Réseau Sentinelles

The "Réseau Sentinelles" or Sentinelles Network (a.k.a. French Communicable Diseases Computer Network) is a network of 1 260 volunteer “médecins généralistes”, or general practitioners, working throughout the metropolitan regions of France (2% of the total general practitioners in these regions). Its goal is to provide clinical surveillance in France for 14 health indicators. Each member doctor is known as a “médecin Sentinelles” (or “Sentinelles doctor”). This network, created in November 1984 by Professor Alain-Jacques Valleron, is regulated under the auspices of the mixed research unit U707 of Inserm and University of Paris VI: Pierre et Marie Curie.

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Continuous surveillance of 14 health indicators

This national system of clinical surveillance collects real-time epidemiological data, originating from the participating general practitioners, to be used in analysis, forecasting and redistribution. It is also a part of the surveillance warning system directed by the Institut de veille sanitaire (InVS) (receiving the CNIL’s favorable recommendation n°471 393).

The 14 health indicators surveyed comprise of 11 infectious diseases:

• Influenza-like illness (ILI) since 1984,
• Acute diarrhea (gastroenteritis) since 1990,
• Measles since 1984,
• Mumps since 1985,
• Varicella zoster since 1990,
• Herpes zoster since 2004,
• Male urethritis since 1984 and
• Hepatitis A Virus (HAV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) since 2000

as well as 3 non infectious diseases:

• Asthma since 2002,
• Suicidal attempts since 1997 and
• Hospitalizations since 1997.

The surveillance system detects, alerts, and predicts future regional and national epidemics specifically for influenza, gastroenteritis and Varicella zoster. The patient de-identified data is obtained via Internet by the Sentinelles doctors and directly streamed into a Geographic information system (GIS) database. A weekly report, called Sentiweb-Hebdo, is edited every Tuesday on the home webpage of the Sentinelle Network and is emailed to more than 4000 subscibers, including members of the national media. An annual report of the number of cases reported is also edited using the surveillance data. These reports are available for online viewing, and can be accessed on the Sentinelles home webpage in the section titled "documentation/bilans annuels" (or “annual reports and totals”).

The Sentinelles Network is also a collaborator with the World Health Organization (WHO) in the electronic surveillance of infectious diseases.

Scientific research

The data provided by the Sentinelles Network had provided research in the following domains:

• Models of detection and alert systems (Serfling regression methods, Costagliola D. and coll ., Am. J. Public Health, on 1991)
• Prediction models of epidemics involving different geographical levels (“Method of analogues”, Viboud C. and coll ., Am J Epidemiol, on 2003).

Field epidemiology

Epidemiological inquiries are regularly performed among the Sentinelles doctors. Their purpose is to maintain the ethical conduct of epidemiological research developed by the “Association des épidémiogistes de langue française”, or the Association of Epidemiologists of the French Language. The order of each inquiry is prespecified in a written protocol. The inquiries are then summarized in a final report and submitted per protocol to the internal auditors to assure their quality. All reports thus far have received a favorable recommendation by the CNIL (n°471 393). The results of these inquiries are available online and can be accessed via the Sentinelle home webpage in the section "documentation/enquêtes ponctuelles" (or “regular inquiry documentation”).