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摘要
In September 2010, two cases of autochthonous dengue fever were diagnosed in metropolitan France for the first time. The cases occurring in Nice, southeast France, where Aedes albopictus is established, are evidence of dengue virus circulation in this area. This local transmission of dengue calls for further enhanced surveillance, active case finding and vector control measures to reduce the spread of the virus and the risk of an epidemic. Dengue fever is the most important mosquito-borne viral disease in the world and is endemic in Africa, Asia, Caribbean and Latin America. According to the World Health Organization, there are annually more than 50 million cases and 22,000 deaths [1]. Dengue fever is caused by viruses of the Flaviviridae family and transmitted by mosquito vectors of the Aedes genus, mainly Ae. aegypti and Ae. albopictus [2]. In Europe, the last dengue epidemic was reported from 1927 to 1928 in Greece with high mortality and Ae. aegypti was implicated as the vector [3]. Since the 1970s, mainly through global trade of car tyres, Ae. albopictus has become increasingly established in European Union Member States, including France, Greece, Italy, the Netherlands (though only in greenhouses), Slovenia and Spain [4]. This mosquito species is also established in neighbouring countries such as Albania, Bosnia and Herzegovina, Croatia, Monaco, Montenegro, San Marino, Switzerland and Vatican City [2,5]. Imported cases of dengue fever in travellers returning from countries where dengue is endemic or where dengue epidemics are taking place have been frequently reported in European countries in recent years [6-10]. In metropolitan France, sporadic Ae. albopictus mosquitoes were first detected in Normandy in 1999 [11], but the mosquito is known to have been established since 2004 in south-east France [12]. Since 2006, and the widespread epidemic of chikungunya in Reunion which had posed an increased risk of importation of cases, enhanced surveillance is implemented each year from May to November in the departments where Ae. albopictus is established, as part of the national plan against the spread of chikungunya and dengue viruses in metropolitan France [13]. Enhanced surveillance, compared with routine surveillance, allows the reporting and confirmation of suspected cases to be accelerated. The laboratory network surveillance system, the most sensitive routine system in France, detected around 350-400 imported dengue cases per year between 2006 and 2009 in metropolitan France [14,15]. During the same four-year period, enhanced surveillance reported a total of 33 imported dengue cases (including 11 cases in 2009). Between 1 May and 17 September 2010 (i.e. the first 4.5 months of surveillance), 120 imported cases of dengue have been reported by the enhanced surveillance system [16], which represents an 11-fold increase when compared with the entire 2009 season. This increase in imported cases is mostly related to the ongoing epidemics in the French West Indies, Martinique and Guadeloupe, since the beginning of 2010. Here we report on the two first cases of autochthonous dengue virus infection ever diagnosed in metropolitan France and the public health measures subsequently implemented.
- 出版日期2010-9-30
