On 6 December 2013, two laboratory-confirmed cases of chikungunya without a travel history were reported on the French part of the Caribbean island of Saint Martin, indicating the start of the first ...documented outbreak of chikungunya in the Americas. Since this report, the virus spread to several Caribbean islands and French Guiana, and between 6 December 2013 and 27 March 2014 more than 17,000 suspected and confirmed cases have been reported. Further spread and establishment of the disease in the Americas is likely, given the high number of people travelling between the affected and non-affected areas and the widespread occurrence of efficient vectors. Also, the likelihood of the introduction of the virus into Europe from the Americas and subsequent transmission should be considered especially in the context of the next mosquito season in Europe. Clinicians should be aware that, besides dengue, chikungunya should be carefully considered among travellers currently returning from the Caribbean region.
The 2016 seasonal influenza in Réunion in the southern hemisphere, was dominated by influenza A(H1N1)pdm09 (possibly genogroup 6B.1). An estimated 100,500 patients with acute respiratory infection ...(ARI) consulted a physician (cumulative attack rate 11.9%). Sixty-six laboratory-confirmed cases (65.7/100,000 ARI consultations) were hospitalised in an intensive care unit, the highest number since 2009. Impact on intensive care units was major. Correlation between severe cases was 0.83 between Réunion and France and good for 2009 to 2015.
Since January 2012, 20 autochthonous cases of dengue virus (DENV) infection have been identified in Réunion. The first cases were detected on the western coast, but the two co-circulating viruses ...(DENV-1 and DENV-3) seemed to have spread later to different cities of the island. There is a non-negligible risk of increase in viral transmission over the following weeks, so health professionals and public health authorities in Réunion are preparing to face a potential epidemic.
In January 2005, an epidemic of chikungunya fever broke out in the Comoro Islands and lasted until May 2005. In April, cases were also reported in Mayotte and Mauritius. On Réunion Island, the first ...cases were reported at the end of April. Surveillance of this epidemic required an adaptive system, which at first was based on active and retrospective case detection around the cases reported, then relied on a sentinel network when the incidence increased. Emerging and severe forms of infection were investigated. Death certificates were monitored. By April 2006, the surveillance estimate was 244,000 cases of chikungunya virus infection, including 123 severe cases and 41 of maternoneonatal transmission, with an overall attack rate of 35%. Chikungunya infection was mentioned on 203 death certificates and significant mortality was observed. This epidemic highlighted the need for a mutual strategy of providing information on arboviral diseases and their prevention and control between countries in the southwestern Indian Ocean.
On 28 August 2009, French authorities reported five cases of chikungunya fever on Reunion Island: three confirmed, one probable, and one suspected case under investigation. All three confirmed ...patients presented with an acute febrile syndrome, arthralgia, myalgia and cutaneaous rash. All live in the same area on the western side of the island.
First infections with the 2009 pandemic H1N1 influenza virus were identified on Reunion Island in July 2009. By the end of July, sustained community transmission of the virus was established. ...Pandemic H1N1 influenza activity peaked during week 35 (24 to 30 August), five weeks after the beginning of the epidemic and has been declining since week 36. We report preliminary epidemiological characteristics of the pandemic on Reunion Island in 2009 until week 37 ending September 13.
Abstract
Issue
After a period of low-level circulation of a few cases per week during 2017, La Réunion experienced an outbreak of dengue in 2018 followed by a second and ongoing larger epidemic wave ...in 2019. Various surveillance systems have been progressively implemented to monitor and characterize the outbreak.
Methods
All laboratory diagnoses of dengue are routinely notified to the regional health authority (RHA) for investigation. With the outbreak onset additional programmes were implemented including the monitoring of presentations to emergency departments (EDs) and hospitalisations of dengue cases. In addition, all death notifications to the RHA which cite dengue are reviewed by an expert committee and the cause of death classified as directly, indirectly or unrelated to dengue. Finally, weekly data from a sentinel network of general practitioners is used to estimate the number of community consultations with dengue-like illness across the island.
Results
In 2017, 97 dengue cases were notified, with low level circulation continuing through the austral winter. In 2018, 6,679 cases (exclusively serotype 2) were notified. Western and southern regions of the island were most affected. The supplementary surveillance identified over 500 ED presentations for dengue-like illness and 160 hospitalisations. Three deaths were determined to be directly due to dengue, while 3 were indirectly related. Finally, there was an estimated 26,000 consultations for dengue-like illness in the community. After a second winter of persistent circulation, a second epidemic wave commenced in December 2018, and is still ongoing.
Lessons
The implementation of additional surveillance systems enabled a better understanding of the magnitude and impact of the outbreak. The use of sentinel network allowed the estimation of the number of people affected in the community without a laboratory diagnosis. The ongoing viral circulation since 2017 suggests a high risk of endemisation of dengue on the island.
Key messages
The outbreak has had a significant impact of health and community health services, and on the wider population.
The second consecutive austral winter with interrupted transmission suggest a high risk of endemisation.
BackgroundLocally-acquired mpox cases were rarely reported outside Africa until May 2022, when locally-acquired-mpox cases occurred in various European countries.AimWe describe the mpox epidemic in ...France, including demographic and behavioural changes among a subset of cases, during its course.MethodsData were retrieved from the enhanced national surveillance system until 30 September 2022. Laboratory-confirmed cases tested positive for monkeypox virus or orthopoxviruses by PCR; non-laboratory-confirmed cases had clinical symptoms and an epidemiological link to a laboratory-confirmed case. A subset of ≥ 15-year-old male cases, notified until 1 August, was interviewed for epidemiological, clinical and sexual behaviour information. Association of symptom-onset month with quantitative outcomes was evaluated by t- or Wilcoxon tests, and with binary outcomes, by Pearson's chi-squared or Fisher exact tests.ResultsA total of 4,856 mpox cases were notified, mostly in Île-de-France region (62%; 3,025/4,855). Cases aged ≥ 15 years were predominantly male (97%; 4,668/4,812), with 37 years (range: 15-81) as mean age. Between May and July, among the subset interviewed, mpox cases increased in regions other than Île-de-France, and mean age rose from 35 (range: 21-64) to 38 years (range: 16-75; p = 0.007). Proportions of cases attending men-who-have-sex-with-men (MSM) meeting venues declined from 60% (55/91) to 46% (164/359; p = 0.012); median number of sexual partners decreased from four (interquartile range (IQR): 1-10) to two (IQR: 1-4; p < 0.001).ConclusionChanges in cases' characteristics during the epidemic, could reflect virus spread from people who were more to less behaviourally vulnerable to mpox between May and July, or MSM reducing numbers of sexual partners as recommended.
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