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Vibert M, Guimard T, Brochard J, Takoudju EM, Larrose C, Boutoille D, Le Turnier P. Leptospirosis in retirees living in rural areas: a poorly recognized emerging problem in mainland France? Open Forum Infect Dis 2022; 9:ofac269. [PMID: 35854997 PMCID: PMC9290540 DOI: 10.1093/ofid/ofac269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/27/2022] [Indexed: 11/15/2022] Open
Abstract
Abstract
Among 40 patients diagnosed with leptospirosis in 3 hospitals of western mainland France between 2014 and 2018 half were at least 60 years old and retired. Their exposure factors were mainly rural residential environment with limited remarkable risk factors. Better awareness and information on leptospirosis appear necessary in this population.
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Affiliation(s)
| | - Thomas Guimard
- Post Emergency and Infectious Diseases department, La Roche sur Yon Hospital , La Roche sur Yon, France
| | - Julia Brochard
- Polyvalent Medicine department, Saint Nazaire Hospital , Saint Nazaire, France
| | - Eve-Marie Takoudju
- Microbiology department, La Roche sur Yon Hospital , La Roche sur Yon, France
| | - Catherine Larrose
- Medical biology department, Nantes University Hospital , Nantes, France
| | - David Boutoille
- Nantes University Hospital Infectious Diseases department, Nantes University Hospital, Nantes, France and INSERM CIC 1413, , Nantes, France
| | - Paul Le Turnier
- Nantes University Hospital Infectious Diseases department, Nantes University Hospital, Nantes, France and INSERM CIC 1413, , Nantes, France
- Infectious Diseases department, Cayenne Hospital , Cayenne, French Guiana
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Velardo F, Bouziri H, Adélaïde L, Oliosi E, Layan M, Descamps A, Berthod D, Patlán-Hernández AR, Ledrans M, Pivette M, Lefort M, Roux J, Crépey P. A cross-sectional study on infectious health risks regarding freshwater sports practice in Brittany, France. JOURNAL OF WATER AND HEALTH 2022; 20:356-368. [PMID: 36366992 DOI: 10.2166/wh.2022.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Freshwater sports expose practitioners to pathogens in the water environment and may result in infection. In French Brittany, these infections are particularly worrying, especially since 2016 with an increase in the incidence of leptospirosis reaching 1 case per 100,000 inhabitants, which represents the highest incidence observed since 1920. We aimed to estimate the prevalence of infectious diseases related to freshwater sports practice and to identify the factors associated with these infections among freshwater sports licensees in Brittany, France. From March 18, 2019, to May 8, 2019, we interviewed freshwater sports licensees (online study) and club presidents and instructors (phone study) in Brittany. Licensee participants were 18 years old or more and practiced at least one freshwater sport in one of the 79 Brittany clubs. We used logistic regression models to study the association between our variables of interest and potential risk factors. In total, 551 licensees (20.3% of the total number of licensees) and 38 clubs (48.1%) were surveyed. Among the licensees, 29 (5.3%) reported being diagnosed with leptospirosis, of which 12 (41.3%) occurred in the last 5 years. The most reported symptoms were skin irritation/itchy skin (24.3%) and 39 individuals (7.1%) reported at least one hospitalization in their lifetime for a disease related to freshwater sports. The occurrence of leptospirosis was negatively associated with boarding from a pontoon (odds ratio (OR)=0.20, 95% confidence interval (95% CI) 0.06-0.56), practicing for less than 4 years (OR=0.17, 95% CI 0.04-0.56) compared to more than 10 years, and the occurrence of leptospirosis was positively associated with taking a soapy shower after practice (OR=4.38, 95% CI 1.90-10.51). Eskimo roll was positively associated with the occurrence of otitis and conjunctivitis (OR=3.22, 95% CI 1.82-6.03), and skin irritation/itchy skin (OR=1.66, 95% CI 0.99-2.84). Otitis, conjunctivitis, and skin irritation/itchy skin are the most commonly reported freshwater sport-related diseases in French Brittany. Despite a good level of knowledge of prevention measures, their implementation by licensees and clubs remains low. Further studies are needed to identify practices associated with infectious risk in freshwater sports.
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Affiliation(s)
- Fanny Velardo
- École Pasteur-Cnam de Santé Publique, Paris, France; These authors contributed equally
| | - Hanifa Bouziri
- Conservatoire National des Arts et Métiers, Paris, France E-mail: ; These authors contributed equally
| | - Lucie Adélaïde
- Université Paris-Saclay, UFR de Pharmacie, Châtenay-Malabry, France; These authors contributed equally
| | - Emma Oliosi
- École Pasteur-Cnam de Santé Publique, Paris, France; These authors contributed equally
| | - Maylis Layan
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, Paris, France; Sorbonne Université, Paris, France; These authors contributed equally
| | - Alexandre Descamps
- Université de Paris, Inserm, CIC Cochin Pasteur, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France; These authors contributed equally
| | - Delphine Berthod
- Service des maladies infectieuses, Institut central des hôpitaux, Hôpital du Valais, Sion, Suisse
| | | | | | - Mathilde Pivette
- Santé Publique France, Cellule régionale Bretagne, Rennes, France
| | - Mathilde Lefort
- Université Rennes, EHESP, REPERES (Recherche en Pharmaco-Épidémiologie et Recours aux Soins)-EA 7449, Rennes, France
| | - Jonathan Roux
- Université Rennes, EHESP, REPERES (Recherche en Pharmaco-Épidémiologie et Recours aux Soins)-EA 7449, Rennes, France
| | - Pascal Crépey
- Université Rennes, EHESP, REPERES (Recherche en Pharmaco-Épidémiologie et Recours aux Soins)-EA 7449, Rennes, France; See the 34th IDEA Field Epidemiology training group in the Acknowledgements section
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Gentile G, Tong C, Renaud C, Menoud N, Casanova L, Blatteau JE, Christen JR, Texier G, Mayet A, Simon F. Incidence of leptospirosis in the French armed forces from 2004 to 2018: Retrospective analysis. Travel Med Infect Dis 2020; 39:101951. [PMID: 33333213 DOI: 10.1016/j.tmaid.2020.101951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The French military personnel may be exposed to leptospirosis during their training or on duty on the field in continental France, and most of all, in intertropical areas in the French departments and in Africa. The aim of this study was to assess the incidence of leptospirosis from epidemiological surveillance and cases data from 2004 to 2018, and to propose tools to assess leptospirosis risk prior to any mission or leisure activity. METHOD A retrospective epidemiological study on leptospirosis cases among French Armed Forces was conducted. More data were collected for 2 clusters in Martinique, as most of leptospirosis cases among French military personnel were identified in Martinique. RESULTS Eighty-eight cases of leptospirosis were reported, 15 cases in continental France and 73 cases in overseas (including 42 cases in the French West Indies). The global leptospirosis incidence rate in continental France was 0.3/100,000 person-years and in overseas 24/100,000 person-years with the higher incidence rate in Martinique (99/100,000 person-years) and in Mayotte (36.9/100,000 person-years). For the clusters in Martinique, between January and June 2009, 7 cases were declared; between 2016 and 2018, 16 cases were reported, high proportions of severe cardiac, renal and neurological forms (6/16) and hospitalizations (9/16). CONCLUSION The occupational risk is real in French Armed Forces, particularly in malaria-free intertropical areas where chemoprophylaxis by doxycycline is not applied. Prevention can be optimized by the use of practical tools such as tables and cartographies, leading to a better leptospirosis risk assessment and application of preventive recommendations.
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Affiliation(s)
- Gaetan Gentile
- Aix-Marseille Université, Département Universitaire de Médecine Générale, Faculté des Sciences Médicales et Paramédicales, 13885, Marseille, France; Aix-Marseille Université, Institut des Neurosciences des Systèmes, INSERM UMR 1106, France; Comité Pédagogique, Pôle Formation-enseignement-recherche, Laveran Military Teaching Hospital, Marseille, France.
| | - Christelle Tong
- Centre D'épidémiologie et de Santé Publique des Armées. GSBDD Marseille Aubagne, 111 Avenue de La Corse BP40026, 13568, Marseille Cedex 02, France.
| | - Christophe Renaud
- Centre Médical des Armées de Toulon, Antenne de L'école de Plongée de Saint-Mandrier, France.
| | - Nastasia Menoud
- Aix-Marseille Université, Département Universitaire de Médecine Générale, Faculté des Sciences Médicales et Paramédicales, 13885, Marseille, France.
| | - Ludovic Casanova
- Aix-Marseille Université, Département Universitaire de Médecine Générale, Faculté des Sciences Médicales et Paramédicales, 13885, Marseille, France; Aix-Marseille Université, VITROME-IHU Méditerranée & ORS PACA (Observatoire Régional de La Santé), France.
| | - Jean-Eric Blatteau
- Service de Médecine Hyperbare et D'Expertise Plongée, HIA Sainte-Anne, Toulon, France.
| | - Jacques-Robert Christen
- Department of Infectious Diseases and Tropical Medicine, Laveran Military Teaching Hospital, Marseille, France.
| | - Gaetan Texier
- Centre D'épidémiologie et de Santé Publique des Armées. GSBDD Marseille Aubagne, 111 Avenue de La Corse BP40026, 13568, Marseille Cedex 02, France; Aix-Marseille Université, VITROME-IHU Méditerranée & ORS PACA (Observatoire Régional de La Santé), France; École Du Val de Grâce, Paris, France.
| | - Aurelie Mayet
- Centre D'épidémiologie et de Santé Publique des Armées. GSBDD Marseille Aubagne, 111 Avenue de La Corse BP40026, 13568, Marseille Cedex 02, France; École Du Val de Grâce, Paris, France; Aix-Marseille Université, INSERM, IRD, SESSTIM UMR1252, Marseille, France.
| | - Fabrice Simon
- Comité Pédagogique, Pôle Formation-enseignement-recherche, Laveran Military Teaching Hospital, Marseille, France; Department of Infectious Diseases and Tropical Medicine, Laveran Military Teaching Hospital, Marseille, France; École Du Val de Grâce, Paris, France.
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Durfort C, Bourée P, Salmon D. Répartition des secteurs professionnels à risque d’exposition chez les cas de leptospirose diagnostiqués en France entre 2007 et 2017. ARCH MAL PROF ENVIRO 2020. [DOI: 10.1016/j.admp.2019.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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House Mice as a Real Sanitary Threat of Human and Animal Leptospirosis: Proposal for Integrated Management. BIOMED RESEARCH INTERNATIONAL 2019; 2019:3794876. [PMID: 31341897 PMCID: PMC6612401 DOI: 10.1155/2019/3794876] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 04/28/2019] [Accepted: 05/28/2019] [Indexed: 12/14/2022]
Abstract
Leptospirosis is a reemerging zoonosis and ranges in severity from benign to sometimes fatal. In cattle, infection may be responsible for abortion and infertility cases causing economic losses. Humans may be contaminated through direct contact with urine of infected animals or indirectly though interaction with urine-contaminated environment. Many wildlife species living close to cattle, especially commensal rodents may play a role in the transmission of leptospires. Because little is known on the epidemiology of nonmaintenance Leptospira serovars, appropriate management is still limited. On a French farm where human and cattle leptospirosis were detected, the transmission cycle was explored to propose appropriate mitigation measures. For that, commensal rodents present on the farm were trapped and their leptospires carriage was studied by molecular methods. Trapped mice were shown to carry two pathogenic Leptospira species (L. interrogans and L. kirschneri). Since these 2 serogroups were simultaneously detected in the trapped mice and in the cows of this farm, we suspected an initial Leptospira transmission from mice to cows requiring an effective management of mice on this farm. Because resistance to anticoagulant rodenticides due to Vkorc1 mutations has been largely described in rodents and first-generation anticoagulant rodenticides seemed to be inefficient in controlling mice on this farm, susceptibility of these mice to anticoagulants has been characterized by Vkorc1 sequencing. 50% of the trapped mice carried mutations in the Vkorc1 gene leading to severe resistance to first-generation anticoagulants. The management of such mice that are a real sanitary threat can be achieved only by using the most toxic second-generation anticoagulants or nonanticoagulant solutions.
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Faucher JF, Chirouze C, Hoen B, Leroy J, Hustache-Mathieu L, Estavoyer JM. Short-course treatment with ceftriaxone for leptospirosis: A retrospective study in a single center in Eastern France. J Infect Chemother 2015; 21:227-8. [DOI: 10.1016/j.jiac.2014.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 09/09/2014] [Accepted: 09/23/2014] [Indexed: 11/28/2022]
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Mikulski M, Boisier P, Lacassin F, Soupé-Gilbert ME, Mauron C, Bruyere-Ostells L, Bonte D, Barguil Y, Gourinat AC, Matsui M, Vernel-Pauillac F, Goarant C. Severity markers in severe leptospirosis: a cohort study. Eur J Clin Microbiol Infect Dis 2014; 34:687-95. [PMID: 25413923 DOI: 10.1007/s10096-014-2275-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 11/03/2014] [Indexed: 01/03/2023]
Abstract
We aimed to evaluate parameters for their value as severity markers in hospitalized leptospirosis patients. We recruited 47 informed adult consenting patients and assessed a number of clinical, hematological, biochemical, and biological variables. Patients were sorted according to severity based on fatality or the requirement of mechanical ventilation or dialysis; the parameters studied were compared between groups on inclusion and the next day. Beside septic shock presentation or a high severity score (Simplified Acute Physiology Score; SAPS II), increased lactate, total bilirubin, lipase, and AST/ALT ratio or a decreased cytokines IL-10/TNF-α ratio were all significantly associated with severity. The gene expression of the IL-1 receptor antagonist IL-1ra, IL-1α, and the long pentraxin PTX-3 were also transcribed at higher levels in most severe cases. Patients could rapidly improve or deteriorate, highlighting the need for a new assessment the next day. Our results add to the limited body of knowledge about severity markers in leptospirosis. They also suggest that patients should be reassessed the next day before being possibly discharged from the hospital. Further studies are needed in order to confirm relevant and reliable prognostic parameters in leptospirosis that would be helpful for the purpose of triage.
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Affiliation(s)
- M Mikulski
- Intensive Care Unit, Centre Hospitalier Territorial, Nouméa, New Caledonia
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