This Friday, April 26, 2024, French Public Health published its weekly report. It appears that leptospirosis is still very active. Number of cases occurring since the beginning of the year, i.e. in less than four months, exceeds the maximum annual number of cases reported since surveillance began (i.e., 169 cases per year in 2022). Dengue fever also exceeds 2023 levels. Since the beginning of the year, 684 cases of dengue fever have been reported. We publish the press release below.
The seasonal leptospirosis epidemic continues at a steady level, with no signs of slowing down.
Since January 1, 2024, ARS has reported 191 cases of indigenous leptospirosis, an increase of 27 cases from the previous week. Number of cases occurring since the beginning of the year, i.e. in less than 4 months, exceeds the highest annual number of cases reported since the start of surveillance, which was in 2022 (169 cases per year).
Climatic conditions are always favorable for the survival of bacteria in soils and humid environments, which increases the risk of infection during risky activities. It is important to remember individual prevention and protection measures for the population, as well as diagnostic, management and case reporting measures for health care workers.
Since January 1, 2024, ARS has received 191 cases of local leptospirosis (Fig. A), i.e. 27 cases more than the previous week. Number of cases occurring since the beginning of the year, i.e. in less than 4 months, exceeds the highest annual number of cases reported since the start of surveillance, which was in 2022 (169 cases per year).
Among the 27 new cases announced between April 18 and April 24, the residential sector was:
• South – 13 buildings (Saint-Pierre, Tampon, Petite-Ile, Saint-Joseph, Saint-Louis). Note that since the beginning of the year, 105 cases have been registered in this sector (55% of all cases);
• West – 9 cases (Saint-Paul, La Possion, Saint-Leu) or 41 cases since the beginning of the year;
• Calculated for 3 cases (Sainte-Rose, Bras-Panon), or a total of 34 cases since the beginning of the year;
• North – 2 cases (Sainte Marie), or 11 cases since the beginning of the year.
There were no new deaths identified during W13 (1 directly linked to H11 and 1 currently being investigated for possible attribution to W10).
In W16, activity for suspected leptospirosis (10 visits and 7 hospitalizations) was 0.2% of activity for all causes combined. Between January 1 and January 16, 2024, there were 136 visits and 76 hospitalizations (i.e., an admission rate of 56%). In comparison, during the same period, hospitalization rates were 65% in 2023 (32 hospitalizations/49 visits) and 55% in 2022 (60 hospitalizations/102 visits).
Data show that to limit the emergence of new cases, prevention should be aimed at groups of the population most at risk of infection, namely: men, age groups 40-79 years, people engaged in risky activities: agricultural work, livestock raising, care of green spaces , yard cleaning, pond hunting, freshwater activities, those who do not protect their wounds, those who use unadapted and unsystematic personal protective equipment, those who wear open shoes in wet environments…
– Dengue –
There have been 684 dengue cases reported since the start of the year, exceeding the total number of cases for 2023, but also the number of cases for 2022 during the same period (659 cases in S15).
In week 15, the number of reported dengue cases was 96 cases compared to 87 cases in W14. After a relative stabilization between S12 and S14, the number of cases began to rise again.
The proportion of cases reported in St. Joseph is declining and currently accounts for only 31% of cases in S15 (52% in S14). As a result, the proportion of cases in the South is falling (67% vs. 75% in S14), despite an increase in cases in Tampon and Saint-Pierre, in favor of the West (26% vs. 23% in S14), where the number of cases is rising sharply in Saint-Leu (18 cases vs. 9 in S14) and to a lesser extent in the North (5% vs. 1% in S14).
The circulating serotype is always DENV2.
The health impact to date remains low, with 95 visits reported to emergency departments (mainly CHU Sud and CHOR) for a syndrome compatible with dengue since the start of the year, including 14 in S15 and 15 in S14. Due to the dispersal of cases in W15, CHOR reported half of the emergency department visits for dengue. The impact of hospitals also remains low, with 18 hospitalizations reported since the start of the year, but rising.
Since the beginning of the year, 35 imported cases have been registered upon returning from trips. The pace slows down.
– Gastro-
In the W16 group, emergency department visits for gastroenteritis increased among all ages. The number of emergency department visits was 90 in W16 compared to 72 in W15, an increase of 25%. Hospitalizations were increasing, with 13 admissions in W16 compared to 7 in W15.
In children under 5 years of age, emergency department visits for gastroenteritis also increased in week 16 (n=43) compared to the previous week (n=32). The number of hospitalizations following emergency department visits was stable, with 4 hospitalizations in W16 compared to 3 in W15.
In W16, the proportion of emergency interventions among children under 5 years of age for gastroenteritis increased compared to the previous week (8.1% in W16 vs. 5.9% in W15).
– Malaria –
In the first quarter of 2024, 22 cases of imported malaria were reported in Reunion. This is a significant increase compared to other years. We note that since 2022, the number of cases reported upon return from Comoros has increased. This is especially true this year (64% of cases in the first quarter), when a malaria epidemic is raging across the archipelago.
As for cases, we do not note any special observations, the disease continues to be predominantly male (despite the fact that the M/F ratio has been decreasing since 2023), and the average age still hovers around 40 years.
The majority of the species considered are P. falciparum (21 cases out of 22). Note that in 4 patients in whom it was known, parasitemia exceeded 4% (severity criterion). However, the proportion of hospitalized cases continues to decline (50% of hospitalized cases compared to 69% in 2022).
Information about the risk of malaria was known to 7 patients, but none of them started chemoprophylaxis.
– COVID-19 –
COVID-19 viral circulation levels are stable and low.
For several weeks now, the viral circulation of COVID-19 has remained very low. The positivity rate (TP) has always been below 5% since late February. In S16 it was 1% compared to 2% in S15.
Screening rates were also low, at 41 tests per 100,000 residents in S16, compared to 45 tests per 100,000 residents in S15.
Analysis of the level of positivity by age group shows the stability of TP for all age groups.
In W16, two patients presented to the emergency department due to COVID-19. There were no COVID-19-related emergency department visits reported in W15. No hospitalizations due to COVID-19 were recorded in either H16 or H15.
– Flu –
In W16, emergency department visits for influenza-like illnesses increased. The emergency department recorded 35 visits for flu syndrome in S16, up from 27 the previous week. Hospitalizations for influenza-like illnesses were stable, with 13 hospitalizations reported in W16 compared to 10 in W15. The share of emergency activities due to influenza was 1% of total activity.
Virological surveillance identified the majority of influenza A(H1N1)pdm09 circulation in S16. The positivity rate increased modestly, with 14% of influenza virus tests positive in S16 compared to 10% in S15.
In public medicine, the share of activity of acute respiratory infections (ARI) in the first half of 2016 remained stable at 4.0% of total activity.
as for S15. The share of IRA activity was higher than the 2013-2023 average in the 16th half of the year.
– Bronchiolitis –
Emergency department visits for bronchiolitis in children under 2 years of age decreased in W16 compared to the previous week. In W16, 21 children under 2 years of age presented to the emergency department for bronchiolitis, compared with 26 in
C15.
The number of new hospitalizations also decreased (n=7) compared to the previous week (n=12). (Table 1).
The proportion of emergency department visits for bronchiolitis among all visits by children under two years of age decreased to 7.0% in the W16 group.
In terms of virologic monitoring, the RSV positivity rate among children under two years of age was stable at 20% in W16 versus 19% in W15 when RSV type A and type B were cocirculating.
– Mortality from any cause –
In S14, the number of reported deaths for all ages and all causes was 89.
Compared to the previous week, the number of observed deaths decreased (n=94 in S13). The number of deaths observed in W14 was lower than the expected number of deaths (n=111).
Among those over 65 years of age, 70 deaths were observed in W14 versus 84 expected deaths. This figure was a slight increase over what was observed in S13 (66 deaths observed). The number of deaths observed in S14 for this age group was then lower than the expected number of deaths (84).
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