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HEALTH

What you should know about ticks in France and how to avoid them

Farmers talk about the dangers of wolves, bears and wild boar in France, and we all know about the risk of infection from mosquitos - but the country is also home to another tiny creature that can do serious harm: the tick

What you should know about ticks in France and how to avoid them
Photo: Erik Karits / Unsplash

When and where do you find them?

Ticks can be found almost everywhere in France. A map on the l’Institut national de recherche pour l’agriculture, l’alimentation et l’environnement (INRAE) website indicates where ticks are most active in France.

Image: Inrae.fr

They can be found in forests, meadows, and long grass, meaning the biggest risk is when you’re out enjoying the glorious French countryside – especially when you’re hiking, camping or foraging.

Some 16 percent of people bitten reported the incident happened in their garden, Sante Publique France said.

Ticks are active when the temperature is higher than 5C, and are most common during the summer months.

What diseases can they cause?

The main disease transmitted by ticks in France is Lyme disease – a total 50,133 cases of Lyme disease were reported in mainland France in 2019, figures from government tick research and awareness programme CiTIQUE show.

And Sante Publique France said in February that the number of reported cases of Lyme disease was rising in France, but believes that this is down to increased awareness.

Around 15 percent of all ticks in France are carriers of the Borrelia bacteria that causes Lyme disease, and 14 percent carry other pathogens, including tick-borne encephalitis (TBE), that can be harmful to humans and animals. Cases of indigenous TBE, it should be noted, are very rare in France.

In France, the Auvergne Rhône-Alpes region is considered a particular hotspot for human tick-borne pathogen infections, with an estimated rate of 156 cases of Lyme disease per 100,000 people every year, according to a report published in 2020.

What are the symptoms

Lyme disease causes no symptoms in around half of those who catch it. For the remainder, it can cause skin redness, migraines, fever, dizziness, fatigue, and can attack the nervous system leading to balance problems. 

But it can be difficult to diagnose because symptoms – which usually appear between two and six weeks after the bite – are similar to those of other conditions. A ‘target’-shaped rash around the bite site, however, may be an indication.

The much rarer TBE is a viral infectious disease involving the central nervous system that often manifests as meningitis, encephalitis or meningoencephalitis. It can lead to a form of paralysis in some cases, and, in the worst cases, symptoms may persist for a year or more.

How can I protect myself?

If you spend time in wooded areas with long grass, especially those known to have a high tick presence, wear long-sleeved clothing and tuck your trousers into your socks. Try to avoid brushing against long grasses where you can. Children should wear hats, especially if they are playing in long grass.

After returning home from a day out, check for ticks and shower shortly after coming inside. This can give you the chance to remove the animals before they bite, for example if you spot them on your clothes. Putting clothes in a tumble dryer for one hour should kill ticks.

As well as wearing clothing that covers skin, you can also use an anti-tick spray which can be bought from pharmacies. 

Remember, too, to check pets, as they can become tick ‘hosts’ and bring them indoors.

What if I get bitten?

Lyme disease has no vaccine but can be treated, while TBE cannot be cured but a vaccine and treatments are available. The vaccine is recommended for anyone planning to travel to countries where TBE is more common, and may be offered to people in France, too.

Countries where TBE vaccination may be required include: Germany, Austria, Estonia, Finland, Latvia, Lithuania, Poland, Czechia, Western Russia, Slovakia, Slovenia, Sweden, Switzerland, Albania, Armenia, Belgium, Belarus, Bosnia, Bulgaria, Croatia, Denmark, Hungary, Italy, Kazakhstan, Macedonia, Moldova, Montenegro, Norway, Netherlands, Romania, Serbia, Ukraine, China (notably the north-east and north-west), South Korea, Japan, Kyrgyzstan, Mongolia, Eastern Russia.

If you do get a tick, you should remove it safely. The sooner you can do this, the lower the risk that it will be able to infect you with Lyme disease as it can take up to 24 hours for the bacteria to be transferred.

Removal can be done with a special tick remover (available at most pharmacies) or tweezers. The important thing is making sure you remove the whole tick, by grabbing it as close to the skin as possible and pulling slowly. 

Then, wash and clean the bite, and contact a doctor if you’re worried, especially if you experience symptoms of illness in the weeks after being bitten. You can request preventative antibiotic treatment against Lyme disease from a doctor.

You can report a tick bite on the CiTIQUE website here

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HEALTH

Health insurance: France to roll out smartphone version of carte vitale

France has begun a trial in eight areas of a smartphone version of the 'carte vitale' - the card required to access the French public health system - with the eventual aim of rolling out the app across the country. Here's how it will work.

Health insurance: France to roll out smartphone version of carte vitale

What is happening?

France is making changes to the carte vitale – the crucial card that allows residents of France to access the public health system. If you don’t have the card – here’s how to get it.

The new project involves replacing the physical card with a virtual one that is stored on your smartphone via an app.

The French government is beginning a pilot project in eight départements with the intention of expanding the system to cover the whole country in 2023.

The trial areas are; Bas-Rhin, Loire-Atlantique, Puy-de-Dôme, Saône-et-Loire, Sarthe, Seine-Maritime, Rhône and Alpes-Maritimes and the trials are voluntary for people who want to sign up. 

How does it work?

At present, the app is only available to those living in the trial areas mentioned above, and it can only be used by people who are already registered in the French system and have a carte vitale. It is not an alternative to the current registration process. 

If you have a carte vitale, however, you can transfer it onto your phone, which saves you having to remember to carry your card around.

You first download the app MonCV and then begin the sign-up process. In order to do this you will need your current card and social security number and will also have to go through a series of security steps including uploading a scan of your passport or ID card and then making a ‘short film’ of your face in order to verify your identity. 

Once registered, you can then use it at the doctor, pharmacist, vaccine centre or any other situation in which you previously used your carte vitale. You will be able to either show a QR code to scan, or scan your phone using NFC technology (similar to Metro and train smartphone tickets, which works even if your phone is turned off or out of battery).

Can you still use a card version?

Yes. If you don’t own a smartphone or are just not a fan of apps you can continue to use the physical card with no changes.

What does this change for healthcare access?

It doesn’t change anything in terms of your access to healthcare or paying for it, but some extra functions are set to be added to the app once the scheme is rolled out nationwide.

The first one is to link up your carte vitale with your mutuelle (complementary insurance) if you have it, so you don’t need to show extra proof from your insurance company in order to get full reimbursement.

The second is to add a ‘trusted person’ to your carte vitale, allowing them to use your card to, for example, pick up a prescription for you or to allow grandparents to take children to medical appointments (normally children are included on their parents’ card). 

Is this replacing the biometric carte vitale? 

You might remember talk earlier this year of a ‘biometric’ carte vitale, in which people would have to register biometric details such as their fingerprints in order to keep using their carte vitale.

This seems to have now been kicked into the long grass – it was a parliamentary amendment to a bill proposed by the centre-right Les Républicains party and was intended to combat prescription fraud.

Experts within the sector say that the costs and inconvenience of making everyone register their biometric details and get a new card far outweigh the costs of prescription fraud and the idea seems to have been put on the back burner for now. 

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