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.
In Reunion Island, the population is very sensitive to public health concerns. In this context, the health authorities implemented since April 2014 a web-based surveillance system, called “Koman i lé” and based on a volunteers' cohort in general population. This surveillance system allowed to follow the seasonal influenza epidemic in 2014 and the major outbreak of conjunctivitis from January to April 2015. In conclusion, the sentinel population allows the population of Reunion Island to take an active part in the health regional policy. Information reported by individuals can increase traditional public health methods for more timely detection of disease outbreaks.
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