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Difficulties by France to identify and properly estimate the impact and consequences of the intensive 2003 heatwave, and the identification of a need for an interoperable real time medical surveillance system in the French military deployed forces, has prompted France to establish two syndromic surveillance systems. These systems, a civil syndromic surveillance system 'Surveillance sanitaire des urgences et des décès' (SurSaUD) [1] and a military syndromic surveillance system, 'Le Système d'Alerte et de Surveillance en Temps Réel' (ASTER) [2] were set up in 2004. The aim of these systems is to reinforce the early warning capacity of public health events. Syndromic surveillance, defined as the (near) real time collection, analysis, interpretation and dissemination of health-related data aims at detecting, monitoring and evaluating unexpected, emerging or expected public health threats and contributes to the monitoring and assessment of the impact of these [3]. .


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