In Makondé, chikungunya means “one who walks with his back bent forward”. Transmitted to humans by the bite of Aedes albopictus and Aedes aegypti mosquitoes, this disease causes sometimes disabling symptoms. To combat this vector-borne disease, the Valvena France group has announced the start of the marketing of the IXCHIQ vaccine in French pharmacies. It is a live attenuated vaccine, made up of a modified virus, in order to lose its infectious power, to induce protection against disease in the vaccinated person.
In Mayotte, 80% of the population is not immune
When questioned, epidemiologists from Public Health France-Mayotte welcomed the arrival of the IXCHIQ vaccine against the chikungunya virus as “a major advance in public health”. Although no cases have been reported since the last epidemic in 2006, Public Health France prefers prevention to cure: “The island remains vulnerable. This situation is explained by the presence of mosquito vectors such as Aedes albopictus and its proximity to areas where the virus is circulating, such as Reunion Island. The risk of importation to Mayotte is currently low but could increase with the flow of travelers during school holidays and if the circulation of the virus increases in Reunion. » In the Mahorais territory, epidemiologists estimate that nearly 80% of the population is not immune.
75% of infected people have persistent symptoms
Although it is rarely fatal, chikungunya leaves its targets little respite. Its symptoms are generally characterized by high fever and severe joint pain. The wrists, fingers, ankles, feet, knees, sometimes the hips and shoulders can be affected, sometimes significantly disabling the patient. Severe forms are generally neurological and meningoencephalitis. Some patients may be symptomatic for several weeks, months or even years. According to the World Health Organization, the chronicity of these symptoms (more or less long) affects nearly 43% of symptomatic people, or 75% of people infected with the disease.
Health establishments cannot yet obtain them
Last July, European marketing authorization was issued for the IXCHIQ vaccine. It was approved in 2023 in the United States and Canada earlier this year. But at this stage, this new vaccine is not on the list approved for use in communities. Health establishments therefore do not yet have authorization to purchase it. “We don’t have it yet and we don’t even have the possibility of ordering it, as health establishments cannot yet buy it, I think it will take a few weeks,” reports a pharmacist at the pharmacy. of the Center. If the application for approval is in progress, the Mahorese pharmacies are ready. However, the vaccine will not be reimbursed by Health Insurance and can only be delivered on medical prescription.
ANSES considers the risk of an epidemic in mainland France “high”
Although chikungunya is a tropical disease, it is spreading on all continents of the world. Mainland France but especially the overseas departments are at risk of experiencing future epidemics. The National Agency for Food, Environmental and Occupational Health Safety (ANSES) estimates that the probability of an epidemic of dengue, zika or chikungunya occurring in the next five years in mainland France is relatively “high”. “. Currently, Reunion Island is experiencing an increase in cases of chikungunya. During the week of November 11 to 17, 2024, Public Health France recorded four new cases of chikungunya on the island of volcanoes, bringing to twenty the total number of cases recorded since August 23, enough to awaken bad memories of a previous epidemic.
A single dose vaccine
In a clinical study, the effectiveness of the vaccine was demonstrated. Published in the scientific journal The Lancet, the results show that 98.9% of participants aged 18 and over had virus-neutralizing antibodies 28 days after vaccination and 96.3% of them still presented these antibodies 6 months after vaccination. Recommended only for adults and contraindicated for immunocompromised people, the IXCHIQ vaccine could be a new tool in the fight against this disease, associated with the application of vector control measures. Public Health France judges that “its use could protect the most vulnerable populations, reduce pressure on the health system and limit the probability of a large-scale epidemic. » To date, the High Health Authority has not issued an opinion on the vaccination strategy to be implemented.
It remains to be seen whether vaccination of the adult population of Mayotte would be relevant and how it could be vaccinated, given that one in two inhabitants is under 18 years old and 30% of the island’s inhabitants are not insured. social security. “Approximately 44% of the population of Mayotte is under the age of 15, which means that approximately 80% of the total population is not immune to chikungunya, making the island vulnerable to a new epidemic in the event of reintroduction of the virus. »
Mathilde Hangard
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