Key Points

Bronchiolitis:

• The 2018–2019 winter season was marked by a bronchiolitis outbreak whose course was comparable to previous years. The outbreak began in mid-November 2018 and ended 7 weeks later (early January 2019).

• Healthcare utilization was comparable to that observed in previous seasons, both in emergency departments and at SOS Médecins. Emergency department visits primarily involved children under 6 months of age.

• Nearly one-third of emergency department visits were followed by hospitalization and primarily involved children under 6 months of age.

Flu:

• The 2018/2019 flu epidemic was late, short (late January to late February 2019), and particularly severe compared to the two previous seasons. Type A influenza viruses were the only ones circulating; however, no subtyping data was available for the region this year.

• The impact was significant in hospitals, with an increase in emergency room visits compared to previous years, and relatively moderate for SOS Médecins consultations. All age groups were affected, but hospitalizations primarily involved the elderly, among whom overall mortality was also the highest.

• The estimate of excess mortality from all causes, extrapolated to the national level during the 9-week epidemic period, was +11.8%. The Normandy region (+15.7%) was among the regions most affected by this excess mortality.

• The surveillance system for severe influenza cases hospitalized in intensive care shifted this season from a comprehensive system to a sentinel mode. Thirteen adult and pediatric intensive care units in Normandy are participating, spread across 9 healthcare facilities. With a total of 84, the number of severe cases reported this season was lower than in the 2017/18 season (111). Nearly all cases were infected with a type A virus.

Gastroenteritis:

• As in previous years, two waves occurred in succession, likely linked to the circulation of different viruses. The first wave, likely caused by norovirus, led to an increase in healthcare utilization across all age groups, both at SOS Médecins and in emergency departments. The second wave, caused by rotavirus, led to an increase in emergency department visits only among children under 5 years of age.

• The impact of gastroenteritis on emergency department visits and subsequent hospitalizations is all the more significant the younger the patients are. This age-related difference is less pronounced at SOS Médecins.