Services d'urgence : observatoires de santé publique

French health system has developed continuous survey for epidemic diseases, like seasonal influenza. Besides recurrent disorders, unpredictable and infrequent conditions may occur that should require public health alert. Health consequences of the European 2003 health wave have demonstrated that precocious and reliable alert systems were mandatory but insufficient. Emergency department could efficiently play the role of public health observatory because of the burden of their activity and their location at the frontier between out- and in-hospital. Additionally, most emergency departments now have computerized data, giving the opportunity to collect information in real time. In North America, several experiences have tested the feasibility of syndromic survey based on patients' symptoms at emergency visit. French public health system currently uses networks that prospectively extract data from patients visiting a panel of emergency department. Interpretation of the aspecific data remains a difficulty because of their analysis occurs a posteriori. We were also taught by the 2003 health wave that the indicators may vary depending on the target population. However, development of syndromic alerts from the emergency department is feasible but future strategies remain to be invented.