Mosquito-borne virus plagues holiday hotspots in the South of France

Telegraph

2 days ago

A mosquito-borne virus that causes debilitating joint pain and fever has begun to spread locally in holiday hotspots in the South of France.
Some 712 imported cases of chikungunya were recorded between May 1 and July 1, leading to 14 locally-acquired infections in the same period, according to data from Santé publique France, the French public health agency.
While the disease is routinely brought back to France by returning travellers, the number of imported cases reported this year is greater than the previous ten combined, largely because of a major outbreak on the French Indian Ocean territory of Réunion.
Chikungunya is primarily spread by the Aedes mosquito (also known as the tiger mosquito) and cannot spread from person to person. But a mosquito can pick up the disease by feeding on an infected individual and then transmit it to new human hosts by biting them.
Most of the locally-acquired cases appear to be clustered around Salon-de-Provence and La Crau, two towns on France's Mediterranean coast near Marseille, Toulon and Saint-Tropez.
There have also been three locally-acquired cases reported on the island of Corsica and, for the first time, an indigenous case of the virus was reported in the Grand Est region, far to the North East.
The high number of imported cases, coupled with the flurry of locally-acquired infections, has raised concerns among public health officials about the potential for the virus to spread more widely in mainland France.
'The occurrence of a first episode of indigenous transmission in the Grand Est region, combined with the precocity and number of episodes already detected, confirms the significant risk of indigenous transmission of chikungunya in mainland France, including in regions that have been free of the disease until now,' Santé publique France said in a statement.
'This is facilitated by the well-adapted nature of the strain of the virus circulating in Réunion and the Indian Ocean to the Aedes albopictus mosquito vector.'
Prof Paul Hunter, Professor in Medicine, University of East Anglia, said: 'What is most worrying is that the 14 reported cases of chikungunya are spread over multiple departments, suggesting that local spread is already widespread in southern France.'
France's public health agency has launched an investigation into the case in the Grand Est region, and has begun implementing containment measures in the worst-affected areas.
'This kind of thing, we know that it can happen but we never see it coming,' said Florence Brau, the mayor of Prades-le-Lez, a commune on the outskirts of Montpellier where insecticides were being used to suppress the local mosquito population and prevent further spread.
'For reasons of medical confidentiality and to avoid people coming to see how things were going, we were instructed not to say which areas were being treated for mosquitoes. The residents concerned received a letter in their mailboxes,' she told Midi Libre, a local newspaper.
While chikungunya very rarely causes death, its symptoms are debilitating. They usually begin within a week of being bitten and can include a sudden high fever, fatigue, nausea, reddening of the eyes, sensitivity to light and a rash.
But it owes its name, which comes from a word in the Kimakonde language spoken in southern Tanzania meaning 'to become contorted,' to the crippling joint pain it causes.
The virus triggers an immune response that leads to inflammation in the joints, causing pain, swelling and stiffness similar to rheumatoid arthritis that can persist for weeks, months and sometimes years after the initial infection.
'A state of exhaustion I've never experienced'
Alain, a 73-year-old from Prades-le-Lez, is believed to be the second person to catch chikungunya locally in France this year. The retired civil engineer lived in Africa for 10 years and never caught anything, not even malaria.
'Two-and-a-half weeks ago, I came home from playing pétanque, had a shower, then started itching my knee,' he told Midi Libre.
'I looked and my leg had gone completely red. I told myself that I must've been bitten by a spider. And the following morning, I woke up in a state of exhaustion that I've never experienced.'
Then the pain in his joints began to set in, and within days became so severe that he was unable to use his hands to open doors.
'I couldn't manage, for example, to bend my wrist to open doors. I had to use my elbow,' he said.
While there is a vaccine available, there is no specific cure or antiviral treatment for chikungunya. Instead, treatment is focused on managing symptoms with rest, fluids, and painkillers.
Alain's pain eventually subsided but he is still recovering from the virus.
'I'm very tired and I get out of breath quickly. This morning, I just walked down my street and I had to take a few pauses.'
Residents of villages and towns across southeastern France have been ordered to take precautions to fight the spread of mosquitoes, including covering or emptying containers that could collect water, keeping pets indoors, covering swimming pools and closing windows.
The health ministry is also urging locals to report sightings of tiger mosquitoes in their communities using an online tool, and to report suspected infections.
While a vaccination campaign is underway on Réunion, there are currently no plans to launch a similar scheme in mainland France, The Telegraph understands.
Several countries including France, the UK and the United States paused the use of Valneva's chikungunya vaccine among individuals 65 and older in May following reports of serious adverse events, including two deaths and hospitalisations, among the vaccinated on Réunion.
As well as grappling with chikungunya, the French health authorities have also reported spikes in imported cases of dengue and Zika, two other tropical diseases spread by the tiger mosquito which is more commonly found in Asia, Africa and South America.
According to the European Centre for Disease Prevention and Control (ECDC), climate change has helped create favourable conditions for the tiger mosquito to spread since it was first spotted in Europe in the late 1970s, making outbreaks of the diseases they carry more common.
Dengue and chikungunya risk becoming endemic in Europe. In the worst-case climate scenarios, the spread of the two viruses could increase to five times the current rate by 2060, according to a recent ECDC study, with countries like Italy, France and Spain to be among those hit hardest.
'The last three years have seen a fairly rapid increase year on year of locally acquired dengue in France, Italy and Spain,' said Prof Hunter. 'We can expect to see increasing reports of both chikungunya and dengue fever from the Mediterranean area over the coming years.'
Travellers to France are currently being advised to take the usual precautions to prevent bites from mosquitoes.
'It is essential to take precautions against mosquito-borne infections such as chikungunya while travelling abroad,' Dr Hilary Kirkbride, the Head of Travel Health at the UK Health Security Agency, told The Telegraph.
'Simple steps, such as using insect repellent, covering exposed skin, and sleeping under insecticide-treated bed nets, can effectively reduce the risk of mosquito-borne infections.'