Dans ce blog, nous parlerons de l'épidémie de chikungunya à La Réunion, de la gestion de cette crise, de l'utilisation des répulsifs et de la coopération médicale entre la France et les Comores

13.4.06

Bulletin quotidien chik- Comptage exhaustif des nouveaux cas

Quelle bonne idée de faire un bulletin de situation quotidien. Les chiffres sont plutôt rassurants à la Réunion pour la journée du 12.04.2006.

Le site chikungunya.net publie ces bulletins dans la partie " presse" : http://chikungunya.net/presse/pressecadre.htm

Une carte météo des nouveaux cas de chik quotidien avait été demandé il y a 3 semaines devant le "groupe pluridisciplinaire chik" qui réunit tout les 15 jours des réprésentant du CRR,de la DRASS, du CG , du CDOM,de l'association des maires , des associations et quelques citoyens.

Le préfet avait répondu par voix de presse , il y a une semaine que cela était difficile techniquement.

Quitte à voir augmenter artificiellement le nombre des malades ( déclarés), une bonne promotion du n° vert de la DRASS ( 0800 110 000) pour déclarer rapidement les nouveaux cas de chik et les localiserserait importante. Cela permettrait de mieux prévenir l'extention de la maladies et distribuer une aide ciblée ( notamment celle récoltée par les associations de métropole).

Un décret devrait être bientôt signé, classant le chikungnuya dans la liste des maladies à déclaration obligatoire. Tous les médecins généralistes, pédiatres et hospitaliers devront bientôt déclarer TOUS les nouveaux cas de chik, comme préconisé par la CIRE-INVS ( épidémio) pour la Réunion ( l'application de ce décret en métropole fait débat) . Ces données , recoupées avec le N° vert, donneraient des chiffres précis pour le bulletin quotidien évoqué si dessus.

Concernant une idée largement répandu, le comptage des cas hebdomadaires et cumulés ( souvent interprétés à tord comme le nombre de malades totaux) n'est pas seulement fait d'après le N° Vert et les déclarations des médecins. Un réseau de médecins sentinelles, les appels au 15, l'activité des hopitaux et des calculs mathématiques sont pris en compte. Plus que le nombre réel , c'est l'évolution des chiffres qui importe. C'est pour cela que les méthodes de recueils et de calculs n'ont pas été modifiées au cours de l'épidémie.

Les différentes études tombent à peu près sur le même résultat, 30 % des réunionnais ont déjà eu le chik. Ce chiffre est très variable entre les hauts et les bas et d'un quartier à l'autre . Dans certaines résidences de l'Est (région la plus pluvieuse) ou les jardins sont petits et les moustiques sont partagés avec les voisins, ce % ( ou taux d'attaque) dépasserait les 75 %. Ces quartiers ont le moins à craindre d'une reprise de l'épidémie.

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A défaut d'enquête rétrospective organisée à grande échelle en médecine générale, l'enquête SIRIUS citoyenne ( INSERM- CHIKUNGUNYA.NET) mérite être promu. Les secrétaires médicales pourraient être de bonnes enquêteuses.!

L'analyse de milliers de questionnaires permettra d'avoir une idée plus précise de la maladie chikungunya: formes atypiques, formes asymptomatiques, durée de la fièvre, durée des douleurs initiales invalidantes, % des patients qui ont une polyarthrite, temps moyens entre les rechutes...

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