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HEALTH

How serious is the threat from dengue fever in France?

As tiger mosquitoes are now present in over 80 percent of mainland France, health authorities are worried that local transmission of tropical diseases, like dengue fever, will increase.

How serious is the threat from dengue fever in France?
An Asian tiger mosquito in 2021 (Photo by Manjunath Kiran / AFP)

As of January 2024, tiger mosquitoes – known for their ability to carry diseases such as dengue, chikungunya and Zika virus – had been detected in 78 of France’s 96 mainland départements, including the Paris region.

This has left public health authorities concerned about the spread of dengue fever in France, particularly this summer as large crowds are expected amid the Olympic Games.

READ MORE: MAP: Tiger mosquitoes reach northern France

How common is dengue fever in France?

In the first four months of 2024, 1,679 cases of dengue fever were identified in mainland France, a number that is 13 times higher than the same period last year, Le Parisien reported.

Crucially, however, none of these are believed to have been contracted in mainland France – they were all reported among patients who had recently travelled from the tropical regions where dengue fever is common.

The majority of cases were from people who had visited the Caribbean islands of Martinique and Guadeloupe – where the disease is endemic.

These islands are for administrative purposes part of France – so often show up in French health data – but they are roughly 7,000km away from Paris.

So far, there have not been any indigenous cases (autochtone – or people infected on mainland French soil) yet this year.

Local transmission of the disease remains relatively rare. In 2023, nine separate outbreaks of indigenous dengue transmission were identified, one of which occurred in the Paris region. These led to 45 cases of local transmission (in mainland France).

Most were in southern France – in the Provence-Alpes-Côte d’Azur, Occitanie and Auvergne-Rhône-Alpes regions – though one outbreak occurred in the Paris region, according to French public health authorities.

This is less than 2022, which was a notable year with 66 total cases of indigenous dengue fever were recorded. In comparison, between 2010 and 2021, only 48 cases (total) were recorded.

What to expect for 2024

Experts believe that the number of cases in France, including indigenous ones, will grow this year, as tiger mosquitoes now occupy more territory in mainland France.

On top of that, the number of cases has increased significantly in Martinique and Guadeloupe.

“What we see in France is a mirror image of what is happening in the French Caribbean, and more widely in Latin America and the rest of the Caribbean, where dengue fever has been circulating since the start of the year at unprecedented levels”, the head of Santé Publique France, Dr Caroline Semaille, said during a press conference.

The Olympic Games will also bring an influx of tourists from all over the world, and weather conditions are expected to be conducive to mosquitoes – a year with a lot of rainfall, and potentially high temperatures. 

What is dengue fever?

The disease is spread to people from bites by infected mosquitoes.

The most common symptoms are high fever, chills, abdominal, joint and muscle pains, and vomiting. It can also cause a skin rash that resembles measles, according to France’s Institut Pasteur.

Symptoms usually begin three to 14 days (with an average of four to seven) after being bitten.

However people are asymptomatic in 50 to 90 percent of cases (depending on the epidemic), which can make monitoring difficult.

At-risk groups include the immunocompromised, children and the elderly, who are more likely to suffer from severe forms of the disease.

Deaths from the disease are very rare, occurring in around 0.01 percent of all cases, almost all in countries that have poor healthcare systems.

How can I avoid tiger mosquitoes?

Female tiger mosquitoes lay their eggs in water, and they can lay several hundred eggs at once. Therefore try to avoid having any standing water outside your home and be aware of the items that might collect rainwater.

This includes regularly emptying vases, flower pots, as well as watering cans and pots. If you want to collect rainwater, you could cover water butts with mosquito nets or fabric to keep the mosquitoes from getting inside.

READ ALSO 5 plants that (allegedly) repel mosquitoes

You can also keep your gutters clean – this helps to keep the water flowing when it rains, and it avoids any stagnant pools from building up.

To protect yourself, try to wear long, loose and light-coloured clothing, in addition to insect repellent. You might also consider wearing a mosquito net head gear.

The main difference between tiger mosquitoes and other species would be getting a bite during the day, and the fact that tiger mosquitoes are likely to bite several times. You can tell for sure if it was a tiger mosquito by seeing the insect itself. They are also silent.

There is no immediate cause for alarm if you are bitten, in almost all cases the bites are just itchy and annoying. In very rare cases, tropical diseases can be spread by the mosquitoes – seek medical help if you develop a high fever and rash.

READ MORE: How to prevent the spread of tiger mosquitoes in France

What do tiger mosquitoes look like?

They are very small, about 5 mm, and they have a highly contrasting colour, with black and white stripes on their body and legs.

If you believe you have spotted a tiger mosquito, you can report it to public health authorities online.

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HEALTH

Do I need a prescription to get antibiotics in France?

A new law means that a prescription is not always required if you need antibiotics in France.

Do I need a prescription to get antibiotics in France?

In most cases, people in France requiring antibiotics will need a prescription (ordonnance) from a doctor.

However, there are two exceptions, according to a new decree published in France’s Journal Officiel on Tuesday.

The updated law allows French pharmacists to dispense antibiotics without a doctor’s prescription for two common infections; cystitis (UTIs) and tonsillitis/strep throat (angines in French), which can both be confirmed by a test at the pharmacy.

If you suspect you have either of these infections, you can go to the pharmacy to get a test, known as a Test Rapide d’Orientation Diagnostique or TROD.

If the test is positive, the pharmacist will be able to prescribe antibiotics without you having to visit a doctor. You can visit the pharmacy on a walk-in basis, with no need for an appointment, and at least one qualified pharmacist should be on the premises at all times.

The move comes after a relaxation on the rules around vaccines allowing pharmacists to give eight common vaccines without a doctor’s prescription – in addition to the Covid and seasonal flu vaccines which can already be accessed at a pharmacy without prescription. 

Pharmacists in France receive a minimum of six years of training and can offer medical advice for a range of conditions, as well as dispensing medication. 

READ MORE: More than prescriptions: 11 things you can do at a French pharmacy

What about prescriptions?

For all other types of conditions requiring antibiotics, a prescription will still be required.

In France, only doctors (both general practitioners and specialists), dental surgeons (chirurgiens-dentistes) and midwives (sages-femmes) are authorised to prescribe medicines.

As such, you would need an appointment with one of these professionals to get a prescription.

What if I’m just visiting France?

French residents would normally go to their registered doctor if they fall ill, but people who are either just visiting France or who are not registered in the French health system can access doctors too.

If you do have the carte vitale – the card confirming that you are registered in the French health system – you can still book an appointment with a doctor, although you won’t be entitled to any state reimbursement. You would have to either pay the costs yourself (€26 for a standard GP appointment, plus the cost of the prescription) or claim on your health or travel insurance if you have it.

Booking a GP appointment can be as simple as phoning a local doctor or using an online service such as Doctolib. You may also call up SOS Médecins if you want a home visit, but this costs more than a usual visit.

READ MORE: How to make a doctor’s appointment in France

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