2023-07-11 08:45:00
The situation is not encouraging. According to data from Public Health France, in 2022, with 378 imported cases of dengue fever, 23 of chikungunya and six of Zika, the situation was “exceptional” in metropolitan France, underlines this Tuesday, July 11, a study by Public Health France, which is concerned about the viability of the current surveillance system.
The Aedes albopictus mosquito, otherwise known as the tiger mosquito and implanted in metropolitan France since 2004, has continued to spread over the territory and with it, native cases of dengue fever, particularly in the Provence-Alpes-Côte d’ Azur, which recorded 16 cases of dengue fever, i.e. almost a tenth of the cases discovered in France, between May and the beginning of July 2023.
Indigenous transmissions were more intense
To limit the risk of transmission of the arboviruses that it can spread (dengue, chikungunya and Zika), monitoring of cases, imported and indigenous, has been in place since 2006, recalls the weekly epidemiological bulletin of SpF. Despite surveillance, the epidemiological situation with regard to dengue in metropolitan France was “exceptional in 2022”, according to Public Health France.
Indigenous cases refer to patients who have not traveled to areas where the virus circulates widely such as the West Indies, but were bitten by an infected mosquito in contact with an infected traveler.
Native transmissions were more intense with a high number of episodes: the number of cases identified for the year 2022 alone is greater than the total number of cases identified over the period 2010-2021 (66 cases versus 48).
New geographical areas were affected with the occurrence of six of the nine episodes in departments where no autochthonous case had previously been identified, in the south-west of France and in Corsica. Transmission was also earlier, with two cases showing clinical signs in June instead of July for the earliest identified cases so far.
Effective monitoring
The surveillance introduced in mainland France since 2006 has proven “effective”according to SpF, and the “control measures put in place when cases are identified have so far helped to limit the size of autochthonous transmissions.”
Nevertheless, “the episodes of 2022 have put the system under tension in Provence-Alpes-Côte d’Azur”, alert the health agency, judging “essential to maintain, or even strengthen, the involvement of the various actors”.
In particular, healthcare professionals must “to be better informed of the risk of indigenous transmission” of these diseases. The population must also “be better aware of the importance of actions to prevent mosquito bites and fight against breeding sites”and consult a healthcare professional in the event of a flu-like syndrome upon returning from transmission areas.
The dengue? It’s what?
Dengue fever is asymptomatic in 50 to 90% of cases (variable percentage depending on the epidemics), recalls Public Health France.
For the 50-10% of infected people who show symptoms, incubation lasts an average of 4-7 days (but can range from 3-14 days)
The “classic” shape is manifested by a high fever of sudden onset. It is often accompanied by chills, headache, retro-orbital pain, nausea, vomiting, joint and muscle pain and, inconsistently, a rash around the 5th day of symptoms. The evolution is most often favorable after a few days.
The “severe (or severe dengue)” form may occur in less than 5% to 1% of symptomatic cases (WHO 2009). It is characterized by an increase in vascular permeability which can lead to shock and haemorrhages which can be life-threatening.
The warning signs occur after 2 to 7 days and the temperature returns to normal (thermal defervescence). Clinical vigilance should be maximal around the 4th day. Treatment of dengue fever is symptomatic. There is no specific antiviral treatment.
The Committee for monitoring and anticipating health risks (Covars) recently indicated that an increase in cases and indigenous outbreaks of dengue, chikungunya and Zika is to be expected throughout France.
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