A mosquito-borne disease on France's far-flung island of La Réunion, which has infected one in seven residents, may be responsible for the deaths of dozens of people, the French Health Minister said.
Xavier Bertrand said 77 deaths in January were "directly or indirectly attributable" to the chikungunya virus on the small island in the western Indian Ocean. This was "a radically new situation, which was not expected, as scientific research showed that chikungunya did not kill."
France is now having to deal with two separate health crises following confirmation that the virulent strain of bird flu, H5N1, has spread to the mainland.
The Prime Minister, Dominique de Villepin, who spent much of Wednesday eating chicken in order to show that home-produced poultry was still safe, will make a special visit to La Réunion this weekend. Many observers believe the government is reacting too late.
The virus takes its name from a Swahili word meaning stooped walk, one of the side effects. Chikungunya is spread by mosquitoes and was first identified in Tanzania in 1952. The symptoms are a high fever, dehydration and severe rashes which can persist for several weeks. The disease also weakens the body's immune system. No cure or vaccine has been developed.
According to the World Health Organisation (WHO), in addition to 1,772 cases of chikungunya on La Réunion, the virus has also been reported on the nearby island of Mauritius, with 206 cases, and in the Seychelles, 1,700km (1,050 miles) to the north, where 1,255 cases have been logged.
M. Bertrand has come under attack from opposition Socialists and doctors for not having ordered simple preventive steps at the right time. "The first cases date from March 2005," said Christophe Desagneaux, a doctor in the town of Saint-André on La Réunion. "Drass [the regional department of health and social affairs] asked GPs at the end of December to account for the number of cases by using a system of tables. But we were already too overworked to do this. As a result, the statistics were widely underestimated from the beginning."
For the inhabitants of La Réunion, which is also a popular destination for European tourists, the virus has become part of everyday life. It is estimated that 110,000 people have been infected there since March last year, or one in seven of the population. Doctors say the actual number of affected people may be higher.
France has ordered an extra 400 military personnel to the island and mosquito breeding grounds have been sprayed. One in 10 workers is now off sick, and tourist bookings have collapsed. Residents are being told to remove stagnant water, use mosquito repellents and bed nets, and spray bedrooms at night. M. de Villepin said the entire island should get rid of mosquitoes to stop the disease from spreading.
The WHO is sending a team to help French authorities set up a regional surveillance system. However, the WHO appeared to cast doubt on the extent to which the deaths in La Réunion can be attributed to chikungunya. On its website, the WHO says "chikungunya is rarely fatal," and WHO scientists pointed out that the symptoms were similar to those of dengue fever.
A WHO spokeswoman rejected any comparison with the H5N1 bird flu virus which has killed more than 90 people who had been in close contact with birds. "Chikungunya is not transmissible vertically," said the spokeswoman. "You catch it from a mosquito bite. You will not infect your husband or your children."
Specialists on La Réunion are less categorical. They point to cases where mothers have passed it on to children. An entomologist, Jean-Sébastien Dehecq, told Le Monde newspaper that the symptoms had continued to change. He said doctors "have found symptoms in the past few weeks that have never been described anywhere else".
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