Description of the Institute

Santé publique France (Public Health France), the French national public health
agency is a governmental institution reporting to the Ministry of Health. Created in
2016, Santé publique France brings together the French Institute for Public Health
Surveillance (former InVS), the National Institute for Prevention and Health
Education, and the Health Emergency Preparedness and Response Agency. Santé
publique France has the following mission:

• to co-ordinate and implement public health surveillance;

• to study the determinants of changes of trends of diseases;
• to alert national public health authorities on potential threats to health,
• to assist public health authorities in disease control, prevention and health
promotion;
• to contribute to the response to health alerts and crises.

The French territory comprises 13 administrative regions. The Regional Units

represent Santé publique France at the regional level and act on behalf of the
national agency.

Training site
In Paris, the EPIET fellows are based in the infectious diseases Department (DMI=
Départment des maladies infectieuses). This department has about 70 staff
members, including 50 epidemiologists. The department is responsible for:
national surveillance of infectious diseases (mandatory notifications, laboratory
networks, hospital based networks, etc.); providing assistance in close
collaboration with the regional units, to Regional Health Agencies in outbreak
investigations, coordinating or conducting investigation of outbreaks of national or
inter- regional importance; conducting or coordinating planned studies (applied
epidemiological research) on infectious disease risk factors to guide prevention
and control strategies; and the evaluation of prevention activities or programmes.
The planned studies may include modelling of infectious diseases. The activities of
the DMI are closely linked to health policy and decision making, which are the
responsibility of the health authorities.

Each region is responsible for the management of the regional health system,
through a Regional Health Agency (Agencé Régionale de Santé - ARS). Regional
offices of Santé publique France (CRs=cellules régionales) have been set up over
the last 20 years. These regional offices, act on behalf of the national institute at
the regional level and, coordinate a regional alert and surveillance program in close
collaboration with the national centre of Santé publique France . For the
investigation of infectious disease outbreaks there is a close and frequent
interaction between DMI and the CRs. In the field of nosocomial infections, the DMI
collaborates closely within a structured network composed of five inter-regional
centres responsible for the inter-regional coordination of hospital infection control,
prevention, surveillance and outbreak response.

The DMI has four units covering different fields of infectious diseases:

• AIDS and HIV epidemiology, STDs and viral hepatitis

• Vaccine preventable and respiratory infections
• Enteric and food-borne diseases, zoonoses, vectorborne and tropical
diseases,
• Health care associated infections, and antibiotic resistance

Statistical support is provided by the statistical unit (DATA).

The EPIET fellows can work on projects in any of these units and most often
he/she will be working with several units. All senior epidemiologists of the five
units are involved in the supervision of fellows working on their specific projects. In
addition, the fellows often work closely with the statisticians of the statistical unit.

Santé publique France has no laboratories but the DMI works very closely with a
network of 47 national reference laboratories.

Training opportunities
The training site offers many opportunities in the field of epidemiology applied to
infectious diseases control and prevention in France: outbreak investigation,
designing and/or evaluation of surveillance systems, surveillance data analysis,
protocol design and applied research (planned studies). There are also
opportunities for international investigations or investigations in the overseas
French regions.

The trainee will be expected to participate in at least one of each of the following
activities: outbreak investigation, analysis of surveillance data, evaluation of a
surveillance system, collaboration in a European project, and to conduct a planned
study. Writing scientific reports and articles is expected. There are several teaching
opportunities, and the fellows usually contribute to the training program of the
French public health residents assigned to Santé publique France and to the three
week French field epidemiology course (IDEA).

Recent examples of work done by EPIET trainees (EU-track and MS-track) include:
investigation of outbreaks: foodborne outbreaks (salmonellosis, STEC infections,
listeriosis, typhoid fever, etc;), Q fever, hepatitis A and E, leptospirosis in a
prison, chikungunya, and Zika virus, etc; as well as, evaluation of the surveillance
system for hemolytic uremic syndrome, evaluation of the surveillance system for
arboviruses, setting up surveillance for Zika virus infections and its complications;
case-control studies on risk factors for infection (lSTEC infections); international
assignments: to Guinea for the Ebola outbreak, DRC for a large measles outbreak
and Haiti for a Cholera outbreak.

Training supervision
General supervision is provided by Kostas Danis, former EPIET coordinator, and
Henriette de Valk, Head of the unit for enteric, foodborne, zoonotic vectorborne and
tropical infections. Supervision of specific projects will be provided by senior
epidemiologists in the Department.

Language requirements
French and English

Training history
• EPIET fellows trained at DMI: 19 EU-track and 3 MS-track (1995-2020)
• EPIET alumni working at DMI: 7
• EPIET fellows currently in training: 1 EU-track

• Acknowledged by EPIET
• Available for next EPIET cohort
• Acknowledged by EUPHEM
• Available for next EUPHEM cohort