Mortality is an indicator of the severity of the impact of an event on the population. In France mortality surveillance is part of the syndromic surveillance system SurSaUD and is carried out by Santé publique France, the French public health agency. The set-up of an Electronic Death Registration System (EDRS) in 2007 enabled to receive in real-time medical causes of death in free-text format. This data source was considered as reactive and valuable to implement a reactive mortality surveillance system using medical causes of death (1).

In late 2015, two economists studying health-related data inadvertently discovered an alarming trend: death rates for middle-aged, white Americans were dramatically increasing from drug overdoses (Kolata, 2015), particularly opioids (CDC, 2015). The opioid epidemic has since been widely publicized in the media. However, as critics have argued, the government's response to the crack epidemic differs dramatically from an arguably equally devastating œdrug epidemic that hit many inner US cities thirty years ago ”the influx of crack cocaine.

In 2017, the dialysis centre of East Reunion Hospital Group (ERHG) based in Saint-Benoit highlighted an increase in bacteraemia's rates. It was a significant rising compared to previous years. Indeed, ERHG is participating since 2013 to the France haemodialysis infections network surveillance (DIALIN) [1], created in 2005 and that is allowing assessing bacteraemia. DIALIN is a multicentre prospective permanent survey that has followed six voluntary centres in 2005 and forty-two in 2016.

Since 1 January 2016, the Auvergne and Rhone-Alpes regions have merged as part of the territorial reform. The new region is composed of 12 departments and accounts for more than 8 million inhabitants. Its territory is heterogeneous in population density with very urban areas (Clermont-Ferrand, Grenoble, Lyon and Saint-Etienne) and important mountainous areas (Arc Alpin, Massif Central).