Search

Chikungunya virus (CHIKV) emerged in the Caribbean island of Saint-Martin in December 2013. We implemented a hospital-based surveillance system to detect and describe CHIKV cases including severe forms of the infection and deaths in the islands of Martinique and Guadeloupe. A case was defined as a patient with a CHIKV laboratory confirmation cared for in a public hospital for chikungunya for at least 24 hours, and a severe CHIKV case was defined as a CHIKV case presenting one or more organ failures. Sociodemographic, clinical, and laboratory data were collected and cases classified into severe or nonsevere based on medical records. From December 2013 to January 2015, a total of 1,836 hospitalized cases were identified. Rate of hospital admissions for CHIKV infection was 60 per 10,000 suspected clinical CHIKV cases and severity accounted for 12 per 10,000. A total of 74 deaths related to CHIKV infection occurred. Infants and elderly people were more frequently hospitalized compared with others and severity was more frequently reported in elderly subjects and subjects with underlying health condition. Fifteen neonatal infections consecutive to mother-to-child transmission were diagnosed, seven of which were severe. The most vulnerable groups of the population, such as the elderly, infants, individuals with comorbidities, and pregnant women, should remain the main targets of public health priorities.

International audience; Background: Guillain-Barré syndrome (GBS) has been reported to be associated with Zika virus (ZIKV) infection in case reports and retrospective studies, mostly on the basis of serological tests, with the problematic cross-reacting antibodies of the Flavivirus genus. Some GBS cases do not exhibit a high level of diagnostic certainty. This prospective study aimed to describe the clinical profiles and the frequency of GBS associated with ZIKV during the ZIKV outbreak in Martinique in 2016.Methods: We recorded prospective data from GBS meeting levels 1 or 2 of diagnostic certainty for the Brighton Collaboration, with proof of recent ZIKV infection and negative screening for etiologies of GBS.Results: Of the sample of 34 patients with suspected GBS during the outbreak, 30 had a proven presence of GBS, and 23 had a recent ZIKV infection. The estimated GBS incidence rate ratio (2016 vs 2006-2015) was 4.52 (95% confidence interval, 2.80-7.64; P = .0001). Recent ZIKV infection was confirmed by urine reverse-transcription polymerase chain reaction (RT-PCR) analysis in 17 cases and by serology in 6 cases. Patients, 65% of whom were male, had a median age of 61 years (interquartile range, 56-71 years) and experienced severe GBS. Electrophysiological tests were consistent with the primary demyelinating form of the disease.Conclusions: ZIKV infection is usually benign, when symptomatic, but in countries at risk of ZIKV epidemics, adequate intensive care bed capacity is required for management of severe GBS cases. Arbovirus RNA detection by RT-PCR should be part of the management of GBS cases.

Introduction La melioidose est une anthropozoonose bacterienne tropicale, due a un bacille Gram negatif saprophyte tellurique, Burkholderia pseudomallei. Elle est endemique en Asie du Sud et au Nord de l’Australie, mais des cas ont ete decrits sur le continent americain et aux Antilles. Bien que la culture sur milieux usuels de B. pseudomallei soit une technique sensible, seulement 11 cas de melioidose avaient ete recenses sur cette ile des Antilles depuis 1994. En 2016, deux nouveaux cas graves, ayant conduit a des deces, ont eu lieu suite au passage de la tempete tropicale Matthew. Materiels et methodes Revue retrospective de tous les cas de melioidose diagnostiques sur une ile de la Caraibe. Description des donnees cliniques et epidemiologiques. Resultats La melioidose a ete responsable d’infections systemiques, principalement chez des hommes, d’âge median 57 ans. Ces cas groupes ont ete diagnostiques a l’issue d’evenements pluviometriques abondants, chez des personnes sejournant dans la partie sud de l’ile plus sujette aux inondations. Tous les patients presentaient des comorbidites ou des plaies cutanees. L’antibiotherapie probabiliste prescrite initialement etait rarement adaptee au phenotype de resistance naturel de la bacterie. Cinq patients sont decedes, dont un homme jeune au retour d’un voyage sur l’ile. Conclusion La melioidose est une pathologie communautaire emergente aux Antilles. Elle survient sous la forme d’epidemies sporadiques, dans les suites d’episodes pluviometriques exceptionnels. La gravite de la pathologie est liee a son caractere opportuniste chez des patients presentant des comorbidites, et au potentiel invasif de la bacterie a l’origine d’une letalite elevee. Sa resistance naturelle aux antibiotherapies communautaires majore le retard a une prise en charge adaptee. Cette infection grave peut toucher le voyageur de retour des Antilles.

Chikungunya virus (CHIKV) emerged in the Caribbean island of Saint-Martin in December 2013. We implemented a hospital-based surveillance system to detect and describe CHIKV cases including severe forms of the infection and deaths in the islands of Martinique and Guadeloupe. A case was defined as a patient with a CHIKV laboratory confirmation cared for in a public hospital for chikungunya for at least 24 hours, and a severe CHIKV case was defined as a CHIKV case presenting one or more organ failures. Sociodemographic, clinical, and laboratory data were collected and cases classified into severe or nonsevere based on medical records. From December 2013 to January 2015, a total of 1,836 hospitalized cases were identified. Rate of hospital admissions for CHIKV infection was 60 per 10,000 suspected clinical CHIKV cases and severity accounted for 12 per 10,000. A total of 74 deaths related to CHIKV infection occurred. Infants and elderly people were more frequently hospitalized compared with others and severity was more frequently reported in elderly subjects and subjects with underlying health condition. Fifteen neonatal infections consecutive to mother-to-child transmission were diagnosed, seven of which were severe. The most vulnerable groups of the population, such as the elderly, infants, individuals with comorbidities, and pregnant women, should remain the main targets of public health priorities.

In December 2012, an outbreak of acute gastrointestinal illness occurred in a geographical distinct area in Denmark covering 368 households. A combined microbiological, epidemiological and environmental investigation was initiated to understand the outbreak magnitude, pathogen(s) and vehicle in order to control the outbreak. Norovirus GII.4 New Orleans 2009 variant was detected in 15 of 17 individual stool samples from 14 households. Norovirus genomic material from water samples was detected and quantified and sequencing of longer parts of the viral capsid region (>1000 nt) were applied to patient and water samples. All five purposely selected water samples tested positive for norovirus GII in levels up to 1.8×104 genomic units per 200 ml. Identical norovirus sequences were found in all 5 sequenced stool samples and 1 sequenced water sample, a second sequenced water sample showed 1 nt (

Introduction – objectifs Les premiers cas autochtones de chikungunya ont ete observes aux Antilles en 12/2013. La Martinique est entree en phase epidemique le 23 janvier 2014. Le vecteur (Aedes aegypti) et le genotype viral (groupe asiatique) sont differents de ceux responsables de l’epidemie de 2005/2006 a la Reunion. L’objectif etait de decrire les formes cliniques observees chez les patients hospitalises dans une population atteinte pour la premiere fois par ce couple vecteur/virus. Materiels et methodes Depuis le 16 decembre 2013 une surveillance des cas confirmes (PCR+) ou probables (IgM+) de chikungunya hospitalises plus de 24 heures a ete mise en place au CHU de Martinique. Les cas ont ete classes en formes communes, inhabituelles non severes, severes (defaillance d’organe), et neonatales severes ou non. Resultats Au 19 fevrier 2014, 88 patients avaient ete hospitalisees plus de 24 heures Le classement des cas a ete effectue chez 28 hommes et 20 femmes âges en mediane de 30 ans, IQR[4,5;71,5]. L’incidence (pour 10 000 hab) globale etait de 1,2, de 18,1 chez les moins de 1 an et de 3,5 chez les plus de 75 ans. Une comorbidite etait notee chez 24 patients. Le classement des cas etait : 32 formes communes, 11 formes inhabituelles (principalement convulsions et atteinte cardiaque), 4 formes severes (1 encephalopathie, 1 defaillance cardiaque, 1 hepatite, 1 thrombopenie), et 1 forme neonatale severe (encephalopathie). La duree mediane d’hospitalisation etait de 3 jours. Un homme de 89 ans, polyvasculaire, est decede d’une pneumonie aigue. Ce deces a ete classe comme indirectement lie au chikungunya. Conclusion Ces donnees montrent une frequence elevee d’hospitalisation des nourrissons et des personnes âgees et confirme l’existence de formes inhabituelles et severes, et le risque de transmission perinatale. Elles seront mises a jour selon l’evolution de l’epidemie