Aedes albopictus (also known as the tiger mosquito), the mosquito that transmits chikungunya, is established in several French territories. In metropolitan France, it has been gradually spreading since 2004.

Santé publique France’s efforts focus on two main areas: surveillance and prevention.

Epidemiological Surveillance of Chikungunya

The epidemiological surveillance system for chikungunya is tailored to the various epidemiological situations and vector risks in metropolitan France and the overseas departments. It is part of the measures to combat arboviral diseases.

In mainland France, surveillance of chikungunya and dengue is governed by Directive No. DGS/VSS1/2019/258 of December 12, 2019, on the prevention of arboviral diseases.

This surveillance is based on:

• The mandatory reporting of all biologically confirmed cases

Any case of chikungunya—whether imported or autochthonous—that is biologically confirmed must be immediately reported to the ARS surveillance and alert unit by any appropriate means (phone, fax, email) and then documented using the mandatory reporting form.

Reporting criteria:
Fever > 38.5 °C with sudden onset AND
debilitating joint pain AND
at least one of the following laboratory criteria: positive PCR OR positive IgM OR seroconversion OR a fourfold increase in IgG levels between two samples taken at different times

• This surveillance is stepped up each year from May 1 to November 30, the expected activity period for Aedes albopictus in the departments where the vector is present. The objective is to enable rapid intervention by the services responsible for all measures aimed at controlling and protecting against vectors of human pathogens (mosquitoes, lice, etc.) and monitoring them." data-tooltip-title="all measures intended to combat and protect against vectors of human pathogens (mosquitoes, lice, etc.) and to monitor them." data-tooltip-content="" data-tooltip-placeholder-is-selection="true" data-tooltip-placeholder-is-selection-text="vector control" data-tooltip-data="[{"tooltipTitle":"all measures intended for à the%control and à protection against vectors of pathogens affecting humans (mosquitoes, lice‖) and their monitoring.’human pathogens (mosquitoes, lice…) and their monitoring.","tooltipContent":"","placeholderIsSelection":"true","placeholderIsSelectionText":"vector control"}]">vector control (LAV) around potentially viremic cases in areas where the Aedes albopictus mosquito is present, in order to prevent a local transmission cycle. The goal is to ensure the early detection of all cases.
• In practice, doctors and laboratories are made aware at the start of the season of the risk of arbovirus transmission and the need to report cases immediately. The reporting of a case of chikungunya (or dengue or Zika) triggers an epidemiological and entomological investigation. In addition, an automated system for transferring results from the Eurofins Biomnis, Cerba, Inovie, and Biogroup laboratories makes it possible to “catch up” on cases that might not have been reported.

The detection of a biologically confirmed locally acquired case triggers an alert that prompts immediate action by the Regional Health Agency (ARS) and mosquito control operators. Santé publique France and the General Directorate of Health (DGS) are notified without delay. A specific epidemiological investigation is conducted, along with an entomological investigation and appropriate vector control measures. These are accompanied by communications to healthcare professionals, the public, travelers, and the relevant local authorities.

Case definition:

• suspected case of chikungunya: a case presenting with a sudden onset of fever > 38.5°C and at least one of the following symptoms: headache, joint pain, muscle pain, lower back pain, or retroorbital pain, with no other identifiable source of infection;
• Probable case of chikungunya: a suspected case AND positive IgM
• Confirmed case of chikungunya: a suspected case AND RT-PCR OR seroconversion OR a fourfold increase in IgG levels between two samples taken at different time points
• Imported case of chikungunya: a case in which the individual has stayed in an area where the virus is known to circulate within 15 days prior to the onset of symptoms.

Measures to Prevent Chikungunya

As part of its prevention efforts, Santé publique France:

• Studies preventive behaviors regarding arboviral diseases in mainland France to identify areas for action that can improve vector control (published in the BEH in July 2018; see the “Publications” tab).
• Provides healthcare professionals and local authorities with brochures on the prevention of dengue and chikungunya in mainland France.
• Provides the general public with informational brochures and posters to promote chikungunya prevention.
• In the event of an indigenous outbreak in mainland France, Santé publique France may also distribute emergency prevention tools. These documents are available in the “Tools” tab.