Search

In April 2012, a cluster of two cases of meningococcal disease caused by rifampicin-resistant C meningococci was reported in the Champagne-Ardenne region, France. The two cases occurred in a student population living in the same town but studying at different schools. Bacteriological and epidemiological investigations of cases have shown that the isolates of both cases were non-differentiable.

From January to April 2012, 16 cases of W135 invasive meningococcal infection were reported in France. Of these, eight were linked to a recent travel history to Sub-Saharan Africa. These cases were reported in France concomitantly with the meningitis epidemic season in Sub-Saharan Africa. Considering the high number of travellers between France and West-African countries belonging to the so-called meningitis belt, the French recommendations for travellers stress the importance of vaccination before travelling to these countries.

Since the beginning of the outbreak in 2008 and through the national early warning system [3], the French Institute for Public Health Surveillance (InVS) received a total of 42 notifications of nosocomial transmission events (three in 2008, 10 in 2009 and 29 since January 2010). Among the notified events, 30 involved at least one HCW, and 44 of 61 cases (72%) were HCWs. Two of the three nosocomial transmission events in 2008 occurred in spite of a low prevalence of measles susceptibility in HCWs [4-7].

Between December 2008 and September 2009, 11 cases of invasive meningococcal disease (IMD) group B were reported in a 20 km diameter area in the Departement Landes, France. Two of them presented with purpura fulminans and one of them died. The strain responsible for this community outbreak was of the clonal complex ST-269.The incidence rate for IMD group B was 3 per 100,000 inhabitants in Landes from week 40 in 2008 to week 40 in 2009; it was the highest in France during that period. The number of cases observed was significantly higher than expected, especially in young adults (standardised incidence ratio: 23.5, p

Since early 2008, France has been experiencing a measles outbreak with almost 5,000 notified cases as of 30 June 2010, including three measles-related deaths. The proportion of cases 20 years or older reached 38% during the first half of 2010. This situation is the consequence of insufficient vaccine coverage (90% at age 24 months in 2007) that led to the accumulation of susceptibles over the last years. It underlines the need for additional measures targeting susceptible children and young adults.

To date, 110 cases of measles have been identified by local health authorities in the Bourgogne and Nord-Pas-de-Calais regions of France, with onset of symptoms between 3 May and 19 July. The first three cases were reported on 25 June by a general practitioner to the French national institute of health (Institut de Veille Sanitaire, InVS) regional office in Bourgogne, in the centre of France. The three unvaccinated cases were students at a private religious school for girls located in Bourgogne and had onset of rash between mid-May and 23 June. On the same day, another general practitioner in Nord-Pas-de-Calais reported a case of measles in an unvaccinated 14 year-old boy attending a private religious boarding school for boys. The boy had developed a rash on 19 June and happened to live in the same place in Bourgogne where the above-mentioned girls' school was located. The two schools have elementary to secondary students. Both are private religious boarding schools. Most of the students come from the surrounding areas, some resident pupils are from other French regions, and some from abroad. All students returned home on 26 June for summer holidays.

At the end of May 2003, the Marseilles Hospital Centre’s virology laboratory informed the French public heath institute of 5 cases of confirmed measles among young adults living in Marseilles. An investigation was conducted, consulting different community and hospital health services, to determine the virus circulation in the Provence-Alpes-Côte d’Azur (PACA) region by the southern interregional epidemiological cell. The investigation identified 259 cases: 183 clinical, 74 serologically confirmed and 2 epidemiologically linked cases. The first cases were identified during the first six months of 2003, with a peak in April. This outbreak of measles in the PACA region was favoured by poor vaccination coverage, which created groups of susceptible population. The real number of cases was probably higher than the number identified. This investigation has outlined the limitations of the measles surveillance system in France: the sentinel network had not detected any case for this period. France needs to reach the WHO objective of measles elimination by 2010 and the surveillance tools used must be those already used in the most countries that are furthest advanced in the elimination process. To reach this goal, the Direction Générale de la Santé has nominated a working group to be in charge of proposing a national plan to interrupt indigenous measles transmission in France.