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In January 2005, an epidemic of chikungunya fever broke out in the Comoro Islands and lasted until May 2005. In April, cases were also reported in Mayotte and Mauritius. On Réunion Island, the first cases were reported at the end of April. Surveillance of this epidemic required an adaptive system, which at first was based on active and retrospective case detection around the cases reported, then relied on a sentinel network when the incidence increased. Emerging and severe forms of infection were investigated. Death certificates were monitored. By April 2006, the surveillance estimate was 244,000 cases of chikungunya virus infection, including 123 severe cases and 41 of maternoneonatal transmission, with an overall attack rate of 35%. Chikungunya infection was mentioned on 203 death certificates and significant mortality was observed. This epidemic highlighted the need for a mutual strategy of providing information on arboviral diseases and their prevention and control between countries in the southwestern Indian Ocean.
Received August 2, 2006. Accepted for publication April 16, 2007.
Acknowledgments: We thank the sentinel physicians, biologists, hospital physicians, and healthcare professionals for caring for their patients and participating in the surveillance system by reporting cases; Hervé Zeller, Isabelle Schuffenecker, and the National Center for Arboviruses for biologic expertise; the vector control teams for vector control efforts and active case-finding in the field; and the Institut de Veille Sanitaire, especially Brigitte Helynck, Florence Kermarec, and Christophe Paquet, for sustained assistance and support on site; and Assimoula Economopoulo, Morgane Dominguez, and Charlotte Renaudat for their intensive work on cases with severe disease. We also thank Intute Publishers (Oxford, United Kingdom) for permission to use Figure 1.
* Address correspondence to Philippe Renault, Cire Réunion-Mayotte, BP 50, 97408 Saint-Denis Cedex 9, Réunion, France. E-mail: philippe.renault{at}sante.gouv.fr
Authors addresses: Philippe Renault, Jean-Louis Solet, Daouda Sissoko, Elsa Balleydier, and Vincent Pierre, Cire Réunion-Mayotte, BP 50, 97408 Saint-Denis Cedex 9, France. Sophie Larrieu and Laurent Filleul, Cire Aquitaine, Espace Rodesse, 103 bis Rue Belleville, BP 952, 33063 Bordeaux Cedex, France. Christian Lassalle and Julien Thiria, Regional Health and Welfare Office de la Réunion, BP 50, 97408 Saint-Denis Cedex 9, France. Emmanuelle Rachou, Observatoire Régional de la Santé de la Réunion, 12 Rue Colbert, 97400 Saint-Denis, France. Henriette de Valk, Daniele Ilef, Martine Ledrans, and Isabelle Quatresous, Institut de Veille Sanitaire, 12 Rue du Val dOsne, 94441 Saint-Maurice Cedex, France. Philippe Quenel, Cire Antilles-Guyane, Centre dAffaires Agora, ZAC de lEtang ZAbricot, Pointe des Grives, BP 658, 97261 Fort-de-France Cedex, France.
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