Key points: - 1,044 cases reported in 2003, with an incidence in France of 1.8 per 100,000 inhabitants; - the number of cases reported in 2003 remained stable compared to 2002; - Case fatality rate of 14%, with risk factors identified in 69% of cases; - Risk exposures reported for 49% of cases; - Outbreaks: 31 cases in Montpellier in July, 24 cases in Poitiers in August; - 86 cases in the Pas-de-Calais region from November 2003 to January 2004: the largest outbreak in terms of number of cases, duration, and geographic spread. (R.A)