Surveillance of Outbreaks of Clustered Cases (ARI – AGE) in Nursing Homes for the Elderly (EHPAD)Acute respiratory infection (ARI) remains the leading cause of infection-related mortality in nursing homes for the elderly (EHPAD) and the leading infectious cause of hospital admission. Outbreaks of acute gastroenteritis (AGE) are also common in these facilities. A surveillance system for ARI and AGE outbreaks in EHPADs has been in place in the region since 2010, implemented by the Cire Midi-Pyrénées. At the regional level, this system makes it possible to track the progression of outbreaks as well as associated risk factors and to adapt control measures for these episodes. During the 2014–2015 season in Midi-Pyrénées, 66 ARI outbreaks and 30 AGE outbreaks were reported to the ARS. Across all these outbreaks, 1,429 residents (including 37 deaths) and 179 nursing home staff members were affected by ARI, while 613 residents (no deaths) were affected by GEA.

Since 2005, several guidelines for managing clusters of IRA or GEA cases have been drafted by the French High Council for Public Health. The most recent available documents are: - Guidelines for IRA in Nursing Homes, July 2012 - Guidelines for GEA in Nursing Homes – HCSP, January 2010 A set of surveillance, prevention, and management tools has been adapted to the regional context and is available on the ARS website: Specific pages on the ARS Midi-Pyrénées website.