Lessons from the heat-wave epidemic in France (summer 2003)

Abstract

This article relates the experiences of the exceptional heat wave of the summer 2003 in France to heat related events as a whole. It focuses on five issues: first, whether heat-waves should be considered as epidemics or as endemic events in order to achieve efficient mitigating strategies. It is recommended to consider heat-waves as both, although it is clear that epidemic situations cannot be dealt with properly without a more general program to decrease the effects of endemic heat-related ill health. Second, it is stressed that there is no model available for predicting the occurrence of future epidemics with the required sensitivity and specificity: More detailed analysis has to be carried out. In addition, it is recommended that the threshold for future relief actions be lowered. Third, the issue of what surveillance system is required to detect epidemics of heat-related illnessis addressed. Fourth, the efficacy and effectiveness of prevention plans are briefly evaluated as well as what must be done during epidemics. Finally, the relationship between epidemics and polical crises is outlined. The heat-wave related epidemics experienced in various countries of Europe during the summer of 2003 has put the issue of extreme heat on the agenda of public health professionals and decision-makers. As with any threat to the health of large populations, the issues to be addressed are those of the prediction and the prevention of the consequences of heat-waves on the one hand and those of the detection of adverse effects and emergency measures to be taken during the episodes on the other. This paper draws conclusions from the lessons learned mainly in France, but also attempts at broadening the scope to heat related events as a whole. © 2005 World Health Organization.