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1. Epidemiological assessment of the severity of dengue epidemics in French Guiana

Author

Narcisse Elenga, Philippe Quénel, Séverine Matheus, Christelle Prince, Philippe Abboud, Magalie Demar, Martine Papaix-Puech, Félix Djossou, Dominique Rousset, Luisiane Carvalho, Rachida Boukhari, Mathieu Nacher, Vanessa Ardillon, Camille Fritzell, Claude Flamand, Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Unité des Maladies Infectieuses et Tropicales [Cayenne, Guyanne Française], Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Cellule Inter Régionale d'Epidémiologie des Antilles - Guyane, Institut de Veille Sanitaire (INVS), Laboratoire de Biologie Médicale, Centre Hospitalier de l'Ouest Guyanais Franck Joly (Saint-Laurent-du-Maroni), Service de Médecine Interne Centre Médico-Chirurgical, Kourou, Guyane Française, Service de Pédiatrie [Cayenne, Guyanne Française], Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Réseau International des Instituts Pasteur ( RIIP ), Unité des Maladies Infectieuses et Tropicales ( UMIT ), Institut de Veille Sanitaire, Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Service de Pédiatrie, Centre d'Investigation Clinique Antilles-Guyane ( CIC - Antilles Guyane ), Université des Antilles et de la Guyane ( UAG ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Institut de recherche, santé, environnement et travail ( Irset ), Université d'Angers ( UA ) -Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -École des Hautes Études en Santé Publique [EHESP] ( EHESP ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ) -Université des Antilles ( UA ), Unité des Maladies Infectieuses et Tropicales (UMIT), Cellule interrégionale d'épidémiologie Antilles-Guyane [CIRE], Cellule Interrégionale d'Epidémiologie Antilles-Guyane, Département de Biologie Clinique [Saint-Laurent-du-Maroni, Guyane Française], EA 3593 Université des Antilles et de la Guyane, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Institut pluridisciplinaire de recherche appliquée dans le domaine du génie pétrolier (IPRADDGP), Université de Pau et des Pays de l'Adour (UPPA)-Centre National de la Recherche Scientifique (CNRS), Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH Guyane), Institut National de Veille Sanitaire, Institut national de veille sanitaire, and Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424

Subjects
Male, Viral Diseases, Serum Proteins, Future studies, Physiology, Epidemiology, lcsh:Medicine, Biochemistry, Severity of Illness Index, Dengue Fever, Hospitalization rate, Dengue fever, Dengue, 0302 clinical medicine, Animal Cells, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Medicine and Health Sciences, Ethnicities, Medicine, Mental health and psychiatry, French People, 030212 general & internal medicine, Fluid accumulation, Child, lcsh:Science, Children, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Multidisciplinary, Schools, Death rates, Mortality rate, Hematology, Fear, Middle Aged, Hospitals, Body Fluids, French Guiana, 3. Good health, Hospitalization, Infectious Diseases, Blood, Hematocrit, Italy, Warning signs, Child, Preschool, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Female, Anatomy, Cellular Types, Research Article, Neglected Tropical Diseases, Platelets, Adult, medicine.medical_specialty, Infectious Disease Control, Adolescent, 030231 tropical medicine, Mothers, Disease Surveillance, Infectious Disease Epidemiology, [ SDV.EE ] Life Sciences [q-bio]/Ecology, environment, 03 medical and health sciences, Internal medicine, Humans, Aspartate Aminotransferases, Hospitalizations, Blood Cells, Platelet Count, business.industry, lcsh:R, Biology and Life Sciences, Proteins, Infant, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, Lithuania, Cell Biology, Tropical Diseases, Serum samples, medicine.disease, Blood Counts, Health Care, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Health Care Facilities, Infectious Disease Surveillance, People and Places, Immunology, Population Groupings, lcsh:Q, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract

International audience; BACKGROUND: Dengue fever is the most important arboviral infection that affects humans, particularly in tropical and subtropical regions. Here, we provide the first comprehensive overview of the severity of dengue epidemics in French Guiana. METHODOLOGY/PRINCIPAL FINDINGS: We monitored hospitalized cases between 2008 and 2013. Detailed clinical features and biological parameters were collected on a daily basis from all cases. Among the 1,356 cases, 216 (16%) were classified according to the WHO 2009 classification as dengue without warning signs (WS), 926 (68%) were classified as dengue with WS and 214 (16%) were classified as severe dengue. The severity rates were similar between the three major epidemics that occurred during the study period, whereas the hospitalization rate was highest in 2013. Fluid accumulation, aspartate aminotransferase (ASAT) counts>193 IU/L and platelet counts

Published
2017
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2. Underestimation of Leptospirosis Incidence in the French West Indies

Author

Sylvie Cassadou, Martine Ledrans, Pascale Bourhy, Philippe Quénel, Martina Escher, Claude Flamand, Jacques Rosine, Mathieu Picardeau, Institut de Veille Sanitaire (INVS), Cellule de l'Institut de Veille Sanitaire en régions Antilles Guyane, Cellule Interrégionale d'Epidémiologie Antilles-Guyane, Cellule interrégionale d'épidémiologie Antilles-Guyane [CIRE], Unité d'Epidémiologie, Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Centre National de Référence de la Leptospirose-Centre Collaborateur FAO/OMS pour l'épidémiologie de la leptospirose-Biologie des Spirochètes, Institut Pasteur [Paris], Institut de recherche, santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), CIRE Antilles-Guyane - Gourbeyre, Centre Collaborateur FAO/OMS pour l'épidémiologie de la leptospirose, Centre National de Référence de la Leptospirose - National Reference Center Leptospirosis (CNR), Biologie des Spirochètes / Biology of Spirochetes, CIRE Antilles-Guyane - Fort de France, The authors received specific funding only from the Institut de Veille Sanitaire, their institution. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Conceived and designed the experiments: SC JR CF ME ML PB MP PQ. Performed the experi- ments: SC JR ME PB. Analyzed the data: SC JR CF. Contributed reagents/materials/analysis tools: PB MP. Wrote the paper: SC JR CF ME ML PB MP PQ. Organized and strenghtened the partners network: PQ ML., Jean-Baptiste Adrien, Hélène Bazus, Sylvie Boa, Fabrice Boulard, André Cabié, Arnaud Duthilly, Emilie Gaubert-Maréchal, Stéphanie Guyomard, Cécile Herrmann, Patrick Hoche- dez, Isabelle Lamaury, Claude Olive, Marion Petit-Sinturel, Raphaelle Théodose, the public health nurses of the CVAGS, all the General Practitionners of the two sentinel networks in Guadeloupe and Martinique, the ambulatory labs, the hospital labs, the hospital medical staffs, the Pasteur Institute of Guadeloupe, the Pasteur Institute of Paris and Jude Sweeney for the revision of the English text., Institut Pasteur [Paris] (IP), and École des Hautes Études en Santé Publique [EHESP] (EHESP)

Subjects
0301 basic medicine, Male, [SDV]Life Sciences [q-bio], Antibodies, Protozoan, Disease, Polymerase Chain Reaction, Dengue fever, 0302 clinical medicine, Environmental protection, Epidemiology, Enzyme-linked immunoassays, Child, Guadeloupe, Aged, 80 and over, Disease surveillance, Incidence (epidemiology), Incidence, lcsh:Public aspects of medicine, Middle Aged, Leptospirosis, Hospitals, 3. Good health, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Infectious Diseases, Child, Preschool, Female, France, Martinique, Adult, medicine.medical_specialty, lcsh:Arctic medicine. Tropical medicine, Adolescent, lcsh:RC955-962, 030231 tropical medicine, 030106 microbiology, Enzyme-Linked Immunosorbent Assay, Sensitivity and Specificity, 03 medical and health sciences, Young Adult, Environmental health, Agglutination Tests, medicine, Humans, Aged, Demography, business.industry, Public Health, Environmental and Occupational Health, Infant, Newborn, Outbreak, Infant, Correction, lcsh:RA1-1270, DNA, Protozoan, medicine.disease, Public and occupational health, Immunoglobulin M, business
Abstract

BACKGROUND:Leptospirosis is a neglected zoonosis affecting mainly tropical and subtropical regions worldwide, particularly South America and the Caribbean. As in many other countries, under-reporting of cases was suspected in the French West Indies because of inadequate access to diagnostic tests for the general population. METHODOLOGY/PRINCIPAL FINDINGS:In order to estimate the real incidence of leptospirosis in Guadeloupe and Martinique, a study was performed in 2011 using the three prevailing available biological tests for diagnosis: Microscopic Agglutination Test (MAT), IgM ELISA and PCR. The study investigated inpatients and outpatients and used active case ascertainment from data provided by a general practitioners' sentinel network. The epidemiology of the disease was also described in terms of severity and demographic characteristics. Leptospirosis incidence was estimated at 69.4 (95%CI 47.6-91.1) and 60.6 (95%CI 36.3-85.0) annual cases per 100,000 inhabitants in Guadeloupe and Martinique, respectively, which was 3 and 4 times higher than previous estimations. CONCLUSION/SIGNIFICANCE:Inclusion of PCR and IgM ELISA tests for diagnosis of leptospirosis resulted in improved sensitivity in comparison with MAT alone. Our results highlighted the substantial health burden of the disease in these two territories and the importance of access to appropriate laboratory tests. Based on our results, PCR and IgM ELISA tests have now been included in the list of tests reimbursed by the national system of social security insurance in France. Our results also underline the relevance of implementing an integrated strategy for the surveillance, prevention and control of leptospirosis in the French West Indies.

Published
2016
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3. Predicting dengue fever outbreaks in French Guiana using climate indicators

Author

Vanessa Ardillon, Claude Flamand, Dominique Rousset, Antoine Adde, Romain Girod, Sébastien Briolant, Pascal Roucou, Jean-Claude Desenclos, Morgan Mangeas, Philippe Quénel, Unité d'Epidémiologie, Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur ( RIIP ) -Réseau International des Instituts Pasteur ( RIIP ), Unité d'Entomologie Médicale, Biogéosciences [Dijon] ( BGS ), Université de Bourgogne ( UB ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique ( CNRS ), Cirad-amis, maison de la télédétection, Centre de Coopération Internationale en Recherche Agronomique pour le Développement, Cellule Interrégionale d'Epidémiologie Antilles-Guyane, Cellule interrégionale d'épidémiologie Antilles-Guyane [CIRE], Département santé environnement, Institut de Veille Sanitaire, Unité de virologie, Direction Interarmées du Service de Santé en Guyane, Institut de Recherches Biomédicales des Armées, Laboratoire d'étude et de recherche en environnement et santé ( LERES ), École des Hautes Études en Santé Publique [EHESP] ( EHESP ), Study supported by a grant from the 'Ministère de l'Outre-Mer' (http://www.outre-mer.gouv.fr/) and by a CNES-DGA-MRIS scholarship (https://cnes.fr/fr)., Unité d'Epidémiologie [Cayenne, Guyane française], Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Unité d'entomologie médicale, Vectopôle Amazonien Emile Abonnenc [Cayenne, Guyane française], Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut Pasteur de la Guyane, Biogéosciences [UMR 6282] [Dijon] (BGS), Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique (CNRS), Institut de Recherche pour le Développement (IRD), Institut de Veille Sanitaire (INVS), Centre National de Référence pour les Arbovirus - Laboratoire de Virologie [Cayenne, Guyane française] (CNR - laboratoire associé), Laboratoire d'étude et de recherche en environnement et santé (LERES), École des Hautes Études en Santé Publique [EHESP] (EHESP), Biogéosciences [UMR 6282] (BGS), Université de Bourgogne (UB)-Centre National de la Recherche Scientifique (CNRS), Entomologie médicale, Laboratoire de Parasitologie, UMR 228 Espace-Dev, Espace pour le développement, Institut de Recherche pour le Développement (IRD)-Université de Perpignan Via Domitia (UPVD)-Avignon Université (AU)-Université de La Réunion (UR)-Université de Montpellier (UM)-Université de Guyane (UG)-Université des Antilles (UA), Département des maladies infectieuses, Institut pluridisciplinaire de recherche appliquée dans le domaine du génie pétrolier (IPRADDGP), Université de Pau et des Pays de l'Adour (UPPA)-Centre National de la Recherche Scientifique (CNRS), Réseau International des Instituts Pasteur (RIIP), Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées (IRBA), and 'Ministère de l'Outre-Mer' (http://www.outre-mer.gouv.fr/) and by a CNES-DGA-MRIS scholarship (https://cnes.fr/fr)

Subjects
Atmospheric Science, Viral Diseases, El Niño-Southern Oscillation, Epidemiology, Climate, Rain, Marine and Aquatic Sciences, Logistic regression, Oceanography, Dengue fever, Disease Outbreaks, Dengue Fever, Dengue, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Oceans, Medicine and Health Sciences, 030212 general & internal medicine, Climatology, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Ecology, lcsh:Public aspects of medicine, 3. Good health, French Guiana, [ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [ SDE.MCG ] Environmental Sciences/Global Changes, Geography, Infectious Diseases, [SDU.STU.CL]Sciences of the Universe [physics]/Earth Sciences/Climatology, Epidemiological Methods and Statistics, Equatorial Ocean Regions, Seasons, [ SDU.STU.CL ] Sciences of the Universe [physics]/Earth Sciences/Climatology, Oceans, Ocean temperature, Seasons, El Niño-Southern Oscillation, Rain, Dengue fever, Epidemiology, Equatorial ocean regions, Research Article, Neglected Tropical Diseases, medicine.medical_specialty, lcsh:Arctic medicine. Tropical medicine, lcsh:RC955-962, [SDE.MCG]Environmental Sciences/Global Changes, 030231 tropical medicine, 03 medical and health sciences, Meteorology, Environmental health, medicine, Humans, Ocean Temperature, Azores High, Models, Statistical, Public health, Public Health, Environmental and Occupational Health, Outbreak, lcsh:RA1-1270, Bodies of Water, medicine.disease, Tropical Diseases, Sea surface temperature, 13. Climate action, Earth Sciences, Early warning system, Climate model, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Epidemiologic Methods, Forecasting, Climate Modeling
Abstract

Background Dengue fever epidemic dynamics are driven by complex interactions between hosts, vectors and viruses. Associations between climate and dengue have been studied around the world, but the results have shown that the impact of the climate can vary widely from one study site to another. In French Guiana, climate-based models are not available to assist in developing an early warning system. This study aims to evaluate the potential of using oceanic and atmospheric conditions to help predict dengue fever outbreaks in French Guiana. Methodology/Principal Findings Lagged correlations and composite analyses were performed to identify the climatic conditions that characterized a typical epidemic year and to define the best indices for predicting dengue fever outbreaks during the period 1991–2013. A logistic regression was then performed to build a forecast model. We demonstrate that a model based on summer Equatorial Pacific Ocean sea surface temperatures and Azores High sea-level pressure had predictive value and was able to predict 80% of the outbreaks while incorrectly predicting only 15% of the non-epidemic years. Predictions for 2014–2015 were consistent with the observed non-epidemic conditions, and an outbreak in early 2016 was predicted. Conclusions/Significance These findings indicate that outbreak resurgence can be modeled using a simple combination of climate indicators. This might be useful for anticipating public health actions to mitigate the effects of major outbreaks, particularly in areas where resources are limited and medical infrastructures are generally insufficient., Author Summary Climatic determinants are amongst the most frequently cited in studies aimed at understanding and explaining the dynamics of vector-borne infections, and dengue in particular. French Guiana, a French overseas territory in which the vector Aedes aegypti is well established, experiences an epidemic cycle of dengue with large and prolonged epidemics occurring approximately every 3 years. Dengue is one of the most prioritized infectious diseases, and it requires an intense mobilization of local public health authorities, health services, and health professional and vector control services. A specific surveillance, preparedness and response plan has been developed based upon these needs. Gaining an accurate understanding of the drivers of dengue transmission is required to develop a model to predict the risk of an epidemic and to plan activities aimed at controlling it. Here, we assessed the effects of climatic factors on dengue spread to develop a predictive model of the epidemics in French Guiana on a country-wide scale. The goal of the model is to anticipate and plan both preventive and control activities. Given climate conditions, the model predicts that a dengue epidemic is likely to occur in early 2016. These conditions, which are favorable for Aedes mosquito proliferation, could also enhance the diffusion of other arboviruses, such as the Zika virus, in northeastern South America.

Published
2016
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4. Malaria on the Guiana Shield: a review of the situation in French Guiana

Author

Félix Djossou, Isabelle Dusfour, Stéphane Pelleau, Lise Musset, Luisiane Carvalho, Eric Legrand, Romain Girod, Margarete do Socorro Mendonça Gomes, Vanessa Ardillon, Centre National de Référence du Paludisme [Cayenne, Guyane française] (CNR), Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Réseau International des Instituts Pasteur (RIIP), Cellule Interrégionale d'Epidémiologie Antilles-Guyane, Cellule interrégionale d'épidémiologie Antilles-Guyane [CIRE], Laboratório Central de Saúde Pública do Amapa, Unité des Maladies Infectieuses et Tropicales (UMIT), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], European Project: 285837,EC:FP7:REGPOT,FP7-REGPOT-2011-1,STRONGER(2011), Centre National de Référence du Paludisme [Cayenne, Guyane française] (CNR - laboratoire associé), Centre Collaborateur OMS pour la surveillance de la résistance aux antipaludiques [Cayenne, Guyane française] (CCOMS), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Laboratoire de Parasitologie [Cayenne, Guyane française], Vectopôle Amazonien Emile Abonnenc [Cayenne, Guyane française], Legrand, Eric, and Strengthening transdisciplinary research on infectious and emerging diseases in French Guiana: linking fieldwork, benchside and bedside - STRONGER - - EC:FP7:REGPOT2011-11-01 - 2015-04-30 - 285837 - VALID

Subjects
Microbiology (medical), lcsh:Arctic medicine. Tropical medicine, lcsh:RC955-962, 030231 tropical medicine, lcsh:QR1-502, malaria, vector control, lcsh:Microbiology, Antimalarials, 03 medical and health sciences, 0302 clinical medicine, Environmental protection, Anopheles, parasitic diseases, medicine, Animals, Humans, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Socioeconomics, 0303 health sciences, drug resistance, biology, 030306 microbiology, Plasmodium falciparum, Articles, medicine.disease, biology.organism_classification, Insect Vectors, 3. Good health, French Guiana, Geography, control strategy, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, epidemiology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.MP.PAR] Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Malaria
Abstract

International audience; In a climate of growing concern that Plasmodium falciparum may be developing a drug resistance to artemisinin derivatives in the Guiana Shield, this review details our current knowledge of malaria and control strategy in one part of the Shield, French Guiana. Local epidemiology, test-treat-track strategy, the state of parasite drug resistance and vector control measures are summarised. Current issues in terms of mobile populations and legislative limitations are also discussed.

Published
2014
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5. Risk of rabies transmission and adverse effects of postexposure prophylaxis in health care workers exposed to a fatal case of human rabies

Author

Hervé Bourhy, Claude Flamand, Didier Hommel, Magalie Demar, Aba Mahamat, Philippe Dussart, Jean-Michel Fontanella, André Spiegel, Félix Djossou, Jean-Baptiste Meynard, Unité des Maladies Infectieuses et Tropicales [Cayenne, Guyanne Française], Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH)-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-Université des Antilles (UA), Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Cellule Interrégionale d'Epidémiologie Antilles-Guyane, Cellule interrégionale d'épidémiologie Antilles-Guyane [CIRE], Centre Collaborateur de l'OMS pour la Rage - Dynamique des lyssavirus et adaptation à l'hôte (CC-OMS), Institut Pasteur [Paris] (IP), Centre National de Référence de la Rage-Dynamique des Lyssavirus et adaptation à l'hôte (CNR), and Institut Pasteur [Paris]

Subjects
Adult, Male, medicine.medical_specialty, Epidemiology, Rabies, Health Personnel, [SDV]Life Sciences [q-bio], MESH: Risk Assessment, Risk Assessment, MESH: Occupational Exposure, 03 medical and health sciences, 0302 clinical medicine, MESH: Rabies, Occupational Exposure, Health care, Hospital-acquired infection, MESH: French Guiana, medicine, Humans, 030212 general & internal medicine, Intensive care medicine, Rabies transmission, Adverse effect, Risk management, 0303 health sciences, MESH: Humans, 030306 microbiology, business.industry, Health Policy, Public Health, Environmental and Occupational Health, MESH: Rabies Vaccines, MESH: Adult, medicine.disease, MESH: Male, 3. Good health, French Guiana, Vaccination, Infectious Diseases, Rabies Vaccines, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, MESH: Health Personnel, business, Risk assessment, Post-Exposure Prophylaxis, MESH: Post-Exposure Prophylaxis
Abstract

Presented in part as an oral communication at the 10th Journées Nationales d’Infectiologie, Marseille, France, June 10-12, 2009.; International audience; On May 27, 2008, a patient died from rabies at the Cayenne Hospital in French Guiana. Postexposure prophylaxis vaccination was implemented for all health care workers exposed to this patient. Examining the management of such a rare risk reveals important factors in the education of personnel who may have contact with a patient with rabies, to permit appropriate risk assessment and reduce unnecessary postexposure prophylaxis, taking into account the risks and costs of adverse events.

Published
2012
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6. Investigation of a sudden malaria outbreak in the isolated Amazonian village of Saul, French Guiana, January-April 2009

Author

Jacques Rosine, Claude Flamand, Isabelle Dusfour, Vanessa Ardillon, Félix Djossou, Patrick Rabarison, Franck Berger, Claire Grenier, Marie-Anne Sanquer, Lise Musset, Eric Legrand, Romain Girod, Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Cellule Interrégionale d'Epidémiologie Antilles-Guyane, Cellule interrégionale d'épidémiologie Antilles-Guyane [CIRE], Laboratoire de Parasitologie Mycologie, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Agence Régionale de Santé de Guyane, Direction de la Démoustication et des Actions Sanitaires, Conseil Général de la Guyane, Département des Centres de Santé, This study was supported by the Institut de Veille Sanitaire (agreement no. 08-S-IT-P30-02) and the Agence Regionale de Sante de Guyane (agreement 041/DSDS-DSE-2008)., Laboratoire de Parasitologie [Cayenne, Guyane française], Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Centre National de Référence du Paludisme [Cayenne, Guyane française] (CNR - laboratoire associé), Agence Régionale de Santé Guyane (ARS Guyane), and Agence Régionale de la Santé (ARS)

Subjects
Male, Insecticides, Attack rate, Plasmodium vivax, Disease Outbreaks, 0302 clinical medicine, MESH: Aged, 80 and over, Surveys and Questionnaires, MESH: Child, MESH: Animals, MESH: Incidence, MESH: Disease Outbreaks, Socioeconomics, Child, MESH: Plasmodium falciparum, Aged, 80 and over, MESH: Aged, 0303 health sciences, MESH: Middle Aged, biology, Ecology, Transmission (medicine), Incidence, Anopheles, Articles, Middle Aged, MESH: Infant, 3. Good health, French Guiana, MESH: Plasmodium vivax, Infectious Diseases, MESH: Young Adult, Child, Preschool, Female, Adult, Adolescent, MESH: Population Density, 030231 tropical medicine, Plasmodium falciparum, MESH: Malaria, MESH: Insect Vectors, MESH: Anopheles, 03 medical and health sciences, Young Adult, Virology, parasitic diseases, MESH: French Guiana, medicine, Animals, Humans, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Aged, Retrospective Studies, Population Density, MESH: Adolescent, MESH: Humans, 030306 microbiology, MESH: Questionnaires, MESH: Child, Preschool, Outbreak, Infant, MESH: Adult, MESH: Retrospective Studies, biology.organism_classification, medicine.disease, MESH: Male, Insect Vectors, Malaria, MESH: Insecticides, Vector (epidemiology), Parasitology, MESH: Female
Abstract

International audience; Malaria is endemic in French Guiana. Plasmodium falciparum and Plasmodium vivax are the predominant species responsible and Anopheles darlingi is described as the major vector. In mid-August 2008, an increase in malaria incidence was observed in Saül. A retrospective cohort survey was performed. In vitro susceptibility profiles to antimalarials were determined on P. falciparum isolates. Collections of mosquitoes were organized. The malaria attack rate reached 70.6/100. The risk of malaria increased for people between 40 and 49 years of age, living in a house not subjected to a recent indoor residual insecticide spraying or staying overnight in the surrounding forest. All isolates were susceptible. Anopheles darlingi females and larvae were collected in the village suggesting a local transmission. Our results strongly support a role of illegal mining activities in the emergence of new foci of malaria. Therefore, public health authorities should define policies to fight malaria at a transborder level.

Published
2012
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7. First human rabies case in French Guiana, 2008: epidemiological investigation and control

Author

Françoise Eltges, Hervé Bourhy, Jean-Baptiste Meynard, Claude Flamand, Philippe Dussart, Jean-Michel Fontanella, Franck Berger, Claire Grangier, Laurent Dacheux, J. Renner, Céline Dupuy, Maryvonne Goudal, Aba Mahamat, André Spiegel, Félix Djossou, Nicolas Krieger, Vanessa Ardillon, Frederic Queuche, Didier Hommel, Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Cellule Interrégionale d'Epidémiologie Antilles-Guyane, Cellule interrégionale d'épidémiologie Antilles-Guyane [CIRE], Departmental Veterinary Direction [Cayenne], Health Regional Agency [Cayenne], Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre National de Référence de la Rage-Dynamique des Lyssavirus et adaptation à l'hôte (CNR), Institut Pasteur [Paris] (IP), Dynamique des Lyssavirus et Adaptation à l'Hôte (DyLAH), The authors thank the Institut de Veille Sanitaire, Saint-Maurice, France (http://www.invs.sante.fr/) for their financial contribution to the National Reference Centre for Rabies that made this work possible., and Institut Pasteur [Paris]

Subjects
Male, medicine.medical_treatment, Saliva/virology, medicine.disease_cause, Health personnel, 0302 clinical medicine, Chiroptera, Epidemiology, MESH: Animals, Skin, 0303 health sciences, medicine.diagnostic_test, lcsh:Public aspects of medicine, Meningoencephalitis, MESH: Chiroptera, MESH: Rabies Vaccines, French Guiana/epidemiology, French Guiana, 3. Good health, MESH: Rabies virus, Rabies Vaccines/administration & dosage, Infectious Diseases, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Medicine, Female, Post-Exposure Prophylaxis, Research Article, medicine.medical_specialty, lcsh:Arctic medicine. Tropical medicine, lcsh:RC955-962, Rabies, Health Personnel, 030231 tropical medicine, Rabies/*diagnosis/*epidemiology/prevention & control/virology, Rabies virus/*isolation & purification, 03 medical and health sciences, MESH: Rabies, MESH: Skin, Chiroptera/virology, parasitic diseases, MESH: French Guiana, medicine, Skin/virology, Animals, Humans, MESH: Saliva, Post-exposure prophylaxis, Saliva, MESH: Humans, 030306 microbiology, business.industry, Rabies virus, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, medicine.disease, Virology, MESH: Male, Rabies Vaccines, Skin biopsy, Post-Exposure Prophylaxis/methods, MESH: Health Personnel, business, MESH: Female, MESH: Post-Exposure Prophylaxis
Abstract

Background Until 2008, human rabies had never been reported in French Guiana. On 28 May 2008, the French National Reference Center for Rabies (Institut Pasteur, Paris) confirmed the rabies diagnosis, based on hemi-nested polymerase chain reaction on skin biopsy and saliva specimens from a Guianan, who had never travelled overseas and died in Cayenne after presenting clinically typical meningoencephalitis. Methodology/Principal Findings Molecular typing of the virus identified a Lyssavirus (Rabies virus species), closely related to those circulating in hematophagous bats (mainly Desmodus rotundus) in Latin America. A multidisciplinary Crisis Unit was activated. Its objectives were to implement an epidemiological investigation and a veterinary survey, to provide control measures and establish a communications program. The origin of the contamination was not formally established, but was probably linked to a bat bite based on the virus type isolated. After confirming exposure of 90 persons, they were vaccinated against rabies: 42 from the case's entourage and 48 healthcare workers. To handle that emergence and the local population's increased demand to be vaccinated, a specific communications program was established using several media: television, newspaper, radio. Conclusion/Significance This episode, occurring in the context of a Department far from continental France, strongly affected the local population, healthcare workers and authorities, and the management team faced intense pressure. This observation confirms that the risk of contracting rabies in French Guiana is real, with consequences for population educational program, control measures, medical diagnosis and post-exposure prophylaxis., Author Summary Until 2008, rabies had never been described within the French Guianan human population. Emergence of the first case in May 2008 in this French Overseas Department represented a public health event that markedly affected the local population, healthcare workers and public health authorities. The antirabies clinic of French Guiana, located at Institut Pasteur de la Guyane, had to reorganize its functioning to handle the dramatically increased demand for vaccination. A rigorous epidemiological investigation and a veterinary study were conducted to identify the contamination source, probably linked to a bat bite, and the exposed population. Communication was a key factor to controlling this episode and changing the local perception of this formerly neglected disease. Because similar clinical cases had previously been described, without having been diagnosed, medical practices must be adapted and the rabies virus should be sought more systematically in similarly presenting cases. Sharing this experience could be useful for other countries that might someday have to manage such an emergence.

Published
2012
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