From dengue outbreaks to endemicity: Reunion Island, France, 2018 to 2021.

BackgroundAfter 40 years of limited viral circulation, Reunion Island has since 2018 experienced recurrent dengue outbreaks of increasing intensity and severity.AimWe aimed to report on the epidemiology and characteristics of dengue in Reunion Island between 2018 and 2021.MethodsBetween 2018 and August 2021, we systematically collected data on dengue cases via an automated transmission system between the health authorities and the medical laboratories. We set up additional surveillance systems for dengue-related activity in primary care, in emergency departments and in inpatient departments.ResultsUntil 2020, despite numerous cases, outbreaks had a limited public health impact because of few severe cases, low lethality and no heavy burden for the health care system. In 2021, however, the number of severe cases increased (from 0.4% of all cases in 2018 to 0.8% in 2021), as did the number of paediatric cases (from 8% in 2018 to 15% in 2021) and atypical clinical forms of dengue (108 cases of post-dengue maculopathy). Of note, haemorrhagic forms were rare and multi-organ failure was the most frequent severity throughout the study period. In parallel, the dominant serotype switched from DENV2 to DENV1 in 2020 and DENV1 became the only serotype detected in 2021.ConclusionThese findings indicate that dengue is becoming endemic in Reunion Island. Since comorbidities associated with severity of dengue are common in the population, health authorities should carefully consider the impact of dengue when addressing public health policies.

Nirsevimab Effectiveness Against Cases of Respiratory Syncytial Virus Bronchiolitis Hospitalised in Paediatric Intensive Care Units in France, September 2023-January 2024.

In September 2023, France was one of the first countries that started a national immunisation campaign with nirsevimab, a new monoclonal antibody against respiratory syncytial virus (RSV). Using data from a network of paediatric intensive care units (PICUs), we aimed to estimate nirsevimab effectiveness against severe cases of RSV bronchiolitis in France. We conducted a case-control study based on the test-negative design and included 288 infants reported by 20 PICUs. We estimated nirsevimab effectiveness at 75.9% (48.5-88.7) in the main analysis and 80.6% (61.6-90.3) and 80.4% (61.7-89.9) in two sensitivity analyses. These real-world estimates confirmed the efficacy observed in clinical studies.

Epidemiological description of an outbreak of dermatitis related to dimethylfumarate, France, 2008.

Following similar events in other European countries, some cases of dermatitis related to contact with China-imported furniture possibly treated with dimethyl(E)-butenedioate (dimethylfumarate [DMF]) were reported to the French institute for public health surveillance at the beginning of September 2008. An active multisource case collection was conducted in order to provide an epidemiological description of this outbreak. Results of this investigation show that, in France, mainly during the 4th quarter of 2008, a large number of people presented dermatological symptoms at least plausibly due to a contact with DMF-treated consumer products. The products involved were mostly shoes and sofa (94% of cases). This work offers an example of a multipartner investigation in the field of environmental health. It also shows how the results obtained contributed to decision-making and resulted in the limitation of DMF-treated products in France and in Europe.

Dysgeusia following consumption of pine nuts: more than 3000 cases in France.

INTRODUCTION: In March 2008, French poison centres (PCs) recorded the first calls reporting persistent bitterness following the ingestion of pine nuts. METHODS: The French toxic exposure surveillance system (French-Tess) was searched and a descriptive analysis of cases was performed on data recorded from 13 March 2008 to 31 January 2010. RESULTS: Some 3111 cases of bitterness were reported to PCs. The number of cases rose sharply from May 2009 to reach a peak in August 2009 with 697 cases. The median time to onset of dysgeusia was 24 hours and it lasted less than 14 days in 95% of cases. Raw as well as cooked or processed pine nuts were implicated. DISCUSSION: The delayed onset and persistence of dysgeusia suggest that the toxin may act via an unknown toxic mechanism on the receptor. The aetiological agent could be an unidentified toxin present in some varieties of non-edible pine nuts. CONCLUSION: The high incidence of the event and the lack of understanding of the nature of the toxin and its pathophysiological mechanism require continued monitoring of poison cases, botanical and biochemical analysis, and experimental studies.