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Simple Summary: Arthropods form an extremely diverse group, including millions of species. Some arthropods, transmitting pathogenic agents, are qualified vectors. To prevent infectious disease outbreaks, accurate identification of arthropods at the species level and distinguishing vectors from non-vectors remain essential. Over the last two decades, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) has emerged as a relevant tool for arthropod identification. Scarce data are available regarding lice and fleas ectoparasites, which present a huge veterinary and human public health problem. These two arthropod species are often collected from livestock in the field and stored in alcohol. However, previous works reported that the duration and conditions of specimen ethanol storage could impede their MS classification. The present study's aim was to evaluate the performance of the MALDI-TOF MS tool for correct identification of Pediculus humanus corporis lice and Ctenocephalides felis fleas preserved in alcohol from one to four years. This study highlighted that a correct rate of identification by MS could be obtained for lice and fleas preserved in alcohol for up to four years on the condition that the drying period was sufficiently long enough for accurate identification. The strategy described in the present work could be used as a guideline for MS identification of other arthropod species stored for a long time in ethanol. MALDI-TOF is now considered a relevant tool for the identification of arthropods, including lice and fleas. However, the duration and conditions of storage, such as in ethanol, which is frequently used to preserve these ectoparasites, could impede their classification. The purpose of the present study was to assess the stability of MS profiles from Pediculus humanus corporis lice and Ctenocephalides felis fleas preserved in alcohol from one to four years and kinetically submitted to MALDI-TOF MS. A total of 469 cephalothoraxes from lice (n = 170) and fleas (n = 299) were tested. The reproducibility of the MS profiles was estimated based on the log score values (LSVs) obtained for query profiles compared to the reference profiles included in the MS database. Only MS spectra from P. humanus corporis and C. felis stored in alcohol for less than one year were included in the reference MS database. Approximately 75% of MS spectra from lice (75.2%, 94/125) and fleas (74.4%, 122/164) specimens stored in alcohol for 12 to 48 months, queried against the reference MS database, obtained relevant identification. An accurate analysis revealed a significant decrease in the proportion of identification for both species stored for more than 22 months in alcohol. It was hypothesized that incomplete drying was responsible for MS spectra variations. Then, 45 lice and 60 fleas were subjected to longer drying periods from 12 to 24 h. The increase in the drying period improved the proportion of relevant identification for lice (95%) and fleas (80%). This study highlighted that a correct rate of identification by MS could be obtained for lice and fleas preserved in alcohol for up to four years on the condition that the drying period was sufficiently long for accurate identification. [ABSTRACT FROM AUTHOR]

Most exposures of residents of Marseille to nonhuman primates occurred among unvaccinated adult travelers to Southeast Asia within the first 10 days of their arrival at 2 major tourist locations in Thailand and 1 in Indonesia. A small proportion of travelers received rabies immunoglobulin in the country of exposure. [ABSTRACT FROM AUTHOR]

Simple Summary: Cimicids are obligate bloodsuckers of animals and vertebrate. Some species have humans as primary hosts and are currently called "bed bugs". Other cimicid species related to birds and bats can also bite humans, especially if these animals have their nests near human dwellings. In this paper, we summarize all the cases found in the literature about these species. The health effects related to the species are described as well as the associated pathogens. Members of the Cimicidae family are significant pests for mammals and birds, and they have attracted medical and veterinary interest. A number of recent studies have investigated bed bugs, due to their dramatic resurgence all over the world. Indeed, bed bugs are of significant public health and socioeconomic importance since they lead to financial burdens and dermatological complications and may have mental and psychological consequences. It is important to note that certain cimicids with a preference for specific hosts (birds and bats) use humans as an alternative host, and some cimicids have been reported to willingly feed on human blood. In addition, members of the Cimicidae family can lead to economic burdens and certain species are the vectors for pathogens responsible for diseases. Therefore, in this review, we aim to provide an update on the species within the Cimicidae family that have varying medical and veterinary impacts, including their distribution and their associated microorganisms. Various microbes have been documented in bed bugs and certain important pathogens have been experimentally documented to be passively transmitted by bed bugs, although no conclusive evidence has yet associated them with epidemiological outbreaks. Additionally, among the studied cimicids (bat bugs, chicken bugs, and swallow bugs), only the American swallow bug has been considered to be a vector of several arboviruses, although there is no proven evidence of transmission to humans or animals. Further studies are needed to elucidate the reason that certain species in the Cimicidae family cannot be biologically involved in transmission to humans or animals. Additional investigations are also required to better understand the roles of Cimicidae family members in the transmission of human pathogens in the field. [ABSTRACT FROM AUTHOR]

MALDI-TOF MS profiling has proved to be efficient for arthropod identification at the species level. However, prior to entomological monitoring, the reference spectra database should cover relevant species. Here, 74 specimens were field-collected from 11 mosquito species captured in two distinct European areas and used either to increment our database or for blind tests. Misidentification was not noted, underlining the power of this approach. Nevertheless, three out of the 26 specimens used for the blind test did not reach the significant identification threshold value set, attributed to lower spectral quality. In the future, the quality control spectra parameters need to be defined to avoid not achieving significant threshold identification. [ABSTRACT FROM AUTHOR]

Abstract: Melophagus ovinus (sheep ked) is one of the most common ectoparasites that contributes to enormous economic losses in the productivity of sheep in many countries. The present study was conducted from January 2012 to July 2013 on M. ovinus collected from sheep at three sites in Ethiopia. Of the sheep studied, 65.7% (88/134) were infested with M. ovinus. The prevalence of M. ovinus was 76% (76/100), 47% (8/17) and 23.5% (4/17) at the Kimbibit, Chacha and Shano sites, respectively. An overall number of 229 M. ovinus specimens (138 females, 86 males and five pupae) and 554 M. ovinus specimens (272 females, 282 males) were collected from young and adult sheep, respectively. Bartonella DNA was detected in 89% (694/783) of M. ovinus using a quantitative Bartonella genus-specific PCR assay targeting the 16S/23S rRNA intergenic spacer region. The sequencing of the PCR products of fragments of the gltA and rpoB genes showed 99.6–100% and 100% homology, respectively, with B. melophagi. Statistically significant variation was not noted in the overall prevalence of Bartonella DNA between female and male M. ovinus. All of the sheep infested with M. ovinus 100% (88/88) harbored at least one M. ovinus specimen that contained Bartonella DNA. This study highlights that B. melophagi in M. ovinus from sheep in highlands in Ethiopia possibly has certain zoonotic importance. [Copyright &y& Elsevier]

Abstract: Rabies prevention in travelers is a controversial issue. According to experts, the decision to vaccinate results from an individual risk assessment based on the duration of stay, the likelihood of engagement in at-risk activities, the age of the traveler, the rabies endemicity and access to appropriate medical care in the country of destination. However, no detailed information is available regarding the last two determinants in many regions. Twenty-two cases of rabies were reported in tourists, expatriates and migrant travelers over the last decade, including three cases following short-term travel of no more than two weeks. Studies on rabies post-exposure prophylaxis (PEP) in travelers show that overall, 0.4% (range 0.01–2.3%) of travelers have experienced an at-risk bite per month of stay in a rabies-endemic country, while 31% of expatriates and 12% of tourists were vaccinated against rabies before traveling. The main reason cited by travelers for not being vaccinated is the cost of the vaccine. The majority of patients who sustained a high risk injury was not vaccinated against rabies before traveling and were not properly treated abroad. From available studies, the following risk factors for injuries sustained from potentially rabid animals may be identified: traveling to South-East Asia, India or North Africa, young age, and traveling for tourism. The duration of travel does not appear to be a risk factor. It should be noted that “at-risk activities” have not been addressed in these studies. Detailed rabies distribution maps and information on the availability of rabies biologics are urgently needed in order to identify those travelers who need pre-travel vaccination. Meanwhile, cost-minimization of rabies pre-exposure vaccination may be achieved in several ways, notably by using the intra-dermal method of vaccination. [Copyright &y& Elsevier]

Tick-borne lymphadenopathy (TIBOLA), also called Dermacentor-borne necrosis erythema and lymphadenopathy (DEBONEL), is defined as the association of a tick bite, an inoculation eschar on the scalp, and cervical adenopathies. We identified the etiologic agent for 65% of 86 patients with TIBOLA/DEBONEL as either Rickettsia slovaca (49/86, 57%) or R. raoultii (7/86, 8%). [ABSTRACT FROM AUTHOR]

Mediterranean spotted fever is the most important tick-borne disease occurring in Southern Europe and North Africa. The first case of this life-threatening zoonosis was reported in 1910. In the 1930s, the role of the brown dog tick, Rhipicephalus sanguineus, and the causative agent, Rickettsia conorii were described. However, basic questions regarding the relationships between the rickettsia and its tick vector are still unresolved, and the life cycle of R. conorii is incompletely known. There is a lack of knowledge associated with the role of Rh. sanguineus in the maintenance and transmission of R. conorii. The infectious rate of Rh. sanguineus ticks with R. conorii has been found low every time it has been tested; usually lower that 1%. The deleterious impact of R. conorii on ticks has been suggested in experimental models as a potential reason to explain a low prevalence in nature. The long-recognized phenomenon known as reactivation has been suggested as a cause of negative effects – that is, the change in temperature and physiology of the tick host induces the agent to emerge from dormancy and attain infectivity with bad effects on ticks. However, naturally infected colonies of ticks have been maintained in laboratory conditions over several generations. We discuss here several aspects that have been recently studied to better understand Rh. sanguineus– R. conorii relationships, including comparison between the fitness of infected and non-infected ticks in laboratory conditions and the role of external factors such as temperature and starvation. [ABSTRACT FROM AUTHOR]

Objective. To assess the awareness of the mode of rabies transmission, travel-associated rabies risk, and adequate preventive measures among French travelers. Methods. Three hundred travelers were administered a detailed questionnaire prior to pretravel advice, addressing their knowledge, attitudes, and practices (KAP) with respect to animal-related injuries and rabies risk. Two hundred and nine were administered a post-travel questionnaire by telephone, addressing the occurrence of contacts with animals during travel. Results. Countries visited were at risk for rabies in 84.7% of the cases. Only 6.7% of travelers knew that the risk of rabies was important, while 40.1% considered it moderate or low. Dog bites appeared to be a well-known mode of transmission of rabies. By contrast, licks on broken skin or contamination of the mucous membrane with saliva (10%) and scratches (0.7%) were rarely known. Cats (23.7%), foxes (28.3%), monkeys (10.3%), and bats (5.0%) were rarely mentioned as possible rabies vectors. Only 50.7% of travelers were aware of the preventive vaccination. Approximately 57.6% of individuals traveling to rabies–endemic countries presented to the clinic less than 21 days before departing, rendering a complete preventive vaccination against rabies unfeasible. Immediate washing of the injury with water and soap was mentioned by only 3.0% of individuals and self-disinfection with antiseptics by 21.3%. Of those who traveled in a rabies-risk country, 3.8% declared that they had been attacked by animals; however, none was injured. Animal encounters were frequent with dogs (53.8%), monkeys (39.5%), bats (17.9%), and cats (15.4%). Conclusions. The KAP of French travelers with regard to travel-associated rabies risk need to be improved, particularly regarding the prevention of animal bites, postbite measures, and their urgency. [ABSTRACT FROM AUTHOR]

Summary: Introduction: Mediterranean spotted fever (MSF) due to Rickettsia conorii is the most important tick-borne disease occurring in North Africa. However, there are only a few fragmentary reports on the epidemiology and clinical aspects of rickettsioses in North Africa, and cases are still rarely documented. We report herein a prospective study conducted in Oran, the second largest city in Algeria. This disease has not been properly described in Oran or in other Algerian cities. Methods: A total of 167 cases of Mediterranean spotted fever were documented for the first time by the use of reference methods including immunofluorescence serology and Western blot and absorption studies, including isolation in culture by the shell-vial techniques, and molecular tools. Results: Although some aspects of MSF were found to be in accordance with the general epidemiology of the disease, uncommon aspects were found, including increased incidence and the presence of multiple inoculation eschars in 12% of patients. The role of climatic changes in alterations of host-seeking and feeding behaviors of the vectors, including the brown dog tick Rhipicephalus sanguineus, is discussed. Also, 49% of patients were hospitalized with a severe form. The global death rate was 3.6%, but it was 54.5% in patients hospitalized with major neurological manifestations and multiorgan involvement. Conclusions: The present report gives a unique panel of clinical aspects of MSF as well as new trends in this disease. Entomological, climatic, and molecular studies are needed to better understand both epidemiological and clinical aspects of MSF. [Copyright &y& Elsevier]

Mediterranean spotted fever due to Rickettsia conorii conorii was thought, for many years, to be the only tick-borne rickettsial disease prevalent in southern and eastern Europe. However, in recent years, six more species or subspecies within the spotted fever group of the genus Rickettsia have been described as emerging pathogens in this part of the world. Tick-borne agents include Rickettsia conorii israelensis, Rickettsia conorii caspia, Rickettsia aeschlimannii, Rickettsia slovaca, Rickettsia sibirica mongolitimonae and Rickettsia massiliae. Many Rickettsia of unknown pathogenicity have also been detected from ticks and could represent potential emerging pathogens to be discovered in the future. Furthermore, a new spotted fever rickettsia, Rickettsia felis, was found to be associated with cat fleas and is an emerging human pathogen. Finally, the mite-transmitted Rickettsia akari, the agent of rickettsialpox, is also known to be prevalent in Europe. We present here an overview of these rickettsioses, focusing on emerging diseases. [ABSTRACT FROM AUTHOR]

Objective: The main objective of this study was to assess the influence of gas mixtures on in vitro Plasmodium falciparum growth and 50% inhibitory concentration (IC50) for chloroquine. Methods: The study was performed between February 2004 and December 2005. 136 Plasmodium falciparum isolates were used to evaluate gas mixtures effect on IC50 for chloroquine by isotopic microtest. The oxygen effect on asexual blood cycle of 3D7 and W2 clones was determined by thin blood smears examination and tritiated hypoxanthine uptake. Results: From 5% O2 to 21% O2 conditions, no parasiticide effect of O2 concentration was observed in vitro on the clones 3D7 and W2. A parasitostatic effect was observed during the exposure of mature trophozoïtes and schizonts at 21% O2 with an increase in the length of schizogony. The chloroquine IC50 at 10% O2 were significantly higher than those at 21% O2, means of 173.5 nM and 121.5 nM respectively (p < 0.0001). In particular of interest, among the 63 isolates that were in vitro resistant to chloroquine (IC50 > 100 nM) at 10% O2, 17 were sensitive to chloroquine (IC50 < 100 nM) at 21% O2. Conclusion: Based on these results, laboratories should use the same gas mixture to realize isotopic microtest. Further studies on comparison of isotopic and non-isotopic assays are needed to establish a standardized in vitro assay protocol to survey malaria drug resistance. [ABSTRACT FROM AUTHOR]

Chikungunya virus (CHIKV) emerged in Indian Ocean islands in 2005 and is causing an ongoing outbreak that involves >260,000 patients, including travelers returning home from these islands. We investigated cases in 4 patients returning from Mayotte and Reunion Islands with CHIKV infection and a nurse infected in metropolitan France after direct contact with the blood of a traveler. Four patients had tenosynovitis and pain at wrist pressure, and 1 had life-threatening manifestations. Four CHIKV strains were isolated, including 1 from the patient with the autochthonous case. The complete genomic sequence identified a new CHIKV variant emerging from the East/ central African evolutionary lineage. Aedes albopictus, the implicated vector of CHIKV in Indian Ocean islands, has dispersed worldwide in recent decades. High viral loads in patients returning from Indian Ocean islands to countries where Ae. albopictus is prevalent may be a source of epidemics. [ABSTRACT FROM AUTHOR]

Tick-borne relapsing fever is a bacterial infection caused by spirochetes of the genus Borrelia. This zoonotic disease is transmitted to humans through the bite of soft ticks of the genus Ornithodoros. It is responsible for recurring fever access associated with spirochetemia. We present here an overview of tick-borne relapsing fever occurring in Europe, as well as of the potential threat to travellers. [ABSTRACT FROM AUTHOR]

Although rickettsioses are among the oldest known vector-borne zoonoses, several species or subspecies of rickettsias have been identified in recent years as emerging pathogens throughout the world including in sub-Saharan Africa. To date, six tick-borne spotted fever group pathogenic rickettsias are known to occur in sub-Saharan Africa, including Rickettsia conorii conorii, the agent of Mediterranean spotted fever; R. conorii caspia, the agent of Astrakhan fever; R. africae, the agent of African tick-bite fever; R. aeschlimannii; R. sibirica mongolitimonae; and R. massiliae. On the other hand, fleas have long been known as vectors of the ubiquitous murine typhus, a typhus group rickettsiosis induced by R. typhi. However, a new spotted fever rickettsia, R. felis, has also been found to be associated with fleas, to be a human pathogen, and to be present in sub-Saharan Africa. Finally, R. prowazekii the agent of louse-borne epidemic typhus continues to strikes tens to hundreds of thousands of persons who live in Sub-Saharan with civil war, famine and poor conditions. We present an overview of these rickettsioses occurring in sub-Saharan Africa, focusing on the epidemiological aspects of emerging diseases. [ABSTRACT FROM AUTHOR]

Abstract: In recent years, a bewildering array of emerging rickettsial pathogens have been described throughout the world, including in the tropics. Here we present an updated overview of scrub typhus, murine typhus, and epidemic typhus. We also present an update on the emerging spotted fever group rickettsioses described in the tropics through 2005, focusing on epidemiologic and clinical data and management. [Copyright &y& Elsevier]

Ticks are currently considered the main vectors of human infectious diseases in Europe, particularly since their role in the transmission of the agent of Lyme borreliosis was demonstrated in the 1980s. In the recent years, ticks have also been shown to be the vectors of numerous emerging rickettsial diseases. Although Mediterranean spotted fever (MSF) due to Rickettsia conorii was thought for a long time to be the only tick-borne rickettsial disease prevalent in Europe, five more spotted fever rickettsiae have been described as emerging pathogens in the last decade. Further, cases of infection due to Anaplasma phagocytophilum, the agent of human anaplasmosis (previously known as human granulocytic ehrlichiosis), have been reported throughout Europe. We present here these emerging diseases and discuss other potential threat for the future. [Copyright &y& Elsevier]

We report a human case of leptospirosis in which the spirochete was detected by dark-field microscopy examination of cerebrospinal fluid (CSF) and isolated from both CSF and blood. Leptospira fainei was identified by sequencing the 16S rDNA gene, which had been amplified by polymerase chain reaction. This case confirms the role of L. fainei as a human pathogen and extends its distribution to southern Europe. [ABSTRACT FROM AUTHOR]

Presents an overview of studies on infectious diseases. Description of a multidrug-resistant Pseudomonas aeruginosa; Documentation of Rickettsia conorii infection in a traveler; Information on a variant of Hantavirus in Apodemus peninsulae in Russia.

Presents information on a study which focused on ticks and tickborne bacterial diseases in humans. Epidemiology of tickborne diseases; Detection and isolation of bacteria from ticks; Treatment of tickborne bacterial diseases.

Simple Summary: People around the world, as well as animals, are at risk of being affected by infectious diseases transmitted by mosquitoes. Indeed, in addition to being pests, some species of mosquitoes have the ability to carry pathogens from one host to another. In the North Africa region, approximately 80 species are currently recorded. In this review, we focus only on mosquitoes of medical and veterinary importance (26 species), providing a concise update of the literature on species and the diseases they carry (two parasitic and five viral infections). Mosquitoes (Diptera: Culicidae) are of significant public health importance because of their ability to transmit major diseases to humans and animals, and are considered as the world's most deadly arthropods. In recent decades, climate change and globalization have promoted mosquito-borne diseases' (MBDs) geographic expansion to new areas, such as North African countries, where some of these MBDs were unusual or even unknown. In this review, we summarize the latest data on mosquito vector species distribution and MBDs affecting both human and animals in North Africa, in order to better understand the risks associated with the introduction of new invasive mosquito species such as Aedes albopictus. Currently, 26 mosquito species confirmed as pathogen vectors occur in North Africa, including Aedes (five species), Culex (eight species), Culiseta (one species) and Anopheles (12 species). These 26 species are involved in the circulation of seven MBDs in North Africa, including two parasitic infections (malaria and filariasis) and five viral infections (WNV, RVF, DENV, SINV and USUV). No bacterial diseases have been reported so far in this area. This review may guide research studies to fill the data gaps, as well as helping with developing effective vector surveillance and controlling strategies by concerned institutions in different involved countries, leading to cooperative and coordinate vector control measures. [ABSTRACT FROM AUTHOR]

Studies the first three documented cases of murine typhus imported into Europe from Indonesia. Symptoms and diagnosis of the disease; Patients' exhibition of serologic cross-reactions with Rickettsia prowazekii and R. conorri; Countries where the disease have been reported; Implications for health screening of travelers who come from high-risk countries.

During January 2010, a husband and wife returned from Laos to France with probable parasitic disease. Increased antibodies against an Acanthamoeba polyphaga mimivirus virophage indicated seroconversion. While in Laos, they had eaten raw fish, a potential source of the virophage. This virophage, associated with giant viruses suspected to cause pneumonia, could be an emerging pathogen. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented about Bartonella clarridgeiae in fleas collected from cats and dogs from Tahiti, French Polynesia.

Detecting spirochetes remains challenging in cases of African tick-borne relapsing fever. Using real-time PCR specific for the 16S rRNA Borrelia gene, we found 27 (13%) of 206 samples from febrile patients in rural Senegal to be positive, whereas thick blood smear examinations conducted at dispensaries identified only 4 (2%) as positive. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented about the genotyping of Orientia tstsugamushi from humans with scrub typhus in Laos.

A letter to the editor is presented on murine typhus in Algeria.

The article examines malarial cases on the Comoros Islands in Marseilles. The Comoros archipelago includes four islands located in the Mozambic Canal of the Indian Ocean, 300 km north of Madagascar. Although much effort has been put into malaria control during recent years, malaria still constitutes a major public health problem in the Federal Islamic Republic of Comoros, where it represents 15% to 30% of the hospitalization cases and 15% to 20% of the registered deaths in the pediatric services. The study compared two groups of patients with falciparum malaria, Comorians, 56% of the patients, all having acquired malaria in Comoros, and non-Comorian patients, including French travelers and people originating from the African mainland, all having acquired malaria in tropical settings other than Comoros. the following differences emerged: (1) the Comorian group complied with malaria chemoprophylaxis less frequently than non-Comorians; (2) the Comorians consulted family doctors less frequently than non-Comorians before presenting to emergency units with malaria; (3) the Comorians more frequently reported headache and vomiting than non-Comorians; and (4) Comorians developed severe malaria less frequently than non-Comorians. As demonstrated in Marseilles, both chloroquine and pyrimethamine in vitro resistance levels are high in patella falciparum parasites acquired in Comoros, and malaria treatment failure is of concern.

The article focuses on the increase in patients getting diagnosed with yellow fever in the population in the Pacific region.

The article discusses research conducted by G. Slesak et al. on leeches as further potential vectors for ricketssial (R.) infections, published in a previous issue of "Proceedings of the National Academy of Sciences" journal. Topics discussed include the leech not having been tested by polymerase chain reaction (PCR), possibility of contamination of the skin by booklice or booklice products such as the psocid Liposcelis bostrychophila, and possible inoculation of R. felis.

Many studies have evaluated the use of hydroxychloroquine in COVID-19. Most retrospective observational studies demonstrate a benefit of using HCQ on mortality, but not most randomized clinical trials. We analyzed raw data collected from a cohort of 30,423 patients with COVID-19 cared for at IHU Méditerranée Infection in Marseille France and extracted from the DRYAD open data platform. We performed univariate and multivariable logistic regressions with all-cause mortality within six weeks. Multivariable logistic regressions were adjusted for sex, age group (<50, 50–69, 70–89 and ​> ​89 years), periods (or variants), and type of patient management. Among 30,202 patients for whom information on treatment was available, 191/23,172 (0.82%) patients treated with HCQ-AZ died, compared to 344/7030 (4.89%) who did not receive treatment with HCQ-AZ. HCQ-AZ therapy was associated with a lower mortality than treatment without HCQ-AZ (odds ratio (OR) 0.16; 95% confidence interval (CI), 0.14–0.19). After adjustment for sex, age, period, and patient management, HCQ-AZ was associated with a significantly lower mortality rate (adjusted OR (aOR) 0.55, 95% CI 0.45–0.68). On a subsample of 21,664 patients with available variant information, results remained robust after adjustment on sex, age, patient management and variant (aOR 0.55; 95% CI 0.44–0.69). On a subsample of 16,063 patients, HCQ-AZ was still associated with a significantly lower mortality rate (aOR 0.47, 95%CI 0.29–0.75) after adjustment for sex, age, period, patient management, vaccination status and comorbidities. Analysis of this large online database showed that HCQ-AZ was consistently associated with the lowest mortality. [ABSTRACT FROM AUTHOR]

Simple Summary: Mosquitoes are capable of transmitting numerous diseases to humans and animals. However, not all mosquitoes are vectors. It is therefore very important to identify mosquitoes in order to distinguish vectors from non-vectors. Our aim was to evaluate the ability of MALDI-TOF MS to identify mosquitoes collected in Senegal and stored for several months in silica gel, and to determine the origin of their blood meal. We have identified 12 different species, most of which are vectors of human disease. We also found that these mosquitoes fed mainly on humans. Our results confirm that MALDI-TOF MS is a promising and rapid technique for identifying mosquitoes and the origin of their blood meal. However, the percentage of good-quality spectra was low, demonstrating that mosquitoes should be pre-treated before being preserved in silica gel. Transferring the MALDI-TOF MS database to Senegal will enable mosquitoes to be identified on the spot as quickly as possible. Mosquitoes are arthropods that represent a real public health problem in Africa. Morphology and molecular biology techniques are usually used to identify different mosquito species. In recent years, an innovative tool, matrix-assisted desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), has been used to identify many arthropods quickly and at low cost, where equipment is available. We evaluated the ability of MALDI-TOF MS to identify mosquitoes collected in Senegal and stored for several months in silica gel, and to determine the origin of their blood meal. A total of 582 mosquitoes were collected and analysed. We obtained 329/582 (56.52%) MALDI-TOF MS good-quality spectra from mosquito legs and 123/157 (78.34%) good-quality spectra from engorged abdomens. We updated our home-made MALDI-TOF MS arthropod spectra database by adding 23 spectra of five mosquito species from Senegal that had been identified morphologically and molecularly. These included legs from Anopheles gambiae, Anopheles arabiensis, Anopheles cf. rivulorum, Culex nebulosus, Anopheles funestus, and three spectra from abdomens engorged with human blood. Having updated the database, all mosquitoes tested by MALDI-TOF MS were identified with scores greater than or equal to 1.7 as An. gambiae (n = 64), Anopheles coluzzii (n = 12), An. arabiensis (n = 1), An. funestus (n = 7), An. cf rivulorum (n = 1), Lutzia tigripes (n = 3), Cx. nebulosus (n = 211), Culex quinquefasciatus (n = 2), Culex duttoni (n = 1), Culex perfescus (n = 1), Culex tritaeniorhynchus (n = 1), and Aedes aegypti (n = 2). Blood meal identification by MALDI-TOF MS revealed that mosquitoes had fed on the blood of humans (n = 97), cows (n = 6), dogs (n = 2), goats (n = 1), sheep (n = 1), and bats (n = 1). Mixed meals were also detected. These results confirm that MALDI-TOF MS is a promising technique for identifying mosquitoes and the origin of their blood meal. [ABSTRACT FROM AUTHOR]

Bed bug has become a major public health pest worldwide. Infestation may result in numerous negative health effects. Homeless shelters are one of the most habitats that can be infested with bed bugs, a few studies have focused on bed bug infestations in these settings. We conducted a survey of infestations of bed bugs in a homeless shelter in southern France, using an innovative seven-level scale (0–6) to assess the degree of infestation, MALDI TOF-MS to identify bed bugs, and a biomolecular tool to detect bacteria. Bed bug infestations were documented in 13% (9/68) of investigated rooms. A total of 184 bed bugs were collected and morphologically identified as Cimex lectularius. MALDI TOF–MS analysis allowed us to obtain high-quality MS spectra for all 184 specimens, to correctly identify all specimens, and included 178/184 (97%) Log Score Values higher than 1.8. Among the bacteria tested, Wolbachia sp. DNA was found in 149/184 (81%) of the bed bugs, and one sample was positive for Coxiella burnetii, the agent of Q fever. Our study is the first of its kind that offers new perspectives for increasing public awareness of the conditions in homeless shelters. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Rabies vaccinations: are abbreviated intradermal schedules the future?" published in the 2013 issue of the periodical.

A letter to the editor is presented about a case of Rickettsia sibirica mongolitimonae in France.

A letter to the editor and a reply to the article about rabies vaccination among travelers are presented.

• MALDI-TOF MS of bed bugs was correct for all good quality spectra. • Several MS peaks were specific to bed bugs infected with either B. quintana or B. henselae. • MALDI-TOF MS was able to identify the bed bug's Bartonella -infectious status in above 90% of the infected bugs. Bed bugs are small hematophagous insects. They are found in temperate and tropical climates around the world. Their vectorial capacity for several pathogens, including Bartonella spp., has been suspected. An experimental study of artificial infection of Cimex lectularius with Bartonella quintana and Bartonella henselae bacteria was developed to evaluate the ability of MALDI-TOF MS to simultaneously identify bed bugs and their infectious status. This experimental study confirmed the ability of MALDI-TOF MS to identify bed bugs. In addition, it was able to differentiate between control bed bugs, bed bugs infected with Bartonella quintana and bed bugs infected with Bartonella henselae, with an identification percentage above 90%. [ABSTRACT FROM AUTHOR]

The determination of the trophic preferences of the Anopheles gambiae Giles (Diptera: Culicidae) is a decisive parameter for the monitoring and the prevention of malaria risk transmission. Currently, arthropod blood feeding sources are identified using immunological or molecular biology traditional techniques. Despite the effectiveness of these methods, they present several limitations, and notably, they are time-consuming and costly techniques. A recent study demonstrated that MALDI-TOF MS could be a useful tool for the identification of blood meal origins in freshly engorged mosquitoes. However, the limited number of blood vertebrate species tested to date, did not allow an assessment of the efficiency of MALDI-TOF MS in distinguishing blood MS spectra among close host species, such as humans versus primates. Therefore, in the present study, blood from ten distinct vertebrate host species, including four domestic species, four wild species, and two primates, was selected to control the reliability of MALDI-TOF MS based identification. Host blood species-specific MS profiles, up to 24 h post-feeding in engorged Anopheles abdomens, were confirmed. Blind tests underlined the high specificity of MS spectra for the recognition of each host species, preventing misidentification. Nevertheless, an accurate analysis of the results from MS spectra queried against the MS database revealed that the reliability of identification is directly linked to the comprehensiveness of the MS reference database. Finally, the rapidity, the low-cost reagents, the simplicity of data analysis, and the accuracy of the tool for blood origin determination, make this proteomic strategy a promising complementary method for the elucidation of host/vector interactions. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented about the molecular detection of Bartonella alsatica in rabbit fleas in France.

A letter to the editor is presented in response to the article "Establishment of Public Health Security in Saudi Arabia for the 2009 Hajj in Response to Pandemic Influenza A H1N1," by Z. A. Memish and colleagues in the November 21, 2009 issue.

A letter to the editor about a case of dengue virus type 3 (DENV3) infection in a traveler who visited West Africa is presented.

A letter to the editor about the cases of rickettsia aeschlimannii infection in Algeria is presented.

A letter to the editor is presented in response to the article "Outbreak of Chikungunya on Reunion Island:early clinical and laboratory features in 157 adult patients," by G Borgherini and colleagues in a previous issue.

Infections due to Toscana virus (TOSV) have been described in the Mediterranean area, mainly in Italy. We describe two cases of acute TOSV infection in southern France, one aseptic meningitis and one influenza-like illness. To our knowledge, only one other case of TOSV infection has been reported in this area. [Copyright &y& Elsevier]

The article presents a case study of 24-year-old previously healthy man who was admitted to the hospital with a 4-day history of fever and aphasia. The case is considered as the second one of typhoid fever in an adult presenting with Broca's aphasia in the absence of brain abscess. The authors also discuss the lack of information on the pathogenesis of neurologic manifestations in typhoid fever particularly when patients present with focal manifestations in the absence of cerebral abscess.