Public Health Surveillance in the Midi-Pyrénées Region. Epidemiological Update as of July 30, 2015.

Update on Enterovirus Infections: Enteroviruses are found worldwide and circulate year-round in tropical regions. In temperate zones such as mainland France, they circulate in winter and spring, but every year during summer and fall there is an increase in diagnosed enterovirus infections, primarily linked to a surge in meningitis cases.They primarily affect children under the age of 15. The virus is transmitted through person-to-person contact via viruses excreted in feces and in the nasopharynx. Other modes of transmission are also possible (saliva, contact with skin lesions, mother-to-fetus). These infections are generally benign, with a significant number of cases remaining asymptomatic. When the infection is symptomatic, the most frequently reported and diagnosed manifestations are cerebrospinal, primarily consisting of meningitis requiring only symptomatic treatment and progressing rapidly toward recovery without sequelae.In France, surveillance of enterovirus infections has been conducted by a network of volunteer laboratories since 2000 (Enterovirus Surveillance Network, RSE, coordinated by the CNR and the InVS). Activity data regarding enterovirus diagnoses are collected monthly. In addition, surveillance of emergency department visits for a diagnosis of enterovirus meningitis is conducted by the Oscour/InVS network. As of mid-July, a resurgence in enterovirus circulation has been observed in France, which has intensified since June, accompanied by an increase in meningitis cases. Preliminary data show a predominance of coxsackievirus B and echovirus types 6 and 9. A definitive diagnosis of enterovirus meningitis through detection of the viral genome in cerebrospinal fluid (CSF) helps avoid "routine" antibiotic therapy and unnecessary additional tests. However, it is imperative to reinforce household and/or community hygiene practices (particularly handwashing) among those in close contact with patients, immunocompromised individuals, and pregnant women in order to limit virus transmission.

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