Vector-borne transmission of Zika virus in Europe, southern France, August 2019.

On 1 October 2019, a locally-acquired Zika virus disease case was laboratory confirmed in Hyères, Var department. Active case finding identified two additional locally-acquired cases living within 90 m, with symptom onset 8 days before the index case. Extensive patient interviews did not yield information supporting transmission through sexual contact or substances of human origin. Vector-borne transmission by local Aedes albopictus mosquitoes is the most likely mode of transmission. Here we describe the public health response.

Preliminary report of an autochthonous chikungunya outbreak in France, July to September 2017.

In August 2017, an autochthonous chikungunya case was reported in south-east France. By mid-September, eight additional autochthonous cases were found in the index case's neighbourhood, where the chikungunya virus vector Aedes albopictus was observed. Genomic characterisation identified an East-Central South African (ECSA) lineage strain, probably from the Central African region and carrying an adaptive mutation facilitating transmission by Ae. albopictus. The event confirms we need early case detection and response to contain chikungunya in Europe.

An alien in Marseille: investigations on a single Aedes aegypti mosquito likely introduced by a merchant ship from tropical Africa to Europe.

Control of invasive species relies partly on permanent surveillance at international points of entry. We report the exceptional trapping of one adult mosquito (Diptera: Culicidae) in the port of Marseille, France, in July 2018, during a routine survey conducted according to International Health Regulations. Morphological and molecular identification classified the specimen as a female Aedes (Stegomyia) aegypti (L.), vector of many arboviruses, absent from Europe and the Mediterranean rim since the 1950s. A world reference panel of approximately 23,000 genome-wide single nucleotide polymorphisms determined that the mosquito originated from Cameroon, west Africa. Cross-reference of this geographic location with boats traveling from Central Africa to Marseille during the trapping period suggests that the mosquito travelled within an identified merchant ship, a vehicles carrier connecting Douala, Cameroon to Marseille, France. This ship left Douala on June 25, 2018 and arrived 20 days later in Marseille on July 15. The mosquito was captured 350 m away from the dock. The interception of a propagule of an invasive species is a rare event that must be considered a priority to prevent its successful establishment.

Title: Un alien à Marseille : enquêtes sur un seul moustique Aedes aegypti vraisemblablement introduit par un navire marchand de l'Afrique tropicale vers l'Europe. Abstract: La lutte contre les espèces invasives repose en partie sur une surveillance permanente aux points d'entrée internationaux. Nous rapportons ici le piégeage exceptionnel d'un moustique adulte (Diptera: Culicidae) dans le port de Marseille, France, en juillet 2018, au cours d'une enquête de routine menée selon les recommandations du Règlement Sanitaire International. L'identification morphologique et moléculaire a désigné ce spécimen comme étant une femelle d'Aedes (Stegomyia) aegypti (L.), vecteur de nombreux arbovirus, absent d'Europe et du pourtour Méditerranéen depuis les années 1950. Une base de référence mondiale du polymorphisme des nucléotides individuels pour ~23 000 génomes complets a permis de déterminer que ce moustique était originaire du Cameroun. Le croisement de cette information de localisation géographique avec celle de la circulation des bateaux entre l'Afrique Centrale et Marseille au cours de la période de piégeage suggère que le moustique a voyagé à l'intérieur d'un navire de commerce identifié, un transporteur de véhicules reliant Douala (Cameroun) à Marseille (France). Ce navire a quitté Douala le 25 juin 2018 pour arriver à Marseille 20 jours plus tard, le 15 juillet 2018. Le moustique a été capturé à 350 mètres du dock. L'interception d'un propagule d'une espèce invasive est un évènement rare qui doit être considéré de façon prioritaire afin d'empêcher la réussite de son installation.

Atypical aetiology of a conjugal fever: autochthonous airport malaria between Paris and French Riviera: a case report.

Endemic malaria has been eradicated from France, but some falciparum malaria cases have been described in patients who have never travelled outside the country. Ms. V. 21 year-old and Mr. M. 23 year-old living together in Paris were on holiday in Saint Raphaël (French Riviera). They presented with fever, vertigo and nausea. A blood smear made to control thrombocytopaenia revealed intra-erythrocytic forms of Plasmodium falciparum. The parasitaemia level was 0.15% for Ms. V and 3.2% for Mr. M. This couple had no history of blood transfusion or intravenous drug use. They had never travelled outside metropolitan France, but had recently travelled around France: to Saint Mard (close to Paris Charles de Gaulle (CdG) airport), to Barneville plage (in Normandy) and finally to Saint Raphaël. The most probable hypothesis is an infection transmitted in Saint Mard by an imported anopheline mosquito at CdG airport. The DNA analysis of parasites from Ms. V.'s and Mr. M.'s blood revealed identical genotypes. Because it is unlikely that two different anopheline mosquitoes would be infected by exactly the same clones, the two infections must have been caused by the infective bites of the same infected mosquito.

Chikungunya: a risk for Mediterranean countries?

The Italian outbreak of the 2007 summer and the active spreading of the Asian tiger mosquito Aedes albopictus in southern Europe, raise the possibility of local transmission of chikungunya (CHIK) in Mediterranean countries. Established in at least 12 countries in southern Europe since the end of the 1970s and in southern France since 2004, Ae. albopictus, is invading the French Mediterranean coast from East to West. To determine the possibility of an outbreak of CHIK in southern France, we provide an assessment of vector competence towards CHIK virus of different mosquito species, including Ae. albopictus, collected in 2006 in Camargue and the "Côte d'Azur" (Alpes Maritimes). In the laboratory, Ae. albopictus showed a high susceptibility to CHIK infection (77.1%) comparable to that observed for specimens collected in March 2006 in La Reunion Island. Hence, Ae. albopictus from southern France has the potential to serve as a vector based on its susceptibility to CHIK infection. Its presence in a tourist area such as the "Côte d'Azur" should be considered as a potential threat for the introduction of CHIK virus as in Italy where the initial case was probably a traveller coming back from an endemic zone.