OJPHI: Vol. 5
Journal Information
Journal ID (publisher-id): OJPHI
ISSN: 1947-2579
Publisher: University of Illinois at Chicago Library
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©2013 the author(s)
open-access: This is an Open Access article. Authors own copyright of their articles appearing in the Online Journal of Public Health Informatics. Readers may copy articles without permission of the copyright owner(s), as long as the author and OJPHI are acknowledged in the copy and the copy is used for educational, not-for-profit purposes.
Electronic publication date: Day: 4 Month: 4 Year: 2013
collection publication date: Year: 2013
Volume: 5E-location ID: e149
Publisher Id: ojphi-05-149

Usefulness of Syndromic Surveillance for Early Outbreak Detection in Small Islands: The Case of Mayotte
Pascal Vilain*1
Olivier Maillard3
Julien Raslan-Loubatie2
Mohamed Ahmed Abdou3
Tinne Lernout2
Laurent Filleul1
1Regional Office of the French Institute for Public Health Surveillance of Indian Ocean, Saint-Denis, Reunion;
2Regional Office of the French Institute for Public Health Surveillance of Indian Ocean, Mamoudzou, Mayotte;
3Hospital Center of Mayotte, Mamoudzou, Mayotte
*Pascal Vilain, E-mail: pascal.vilain@ars.sante.fr


To present the usefulness of syndromic surveillance for the detection of infectious diseases outbreak in small islands, based on the experience of Mayotte.


Mayotte Island, a French overseas department of around 374 km2 and 200 000 inhabitants is located in the North of Mozambique Channel in the Indian Ocean (Figure 1).

In response to the threat of the pandemic influenza A(H1N1)2009 virus emergence, a syndromic surveillance system has been implemented in order to monitor its spread and its impact on public health (1). This surveillance system which proved to be useful during the influenza pandemic, has been maintained in order to detect infection diseases outbreaks.


Data are collected daily directly from patients’ computerized medical files that are filled in during medical consultations at the emergency department (ED) of the hospital Center of Mayotte (2). Among the collected variables, the diagnosis coded according to ICD-10 is used to categorize the syndromes. Several syndromes are monitored including the syndromic grouping for conjunctivitis and unexplained fever.

For early outbreak detection, a control chart is used based on an adaptation of the Cusum methods developed by the CDC within the framework of the EARS program (3).


Each week, about 700 patients attend the ED of the hospital. The syndromic surveillance system allowed to detect an outbreak of conjunctivitis from week 10 (Figure 2). During the epidemic peak on week 12, conjunctivitis consultations represented 5% of all consultations. The data of the sentinel practitioner network confirmed this epidemic and the laboratory isolated Enterovirus (4). At the same time, an unusual increase of unexplained fever was detected.


Due to its geographical and socio-demographical situation, the population of Mayotte is widely exposed to infectious diseases. Even on a small island, syndromic surveillance can be useful to detect outbreak early leading to alerts and to mobilize a rapid response in addition to others systems.


We are thankful to all the sentinel network practitioners and the practitioners of the emergency department.

1.. Lernout T, Durquety E, Chollet P, Helleisen F, Javaudin G, Lajoinie G, Filleul L. [Influenza A (H1N1) 2009 surveillance on Mayotte island: the challenge of setting up a new system facing the pandemic]Bull Soc Pathol Exot 2011 May;104(2):114–8.
2.. Filleul L, Durquety E, Baroux N, Chollet P, Cadivel A, Lernout T. [The development of non-specific surveillance in Mayotte and Reunion Island in the context of the epidemic influenza A(H1N1)2009] [Article in French]Bull Epidémiol Hebd 2010;(24–26):283–5.
3.. Hutwagner L, Browne T, Seeman GM, Fleischauer AT. Comparing aberration detection methods with simulated dataEmerg Infect Dis 2005 Feb;11(2):314–6.
4.. Lernout T, Maillard O, Boireaux S, Collet L, Filleul L. A large outbreak of conjunctivitis on Mayotte Island, France, February to May 2012Euro Surveill 2012 Jun 7;17(23):pii: 20192.

[Figure ID: f1-ojphi-05-149]
Figure 1 

Map of the western Indian Ocean featuring Mayotte Island

[Figure ID: f2-ojphi-05-149]
Figure 2 

Weekly number of conjonctivitis and unexplained fever consultations and statistical alarms detected

Article Categories:
  • ISDS 2012 Conference Abstracts

Keywords: Syndromic surveillance, Early outbreak detection, Mayotte Island.

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org