In Reunion, severe cases of dengue fever now all year round

A first death caused directly by dengue fever this year in Reunion was announced Thursday, September 15, by the regional health agency (ARS). A death that “confirms the dangerousness of the disease”, underlines the ARS. Since the beginning of the year, 1,129 confirmed cases of dengue fever have been recorded on the island. The authorities also list 54 hospitalizations and 177 visits to the emergency room. Figures which remain well behind previous years marked, according to Santé Publique France, by “increasing epidemic waves”.

If 2022 is distinguished by the absence of an epidemic, this death nevertheless tragically confirms that “We are in a situation where dengue fever is becoming endemic, because it is circulating continuously. We now have cases all year round”, including in the cold season, notes Professor Xavier Deparis, director of monitoring and health security at ARS Réunion. During the austral winter, which begins in June, the reproduction cycle of tiger mosquitoes, the 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 sick person and transmits the virus by biting another, is therefore more resistant today to lower temperatures. The peak of epidemics is in the hot season and, when the rains are stronger 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) denounced an epidemic ” unprecedented ” on the island with 1,616 proven and autochthonous cases between 1er January and April 23. Since then, Reunion has experienced a much more alarming health crisis. The 2021 epidemic left behind nearly 30,000 confirmed cases, 1,185 hospitalizations (including 27 for severe forms) and 33 deaths, 21 of which were directly attributed to dengue fever. 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 by its magnitude but also by the high number of severe cases (about 21%). Dengue shock syndromes and myocarditis (damage to the heart muscle) have been observed. Affecting fragile people due to comorbidities like those in good health, this pathology is characterized by a sharp decrease in blood pressure, accompanied by restlessness, pallor and loss of consciousness. Ocular forms of the disease with sometimes irreversible partial loss of vision have also been observed.

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