Autochthonous dengue outbreak in Nîmes, South of France, July to September 2015

Abstract

In August and September 2015, seven locally acquired cases of dengue virus type 1 (DENV-1) were detected in Nîmes, south of France, where Aedes albopictus has been established since 2011. Epidemiological and entomological investigations allowed to steer vector control measures to contain transmission. An imported case from French Polynesia with onset fever on 4 July was identified as primary case. This outbreak occurred from 8 August to 11 September in a 300 m radius area. Six sprayings to control mosquitos were performed in the affected area. We describe the first considerable dengue outbreak in mainland France where only sporadic cases of autochthonous dengue were recorded previously (2010, 2013 and 2014). The 69 day-period between the primary case and the last autochthonous case suggests multiple episodes of mosquito infections. The absence of notification of autochthonous cases during the month following the primary case's symptoms onset could be explained by the occurrence of inapparent illness. Recurrence of cases every year since 2013, the size of the 2015 outbreak and continuing expansion of areas with presence of Ae. albopictus highlight the threat of arboviral diseases in parts of Europe. Thus, European guidelines should be assessed and adjusted to the current context.

High risk of dengue type 2 outbreak in French Polynesia, 2017

“…in Europe and the Americas [17,18]. Autochthonous transmission of DENV in Europe and North America has already been reported [19-23]. The occurrence of a DENV-2 outbreak in the coming months in French Polynesia would increase the risk of virus importation into such non-endemic countries, particularly mainland France, during the most favourable season for vector-borne transmission.…”

Global Epidemiology of Dengue Outbreaks in 1990–2015: A Systematic Review and Meta-Analysis

“…Among countries worldwide, the highest numbers of outbreak (58/262) are observed in India, followed by China (38/262) and Brazil (24/262) from 1990 to 2015. All the outbreaks occurred in tropical (77/262) and subtropical (174/262) regions, except for one outbreak, which occurred in Nîmes, 2015 (Succo et al, 2016), and was considered the first considerable dengue outbreak in mainland France (Figure 2). Among the six WHO regions, the largest number of outbreaks occurred in the Southeast Asia region (82/262), followed by the Western Pacific region (72/262) and the American region (65/262), accounting for more than 83.6% of outbreaks overall.…”

“…In contrast, only a few dengue outbreaks were reported in the Europe region, and these outbreaks involved in only two countries (France and Portugal). The disappearance of A. aegypti from the European Basin between the 1950s and 2005 might be one reason for its low-prevalence of dengue outbreaks (Succo et al, 2016). It is important to note that many dengue outbreaks were influenced by the dengue epidemics in nearby/neighboring countries.…”

Low sensitivity of the tourniquet test for differential diagnosis of dengue: an analysis of 28,000 trials in patients

“…The incidence is even higher in tropical and subtropical countries where environmental conditions favor the proliferation of the Aedes mosquitoes [2–5]. However, this disease is also advancing into developed countries, where the occurrence of dengue has not been previously registered, such as the United States of America [6–8], Japan [9–11], and France [12]. …”