Early detection of West Nile virus in France: quantitative assessment of syndromic surveillance system using nervous signs in horses
Résumé
West Nile virus (WNV) is a growing public health concern in Europe and there is a need to
develop more efficient early detection systems. Nervous signs in horses are considered to be an
early indicator of WNV and, using them in a syndromic surveillance system, might be relevant.
In our study, we assessed whether or not data collected by the passive French surveillance system
for the surveillance of equine diseases can be used routinely for the detection of WNV. We tested
several pre-processing methods and detection algorithms based on regression. We evaluated
system performances using simulated and authentic data and compared them to those of the
surveillance system currently in place. Our results show that the current detection algorithm
provided similar performances to those tested using simulated and real data. However, regression
models can be easily and better adapted to surveillance objectives. The detection performances
obtained were compatible with the early detection of WNV outbreaks in France (i.e. sensitivity
98%, specificity >94%, timeliness 2·5 weeks and around four false alarms per year) but further
work is needed to determine the most suitable alarm threshold for WNV surveillance in France
using cost-efficiency analysis.