2024-02-23 11:33:45
Regional epidemiological update – Week 07 (February 12 to 18, 2024)
Emergency activity was up with 4,158 visits recorded in S07 versus 4,140 visits in S06 following data consolidation.
The activity of sentinel doctors remained stable with 2,300 visits in S07 versus 2,349 visits in S06.
Consultations for ARI remained at a high level (5.1% in S07) despite a drop compared to the previous week (5.9% in S06). The proportion of consultations for reasons of conjunctivitis remained at a high level, representing 2.9% of consultations.
– Leptospirosis –
With the rainy season, climatic conditions are favorable for the persistence of the bacteria in water and humid environments, thus increasing the risk of contamination during risky activities. On average in the department, with a rainfall of around 2.5 times normal and an average island accumulation just exceeding 1000 mm, January 2024 ranks 3rd among the rainiest Januarys in more than 50 years of measurements (Meteo France data). Météo France notes a certain resemblance with 2018 where the south and south-east areas were also particularly affected.
Assessment as of February 20, 2024: since January 1, 2024, 54 cases of biologically confirmed leptospirosis occurring during the month of January have been declared to the ARS (Figure A). At the same time of year, 22 cases had been declared in 2023 and 18 in 2022.
The main hypotheses of contamination declared by the cases were activities carried out in the context of leisure activities: agricultural work, gardening, market gardening, pruning trees, cutting breds, pineapples, breeding and to a lesser extent DIY/cleaning the yard, or practicing sports in fresh water. The main leisure places at risk of contamination identified were the home, fields or agricultural plots. Furthermore, a
professional hypothesis can be retained for 6 cases (farmer, market gardener, road maintenance).
In parallel between S01 and S07/2024, monitoring of emergency visits (Oscour®) identified 29 visits (including 9 respectively in S06 and S07/2024) for suspected leptospirosis. Among these passages, 17 resulted in hospitalization (59%). In 2023, 23 passages including 17 hospitalizations (74%) were identified for the same period.
– COVID-19 –
In S07, the positivity rate (TP) was stable: 9% in S07 compared to 8% the previous week (Figure 1). The screening rate was also stable, at 56 tests per 100,000 inhabitants in S07 compared to 53 tests per 100,000 inhabitants in S06. The TP was generally stable for all age groups except for those aged 45-64 and those over 75 for whom it was increasing (Figure 2).
Virological surveillance implemented with virology data from the CHU microbiology laboratory (CNR Arbovirus Associated, CNR Respiratory Virus Associated, Reunion) and private laboratories, shows a stable COVID-19 TP in W07 compared to W06 . There were 43 positive tests among 484 tests in S07, i.e. a TP of 9% vs. 37 positive tests among 463 tests in S06 (TP = 8%).
In W07, visits to the emergency room for reasons of COVID-19 were stable (Figure 3). In S07, 10 visits to the emergency room for COVID-19 were recorded compared to 7 the previous week (Figure 3). In S07, the number of visits to the emergency room for reasons of COVID-19 remained lower than the average of visits to S07 between 2020 and 2023 (Figure 3).
The number of hospitalizations following a visit to the emergency room for COVID-19 was also stable with 5 hospitalizations in W07 vs. 5 in W06 (Figure 4). The level of hospitalizations was below the 2020-2023 average.
– Flu, acute respiratory infection and influenza viruses –
In S07, visits to the emergency room due to influenza-like illness were slightly increasing. The emergency department recorded 27 visits for reasons of influenza syndrome in S07 compared to 21 the previous week (Figure 5). The number of hospitalizations for influenza-like illness was down in W07 since no hospitalizations were reported vs. 7 in W06. The share of emergency activity for influenza reasons remained low and represented less than 1% of total activity.
Virological surveillance identifies in S07 a circulation of influenza mainly of type A(H1N1)pdm09 (Figure 8). The positivity rate was down with 14% of tests positive for influenza viruses in S07 compared to 18% in S06.
In view of the epidemiological data, Reunion was not in the context of an epidemic.
In community medicine, despite a drop in the share of activity in Acute Respiratory Infections (ARI), it remained at a high level with 5.1% of total activity in S07 compared to 5.9% in S06. The share of activity for IRA was above the 2013-2023 average (Figure 7).
– Bronchiolitis (in children under 2 years old) –
Visits to the emergency room for bronchiolitis in children under 2 years old were stable in W07 compared to the previous week (Figure 10). In W07, 38 children aged under 2 years consulted the emergency room for bronchiolitis versus 41 in W06 (Figure 10).
The number of new hospitalizations was stable in W07 with 19 hospitalizations compared to 22 hospitalizations in W06 (Table 1).
The share of visits to the emergency room for bronchiolitis among all visits of children under two years old was down to 10.8% in S07 compared to 13.1% in S06.
Concerning virological surveillance, the positivity rate for RSV among those under two years of age was down sharply to 26% in S07 (vs. 44% in S06) with a majority of circulation of RSV type A without generating any impact. consequent health.
End of the bronchiolitis epidemic in Reunion.
– Gastro-enterites aigues (GEA) –
In S07, visits to emergency departments of all ages for reasons of gastroenteritis were down slightly with 72 visits compared to 78 visits in S06 (Figure 11). The number of hospitalizations was down moderately with 6 hospitalizations in W07 vs. 9 in W06.
In children under 5 years old, visits to the emergency room for gastroenteritis were stable in W07 (n=38) compared to the previous week (n=35) (Figure 12). Hospitalizations following a visit to the emergency room were down with 2 hospitalizations in W07 compared to 1 in W06.
In S07, the share of emergency activity among children under 5 years old for gastroenteritis was 7% as in S06.
Reunion is not in an epidemic phase.
In community medicine, the share of activity for acute diarrhea was decreasing and stood at 2.3% in S07 (Figure 13). It was below the average for the years 2013-2023.
– Dengue –
The increase in dengue cases continues in Réunion (Figure 14). Between S05 and S06, the number of cases increased from 16 to 27 cases. More than half of the cases (52%) are detected in Saint Joseph, which has several active outbreaks.
In week 06, 4 cases were reported in St Paul while none were identified there in S05. This situation is being monitored vigilantly. Elsewhere on the island, cases were reported in Le Tampon and St Denis (2 cases each) and in St Pierre, La Possession, St Leu, St Louis and St André (1 case each).
The first results show the presence of the DENV2 serotype.
The health impact remains low to date with 6 visits to the emergency room (CHU Sud) for syndrome compatible with dengue fever since the start of the year and no hospitalizations reported. However, there was a small increase in the number of consultations for syndromes clinically compatible with dengue fever in community medicine in week 07 (from 13 consultations in W06 to 18 in W07).
Furthermore, there is a dengue epidemic in Mauritius and Rodrigues. To date, 10 imported cases have been reported returning from a trip to one of these 2 islands. A serotyping result revealed DENV2 in a person returning from Rodrigues.
In view of the weather conditions conducive to the development of the insect vector and therefore viral circulation, the situation is being monitored with the greatest vigilance.
– Increase in cases of conjunctivitis in private doctors in Reunion –
Conjunctivitis outbreaks generally occur in densely populated tropical regions during hot, humid seasons. In Réunion, no major epidemic had been described since the epidemic which occurred in 2015 with grouped cases of conjunctivitis which had been detected in the commune of Saint-Paul, via the OSCOUR® network.
For three weeks, there has been an increase in consultations for reasons of conjunctivitis reported by the network of sentinel doctors (Figure 18). The Réunion regional unit has strengthened epidemiological surveillance of this pathology.
This surveillance is based on the OSCOUR® surveillance system (data on emergency room visits and hospitalizations) to characterize the health impact and the network of sentinel doctors which reports the weekly number of consultations for conjunctivitis. Finally, the data on the number of consultations transmitted by the Caisse Générale de Sécurité Sociale allows us to extrapolate the number of cases and the incidence of conjunctivitis in the general population.
• The network of sentinel doctors
In community medicine, the share of activity for conjunctivitis was well above the 2013-2023 average since S05 (Figure 18). In S07/2024, the share of activity is estimated at 2.9% (n=47).
• The OSCOUR® network
In terms of monitoring health indicators at the hospital (emergency room visits and hospitalizations), no health impact has been identified (Figure 19). We have observed a limited number of weekly emergency room visits (less than 15) since the beginning of February due to conjunctivitis.
At this stage, the increase in cases of conjunctivitis is limited to the private medicine sector without causing a significant health impact on the hospital system in Reunion.
The Public Health France unit in Reunion remains mobilized to monitor the evolution of the number of cases of conjunctivitis in the territory.
– Mortality (all causes) –
In S05, the number of deaths observed for all ages and all causes was 114 people. Compared to the previous week, the number of deaths observed was stable (n=115 in S04). The observed number of deaths was higher but not significant compared to the expected number of deaths (n=110).
Among those over 65, in S05, 86 deaths were observed vs. 83 expected deaths. This figure was up compared to S04 (77 deaths observed).
Among those under 15, the number of deaths observed in S05 was 3 (the expected number of deaths is 2).
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