 of the 22 French regions describes a rotavirus outbreak each winter that is concom itant of outbreaks detected by the GP sentinel network and seen in hospital s. Most of the isolates (98%) identified through this surveillance system a re among children under 5 y of age. All the data reviewed in this study ind icate that the epidemiology of rotavirus diarrhoea in France fits well with what has been reported in other developed countries.