Surveillance of clusters of acute respiratory infections (ARI) in long-term care facilities
This system was established to enable the reporting and monitoring of clusters of acute respiratory infections (ARI) in long-term care facilities (LTCFs). The system relies on a single reporting channel via the Ministry of Health and Prevention’s national reporting portal. The objectives of this surveillance are to reduce morbidity and mortality associated with respiratory infections by identifying clusters of ARI cases and implementing appropriate control measures early on.
This new tool is part of a broader approach to alerting, management support, and epidemiological surveillance of clusters of ARIs in long-term care facilities and aims to:
to alert, through rapid detection within a facility of the occurrence of a cluster of residents with ARI, in order to implement appropriate management measures;
to simplify the reporting procedure for nursing homes. Only clusters of ARI cases, including COVID-19, must be reported through a two-step process: opening and closing the cluster;
to collect the information necessary to assist in the management of clusters of ARI cases in long-term care facilities;
to enable national and regional epidemiological surveillance of clusters of ARI cases within long-term care facilities, which house individuals particularly vulnerable to ARI.
Facilities concerned: outbreaks must be reported by long-term care facilities for the elderly (EHPAD and other EHPA, independent living facilities, senior residences) and long-term care facilities for people with disabilities (HPH).
Definition of a cluster of ARI cases: the occurrence of at least 3 cases of ARI among residents within a 4-day period.
Definition of an IRA case: any person in whom the recent onset of at least one general sign suggestive of infection and at least one functional or physical sign of lower respiratory tract involvement (Table 1) or a biologically confirmed respiratory infection has been observed.
| Symptoms suggestive of ARI* | |
|---|---|
| Fever | Sore throat |
| Chills | Runny nose ("cold") |
| Sweating | Cough |
| Joint pain | Shortness of breath |
| Muscle pain | Chest pain |
| Headaches | Wheezing |
| Fatigue | Recent diffuse or focal auscultatory signs |
*Adapted from the HCSP report, July 2012.
Reports are submitted online via the Ministry of Health and Prevention’s reporting portal.
Reporting process: the online report is forwarded to the Regional Health Agency (ARS) overseeing the reporting long-term care facility, enabling it to receive an assessment of the situation with, if necessary, additional support from the Center for the Prevention of Healthcare-Associated Infections (Cpias) in implementing corrective measures and, if needed, from the regional office of Santé publique France in conducting epidemiological investigations. It also contributes to regional and national surveillance of HAI outbreaks.
A methodological guide is available for facilities, describing the system and the case definition.
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