In Réunion, serious cases of dengue now all year round

The female tiger mosquito

The first death caused directly by dengue this year in Réunion was announced on Thursday, September 15, by the regional health agency (ARS). a death that “confirms the danger of the disease”, underlines the ARS. Since the beginning of the year, 1,129 confirmed cases of dengue have been registered on the island. Authorities also list 54 hospitalizations and 177 emergency room visits. Figures that remain well below previous years marked, according to Santé Publique France, by “growing epidemic waves”.

If 2022 is distinguished by the absence of an epidemic, this death, however, tragically confirms that “We are in a situation where dengue is becoming endemic, because it continuously circulates. Now we have cases all year long.”, even in the cold season, points out Professor Xavier Deparis, director of surveillance and health security at ARS Réunion. During the austral winter, which begins in June, the reproduction cycle of the tiger mosquito, vector of the virus, slows down. Until 2018, no patients were reported during this “inter-epidemic” period.

The mosquito Aedes albopictus, which becomes infected by biting a patient and transmits the virus by biting another, is therefore today more resistant to lower temperatures. The peak of epidemics is in the warm season, and when the rains are heaviest from November to April, the female mosquito can lay her eggs on the surface of the water.

A massive epidemic

In 2018, the World Health Organization (WHO) reported an epidemic ” unprecedented ” on the island with 1,616 proven and autochthonous cases between 1Ahem January 23 and April. Since then, Réunion has experienced a much more alarming health crisis. The 2021 epidemic left nearly 30,000 confirmed cases, 1,185 hospitalizations (including 27 for severe forms) and 33 deaths, 21 of which were directly attributed to dengue. In the west of the island, the main focus of the epidemic, the emergency department of the Ouest Réunion hospital center (CHOR), already affected by Covid-19, was saturated with 50% more activity and perfused patients installed in the ambulance reception area. transformed for the occasion.

This epidemic has marked the spirits due to its magnitude but also due to the high number of serious cases (around 21%). Dengue shock syndromes and myocarditis (heart muscle damage) have been observed. This pathology, which affects frail people due to comorbidities such as those in good health, is characterized by a sharp drop in blood pressure, accompanied by restlessness, paleness and loss of consciousness. Ocular forms of the disease with sometimes irreversible partial loss of vision have also been observed.

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