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Preliminary Report on the Flu Outbreak

In mainland France, the epidemic began in Brittany and the Île-de-France region in week 49 of 2016 (December 5–11, 2016), spreading to all regions within two weeks, and ending in week 7 of 2017 (February 13–19, 2017).As in 2014–2015, the 2016–2017 flu season was characterized by an H3N2-dominated epidemic that had a significant impact on the elderly.The epidemic was more severe in 2014–2015, with nearly 2.9 million medical visits, compared to 1.9 million in 2016–2017, and the impact on the healthcare system was marked by the activation of “hospital under strain” protocols in healthcare facilities and an increase in outbreaks in long-term care facilities.While the epidemic was more severe in 2014–2015 in terms of morbidity, excess mortality this winter is estimated at 21,200 deaths from all causes (including approximately 14,400 deaths attributable to influenza, according to recent statistical modeling), comparable to the 18,300 deaths from all causes during the 2014–2015 epidemic.In Bourgogne-Franche-Comté, the epidemic followed the same pattern but with a one-week delay. The epidemic peak occurred simultaneously, in week 03.The insufficient number of doctors in the Sentinelles® network allows for estimating the impact only within a broad range, between 64,000 and 84,000 "clinical flu cases" seen in outpatient visits during these 10 weeks of the epidemic. Activity was moderate in outpatient care and significant in hospitals. By way of comparison, during this winter’s epidemic (December 12, 2016, to February 19, 2017), the percentage of patients aged 65 and older was 24% in emergency departments (vs. 8% in 2015–2016, from January 25 to April 17, 2016, and 13% in 2014–2015, from January 12 to March 15, 2015) and 7% for SOS Médecins (vs. 3% and 5%, respectively). Similarly, the hospitalization rate is 11% for emergency departments (vs. 6% and 8%, respectively), of whom 78% were aged 65 and older (vs. 35% and 56%, respectively).Seventy-eight severe cases of influenza were admitted to intensive care (75 linked to influenza A, 1 co-infection, and 2 unconfirmed cases with no other etiology), including eleven deaths. Most (68%) of the patients were aged 65 and older. The median age of 75 is particularly high this season. The influenza viruses isolated by the virology laboratory at the Dijon University Hospital were almost exclusively type A.