Opinion/Feedback

Arboviruses cause very recurrent epidemics, the oldest Dengue, known especially outside the flu-like syndrome with high fever mainly impacting vulnerable populations, may be responsible for severe hemorrhagic fevers, but also a few cases of Guillain-Barré syndrome. In 2014, the French Antilles occurred an outbreak of Chikungunya, following that of the Reunion’s outbreak. During this period have been described, the articular and musculo-squellettic lesions, responsible for loss of autonomy in populations already carriers of chronic inflammatory joint damage or mechanical, but also a heavy impact on the autonomy of elderly and frail people. The Reunion experience has allowed the French Antilles to prepare for managing this epidemic by implementing an algorithm based on precise stripping algic and incapacitating phenomena. The role of the MPR in this dismemberment will allows distinguish true neurogenic damage to types of complex pain syndrome, combining autonomic neuropathy syndromes and tables of small fibers at the crossroads between diagnostic of arthropathy of periarthropaties, synovitis, tenosynovitis and tunnel syndrome on the rise during this epidemic period. And other complications such as bladder and sphincter disorders, and increase of spastic tables in patients suffering from chronic neurological disease. The reach of virus Zika shows an increased incidence of Guillain-Barre syndrome, brings interrogation with the appearance of atypical neurological damage such as myelitis, meningitis, cerebellites showing well this neurotropism. There are also atypical presentation on the neuro-urology plan that raises the question of the pathophysiology of such viruses. As has been the case for the Chikungunya, the overall vision of the MPR will allow better interpretation of pathological phenomena helping the understanding of the pathophysiology of these arboviruses. But it also plays a role in measuring the impact of emerging diseases on the autonomy of individuals.