The Regional Health Agency (ARS) has implemented “reinforced surveillance”. In Mayotte, concern about a cholera epidemic is growing after the detection of the first three indigenous cases, a woman, a man and an infant, identified Friday April 26 on the archipelago, in the commune of Koungou.
Ten imported cases had already been recorded in Mayotte since mid-March among people arriving from neighboring Comoros, where the epidemic has been flaring since the start of the year, with more than 2,500 cases and around sixty deaths. The Comoros epidemic itself was imported from the African continent, notably Tanzania and the Democratic Republic of Congo where the majority of asylum seekers come from.
If there is no epidemic nature at the moment, according to the director general of the ARS, measures to identify contacts and put them on antibiotics have been put in place, in addition to the organization vaccination of residents of the area concerned. A screening center will also be opened on site, and this Saturday, April 27, 20 doctors and nurses were to arrive as reinforcements in Mayotte.
What is cholera? What symptoms?
Cholera is an acute form of diarrhea that can kill within hours. But according to the Pasteur Institute, “less than 25% of infected people develop symptoms”. If symptoms occur, diarrhea and vomiting may appear between 12 hours and five days after infection. Water and electrolyte losses can reach 15 liters per day. But, according to the Institute, 10 to 20% of infected people develop severe illness from the start.
If cholera is not treated immediately, death can occur within 1 to 3 days, due to cardiovascular collapse in 25 to 50% of cases, making it one of the most rapidly fatal infectious diseases. Children, the elderly and frail individuals are those most at risk of dying.
Bronchiolitis: the infant immunization campaign is a success
The winter of 2022-2023 was marked by a particularly intense epidemic of bronchiolitis due to respiratory syncytial virus (RSV), leading to numerous visits to the emergency room and hospitalizations of newborns. As a reminder, RSV is a major cause of hospitalizations and deaths among infants worldwide. Faced with this situation, French health authorities have launched a preventive immunization campaign for all infants from September 15, 2023 and throughout the winter. France was thus one of the first countries to administer nirsevimab, a treatment based on a long-acting monoclonal antibody administered in a single dose (Beyfortus®), with the aim of preventing lower respiratory tract infections caused by RSV. However, the real-life effectiveness of nirsevimab (i.e. excluding experimental studies), as well as the number of hospitalizations avoided, remained unknown.
How is the disease transmitted?
The disease develops via a very mobile bacteria, the cholera vibrio, which is transmitted mainly between humans. It results from the absorption of water through the mouth or contaminated food. Contaminated stools largely play a role in the spread of bacilli in the environment. The relatively long incubation period and the number of asymptomatic people can facilitate contamination. High population concentrations and poor sanitation also encourage the spread of the bacteria.
