Background and Objectives. In July 2010, a nursing home in Charente reported the deaths of five residents with disabilities who had experienced acute respiratory distress within a three-week period. The deaths occurred within a month of a fire breaking out at the facility. Methods. A descriptive epidemiological study of the deaths, the entire resident population, and the facility’s staff was conducted. Several expert assessments were conducted, covering both general clinical and specialty areas (pulmonologist, infectious disease specialist, toxicologists), as well as environmental factors and pharmaceutical practices. Surveillance of cases presenting with acute respiratory illness was implemented for two months. Results. A total of seven cases presenting with acute respiratory illness, including five deaths, were identified among the residents. The investigation ruled out an infectious outbreak within the facility and exogenous respiratory tract contamination during care as possible causes of the abnormal cluster of deaths. The potentially harmful role of low-level exposure to fire smoke was considered minor. Conclusion. The investigation raised suspicion that a common viral infection and a heat wave played a role in the deaths among residents who were likely already compromised by the indirect consequences of the fire (transfer, psychological shock). Given the concurrence of these events, an interaction between these different exposures cannot be ruled out. (R.A)