title: A major outbreak of conjunctivitis caused by coxsackievirus A24, Réunion, January to April 2015.
abstract: From January to April 2015, Réunion experienced a major outbreak of acute haemorrhagic conjunctivitis (AHC) caused by coxsackievirus A24, which heavily impacted the healthcare system. According to the general practitioners' (GP) sentinel network, the number of medical consultations due to conjunctivitis during this period was estimated at ca 100,000. This report describes the characteristics of the outbreak, which were obtained through several different yet complementary surveillance systems on the island. These included the network of hospital emergency departments (OSCOUR network), the GPs' sentinel network, an Internet-based population cohort ('Koman i lé') participating in a survey on distinct symptoms including 'red eyes' and the monitoring of eye drop sales. Overall the results of the different surveillance approaches were in good agreement regarding the outbreak dynamic. A peak of patients with conjunctivitis was detected in the first 15 days of March (week 10 and 11), coinciding with increased eye drop sales on the island. Strains recovered from outbreak cases belonged to genotype IV and were most closely related to strains identified in AHC outbreaks in China, Egypt and Japan since 2010. Continued surveillance of AHC in Réunion remains important not only locally, but also because frequent exchanges between the island and mainland France may lead to introduction of this virus in Europe.
authors.affiliation: Santé publique France, French national public health agency, Regional unit (Cire océan Indien), Saint-Denis, Réunion, France.
authors.forename: Nadège
authors.initials: N
authors.lastname: Marguerite
authors.forename: Elise
authors.initials: E
authors.lastname: Brottet
authors.forename: Frédéric
authors.initials: F
authors.lastname: Pagès
authors.forename: Marie Christine
authors.initials: MC
authors.lastname: Jaffar-Bandjee
authors.forename: Isabelle
authors.initials: I
authors.lastname: Schuffenecker
authors.forename: Laurence
authors.initials: L
authors.lastname: Josset
authors.forename: Pascal
authors.initials: P
authors.lastname: Vilain
authors.forename: Laurent
authors.initials: L
authors.lastname: Filleul
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003232:Conjunctivitis, Acute Hemorrhagic / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology*; D003384:Coxsackievirus Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology*; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data*; D030015:Enterovirus C, Human / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D017508:Reunion / Q000453:epidemiology; D012307:Risk Factors; D018571:Sentinel Surveillance; D017678:Sex Distribution; D055815:Young Adult
keywords: conjunctivitis; coxsackievirus; outbreak; surveillance