2023-11-17 11:01:18
If the flu becomes post-epidemic, visits to emergency rooms for gastroenteritis and Covid-19 increased from November 6 to 12, 2023 in Reunion. For Covid-19, an increase in the positivity rate for all age groups and mainly for people aged over 65 is observed.
Regional epidemiological update – Week 45 (November 6 to 12, 2023)
Emergency visits were stable in W45 (n = 3,914) compared to the previous week (n = 3,959). Emergency visits for under-15s were also stable in S45 (-3%), compared to S44. Among people aged 65 and over, the number of visits to the emergency room was, however, down in W45 compared to W44 (-8%).
The participation of the network of sentinel doctors was 61% in W45 compared to 80% the previous week. The number of city consultations was on the rise in S45 with a number of 2,072 consultations in S45 compared to 1,918 in S44.
Consultations for ARI were decreasing in W45 (4.7% vs 5.1% in W44) while they were increasing for gastroenteritis (3.7% vs 2.8% in W44).
– COVID-19 in emergency –
Since week 42, a resumption of COVID-19 viral circulation at a moderate level has been noted.
The end of SI-DEP had an impact on screening activity, resulting in a sharp drop in the latter. However, since the implementation of neo-sidep and the evolution of screening activity, we are witnessing for the first time such a significant increase in the positivity rate (PT). The TP for covid-19 increased from 9% to 22% between S43 and S45 while the screening rate increased from 66 tests per 100,000 inhabitants to 60 tests per 100,000 inhabitants between S43 and S45.
The increase in TP observed since S42 concerns all age groups and mainly people aged over 65, with a TP increasing from 16% to 25% for 65-75 year olds and from 17% to 28% for those aged 75 and over between S44 and S45.
Virological surveillance implemented with virology data from the CHU microbiology laboratory (CNR Arbovirus Associé, CNR Virus respiratory Associé, Réunion) shows the same trend. The COVID-19 positivity rate increased between W44 and W45, going from 5% to 18%.
The number of visits to the emergency room for reasons of COVID-19 was on the rise in S45 with 14 visits compared to 5 visits the previous week (Figure 3). This is a weekly passing level never reached since the beginning of July 2023.
However, the number of hospitalizations following a visit to the emergency room for COVID-19 was stable and low with only 3 hospitalizations in W45 compared to 2 in W44 (Figure 4).
– Flu –
The drop in visits to emergency rooms due to influenza-like illness that began in W42 continued in W45. In total, 21 visits to the emergency room due to influenza-like illness were recorded in W45 compared to 36 the previous week (Figure 5). However, hospitalizations were stable with 5 hospitalizations in W45 vs 6 in W44. The share of emergency activity for influenza reasons remained low, representing only 1% of total activity.
Since the start of the flu epidemic, a total of 17 serious cases have been identified by the intensive care units, including 14 adults and 3 children. For adults, the median age was 62 years. The majority of serious cases were represented by women with a M/F sex ratio of 0.21. Serious adult cases all presented at least one comorbidity. Two deaths were reported. From a virological point of view, the majority of serious cases had contracted type A(H3N2) influenza.
Virological surveillance identifies a majority of circulation of type A(H3N2) influenza (Figure 8). The positivity rate was decreasing in W45 with 9% of tests positive for influenza viruses in W45 compared to 26% in W44.
Reunion Island is in the post-flu epidemic. The end of the epidemic remains to be confirmed in the coming weeks.
In community medicine, the share of activity for acute respiratory infections (ARI) was down with 4.7% of total activity in W45 compared to 5.1% in W44, nevertheless remaining above the 2013-average. 2022 (Figure 7).
– Bronchiolitis (in children under 2 years old) –
Emergency department visits for bronchiolitis in children under 2 years old were stable in week 45 compared to the previous week (Figure 10). In W45, 44 children aged under 2 years were in the emergency room for bronchiolitis versus 43 in W44 (Figure 10).
The number of new hospitalizations was also stable in W45 with 17 hospitalizations as in W44 (Table 1).
The share of visits to the emergency room for bronchiolitis among all visits of children under two years old was 12.7% in W45 compared to 11.2% in W44.
Concerning virological monitoring, the RSV positivity rate was 1% in W45 compared to 2% in W44. In W45, only one sample was positive for RSV and was type B (Figure 10). Reunion Island was not in the context of a bronchiolitis epidemic unlike several regions of France.
– Gastro –
In W45, visits to emergency rooms of all ages for reasons of gastroenteritis were on the rise with 125 visits versus 114 visits in W44 (Figure 11). The number of hospitalizations, however, was down moderately with 16 hospitalizations in W45 vs. 20 in W44.
Among children under 5 years old, visits to the emergency room for reasons of gastroenteritis were also on the rise (n=76) compared to the previous week (n=62) (Figure 12). Hospitalizations following a visit to the emergency room numbered 12 hospitalizations in W45 versus 10 in W44.
In W45, the share of emergency activity among those under 5 years old for gastroenteritis was 13.3% compared to 10.4% in W44.
Reunion remains in the context of a gastroenteritis epidemic.
In community medicine, the share of activity for acute diarrhea was increasing and stood at 3.7% in W45 (Figure 13). The share of activity was above the 2013-2022 average.
– Mortality (all causes) –
In S43, the observed number of deaths of all ages and all causes was 117 people. The difference was -15% compared to S42 (n=138). The observed number of deaths was higher but not significant than the expected number of deaths (n=109).
Among those under 15, 3 deaths were observed in W43 (vs. 2 expected deaths), compared to 1 death observed in W42.
Among those over 65, in W43, 91 deaths were observed vs. 82 expected deaths. This figure was down compared to S42 (99 deaths observed).
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