how is vaccination organized to try to stem the epidemic?

More than 4,000 contact cases have been vaccinated in the archipelago. Nearly 100 cases of cholera have been recorded since mid-March.

Unsanitary water, precarious habitats… French health authorities are carefully monitoring the evolution of the cholera epidemic which is striking the commune of Koungou (Mayotte) and which caused the death of a 3-year-old girl. According to a press release from the Regional Health Agency (ARS) published Tuesday May 21, 94 people have been affected since the start of the epidemic in mid-March.

The vast majority of cases recorded live in the precarious neighborhood of Kirson, faced with difficulties in accessing drinking water and poor sanitation, the main risks of spreading this very contagious disease, which can quickly be fatal in its the most severe forms.

To stem the epidemic, the health authorities called on 86 volunteers from the Health Reserve, mobilized in “reinforcements” since mid-April, including 54 specifically assigned to the fight against cholera, according to Public Health France.

They have also put in place a health protocol which provides for the disinfection of the patient’s home, the identification and treatment of contact cases and vaccination. “in rings”, expanded depending on the epidemic spread. For the moment, vaccination is limited to the communes of Koungou (where, as of May 13, 4,456 contact cases had been vaccinated) and M’Tsangamouji, at the other end of the island, where an outbreak has been identified .

This vaccination strategy is considered insufficient by Liot MP from Mayotte, Estelle Youssouffa. “There are not enough vaccines to protect the population, the government refuses to distribute bottled water to limit the spread of the disease”, writes the chosen one on. “Under these conditions, it is imperative to immediately close the borders to protect our citizens.”

The Living Forces of Mayotte, collective against illegal immigration and insecurity known for having set up the roadblocks which hampered the department at the beginning of the yearfear “an epidemic outbreak” to “dramatic consequences”and demand in a press release (PDF document) “the establishment of an iron curtain (…) so that [les] borders are better monitored..

“Today, the best way to fight cholera is vaccination targeted”had defended the Minister Delegate for Health, Frédéric Valletoux, on Mayotte La 1ère, during a trip to the archipelago on May 9. “As soon as there is a proven case of cholera, we will vaccinate those around us, people who have been seen by the person in recent days and close family in order to contain the epidemic as much as possible,” he explained, based on an opinion from the High Council of Public Health (HCSP) published in mid-April.

“Mass vaccination would make no sense. It could not limit the damage. What would allow this is respect for hygiene rules.”

Frédéric Valletoux, Minister Delegate for Health

in Mayotte La 1ère

There “best way” to overcome this disease “is to adopt strict hygiene rules, wash your hands with soap, use drinking water, do not go into wastewater or river water which has a high chance of transporting” illness, the minister insisted.

“This strategy is very coherent”adds epidemiologist Renaud Piarroux to franceinfo. “VS“It is not a political decision, but a technical one, which has received the approval of a committee of experts.” of which this cholera specialist is a part, he adds. According to the practitioner, it is not “it is not necessary to vaccinate the entire population. This vaccine is used to treat local populations and prevent the epidemic from spreading in these neighborhoods”.

Furthermore, the vaccine used, Vaxchora, is “more effective than the others” vaccines, but “is produced in limited quantities” And “its effectiveness diminishes over time”going from 90.3% effectiveness ten days after taking to 79.5% at three months, according to the HCSP. “Which proves that vaccination in uncontaminated areas would not be of much use,” notes Renaud Piarroux. “It is a vaccine which is mainly offered in the United States to travelers who go to contaminated areas.

Like the HCSPhe believes that to overcome the epidemic, the most important thing will be to provide access to drinking water possible in the most precarious neighborhoods, in particular by installing taps near them.

The doctor is not the only one to make this observation. “Thinking of a response to fight cholera without taking into account the conditions of access to water is not very effective”explains on franceinfo the coordinator of Médecins du monde in Mayotte, Marion Ramstein. Indeed, in 2013, 28% of Mahorais households, i.e. 14,900 households, still did not have running water in their homesaccording to INSEE. “Here, the river water is used for washing and washing as well as for cooking. And many drink it”regrets Julie Durand, local health officer at the ARS.