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Diouf FS, Tidjani Alou M, Bassene H, Cortaredona S, Diatta G, Raoult D, Sokhna C, Lagier JC. Seasonal variation of asymptomatic viral and bacterial nasopharyngeal carriage in rural Senegal. J Infect Public Health 2024; 17:922-928. [PMID: 38579539 DOI: 10.1016/j.jiph.2024.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/26/2024] [Accepted: 03/17/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND The surveillance of respiratory pathogens in rural areas of West Africa has, to date, largely been focussed on symptoms. In this prospective study conducted prior to the COVID-19 pandemic, we aimed to assess the asymptomatic prevalence of respiratory pathogen carriage in a group of individuals living in a rural area of Senegalese. METHODS Longitudinal follow up was performed through monthly nasopharyngeal swabbing during the dry season and weekly swabbing during the rainy season. We enrolled 15 individuals from the village of Ndiop. A total of 368 nasopharyngeal swabs were collected over a one-year period. We investigated the prevalence of 18 respiratory viruses and eight respiratory bacteria in different age groups using singleplex and multiplex PCR. RESULTS In total, 19.56% of the samples (72/368) were positive for respiratory viruses and 13.60% of the samples (50/368) were positive for respiratory bacteria. Coronaviruses (19/72, 26.39%), adenoviruses (17/72, 23.61%), rhinoviruses (14/72, 19.44%), Streptococcus pneumoniae (17/50, 34%), and Moraxella catarrhalis (15/50, 30%) were the most frequently detected viruses. Interestingly, the carriage of respiratory pathogens was shown to be more frequent during the rainy season, as pluviometry was shown to be positively associated with the occurrence of respiratory viruses such as influenza (P = .0078, r2 =.523) and RSV (P = .0055, r2 =.554). CONCLUSIONS Our results show a non-negligible circulation of respiratory pathogens in a rural area in Senegal (West Africa) with an underestimated proportion of asymptomatic individuals. This study highlights the fact that the circulation of viruses and bacteria in the community has been overlooked.
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Affiliation(s)
- Fatou Samba Diouf
- VITROME IRD, Campus International de Recherche IRD-UCAD Hann, Dakar, Senegal; IHU Méditerranée Infection, Marseille, France; Aix-Marseille Université, APHM, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Maryam Tidjani Alou
- IHU Méditerranée Infection, Marseille, France; Aix-Marseille Université, APHM, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Hubert Bassene
- VITROME IRD, Campus International de Recherche IRD-UCAD Hann, Dakar, Senegal
| | - Sebastien Cortaredona
- VITROME IRD, Campus International de Recherche IRD-UCAD Hann, Dakar, Senegal; IHU Méditerranée Infection, Marseille, France; Aix-Marseille Université, APHM, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Georges Diatta
- VITROME IRD, Campus International de Recherche IRD-UCAD Hann, Dakar, Senegal
| | - Didier Raoult
- VITROME IRD, Campus International de Recherche IRD-UCAD Hann, Dakar, Senegal; IHU Méditerranée Infection, Marseille, France; Aix-Marseille Université, APHM, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Cheikh Sokhna
- VITROME IRD, Campus International de Recherche IRD-UCAD Hann, Dakar, Senegal; IHU Méditerranée Infection, Marseille, France; Aix-Marseille Université, APHM, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Jean-Christophe Lagier
- IHU Méditerranée Infection, Marseille, France; Aix-Marseille Université, APHM, MEPHI, IHU Méditerranée Infection, Marseille, France.
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Ouaddane I, Goumballa N, Tran XD, Diouf C, Diene SM, Rolain JM, Sokhna C, Gautret P. Epidemiology of bacterial resistance at the Grand Magal of Touba in Senegal. Travel Med Infect Dis 2024; 59:102709. [PMID: 38479605 DOI: 10.1016/j.tmaid.2024.102709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 03/05/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND The Grand Magal of Touba (GMT) associates with risks of infection, but no study on the circulation of resistant bacteria has yet been conducted. MATERIALS AND METHODS qPCR was performed on rectal samples from GMT pilgrims between 2018 and 2021, before and after their participation in the gathering. Rectal samples from between 2018 and 2020 were also cultured on specific media, and antibiotic susceptibility testing was performed. RESULTS Forty-one of the 296 (13.8%) pilgrims had at least one gastrointestinal symptom and 91/290 (31.4%) acquired pathogenic bacteria, mostly Escherichia coli. A total of 54.7% of pilgrims reported washing their hands more frequently than usual and 89.2% used soap. One hundred and five (36.2%) acquired at least one resistance gene, notably CTX-M A (21.0%), SHV (16.5%) and TEM (8.2%). The strains isolated by culture were mostly E. coli. These bacteria were found to be sensitive to carbapenems and resistant to amoxicillin and amoxicillin-clavulanic acid. The acquisition of enteroaggregative E. coli was independently associated with CTX-M A and TEM acquisition. CONCLUSION Pilgrims presented a risk for acquisition of CTX-M A after the GMT. Surveillance of the prevalence of resistant bacteria and the occurrence of associated clinical infections among pilgrims are necessary in the future.
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Affiliation(s)
- Ihssane Ouaddane
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Ndiaw Goumballa
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France; VITROME, Campus International IRD-UCAD de L'IRD, Dakar, Senegal
| | - Xuan Duong Tran
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Coumba Diouf
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France; VITROME, Campus International IRD-UCAD de L'IRD, Dakar, Senegal
| | - Seydina M Diene
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Jean-Marc Rolain
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Cheikh Sokhna
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France; VITROME, Campus International IRD-UCAD de L'IRD, Dakar, Senegal
| | - Philippe Gautret
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France.
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Goumballa N, Diouf FS, Beye M, Sambou M, Bassène H, Dieng M, Aïdara A, Targa LLE, Colson P, Gautret P, Sokhna C. Influenza at the 2021 Grand Magal of Touba and possible spread to rural villages in South Senegal - a genomic epidemiological study. Int J Infect Dis 2024; 141:106952. [PMID: 38336005 DOI: 10.1016/j.ijid.2024.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/26/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
OBJECTIVES Influenza is frequent among pilgrims participating in the Grand Magal de Touba (GMT), in Senegal, with a potential to spread to contacts when they return home. METHODS Ill pilgrims consulting at a health care center in Mbacké city close to Touba during the 2021 GMT, pilgrims returning to Dielmo and Ndiop villages, and patients who did not travel to Touba and consulted at health care centers in these two villages in 2021 were tested for the influenza virus by polymerase chain reaction on nasopharyngeal samples. Next-generation sequencing and comparative and phylogenetic analyses of influenza A virus genomes were performed. RESULTS A total of 62 of 685 patients tested positive for influenza A virus, including 34 of 53 who were consulted in Mbacké in late September, six of 129 pilgrims who returned home in early October, and 20 of 42 villagers from October 3 to 29. A total of 27 genomes were obtained. Four clusters were observed based on the phylogenetic analyses, suggesting that Mbacké patients and returned pilgrims may have shared closely related viral strains with patients inhabiting the villages who did not participate in the GMT. CONCLUSIONS Villagers in Ndiop and Dielmo may have been infected with viral strains originating from the GMT and possibly imported by pilgrims who returned from the GMT.
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Affiliation(s)
- Ndiaw Goumballa
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Senegal; IHU-Méditerranée Infection, Marseille, France
| | - Fatou Samba Diouf
- VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Senegal; IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, MEPHI, Marseille, France
| | | | - Masse Sambou
- VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Senegal
| | - Hubert Bassène
- VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Senegal
| | | | | | - Lorlane L E Targa
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, MEPHI, Marseille, France
| | - Philippe Colson
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, MEPHI, Marseille, France
| | - Philippe Gautret
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Cheikh Sokhna
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Senegal; IHU-Méditerranée Infection, Marseille, France.
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Diouf FS, Tidjani Alou M, Million M, Diatta G, Goumballa N, Ndiaye D, Bassene H, Dubourg G, Raoult D, Sokhna C, Lagier JC. Influence of Microbiota on Clinical Expressions of Respiratory Viral Infections. Am J Trop Med Hyg 2024; 110:391-398. [PMID: 38109763 PMCID: PMC10859809 DOI: 10.4269/ajtmh.23-0244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/12/2023] [Indexed: 12/20/2023] Open
Abstract
Respiratory infections, mainly due to viruses, are among the leading causes of worldwide morbidity and mortality. We investigated the prevalence of viruses and bacteria in a cross-sectional survey conducted in Dielmo, a village in rural Senegal with a population of 481 inhabitants. Nasopharyngeal sampling was performed in 50 symptomatic subjects and 101 asymptomatic subjects. Symptomatic subjects were defined as individuals presenting with clinical signs of respiratory infection, whereas asymptomatic subjects were recruited in the same households. The identification of pathogens was performed by polymerase chain reaction for 18 respiratory viruses and eight respiratory bacteria. The prevalence results for respiratory viruses detected in each study group demonstrated that 83.6% of symptomatic samples were positive for at least one respiratory virus, and 21.8% were detected in asymptomatic samples. Influenza A (P = 0.0001), metapneumovirus (P = 0.04), and enterovirus (P = 0.001) were significantly more prevalent in symptomatic patients. Overall, 82.0% of symptomatic subjects and 26.9% of asymptomatic subjects were positive for at least one respiratory bacterium. The most frequent pathogenic bacteria detected were Moraxella catarrhalis (56%) and Streptococcus pneumoniae (48.0%) among symptomatic individuals, whereas in asymptomatic subjects Corynebacterium propinquum was more prevalent (18%). A principal component analysis showed that parainfluenzas 2 and 4 were associated with asymptomatic subjects, whereas influenza A was associated with the presence of symptoms. Considering these results, a large epidemiological surveillance of the circulation of these respiratory pathogens in the general population should be conducted to provide a better understanding of their carriage and to potentially prevent epidemics.
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Affiliation(s)
- Fatou Samba Diouf
- VITROME IRD, Campus International de Recherche IRD-UCAD Hann, Dakar, Senegal
- Aix Marseille Université, Institut de recherche pour le développement, Assistance Publique - Hôpitaux de Marseille, Microbes, Évolution, Phylogénie et Infection, Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France
| | - Maryam Tidjani Alou
- Aix Marseille Université, Institut de recherche pour le développement, Assistance Publique - Hôpitaux de Marseille, Microbes, Évolution, Phylogénie et Infection, Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France
| | - Mathieu Million
- Aix Marseille Université, Institut de recherche pour le développement, Assistance Publique - Hôpitaux de Marseille, Microbes, Évolution, Phylogénie et Infection, Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France
| | - Georges Diatta
- VITROME IRD, Campus International de Recherche IRD-UCAD Hann, Dakar, Senegal
| | - Ndiaw Goumballa
- VITROME IRD, Campus International de Recherche IRD-UCAD Hann, Dakar, Senegal
- Aix-Marseille Université, Institut de recherche pour le développement, Assistance Publique-Hôpitaux de Marseille, Service de santé des armées, Vecteurs – Infections Tropicales et Méditerranéennes, Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France
| | - Dame Ndiaye
- VITROME IRD, Campus International de Recherche IRD-UCAD Hann, Dakar, Senegal
| | - Hubert Bassene
- VITROME IRD, Campus International de Recherche IRD-UCAD Hann, Dakar, Senegal
| | - Gregory Dubourg
- Aix Marseille Université, Institut de recherche pour le développement, Assistance Publique - Hôpitaux de Marseille, Microbes, Évolution, Phylogénie et Infection, Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France
| | - Didier Raoult
- Aix Marseille Université, Institut de recherche pour le développement, Assistance Publique - Hôpitaux de Marseille, Microbes, Évolution, Phylogénie et Infection, Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France
| | - Cheikh Sokhna
- VITROME IRD, Campus International de Recherche IRD-UCAD Hann, Dakar, Senegal
- Aix Marseille Université, Institut de recherche pour le développement, Assistance Publique - Hôpitaux de Marseille, Microbes, Évolution, Phylogénie et Infection, Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France
| | - Jean-Christophe Lagier
- Aix Marseille Université, Institut de recherche pour le développement, Assistance Publique - Hôpitaux de Marseille, Microbes, Évolution, Phylogénie et Infection, Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France
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Tambe LAM, Mathobo P, Munzhedzi M, Bessong PO, Mavhandu-Ramarumo LG. Prevalence and Molecular Epidemiology of Human Coronaviruses in Africa Prior to the SARS-CoV-2 Outbreak: A Systematic Review. Viruses 2023; 15:2146. [PMID: 38005824 PMCID: PMC10675249 DOI: 10.3390/v15112146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 11/26/2023] Open
Abstract
Coronaviruses, re-emerging in human populations, cause mild or severe acute respiratory diseases, and occasionally epidemics. This study systematically reviewed human coronavirus (HCoVs) infections in Africa prior to the SARS-CoV-2 outbreak. Forty studies on the prevalence or molecular epidemiology of HCoVs were available from 13/54 African countries (24%). The first published data on HCoV was from South Africa in 2008. Eight studies (20%) reported on HCoV molecular epidemiology. Endemic HCoV prevalence ranged from 0.0% to 18.2%. The prevalence of zoonotic MERS-CoV ranged from 0.0% to 83.5%. Two studies investigated SARS-CoV infection, for which a prevalence of 0.0% was reported. There was heterogeneity in the type of tests used in determining HCoV prevalence. Two studies reported that risk factors for HCoV include exposure to infected animals or humans. The quantity of virologic investigations on HCoV on the African continent was scant, and Africa was not prepared for SARS-CoV-2.
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Affiliation(s)
- Lisa Arrah Mbang Tambe
- HIV/AIDS & Global Health Research Programme, Faculty of Science, Engineering and Agriculture, University of Venda, Thohoyandou 0950, South Africa; (L.A.M.T.); (P.M.); (M.M.); (P.O.B.)
- Department of Biochemistry and Microbiology, Faculty of Science, Engineering and Agriculture, University of Venda, Thohoyandou 0950, South Africa
| | - Phindulo Mathobo
- HIV/AIDS & Global Health Research Programme, Faculty of Science, Engineering and Agriculture, University of Venda, Thohoyandou 0950, South Africa; (L.A.M.T.); (P.M.); (M.M.); (P.O.B.)
- Department of Biochemistry and Microbiology, Faculty of Science, Engineering and Agriculture, University of Venda, Thohoyandou 0950, South Africa
| | - Mukhethwa Munzhedzi
- HIV/AIDS & Global Health Research Programme, Faculty of Science, Engineering and Agriculture, University of Venda, Thohoyandou 0950, South Africa; (L.A.M.T.); (P.M.); (M.M.); (P.O.B.)
- Department of Biochemistry and Microbiology, Faculty of Science, Engineering and Agriculture, University of Venda, Thohoyandou 0950, South Africa
| | - Pascal Obong Bessong
- HIV/AIDS & Global Health Research Programme, Faculty of Science, Engineering and Agriculture, University of Venda, Thohoyandou 0950, South Africa; (L.A.M.T.); (P.M.); (M.M.); (P.O.B.)
- Centre for Global Health Equity, School of Medicine, 1400 University Ave, Charlottesville, VA 22903, USA
| | - Lufuno Grace Mavhandu-Ramarumo
- HIV/AIDS & Global Health Research Programme, Faculty of Science, Engineering and Agriculture, University of Venda, Thohoyandou 0950, South Africa; (L.A.M.T.); (P.M.); (M.M.); (P.O.B.)
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Lovey T, Hasler R, Gautret P, Schlagenhauf P. Travel-related respiratory symptoms and infections in travellers (2000-22): a systematic review and meta-analysis. J Travel Med 2023; 30:taad081. [PMID: 37310895 PMCID: PMC10481419 DOI: 10.1093/jtm/taad081] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND Respiratory tract infections (RTIs) are common in travellers due to the year-round or seasonal presence of respiratory pathogen and exposure to crowded environments during the itinerary. No study has systematically examined the burden of RTI infections among travellers. The aim of this systematic review and meta-analysis is to evaluate the prevalence of RTIs and symptoms suggestive of RTIs among travellers according to risk groups and/or geographic region, and to describe the spectrum of RTIs. METHODS The systematic review and meta-analysis was registered in PROSPERO (CRD42022311261). We searched Medline, Embase, Scopus, Cochrane Central, Web of Science, Science Direct and preprint servers MedRxiv, BioRxiv, SSRN and IEEE Xplore on 1 February 2022. Studies reporting RTIs or symptoms suggestive of RTIs in international travellers after 1 January 2000 were eligible. Data appraisal and extraction were performed by two authors, and proportional meta-analyses were used to obtain estimates of the prevalence of respiratory symptoms and RTIs in travellers and predefined risk groups. FINDINGS A total of 429 articles on travellers' illness were included. Included studies reported 86 841 symptoms suggestive of RTIs and 807 632 confirmed RTIs. Seventy-eight percent of reported respiratory symptoms and 60% of RTIs with available location data were acquired at mass gatherings events. Cough was the most common symptom suggestive of respiratory infections, and the upper respiratory tract was the most common site for RTIs in travellers. The prevalence of RTIs and respiratory symptoms suggestive of RTIs were 10% [8%; 14%] and 37% [27%; 48%], respectively, among travellers. Reporting of RTIs in travellers denoted by publication output was found to correlate with global waves of new respiratory infections. INTERPRETATION This study demonstrates a high burden of RTIs among travellers and indicates that travellers' RTIs reflect respiratory infection outbreaks. These findings have important implications for understanding and managing RTIs among travellers.
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Affiliation(s)
- Thibault Lovey
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Hirschengraben 84, 8001 Zürich Switzerland
| | - Robin Hasler
- HFR Fribourg – Cantonal Hospital, 1708 Fribourg, Switzerland
| | | | - Patricia Schlagenhauf
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Hirschengraben 84, 8001 Zürich Switzerland
- Department of Global and Public Health, MilMedBiol Competence Centre, Epidemiology Biostatistics and Prevention Institute, WHO Collaborating Centre for Travellers’ Health, Hirschengraben 84, 8001 Zürich, Switzerland
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Goumballa N, Sambou M, Samba DF, Bassene H, Bedotto M, Aidara A, Dieng M, Hoang VT, Parola P, Sokhna C, Gautret P. PCR investigation of infections in patients consulting at a healthcare centre over a four-year period during the Grand Magal of Touba. Travel Med Infect Dis 2022; 52:102515. [PMID: 36470351 DOI: 10.1016/j.tmaid.2022.102515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/15/2022] [Accepted: 12/01/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Respiratory and gastrointestinal symptoms and febrile illness are the most common complaints among ill pilgrims attending the Grand Magal of Touba (GMT) in Senegal. METHODS Patients presenting with respiratory or gastrointestinal symptoms or febrile systemic illnesses were recruited between 2018 and 2021 at a healthcare centre close to Touba. Respiratory, gastrointestinal and blood samples were tested for potential pathogens using qPCR. RESULTS 538 patients were included. 45.5% of these were female, with a median age of 17 years. Of the 326 samples collected from patients with a cough, 62.8% tested positive for at least one virus, including influenza viruses (33.1%). A high positivity rate of bacterial carriage was observed for Haemophilus influenzae (72.7%), Streptococcus pneumoniae (51.2%) and Moraxella catarrhalis (46.0%). Of the 95 samples collected from patients with diarrhoea, 71.3% were positive, with high rates of bacterial carriage, ranging from 4.2% for Tropheryma whipplei to 45.3% for Entero-pathogenic Escherichia coli. Of the 141 blood samples collected from patients with fever, 31.9% were positive including Plasmodium falciparum (21.3%), Borrelia sp. (5.7%) and dengue virus (5.0%). CONCLUSION This study provides insight into the aetiology of most common infections at the GMT on which to base therapeutic options.
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Affiliation(s)
- Ndiaw Goumballa
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Senegal; IHU-Méditerranée Infection, Marseille, France
| | - Masse Sambou
- VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Senegal
| | - Diouf Fatou Samba
- VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Senegal; IHU-Méditerranée Infection, Marseille, France
| | - Hubert Bassene
- VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Senegal
| | | | - Adama Aidara
- Région Médicale de Diourbel, Senegal; Centre de Santé de Mbacké, Senegal
| | | | - Van Thuan Hoang
- Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam
| | - Philippe Parola
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Cheikh Sokhna
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Senegal; IHU-Méditerranée Infection, Marseille, France
| | - Philippe Gautret
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France.
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Risk factors for symptoms of infection and the acquisition of pathogens among pilgrims at the Grand Magal of Touba, 2017–2021. Travel Med Infect Dis 2022; 49:102418. [DOI: 10.1016/j.tmaid.2022.102418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/28/2022] [Accepted: 07/31/2022] [Indexed: 01/07/2023]
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Tchoupou Saha OLF, Dubourg G, Yacouba A, Bossi V, Raoult D, Lagier JC. Profile of the Nasopharyngeal Microbiota Affecting the Clinical Course in COVID-19 Patients. Front Microbiol 2022; 13:871627. [PMID: 35655997 PMCID: PMC9152678 DOI: 10.3389/fmicb.2022.871627] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
While populations at risk for severe SARS-CoV-2 infections have been clearly identified, susceptibility to the infection and its clinical course remain unpredictable. As the nasopharyngeal microbiota may promote the acquisition of several respiratory infections and have an impact on the evolution of their outcome, we studied the nasopharyngeal microbiota of COVID-19 patients in association with baseline disease-related clinical features compared to that of patients tested negative. We retrospectively analyzed 120 nasopharyngeal pseudonymized samples, obtained for diagnosis, divided into groups (infected patients with a favorable outcome, asymptomatic, and deceased patients) and patients tested negative for SARS-CoV-2, by using Illumina-16S ribosomal ribonucleic acid (rRNA) sequencing and specific polymerase chain reaction (PCR) targeting pathogens. We first found a depletion of anaerobes among COVID-19 patients, irrespective of the clinical presentation of the infection (p < 0.029). We detected 9 taxa discriminating patients tested positive for SARS-CoV-2 from those that were negative including Corynebacterium propinquum/pseudodiphtericum (p ≤ 0.05), Moraxella catarrhalis (p ≤ 0.05), Bacillus massiliamazoniensis (p ≤ 0.01), Anaerobacillus alkalidiazotrophicus (p ≤ 0.05), Staphylococcus capitis subsp. capitis (p ≤ 0.001), and Afipia birgiae (p ≤ 0.001) with 16S rRNA sequencing, and Streptococcus pneumoniae (p ≤ 0.01), Klebsiella pneumoniae (p ≤ 0.01), and Enterococcus faecalis (p ≤ 0.05) using real-time PCR. By designing a specific real-time PCR, we also demonstrated that C. propinquum is decreased in asymptomatic individuals compared to other SARS-CoV 2 positive patients. These findings indicate that the nasopharyngeal microbiota as in any respiratory infection plays a role in the clinical course of the disease. Further studies are needed to elucidate the potential role in the clinical course of the disease of M. catarrhalis, Corynebacterium accolens, and more specifically Corynebacterium propinquum/diphteriticum in order to include them as predictors of the severity of COVID-19.
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Affiliation(s)
- Ornella la Fortune Tchoupou Saha
- Aix-Marseille Université, Institut de Recherche pour le Développement (IRD), Assistance Publique - Hôpitaux de Marseille (AP-HM), Microbes Evolution Phylogeny and Infections (MEPHI), Marseille, France.,IHU Méditerranée Infection, Marseille, France
| | - Grégory Dubourg
- Aix-Marseille Université, Institut de Recherche pour le Développement (IRD), Assistance Publique - Hôpitaux de Marseille (AP-HM), Microbes Evolution Phylogeny and Infections (MEPHI), Marseille, France.,IHU Méditerranée Infection, Marseille, France
| | - Abdourahamane Yacouba
- Aix-Marseille Université, Institut de Recherche pour le Développement (IRD), Assistance Publique - Hôpitaux de Marseille (AP-HM), Microbes Evolution Phylogeny and Infections (MEPHI), Marseille, France.,IHU Méditerranée Infection, Marseille, France
| | | | - Didier Raoult
- Aix-Marseille Université, Institut de Recherche pour le Développement (IRD), Assistance Publique - Hôpitaux de Marseille (AP-HM), Microbes Evolution Phylogeny and Infections (MEPHI), Marseille, France.,IHU Méditerranée Infection, Marseille, France
| | - Jean-Christophe Lagier
- Aix-Marseille Université, Institut de Recherche pour le Développement (IRD), Assistance Publique - Hôpitaux de Marseille (AP-HM), Microbes Evolution Phylogeny and Infections (MEPHI), Marseille, France.,IHU Méditerranée Infection, Marseille, France
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10
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High influenza A prevalence but no SARS-CoV-2 among 2021 Grand Magal pilgrims in Touba, Senegal. Travel Med Infect Dis 2021; 44:102189. [PMID: 34695566 DOI: 10.1016/j.tmaid.2021.102189] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 12/20/2022]
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11
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Dao TL, Hoang VT, Ly TDA, Goumballa N, Gautret P. Epidemiological Investigations of Infectious Diseases among Mobile Populations at the University Hospital Institute Mediterranean Infection in Marseille, France. J Epidemiol Glob Health 2021; 11:271-282. [PMID: 34514760 PMCID: PMC8435867 DOI: 10.2991/jegh.k.210526.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 05/21/2021] [Indexed: 11/29/2022] Open
Abstract
We review the most recent work conducted by our group on the circulation of infectious agents in mobile populations, including pilgrims participating in the Hajj (Mecca, Saudi Arabia) and the Grand Magal of Touba (Senegal) pilgrimages, homeless people, and medical students participating in an elective abroad. Using a similar epidemiological study design with standardized questionnaires and molecular assays allows comparison of different populations of travelers. The main infectious pathogens and antibiotic resistance genes linked to travel were identified in certain specific populations of travelers, as well as in a group of homeless migrant people in Marseille. The role of several risk factors has also been demonstrated, allowing identifying individuals at increased risk of disease or pathogen carriage on which to base targeted preventive measures. Such results, together with those obtained through international surveillance networks allow better description of the epidemiology of travel-associated infectious diseases.
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Affiliation(s)
- Thi Loi Dao
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, France.,IHU-Méditerranée Infection, 19-21 Boulevard Jean, Moulin 13385, Marseille Cedex 05, France.,Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Van Thuan Hoang
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, France.,IHU-Méditerranée Infection, 19-21 Boulevard Jean, Moulin 13385, Marseille Cedex 05, France.,Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Tran Duc Anh Ly
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, France.,IHU-Méditerranée Infection, 19-21 Boulevard Jean, Moulin 13385, Marseille Cedex 05, France
| | - Ndiaw Goumballa
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, France.,IHU-Méditerranée Infection, 19-21 Boulevard Jean, Moulin 13385, Marseille Cedex 05, France
| | - Philippe Gautret
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, France.,IHU-Méditerranée Infection, 19-21 Boulevard Jean, Moulin 13385, Marseille Cedex 05, France
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12
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Sokhna C, Goumballa N, Hoang VT, Bassene H, Parola P, Gautret P. The Grand Magal of Touba was spared by the COVID-19 pandemic. Int J Infect Dis 2021; 105:470-471. [PMID: 33434665 PMCID: PMC9183244 DOI: 10.1016/j.ijid.2021.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 12/23/2020] [Accepted: 01/01/2021] [Indexed: 12/12/2022] Open
Abstract
In the context of the coronavirus disease-2019 (COVID-19) pandemic, all mass gathering (MG) events have been cancelled. The Grand Magal took place on October 6, 2020, in Touba, Senegal, which was the only MG event organized in 2020. This Muslim pilgrimage gathers about four million Muslim Mourides from Senegal and beyond. No significant increase in COVID-19 cases was therefore observed at the national level in the weeks following the Grand Magal. This successful strategy is an invitation to better promote community commitments by public authorities in their various strategies.
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13
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Al-Tawfiq JA, Memish ZA. The Emergence, Persistence, and Dissemination of Antimicrobial-Resistant Bacteria in Environmental Hajj Settings and Implications for Public Health. Trop Med Infect Dis 2021; 6:33. [PMID: 33802167 PMCID: PMC8005974 DOI: 10.3390/tropicalmed6010033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 11/21/2022] Open
Abstract
The emergence of antimicrobial resistance is causing the loss of what was once considered the miracle cure. The transmission of antimicrobial resistance during mass gathering is a potential threat in addition to other infectious diseases. Here, we review the English language literature on the rate and the acquisition of antimicrobial resistance during the Hajj. There is a variable incidence of methicillin-resistant Staphylococcus aureus, Escherichia coli, and Enterobacteriaceae. There had been no report of multi-drug-resistant Mycobacterium tuberculosis. Continued surveillance of antimicrobial resistance coupled with public health measures are needed to decrease the rate of emergence of resistance.
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Affiliation(s)
- Jaffar A. Al-Tawfiq
- Specialty Internal Medicine and Quality Division, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia;
- Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21093, USA
| | - Ziad A. Memish
- Director Research and Innovation Center, King Saud Medical City, Ministry of Health, Riyadh 12746, Saudi Arabia
- Al-Faisal University, Riyadh 11533, Saudi Arabia
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
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14
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Sokhna C, Mboup BM, Goumbala N, Dieng M, Sylla AB, Raoult D, Parola P, Gautret P. Establishing Medical Coverage and Epidemiological Surveillance during the Grand Magal of Touba in Senegal: A Public Health Need. J Epidemiol Glob Health 2020; 10:247-249. [PMID: 32959622 PMCID: PMC7758853 DOI: 10.2991/jegh.k.200620.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 05/18/2020] [Indexed: 12/16/2022] Open
Abstract
The Grand Magal is a religious pilgrimage that takes place in Senegal. An estimated 4–5 million individuals yearly gather in the holy city of Touba. Pilgrims comes from the whole Senegal and surrounding countries and from countries outside of Africa where Mouride Senegalese emigrated. It is the largest Mass Gathering (MG) event of the Mouride community and the largest Muslim religious MG in West Africa. The context of the Grand Magal MG is unique given its location in a tropical developing country and its international component which may favour the globalization of local endemic diseases and warrants investment in modern methods for public health surveillance and planning of the event.
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Affiliation(s)
- Cheikh Sokhna
- Aix Marseille University, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France.,VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Senegal
| | | | - Ndiaw Goumbala
- VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Senegal
| | | | | | - Didier Raoult
- Aix Marseille University, IRD, AP-HM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | - Philippe Parola
- Aix Marseille University, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France
| | - Philippe Gautret
- Aix Marseille University, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France
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15
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Goumballa N, Dieng M, Sokhna C, Gautret P. Lack of SARS-CoV-2 among Grand Magal de Touba pilgrims consulting for respiratory symptoms in October 2020. Travel Med Infect Dis 2020; 39:101916. [PMID: 33189885 DOI: 10.1016/j.tmaid.2020.101916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 10/24/2020] [Accepted: 10/26/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Ndiaw Goumballa
- IHU-Méditerranée Infection, Marseille, France; VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Senegal
| | | | - Cheikh Sokhna
- IHU-Méditerranée Infection, Marseille, France; VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Senegal
| | - Philippe Gautret
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.
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16
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Colson P, Esteves-Vieira V, Giraud-Gatineau A, Zandotti C, Filosa V, Chaudet H, Lagier JC, Raoult D. Temporal and age distributions of SARS-CoV-2 and other coronaviruses, southeastern France. Int J Infect Dis 2020; 101:121-125. [PMID: 32976991 PMCID: PMC7511210 DOI: 10.1016/j.ijid.2020.09.1417] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/11/2020] [Accepted: 09/15/2020] [Indexed: 01/10/2023] Open
Abstract
Objectives The SARS-CoV-2 epidemic presents a poorly understood epidemiological cycle. We aimed to compare the age and weekly distributions of the five human coronaviruses, including SARS-CoV-2, that circulated in southeastern France. Methods We analyzed all available diagnoses of respiratory viruses, including SARS-CoV-2, performed between 09/2013 and 05/2020 at the University Hospital Institute Méditerranée Infection in Marseille, southeastern France. Results For SARS-CoV-2, positive children <15 years of age represented 3.4% (228/6,735) of all positive cases, which is significantly less than for endemic coronaviruses (46.1%; 533/1,156; p < 0.001). Among 10,026 patients tested for SARS-CoV-2 and endemic coronaviruses in 2020, children <15 years represented a significantly lower proportion of all positive cases for SARS-CoV-2 than for endemic coronaviruses [2.2% (24/1,067) vs. 33.5% (149/445), respectively; p < 0.001]. Epidemic curves for endemic coronaviruses and SARS-CoV-2 in 91,722 patients showed comparable bell-shaped distributions with a slight time lag. In contrast, the age distribution of endemic coronaviruses and 14 other respiratory viruses differed significantly compared to that of SARS-CoV-2, which was the only virus to relatively spare children. Conclusions We observed for SARS-CoV-2 a temporal distribution resembling that of endemic coronaviruses but an age distribution that relatively spares the youngest subjects, who are those the most exposed to endemic coronaviruses.
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Affiliation(s)
- Philippe Colson
- IHU Méditerranée Infection, Marseille, France; Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France; Aix-Marseille Univ., Microbes Evolution Phylogeny and Infections (MEPHI), Institut de recherche pour le développement (IRD), Marseille, France
| | - Vera Esteves-Vieira
- IHU Méditerranée Infection, Marseille, France; Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Audrey Giraud-Gatineau
- IHU Méditerranée Infection, Marseille, France; Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France; Aix-Marseille Univ., Microbes Evolution Phylogeny and Infections (MEPHI), Institut de recherche pour le développement (IRD), Marseille, France; Service de Santé des Armées (SSA), Marseille, France
| | - Christine Zandotti
- IHU Méditerranée Infection, Marseille, France; Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Véronique Filosa
- IHU Méditerranée Infection, Marseille, France; Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Hervé Chaudet
- IHU Méditerranée Infection, Marseille, France; Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France; Aix-Marseille Univ., Microbes Evolution Phylogeny and Infections (MEPHI), Institut de recherche pour le développement (IRD), Marseille, France; Service de Santé des Armées (SSA), Marseille, France
| | - Jean-Christophe Lagier
- IHU Méditerranée Infection, Marseille, France; Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France; Aix-Marseille Univ., Microbes Evolution Phylogeny and Infections (MEPHI), Institut de recherche pour le développement (IRD), Marseille, France
| | - Didier Raoult
- IHU Méditerranée Infection, Marseille, France; Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France; Aix-Marseille Univ., Microbes Evolution Phylogeny and Infections (MEPHI), Institut de recherche pour le développement (IRD), Marseille, France.
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17
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Gautret P, Goumballa N, Hoang VT, Sokhna C. The 2020 Grand Magal of Touba, Senegal in the time of the COVID-19 pandemic. Travel Med Infect Dis 2020; 38:101880. [PMID: 32949701 PMCID: PMC7494441 DOI: 10.1016/j.tmaid.2020.101880] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Philippe Gautret
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France.
| | - Ndiaw Goumballa
- IHU-Méditerranée Infection, Marseille, France; VITROME, Campus International IRD-UCAD de L'IRD, Dakar, Senegal
| | - Van Thuan Hoang
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France; Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam
| | - Cheikh Sokhna
- IHU-Méditerranée Infection, Marseille, France; VITROME, Campus International IRD-UCAD de L'IRD, Dakar, Senegal
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18
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Gastrointestinal symptoms and the acquisition of enteric pathogens in Hajj pilgrims: a 3-year prospective cohort study. Eur J Clin Microbiol Infect Dis 2020; 40:315-323. [PMID: 32918166 DOI: 10.1007/s10096-020-04018-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 08/24/2020] [Indexed: 10/23/2022]
Abstract
The acquisition of enteric pathogens and risk factors for Hajj-associated diarrhea in Hajj pilgrims is poorly documented. Pilgrims from Marseille participating in the Hajj in 2016-2018 underwent successive systematic rectal swabbing before and after their travel. Carriage of the main enteric pathogens was assessed by real-time PCR. Baseline demographics, adherence to individual preventive measures, gastrointestinal symptoms, and treatments were recorded. A total of 376 pilgrims were included. The median age was 62.0 years. During the Hajj, 18.6% presented at least one gastrointestinal symptom, 13.8% had diarrhea, and 36.4% had acquired at least one enteric pathogen. Enteropathogenic Escherichia coli (EPEC) and Enteroaggregative E. coli (EAEC) were the pathogens most frequently acquired by pilgrims (17.6% and 14.4%, respectively). Being female was associated with increased frequency of gastrointestinal symptoms during the pilgrimage (aOR = 2.38, p = 0.004). Enterohemorrhagic Escherichia coli (EHEC) acquisition was associated with a four-fold higher risk of reporting at least one gastrointestinal symptom and diarrhea (aOR = 3.68 and p = 0.01 and aOR = 3.96 and p = 0.01, respectively). Pilgrims who suffered from diarrhea were more likely to wash their hands more often (aOR = 2.07, p = 0.03) and to be either overweight (aOR = 2.71, p = 0.03) or obese (aOR = 2.51, p = 0.05). Enteric bacteria such as E. coli that are frequently associated with traveler's diarrhea due to the consumption of contaminated food and drink were frequently found in pilgrims. Respecting strict measures regarding food and water quality during the Hajj and adherence to preventive measures such as good personal hygiene and environmental management will help reduce the burden of gastrointestinal infections at the event.
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19
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Aherfi S, Gautret P, Chaudet H, Raoult D, La Scola B. Clusters of COVID-19 associated with Purim celebration in the Jewish community in Marseille, France, March 2020. Int J Infect Dis 2020; 100:88-94. [PMID: 32829043 PMCID: PMC7441020 DOI: 10.1016/j.ijid.2020.08.049] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/12/2020] [Accepted: 08/16/2020] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES We investigated possible COVID-19 epidemic clusters and their common sources of exposure that led to a sudden increase in the incidence of COVID-19 in the Jewish community of Marseille between March 15 and March 20, 2020. METHODS All data were generated as part of routine work at Marseille university hospitals. Biological diagnoses were made by RT-PCR testing. A telephone survey of families in which a laboratory confirmed case was diagnosed was conducted to determine possible exposure events. RESULTS As of March 30, 2020, 63 patients were linked to 6 epidemic clusters. The 6 clusters were linked to religious and social activities: a ski trip, organized meals for the Purim Jewish celebration in community and family settings on March 10, a religious service and a charity gala. Notably, 40% of the patients were infected by index patients during the presymptomatic period, which was 2.5 days before symptom onset. When considering household members, all 12 patients who tested negative and who did not develop any relevant clinical symptoms compatible with COVID-19 were 1-16 years of age. The clinical attack rate (symptoms compatible with COVID-19, and biologically confirmed by PCR) in adults was 85% compared to 26% in children. CONCLUSIONS Family and community gatherings for the Purim Jewish celebration probably accelerated the spread of COVID-19 in the Marseille Jewish community, leading to multiple epidemic clusters. This investigation of family clusters suggested that all close contacts of patients with confirmed COVID-19 who were not infected were children.
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Affiliation(s)
- Sarah Aherfi
- Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France; MEPHI, Institut de Recherche pour le Développement (IRD), Aix-Marseille Université, Marseille, France; Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France.
| | - Philippe Gautret
- Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France; Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France; VITROME, Institut de Recherche pour le Développement (IRD), Aix-Marseille Université, Marseille, France
| | - Hervé Chaudet
- Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
| | - Didier Raoult
- Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France; MEPHI, Institut de Recherche pour le Développement (IRD), Aix-Marseille Université, Marseille, France; Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Bernard La Scola
- Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France; MEPHI, Institut de Recherche pour le Développement (IRD), Aix-Marseille Université, Marseille, France; Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
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20
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Goumballa N, Diop A, Hoang VT, Mboup BM, Aïdara A, Ninove L, Fenollar F, Raoult D, Parola P, Sokhna C, Gautret P. Pathogens associated with respiratory, gastrointestinal and febrile illness in patients consulting at Mbacke healthcare centre during the 2018 Grand Magal of Touba: A preliminary study. Travel Med Infect Dis 2020; 37:101820. [PMID: 32711034 PMCID: PMC7375268 DOI: 10.1016/j.tmaid.2020.101820] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 06/23/2020] [Accepted: 07/08/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Ndiaw Goumballa
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; VITROME, Campus International IRD-UCAD de L'IRD, Dakar, Senegal
| | - Awa Diop
- VITROME, Campus International IRD-UCAD de L'IRD, Dakar, Senegal
| | - Van Thuan Hoang
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France; Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam
| | | | - Adama Aïdara
- Région Médicale de Diourbel, Senegal; Centre de Santé de Mbacké, Senegal
| | - Laetitia Ninove
- IHU-Méditerranée Infection, Marseille, France; Unité des Virus Émergents (UVE: Aix-Marseille Univ - IRD 190 - Inserm 1207 - IHU Méditerranée Infection), Marseille, France
| | - Florence Fenollar
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Didier Raoult
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France
| | - Philippe Parola
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Cheikh Sokhna
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; VITROME, Campus International IRD-UCAD de L'IRD, Dakar, Senegal; IHU-Méditerranée Infection, Marseille, France
| | - Philippe Gautret
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France.
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21
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Rajasekharan Nayar K, Fazaludeen Koya S, Mohandas K, Sivasankaran Nair S, Chitra GA, Abraham M, Lordson J. Public health implications of Sabarimala mass gathering in India: A multi-dimensional analysis. Travel Med Infect Dis 2020; 37:101783. [PMID: 32561393 DOI: 10.1016/j.tmaid.2020.101783] [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: 03/31/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Mass gathering for religious and spiritual purposes are common in India. However, mass gathering health and travel medicine is still in its infancy in India. OBJECTIVES The study explored bio-medical, environmental and psycho-social dimensions of mass gathering in Sabarimala pilgrimage, which is annually attended by 25 million pilgrims. METHODS In a cross sectional design, the investigators travelled the pilgrim trail and stayed in the shrine area to conduct the interviews (sample = 1259), to observe the practices as well as to assess the environmental conditions including sanitation. We did in-depth interviews of a subset of samples of the pilgrims, laboratory tests for water quality and secondary analysis of health services data. RESULT 43.4% pilgrims reported at least one health problem. Leg pain, joint/muscle pain, breathlessness, were the common symptoms. Pilgrims expressed concern about drinking water and food safety and majority of them felt the crowd management as unsatisfactory. Untreated sewage and solid waste were found to pollute the water downstream. Average patient presentation rate for 2014-2017 was 4999.6 per 100,000 pilgrims and referral to Hospital Rate was 19 per 100,000 pilgrims. Mortality rate ranged from 18.5 to 21 per 100,000 pilgrims among those who attended the health centers for ailments. Death due to Coronary Artery Heart Disease (CAHD) has slightly decreased over the period of 3 years from 97.6% to 85.1%. CONCLUSION Data with respect to safety, health and environment at the pilgrim sites need to be continuously assessed to understand changes and trends and to develop an effective mass gathering and safe pilgrimage policy (MGSPP).
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Affiliation(s)
- Kesavan Rajasekharan Nayar
- Global Institute of Public Health, Trivandrum, Kerala, India; Santhigiri Research Foundation, Trivandrum, Kerala, India.
| | - Shaffi Fazaludeen Koya
- Global Institute of Public Health, Trivandrum, Kerala, India; Ministry of Health, Al Taif, Makkah, Saudi Arabia; Boston University School of Public Health, Boston, MA, USA.
| | - K Mohandas
- Santhigiri Research Foundation, Trivandrum, Kerala, India.
| | | | - Grace A Chitra
- Global Institute of Public Health, Trivandrum, Kerala, India.
| | - Minu Abraham
- Global Institute of Public Health, Trivandrum, Kerala, India.
| | - Jinbert Lordson
- Global Institute of Public Health, Trivandrum, Kerala, India.
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22
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Sokhna C, Goumballa N, Hoang VT, Mboup BM, Dieng M, Sylla AB, Diallo A, Raoult D, Parola P, Gautret P. Senegal's Grand Magal of Touba: Syndromic Surveillance during the 2016 Mass Gathering. Am J Trop Med Hyg 2020; 102:476-482. [PMID: 31872797 DOI: 10.4269/ajtmh.19-0240] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The Grand Magal of Touba (GMT) is an annual 1-day Muslim religious event that takes place in Touba in Senegal. The city of Touba swells from 800,000 to four million people during the GMT. All patients who attended one of the 154 dedicated medical care public healthcare structures of the medical region of Diourbel during the GMT were included in a cross-sectional survey from November 16 to November 21, 2016. Demographic, morbidity, and mortality data were collected on a daily basis using a standardized article form that allows data to be recorded in a free-text format. Data were obtained from a total of 20,850 healthcare encounters, and 30.9% patients were aged ≤ 15 years. The most frequent conditions were gastrointestinal and respiratory diseases. Most frequent gastrointestinal symptoms were abdominal and gastric pain, nausea and vomiting, and diarrhea, suggesting that most patients suffered gastroenteritis. The predominance of cough, rhinitis, influenza-like illness, and sore throat among patients with respiratory symptoms suggests that most patients suffered from upper respiratory tract infections. Other frequent symptoms were headaches and pain in various organs. Three percentage of patients were considered to have malaria, 29.8% of patients were prescribed antibiotics and 2.6% antimalarial drugs, and 1.5% of patients were hospitalized. Only one death was recorded. Preparedness of the medical infrastructure should target these syndromic features, in terms of diagnostic tools and specific treatments, including pediatric formulations. It is also essential to improve the quality and rapid availability of data to enable real-time analysis of medical events at the GMT and to implement a rapid response, if necessary.
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Affiliation(s)
- Cheikh Sokhna
- VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Senegal.,Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Ndiaw Goumballa
- VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Senegal
| | - Van Thuan Hoang
- Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam.,IHU-Méditerranée Infection, Marseille, France.,Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France
| | | | | | | | - Aldiouma Diallo
- VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Senegal
| | - Didier Raoult
- Aix Marseille University, IRD, AP-HM, MEPHI, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Philippe Parola
- IHU-Méditerranée Infection, Marseille, France.,Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Philippe Gautret
- IHU-Méditerranée Infection, Marseille, France.,Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France
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23
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Rapid viral diagnosis and ambulatory management of suspected COVID-19 cases presenting at the infectious diseases referral hospital in Marseille, France, - January 31st to March 1st, 2020: A respiratory virus snapshot. Travel Med Infect Dis 2020; 36:101632. [PMID: 32205269 PMCID: PMC7102626 DOI: 10.1016/j.tmaid.2020.101632] [Citation(s) in RCA: 97] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 03/12/2020] [Accepted: 03/14/2020] [Indexed: 12/21/2022]
Abstract
Background Rapid virological diagnosis is needed to limit the length of isolation for suspected COVID-19 cases. Method We managed the first 280 patients suspected to have COVID-19 through a rapid care circuit and virological diagnosis in our infectious disease reference hospital in Marseille, France. Rapid viral detection was performed on sputum and nasopharyngeal samples. Results Over our study period, no SARS-CoV-2 was detected. Results were obtained within approximately 3 h of the arrival of patient samples at the laboratory. Other viral infections were identified in 49% of the patients, with most common pathogens being influenza A and B viruses, rhinovirus, metapneumovirus and common coronaviruses, notably HKU1 and NL63. Conclusion Early recognition of COVID-19 is critical to isolate confirmed cases and prevent further transmission. Early rule-out of COVID-19 allows public health containment measures to be adjusted by reducing the time spent in isolation.
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24
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Hoang VT, Nguyen TTT, Belhouchat K, Meftah M, Sow D, Benkouiten S, Dao TL, Anh Ly TD, Drali T, Yezli S, Alotaibi B, Raoult D, Parola P, Pommier de Santi V, Gautret P. Antibiotic use for respiratory infections among Hajj pilgrims: A cohort survey and review of the literature. Travel Med Infect Dis 2019; 30:39-45. [DOI: 10.1016/j.tmaid.2019.06.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 06/12/2019] [Accepted: 06/17/2019] [Indexed: 01/10/2023]
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