Adverse events reported during vector control campaigns using deltamethrin or Bti (Bacillus thuringiensis israelensis), France, 2006–2013. December 2013
Background: Dengue and chikungunya viruses (arboviruses) are transmitted from person to person by mosquitoes of the genus Aedes. Present in France’s overseas departments, they have recently become established in several departments in southern France [1, 2]. The Vector Control Plan (LAV) relies on the use of two insecticides: an adulticide, deltamethrin, and a larvicide, Bacillus thuringiensis israelensis (Bti). ANSES referred the matter to the Toxicovigilance Coordination Committee to identify cases reported by the CAPTVs and the InVS, as well as those reported by the Indian Ocean Regional Health Surveillance Unit (Cire OI) during the 2006 chikungunya epidemic. Materials and Methods: This study draws on two data sources from January 1, 2006, to June 30, 2013: exposure cases recorded in the National Poisoning Case Database (BNCI) of the CAPTVs’ Joint Information System and cases collected by Cire Indian Ocean. Results: Various queries conducted in the BNCI identified 10 human exposure clusters: 6 involving deltamethrin, 2 involving Bti, 1 involving a combination of deltamethrin and Bti, and one cluster involving an unidentified insecticide. In 2 of these incidents, exposure was collective (about 40 exposed individuals in one and 5 in the other), occurring in a collective setting (daycare center) in one case and in a private setting in the second. Symptoms were present in 6 incidents. Most of these exposures occurred outside mainland France (7/10). Those exposed were adults in 7 of the 8 individual cases. In the two group cases, both children and adults were exposed. The circumstances of exposure were occupational in 3 cases, due to environmental contamination in 6 cases, and related to a domestic accident involving an 18-month-old child. Patients exposed to Bti were all asymptomatic. Patients exposed to deltamethrin were symptomatic in 5 out of 7 cases and, for the most part, presented with minor irritative symptoms. Over the entire period, the Indian Ocean Regional Center reported approximately 30 individual cases resulting in irritative effects, and one case involving an asthma attack; the patients had not taken protective measures due to a lack of awareness of the treatment dates. Between February 13 and March 18, 2006, 19 group cases were recorded in schools. A complaint of an odor was mentioned twelve times; it was isolated in 9 out of 19 cases. The reported clinical signs were mainly irritative. The causes were varied (3 treatments near the school, 2 treatments on the same day, 7 cases of drafty windows, 6 meteorological explanations (wind)). Discussion: In Réunion, as in mainland France, cases are rare and no severe cases have been reported. Individual cases occur when the public has not received sufficient information and has not implemented the recommended preventive measures. Occupational exposures occur mainly when protective equipment is not properly used. At the CAPTV level, it appears necessary to systematically implement a specific "LAV" computer code to facilitate the subsequent identification of cases in the BNCI.
Author(s): Chataignier D, Pulce C, Solet JL
Publishing year: 2013
Pages: 25 p.
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