As of Sept. 20, 2022, 47 autochthonous cases of dengue fever, spread across five clusters, have been reported in mainland France since July. These figures mark an increase in autochthonous transmission on several levels.
A record number of cases has been identified. The previous maximum number of cases reported was 14 in 2020.
The clusters are larger than they were previously. One cluster in a town in Alpes-Maritimes was particularly large, with 29 cases, and two other cases also were identified nearby. The previous highest transmission involved eight people in Nîmes in 2015.
The risk has spread to previously unaffected departments, including Pyrénées-Orientales, Hautes-Pyrénées, and Haute-Garonne. Prior cases had mainly occurred in the departments of Var, Alpes-Maritimes, Hérault, and Gard.
As a reminder, dengue fever is an infectious disease caused by an arbovirus and transmitted by the Aedes genus of mosquitos: Aedes aegypti and Aedes albopictus (Asian tiger mosquito). It most commonly manifests as flulike symptoms, which may be combined with a rash within 3 to 14 days after a bite by an infected mosquito. Dengue fever is usually benign but can be complicated by visceral failure and hemorrhagic forms of the disease, which require hospitalization and intensive care. The disease is subject to mandatory reporting.
Treatment is symptomatic (analgesics and antipyretics), but aspirin and nonsteroidal anti-inflammatories are contraindicated due to the risk of hemorrhage.
Why the Increase?
There are several factors contributing to this rise in autochthonous transmission in mainland France, including the following:
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The territorial expansion and high densities of the vector Aedes albopictus mosquito.
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The restart of travel and the return of travelers from endemic areas.
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Climate conditions of increased heat and rain, both of which contribute to the proliferation of mosquitoes.
Global warming, drought, heavy rain, and flooding all contribute to the proliferation of mosquitoes. Hence, arboviruses are among the infectious diseases most closely linked to climate change. Similarly, the huge amount of global trade and movement of people around the world, deforestation, and urbanization are big contributing factors to this proliferation.
Is Prevention Possible?
Prevention must be undertaken individually and collectively along the following lines:
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Combating mosquito breeding sites at home and in public spaces.
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Wearing clothes that cover the body and using mosquito nets and repellents (sprays or creams, coils, electric diffusers), especially while traveling in endemic areas and when returning from travel to avoid being infected by mosquitos. It should be noted that Aedes vector mosquitos mainly bite during the day.
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Implementing a mosquito control program by the Regional Health Authorities (ARS) as soon as an imported or autochthonous case is reported.
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Developing vaccines: The first dengue fever vaccine has been marketed but is not recommended for people living in mainland France.
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Consulting a medical professional at the first appearance of symptoms, particularly if they appear within 15 days of returning from a trip to a tropical region, to receive care and recommendations regarding how to avoid transmitting the disease to others (avoiding being bitten by mosquitoes during the contagious period).
A global, multidisciplinary response involving all societies and populations is vital.
This article was translated from Univadis France.
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