In January 2008, the Interregional Epidemiology Unit (CIRE) of the Pays de la Loire region established a winter surveillance system that provided weekly feedback to partners. The data used came from the Grog and Sentinelles networks, emergency department visits, mortality rates, and outbreaks of acute respiratory infections (ARI) in nursing homes. The 2007–08 winter season was marked by several phenomena: - a gastroenteritis outbreak of unusual scale and duration; - a bronchiolitis outbreak with a significant impact on emergency department visits among infants; - a flu outbreak deemed moderate by primary care physicians; - a higher number of emergency department visits by older adults and mortality among the very elderly, occurring earlier than the influenza outbreak; - outbreaks of acute respiratory infections (ARI) in long-term care facilities for dependent older adults (Ehpad) occurring later than the influenza outbreak observed in the community. The impact on hospital activity was significant for several facilities in the region. These observed epidemic phenomena raise several questions (imbalance in healthcare supply during the holiday season, impact of infections other than influenza) that cannot be resolved with current surveillance systems. Prospects for next winter will allow for improved surveillance with the availability of emergency department visit summaries (RPU) in 7 emergency departments in the region and detailed information on causes of death in these facilities via electronic certification. This surveillance will also be supplemented by the inclusion in the surveillance bulletin of data from the regional network of the Regional Influenza Surveillance Group (GROG) and by the analysis of the reasons for calls to the region’s two SOS-Médecins associations. (R.A.)