The 2009 A(H1N1) influenza pandemic in the French Armed Forces: epidemiological surveillance and operational management.
OBJECTIVE
The main objective of this study was to evaluate the contribution of a newly implemented daily surveillance system to the management of the 2009 A(H1N1) influenza pandemic by the military decision-makers at different levels in the French Department of Defence.


METHODS
The study sample included all medical advisors in the Ministry of Defence and the French Armed Forces Staff and also the members of the specific committee dedicated to flu pandemic control. The variables studied were mental representation of epidemiology, relevance, usefulness, and real-time use of surveillance data using quantitative questionnaires and qualitative face-to-face semistructured interviews.


RESULTS
Among the risk managers of the flu pandemic in the Armed Forces, 84% responded. The data generated by epidemiological surveillance were considered relevant and useful, and were reported as effectively used. On the basis of the information produced, concrete actions were planned and implemented in the French Armed Forces.


CONCLUSIONS
In a pandemic situation involving low mortality, the daily monitoring of the disease did not target public health issues, but it was mainly used to assess the availability of the Armed Forces in real time. For the military staff, epidemiological surveillance represents an essential information tool for the conduct of operations.
National Office of the French Military Medical Department, Fort Neuf de Vincennes, Cours des Maréchaux, Paris Cedex 12 75614, France.
Jean-Baptiste
JB
Pohl
Military Centre for Epidemiology and Public Health (CESPA), GSBdD Marseille Aubagne, 111 Avenue de la Corse, BP40026, Marseille 13568, France.
Aurélie
A
Mayet
Military Centre for Epidemiology and Public Health (CESPA), GSBdD Marseille Aubagne, 111 Avenue de la Corse, BP40026, Marseille 13568, France.
Gabriel
G
Bédubourg
Military Centre for Epidemiology and Public Health (CESPA), GSBdD Marseille Aubagne, 111 Avenue de la Corse, BP40026, Marseille 13568, France.
Sandrine
S
Duron
Military Centre for Epidemiology and Public Health (CESPA), GSBdD Marseille Aubagne, 111 Avenue de la Corse, BP40026, Marseille 13568, France.
Rémy
R
Michel
Military Centre for Epidemiology and Public Health (CESPA), GSBdD Marseille Aubagne, 111 Avenue de la Corse, BP40026, Marseille 13568, France.
Xavier
X
Deparis
Begin Military Teaching Hospital, 69 Avenue de Paris, Saint-Mandé 94163, France.
Christophe
C
Rapp
DoD, French Military Command, 14 Rue Saint-Dominique, Paris SP 07 75700, France.
Patrick
P
Godart
Military Centre for Epidemiology and Public Health (CESPA), GSBdD Marseille Aubagne, 111 Avenue de la Corse, BP40026, Marseille 13568, France.
René
R
Migliani
Military Centre for Epidemiology and Public Health (CESPA), GSBdD Marseille Aubagne, 111 Avenue de la Corse, BP40026, Marseille 13568, France.
Jean-Baptiste
JB
Meynard
D003657:Decision Making; D005602:France / Q000453:epidemiology; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control* / Q000821:virology; D008889:Military Personnel; D058873:Pandemics / Q000517:prevention & control*; D011159:Population Surveillance; D012308:Risk Management; D013997:Time Factors