2014.ISDS.Abstracts.Final.pdf


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ISDS 2014 Conference Abstracts

Using an Emergency Department Syndromic 
Surveillance System to Assess the Impact of Cyclone 
Bejisa, Reunion Island
Pascal Vilain*1, Frédéric Pagès1, Katia Mougin-Damour2, Xavier Combes3, Pierre-Jean 
Marianne Dit Cassou4, Yves Jacques Antoine5 and Laurent Filleul1

1Regional Office of French Institute for Public Health Surveillance in Indian Ocean, Saint-Denis, Réunion; 2Hospital Centre, Saint-
Paul, Réunion; 3University Hospital Centre, Saint-Denis, Réunion; 4University Hospital Centre, Saint-Pierre, Réunion; 5Hospital 
Centre, Saint-Benoît, Réunion

Objective
To assess the health impact of cyclone Bejisa from data of 

emergency departments (EDs) and emergency medical service (EMS)

Introduction
On January 2, 2014 the cyclone Bejisa struck Reunion Island. 

This storm of Category 3 (Saffir–Simpson scale) disturbed electricity 
supply and drinking water systems. Floods, roof destructions and the 
threat of landslide led to the evacuation of residents to emergency 
shleters. In this context, the regional office of French Institute for 
Public Health Surveillance in Indian Ocean set up an epidemiological 
surveillance in order to assess the impact in the aftermath of the 
cyclone.

Methods
Short-term health effects were assessed using a syndromic 

surveillance system including the activity of all EDs and the EMS of 
the island1. From these data, several health indicators were collected 
and monitored. Daily indicators were analyzed using the C2 aberration 
detection algorithm and weekly indicators, the threshold was defined 
using the method of Farringhton. To complete this assessment, a field 
investigation was carried out in EDs. All medical files recorded in 
the EDs of Reunion Island from January 2 to 5, 2014 were reviewed 
in order to identify visits related to the cyclone and to determine 
mechanisms of injuries.

Results
The number of calls to the EMS peaked the day of the cyclone 

and the number of ED visits increased markedly over the next two 
days. At the same time, a significant increase of visits for trauma, 
burns, conjunctivitis was observed on all EDs (Figure 1). Six visits 
for carbon monoxide poisoning were detected in the southern ED. 
Epidemiological investigations allowed to identify an inappropriate 
use of generator. Among 1 748 medical records reviewed, 216 visits 
were related to the cyclone. Injuries represented nearly half of these 
visits. The main mechanisms of trauma were falls and injuries by 
machinery or tools during the clean-up and repair works. Due to 
prolonged power outage, several patients were hospitalized: some to 
assure continuity of care, others to take care of an exacerbation of a 
chronic disease.

Conclusions
The reactivity and the flexibility of the syndromic surveillance 

system based on the near real-time transmission of data from EDs 
allowed to rapidly assess the health impact of the cyclone Bejisa in 
Reunion Island, the syndromic surveillance system appears to be an 
adapted response in this context2. However an underestimation of this 
impact was still possible. In the near future several work leads will be 
planned in order to improve the assessment.

Figure 1. Daily number of ED visits for trauma, burns, conjunctivitis and all 
causes, December 1, 2013 to January 7, 2014.

Keywords
Syndromic surveillance; Natural disasters; Public Health Reports

Acknowledgments

We acknowledge all practitioners of emergency departments and 
emergency medical service.

References

1.Vilain P, L Filleul. La surveillance syndromique à la Réunion :
un système de surveillance intégré. [Syndromic surveillance 
in Reunion Island: integrated surveillance system]. Bulletin 
de Veille Sanitaire. 2013;(21):9-12. http://www.invs.sante.fr/
Publications-et-outils/Bulletin-de-veille-sanitaire/Tous-les-numeros/
Ocean-indien-Reunion-Mayotte/Bulletin-de-veille-sanitaire-ocean-
Indien.-N-21-Septembre-2013. Accessed August 12, 2014.

2.Hope K, Merritt T, Eastwood K, Main K, Durrheim DN, Muscatello D, 
Todd K, Zheng W. The public health value of emergency department 
syndromic surveillance following a natural disaster. Commun Dis 
Intell Q Rep. 2008;32(1):92-4.

*Pascal Vilain
E-mail: pascal.vilain@ars.sante.fr    

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * (1):e171, 201