Chikungunya Outbreak Overwhelms Reunion’s Healthcare System

Reunion Island is grappling with a severe chikungunya outbreak, with over 4,000 new cases reported in a single week. The surge in infections has placed immense strain on the healthcare infrastructure, leading to a notable increase in hospitalizations. The situation is notably dire for newborns, with several infants requiring intensive care.

Newborns Bear the Brunt of the Epidemic

Among those hospitalized, seven newborns are in critical condition, highlighting the vulnerability of infants to the virus. The severity of their condition underscores the urgent need for enhanced preventative measures and specialized care.

Dr. Brahim Boumahni, a pediatrician at the southern CHU of Reunion, described the infants’ suffering: These children are vrey bad, as soon as they are touched, they cry, they suffer from pain in the muscles and joints.

They cannot eat easily. We were forced to put them under morphine. After two to three days, we notice that they start suckling again. Their state is improving.

Dr Brahim Boumahni, pediatrician at the southern CHU

Maternal Transmission: A Critical Risk Factor

Health officials are particularly concerned about perinatal transmission, where the virus is passed from mother to child during childbirth. Public health France reports that Two perinatal transmissions have been reported in a severe clinical picture requiring intensive care. This form of transmission poses a significant threat to newborns, frequently enough resulting in severe complications.

Dr. Boumahni explained, A baby was born when the mother had chikungunya, she had caught it just before childbirth.At the time of childbirth, the virus transmitted from mother to child… and onc in two, the child has a serious attack and is forced to be hospitalized. he further noted that other infants contracted the virus shortly after birth, often upon returning home.

Long-Term Neurological Risks for Infected Infants

Research indicates that newborns infected with chikungunya at birth face an elevated risk of psychomotor delays later in life. A 2005 INSERM study conducted in Reunion highlighted the potential for long-term neurological sequelae in these cases.

Dr. Xavier Fritel, coordinator of the study, stated in 2014: An infection that is declared in the mother at the time of birth takes a risk of transmission and neurological sequelae for the newborn.

Previous work on our team have shown that infection during pregnancy is blunt and without consequences for the mother and the child. But an infection at the time of childbirth is critical for the child.

Dr Xavier fritel, coordinator of a study on chikungunya

Researchers from Inserm summarized that while the chikungunya virus typically doesn’t cross the placental barrier during pregnancy, the exchanges during childbirth create an prospect for transmission in approximately 50% of cases. They added, Though, in the newborn, the virus leads to a risk of encephalopathy due to the permeability of the tissues and the immaturity of the immune system.

Island-Wide Spread and Evolving Diagnostic Protocols

Since August 2024, Reunion has recorded 13,594 chikungunya cases, resulting in two fatalities among elderly individuals with pre-existing conditions. The epidemic has spread across the island, prompting adjustments to diagnostic procedures. To alleviate pressure on medical laboratories, systematic blood tests are no longer mandatory for all patients, particularly in areas with widespread circulation. Priority is now given to the most severe cases.

Public Health Recommendations

Authorities are urging residents to adopt effective prevention strategies, including eliminating standing water around homes, using mosquito repellent, and seeking medical attention at the first sign of symptoms. These measures are crucial in curbing the spread of the virus and protecting vulnerable populations.