Re-emergence of dengue in Reunion, France, January to April 2012.

Since January 2012, 20 autochthonous cases of dengue virus (DENV) infection have been identified in Réunion. The first cases were detected on the western coast, but the two co-circulating viruses (DENV-1 and DENV-3) seemed to have spread later to different cities of the island. There is a non-negligible risk of increase in viral transmission over the following weeks, so health professionals and public health authorities in Réunion are preparing to face a potential epidemic.

[Influenza A(H1N1)2009 epidemic in Réunion Island: experience in the out-patient influenza clinic, July-September 2009]. / Épidémie de grippe A(H1N1)2009 à La Réunion: expérience de la consultation ambulatoire dédiée, juillet-septembre 2009.

From July 6 to September 29, 2009, 380 patients were seen as out-patients for flu-like illness, and 355 files (253 women and 102 men) were available for retrospective analysis. Mean age was 32 years. 158 patients, including 22 with A(H1N1)2009 influenza had underlying medical conditions: pregnancy (N = 87), asthma (N = 37), obesity (N = 17). Most frequent symptoms of A(H1N1)2009 influenza patients were fever (97% of the patients), cough (94%), rhinorrhea (59%), myalgia (56%), headache (36%). A nasopharyngeal swab for influenza virus detection by PCR was performed on 118 patients including 27 pregnant women. 44 patients, including 40 A(H1N1)2009 influenza cases were tested positive. 21 patients were referred to the emergency department for further tests or treatment and 31 patients were admitted as in-patients. 20 pregnant women were referred for further obstetrical monitoring; none presented with respiratory failure or foetal distress. None of the patients were admitted to the ICU or died.

[Chikungunya in paediatrics: epidemic of 2005-2006 in Saint-Denis, Reunion Island]. / Aspects pédiatriques de l'épidémie de Chikungunya à l'île de la Réunion.

UNLABELLED: During the southern-hemispheric 2005-2006 summer, Reunion Island was struck by an epidemic of Chikungunya (Chik), which affected more than a third of the overall population. OBJECTIVES: Our objective was to describe pediatric cases of Chick. MATERIAL AND METHODS: We conducted a retrospective descriptive monocentric study of confirmed pediatric cases of Chik recruited at Saint-Denis' departmental hospital during the peak of the epidemic (January 1st to April 30th 2006). RESULTS: Eighty-six children aged 10 days to 18 years were included. In addition to the typical clinical presentation, we observed other phenotypes. Well-known complicated forms with neurologic, cardiac, gastro-intestinal (plus dehydration) involvement were thoroughly investigated using modern medical technology. We observed 2 fatal cases of acute disease in 9-year-old children: death resulted from a central nervous system insult in one case, and multisystemic neurological, cardiac, haemorrhagic involvement in another. Severe acute presentations requiring hospital admission involved mainly children aged less than 6 months, and those with cardiac, skin and neurologic impairment. The study identified 3 cases of epidermolysis bullosa, which to our knowledge, have never been described previously. CONCLUSION: Chik in children warrants further research in order to propose early and appropriate treatments to avoid complications.

[Angiostrongylus in the infant at Reunion and Mayotte. Apropos of 3 cases of eosinophilic meningitis including 1 fatal radiculomyeloencephalitis with hydrocephalus]. / L'angiostrongylose chez le nourrisson à la Réunion et à Mayotte. A propos de trois méningites à éosinophiles dont une radiculomyéloencéphalite avec hydrocéphalie fatale.

BACKGROUND: Eosinophilic meningitis caused by Angiostrongylus cantonensis is widespread in Southeast Asia and Pacific islands. Adults develop a transient meningitis with a benign course but severe or fatal disease may occur in pediatric patients. CASE REPORT 1: A 11 months old boy living in Mayotte island was hospitalized some days after fever and skin rash with seizure status, coma, flaccid quadriplegia, absence of deep tendon reflexes, urinary retention and anal incontinence. Eosinophilia was observed in peripheral blood and in the cerebrospinal fluid. Secondary, he developed a triventricular hydrocephalus treated by a ventriculoperitoneal shunt. After 3 weeks, the child died. Retrospectively, the diagnosis of angiostrongylus infection was established with the help of serology. CASE REPORTS 2 AND 3: Two infants, 10 and 11 months old boys, living in Reunion island, developed fever and vomitings, irritability and, for one of them, a unilateral sixth cranial nerve palsy. There was eosinophilia in the peripheral blood and in the cerebrospinal fluid. All symptoms progressively disappeared with complete recovery. The suspected diagnosis of angiostrongylus infection was confirmed by the serology. CONCLUSION: We report the first case of Angiostrongylus cantonensis infection in the French island of Mayotte (Comoro Islands) and we confirm the presence of this disease in Reunion island. In this Indian Ocean area, eosinophilic meningitis occurs most of the time in infants with sometimes severe radiculomyeloencephalitic forms. The origin of these occasionally massive infections is the giant African snail Achatina fulica. For a child with meningitis living in Reunion or Mayotte, or coming back from these 2 islands, Angiostrongylus cantonensis infection must be evoked, especially if there is a blood eosinophilia. Since efficiency of antiparasitic treatment is nowadays not proved, information must be given to people living in exposed areas in view to limit incidence of this disease.