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Oberlis M, Guyot M, Le Turnier P, Carvalho L, Succo T, Rousset D, De Thoisy B, Gaillet M, Lavergne A, Vandentorren S, Epelboin L. The role of health mediation in investigation of Hantavirus cases among informal settlements inhabitants of Cayenne area, French Guiana, 2022-2023. Front Public Health 2024; 12:1364229. [PMID: 38983256 PMCID: PMC11232507 DOI: 10.3389/fpubh.2024.1364229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 05/13/2024] [Indexed: 07/11/2024] Open
Abstract
Context In 2022, four severe cases of Hantavirus pulmonary syndrome (HPS) were reported in patients from informal settlements around Cayenne, the main city in French Guiana. Regional Health Agency (RHA) was commissioned by the French Public Health Agency to estimate the seroprevalence of Hantavirus infections in the neighborhoods of confirmed cases of HPS. RHA then commissioned the French Red Cross (FRC) mobile public health team, providing support in environmental health issues to the population living in informal settlements by health mediators, to facilitate the investigation. The objective of this study was to describe the health mediators' activities set up to improve the efficiency of the investigation. Methods The health mediators' team was specifically trained by virologist and infectiologist specialized in HPS. They helped the investigating team and health workers at various steps of the investigation. These interventions are then described in the results section. Results The investigation took place between Nov. 2022 and March 2023 in three neighborhoods. During the pre-investigation activities, the mediators raised awareness about HPS of 343 people, among whom 319 (93%) planned to participate in the investigation. Altogether, 274 people finally participated in the investigation, including, i.e., 30.8% of the estimated population living in the three concerned settlements. The global proportion of patients with positive IgG anti-Hantavirus was 5.1%. The health mediators team supported the following steps: preliminary meetings and training modules, identification of resource persons, field visits and awareness and information campaigns (pre-investigation); on field data collection in informal settlements (per-investigation) and communication of individual results, public feedback meeting (post-investigation). Discussion/Conclusion The involvement of mediators was probably a factor in the success of the public health response to socially vulnerable people living in the investigated neighborhoods. The preliminary prevention activities helped to raise awareness of the health risk and to enroll participants. Health mediation and outreach activities seem relevant tools of epidemiological field investigations in diseases affecting inhabitants of informal settlements.
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Affiliation(s)
- Margot Oberlis
- Équipe Mobile Santé Environnement, Croix-Rouge française, Cayenne, French Guiana
| | | | - Paul Le Turnier
- Infectious and Tropical Diseases Unit, Centre Hospitalier de Cayenne, Cayenne, French Guiana
- Centre d'Investigation Clinique Antilles-Guyane, Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | | | | | - Dominique Rousset
- Centre national de référence des Hantavirus, Institut Pasteur de la Guyane, Cayenne, French Guiana
| | | | - Mélanie Gaillet
- Centres Délocalisés de Prévention et de Soins, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Anne Lavergne
- Centre national de référence des Hantavirus, Institut Pasteur de la Guyane, Cayenne, French Guiana
| | - Stéphanie Vandentorren
- Bordeaux University, Inserm, UMR1219, Vintage Team, Bordeaux, France
- Santé publique France, Saint-Maurice, France
| | - Loïc Epelboin
- Infectious and Tropical Diseases Unit, Centre Hospitalier de Cayenne, Cayenne, French Guiana
- Centre d'Investigation Clinique Antilles-Guyane, Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
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Velut G, de Laval F, Berry M, Dufour Gaume F, André N, Epelboin L, Lavergne A, Enfissi A, Djossou F, Rousset D, Briolant S. Etiology of Acute Febrile Illnesses in Adults in the Defense Community in French Guiana. Am J Trop Med Hyg 2024; 110:819-825. [PMID: 38377600 PMCID: PMC10993844 DOI: 10.4269/ajtmh.22-0638] [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: 10/06/2022] [Accepted: 06/13/2023] [Indexed: 02/22/2024] Open
Abstract
In tropical countries, acute febrile illnesses represent a complex clinical problem for general practitioners. We describe the prevalence of different etiologies of acute febrile illnesses occurring among French service members and their families, excluding children, in general practice in French Guiana. From June 2017 to March 2020, patients with a fever ≥37.8°C with a duration of less than 15 days who sought medical care at the army medical centers in Cayenne and Kourou were prospectively enrolled. Based on clinical presentation, blood, urine, nasopharyngeal, and stool samples were collected for diagnostic testing for viruses, bacteria, and parasites (by direct examination, microscopic examination of blood smears, culture, serology, or polymerase chain reaction), and standardized biological tests were systematically performed. Among 175 patients retained for analysis, fever with nonspecific symptoms was predominant (46.9%), with 10 Plasmodium vivax malaria cases, 8 dengue infections, and 6 cases of Q fever. The second most frequent cause of acute febrile illness was upper respiratory tract infections (32.0%) due to influenza virus (n = 18) or human rhinovirus (n = 10). Among the causes of acute febrile illness in French Guiana, clinicians should first consider arboviruses and malaria, as well as Q fever in cases of elevated C-reactive protein with nonspecific symptoms and influenza in cases of signs and symptoms associated with upper respiratory tract infections. Despite an expanded microbiological search, the etiology of 51.4% of acute febrile illnesses remain unknown. Further investigations will be necessary to identify the etiology of acute febrile illnesses, including new pathogens, in French Guiana.
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Affiliation(s)
- Guillaume Velut
- Centre d’Epidémiologie et de Santé Publique des Armées, Marseille, France
| | - Franck de Laval
- Centre d’Epidémiologie et de Santé Publique des Armées, Marseille, France
- Aix-Marseille Université, INSERM, Institut de Recherche pour le Développement, Economic and Social Sciences, Health Systems, and Medical Informatics, Marseille, France
| | - Morgane Berry
- Centre Médical Interarmées de Cayenne, Cayenne, French Guiana
| | | | - Nathalie André
- Direction Interarmées du Service de Santé des Forces Armées en Guyane, Cayenne, French Guiana
| | - Loïc Epelboin
- Service des Maladies Infectieuses et Tropicales, et Centre d’investigation Clinique (CIC INSERM 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Anne Lavergne
- Laboratoire des Interactions Virus-Hôtes, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana
| | - Antoine Enfissi
- Laboratoire de Virologie, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana
| | - Felix Djossou
- Service des Maladies Infectieuses et Tropicales, et Centre d’investigation Clinique (CIC INSERM 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Dominique Rousset
- Laboratoire de Virologie, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana
| | - Sébastien Briolant
- Aix Marseille Université, Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Service de Santé des Armées, Vecteurs – Infections Tropicales et Méditerranéennes, Marseille, France
- Institut Hospitalo-Universitaire – Méditerranée Infection, Marseille, France
- Unité de Parasitologie Entomologie, Département de Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, Marseille, France
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3
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de La Porte des Vaux C, Sainte-Rose V, Le Turnier P, Djossou F, Nacher M, Zappa M, Epelboin L. Chest CT findings in community-acquired pneumonia due to Coxiella burnetii (Q fever) compared to Streptococcus pneumoniae, a cross sectional study in French Guiana, 2013-2017. Travel Med Infect Dis 2024; 57:102679. [PMID: 38135242 DOI: 10.1016/j.tmaid.2023.102679] [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: 09/13/2023] [Revised: 11/29/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVES Few and small studies previously examined chest CT-scan characteristics of Coxiella burnetii (Cb) community-acquired pneumonia (CAP). Larger studies are needed to guide physicians towards diagnosis of Q fever in case of pneumonia. METHODS We conducted a single-center retrospective observational study between 2013 and 2017. All patients with Cb or Streptococcus pneumoniae (Sp) CAP who had a chest CT-scan on admission at Cayenne Hospital (French Guiana) were included. Chest CT-scan were all analyzed by the same expert radiologist. RESULTS We included 75 patients with Cb CAP and 36 with Sp CAP. Fifty-nine percent of all patients were men (n = 66) and median age was 52 [IQR = 38-62]. Chest CT-scans of Cb CAP patients revealed 67 alveolar condensations (89 %), 52 ground-glass opacities (69 %), 30 cases of lymphadenopathy(ies) (40 %) and 25 pleural effusions (33 %). Parenchyma lesions caused by Cb were predominantly unilateral (67 %). We found high numbers of alveolar condensations in both Cb and Sp CAP (89 % and 75 %; respectively), but the presence of ground-glass opacities was significantly associated with Cb CAP (69 % versus 30 %; p < 0.01). Cb CAP were associated with more lymphadenopathies (40 % vs 17 %; p = 0.01) while Sp CAP showed more bronchial thickening (19 % versus 3 %; p < 0.01) and (micro)nodule(s) ≤1 cm (25 % vs 3 %, p < 0.01). CONCLUSIONS This large study shows that the most typical aspect of chest CT-scan in case of Cb CAP in French Guiana is a unilateral alveolar consolidation associated with ground glass opacities and lymphadenopathies. C. burnetti and S. pneumoniae both most often cause alveolar consolidations, but present some significantly different CT-scan patterns. This could help physicians through therapeutic choices.
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Affiliation(s)
- Clémentine de La Porte des Vaux
- Department of Infectious and Tropical Diseases, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana; Department of Infectious and Tropical Diseases, Hôpital Universitaire Necker-Enfants malades, Paris, France.
| | - Vincent Sainte-Rose
- Department of Microbiology, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - Paul Le Turnier
- Department of Infectious and Tropical Diseases, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - Félix Djossou
- Department of Infectious and Tropical Diseases, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - Mathieu Nacher
- CIC INSERM 1424, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - Magaly Zappa
- Department of Radiology, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - Loïc Epelboin
- Department of Infectious and Tropical Diseases, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana; CIC INSERM 1424, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
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Nacher M, Epelboin L, Bonifay T, Djossou F, Blaizot R, Couppié P, Adenis A, Lucarelli A, Lambert Y, Schaub R, Douine M. Migration in French Guiana: Implications in health and infectious diseases. Travel Med Infect Dis 2024; 57:102677. [PMID: 38049022 DOI: 10.1016/j.tmaid.2023.102677] [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: 01/24/2023] [Revised: 11/20/2023] [Accepted: 11/24/2023] [Indexed: 12/06/2023]
Abstract
In French Guiana, more than a third of the population, and nearly half of the adults, are of foreign origin. This immigration is explained by the French standard of living, which is attractive to nationals of surrounding countries. Infectious diseases remain in the top 10 causes of premature death, often in the most precarious populations. In this context we aimed to synthesize the state of the knowledge regarding immigration and infectious diseases in French Guiana and the general implications that follow this diagnosis. For HIV, although the majority of patients are of foreign origin, estimates of the presumed date of infection based on CD4 erosion modelling and from molecular analyses suggest that the majority of transmissions in foreign-born individuals occur in French Guiana and that the Guiana shield has been a crossroad between Latin America and the Caribbean. Among key populations bridging these regions illegal gold miners are very mobile and have the greatest proportion B Caribbean HIV viruses. Gold miners have been a key vulnerable population for falciparum malaria and other tropical diseases such as leishmaniasis, leprosy, or leptospirosis. The complex history of migrations in French Guiana and on the Guiana Shield is also reflected in the fingerprinting of mycobacterium tuberculosis and the high incidence of tuberculosis in French Guiana, notably in immigrants, reflects the incidences in the countries of origin of patients. The high burden of infectious diseases in immigrants in French Guiana is first and foremost a reflection of the precarious living conditions within French Guiana and suggests that community-based proactive interventions are crucial to reduce transmission, morbidity, and mortality from infectious diseases.
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Affiliation(s)
- Mathieu Nacher
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana; Université de Guyane, Cayenne, 97300, Cayenne, French Guiana; Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana.
| | - Loïc Epelboin
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana; Université de Guyane, Cayenne, 97300, Cayenne, French Guiana; Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana; Department of Infectious Diseases, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana
| | - Timothée Bonifay
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana; Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana
| | - Félix Djossou
- Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana; Department of Infectious Diseases, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana
| | - Romain Blaizot
- Department of Dermatology, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana
| | - Pierre Couppié
- Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana; Department of Dermatology, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana
| | - Antoine Adenis
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana; Université de Guyane, Cayenne, 97300, Cayenne, French Guiana; Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana
| | - Aude Lucarelli
- Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana; Coordination Regionale de lutte contre le VIH, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana
| | - Yann Lambert
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana; Université de Guyane, Cayenne, 97300, Cayenne, French Guiana; Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana
| | - Roxane Schaub
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana; Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana
| | - Maylis Douine
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana; Université de Guyane, Cayenne, 97300, Cayenne, French Guiana; Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana
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5
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Hagiya H, Koyama T, Otsuka F. Epidemiological Characteristics and Trends in the Incidence of Leptospirosis in Japan: A Nationwide, Observational Study from 2006 to 2021. Am J Trop Med Hyg 2023; 109:589-594. [PMID: 37487568 PMCID: PMC10484259 DOI: 10.4269/ajtmh.23-0131] [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: 03/01/2023] [Accepted: 05/23/2023] [Indexed: 07/26/2023] Open
Abstract
During this age of climate change, the incidence of tropical diseases may change. This study compared the epidemiological characteristics and trends of leptospirosis in Japan between the endemic region, Okinawa, and the rest of the country. Infectious Diseases Weekly Reports were used to determine the numbers and crude incidence rates of leptospirosis. Data were stratified by sex, age, the estimated location of the infection, the notified regions, and the reporting month. A joinpoint regression analysis was performed to estimate the annual percentage change (APC). During the 16-year study period (2006-2021), 543 leptospirosis cases were reported, with male dominance (86.2%). Approximately half of these cases were reported from Okinawa (47.1%). The patients were relatively younger in Okinawa (20-29 years, 23.4%; 30-39 years, 20.7%) than outside Okinawa. The frequency of imported cases was significantly higher outside Okinawa (0.4% versus 14.3%). The incidences of leptospirosis in and outside Okinawa were apparently higher during the summer and typhoon seasons. The annual crude incidence ratios were 20-200 times higher in Okinawa than in the rest of the country. The average APCs for the entire study period in Okinawa and the rest of Japan were 1.6% (95% CI: -5.9 to 9.6) and -1.8% (95% CI: -7.8 to 4.6), respectively, without any particular trends. Collectively, the patient profile of leptospirosis differed between Okinawa (younger men) and outside Okinawa (middle- or older-aged men with a history of traveling abroad). The disease remains a neglected tropical disease; continuous surveillance with close monitoring is required.
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Affiliation(s)
- Hideharu Hagiya
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Kitaku, Okayama, Japan
| | - Toshihiro Koyama
- Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Kitaku, Okayama, Japan
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Epelboin L, Abboud P, Abdelmoumen K, About F, Adenis A, Blaise T, Blaizot R, Bonifay T, Bourne-Watrin M, Boutrou M, Carles G, Carlier PY, Carod JF, Carvalho L, Couppié P, De Toffol B, Delon F, Demar M, Destoop J, Douine M, Droz JP, Elenga N, Enfissi A, Franck YK, Fremery A, Gaillet M, Kallel H, Kpangon AA, Lavergne A, Le Turnier P, Maisonobe L, Michaud C, Mutricy R, Nacher M, Naldjinan-Kodbaye R, Oberlis M, Odonne G, Osei L, Pujo J, Rabier S, Roman-Laverdure B, Rousseau C, Rousset D, Sabbah N, Sainte-Rose V, Schaub R, Sylla K, Tareau MA, Tertre V, Thorey C, Vialette V, Walter G, Zappa M, Djossou F, Vignier N. [Overview of infectious and non-infectious diseases in French Guiana in 2022]. MEDECINE TROPICALE ET SANTE INTERNATIONALE 2023; 3:mtsi.v3i1.2023.308. [PMID: 37389381 PMCID: PMC10300792 DOI: 10.48327/mtsi.v3i1.2023.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 09/15/2022] [Indexed: 07/01/2023]
Abstract
Source of many myths, French Guiana represents an exceptional territory due to the richness of its biodiversity and the variety of its communities. The only European territory in Amazonia, surrounded by the Brazilian giant and the little-known Suriname, Ariane 6 rockets are launched from Kourou while 50% of the population lives below the poverty line. This paradoxical situation is a source of health problems specific to this territory, whether they be infectious diseases with unknown germs, intoxications or chronic pathologies.Some infectious diseases such as Q fever, toxoplasmosis, cryptococcosis or HIV infection are in common with temperate countries, but present specificities leading to sometimes different management and medical reasoning. In addition to these pathologies, many tropical diseases are present in an endemic and / or epidemic mode such as malaria, leishmaniasis, Chagas disease, histoplasmosis or dengue. Besides, Amazonian dermatology is extremely varied, ranging from rare but serious pathologies (Buruli ulcer, leprosy) to others which are frequent and benign such as agouti lice (mites of the family Trombiculidae) or papillonitis. Envenomations by wild fauna are not rare, and deserve an appropriate management of the incriminated taxon. Obstetrical, cardiovascular and metabolic cosmopolitan pathologies sometimes take on a particular dimension in French Guiana that must be taken into account in the management of patients. Finally, different types of intoxication are to be known by practitioners, especially due to heavy metals.European-level resources offer diagnostic and therapeutic possibilities that do not exist in the surrounding countries and regions, thus allowing the management of diseases that are not well known elsewhere.Thanks to these same European-level resources, research in Guyana occupies a key place within the Amazon region, despite a smaller population than in the surrounding countries. Thus, certain pathologies such as histoplasmosis of the immunocompromised patient, Amazonian toxoplasmosis or Q fever are hardly described in neighboring countries, probably due to under-diagnosis linked to more limited resources. French Guiana plays a leading role in the study of these diseases.The objective of this overview is to guide health care providers coming to or practicing in French Guiana in their daily practice, but also practitioners taking care of people returning from French Guiana.
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Affiliation(s)
- Loïc Epelboin
- Unité des maladies infectieuses et tropicales, Centre hospitalier de Cayenne, Cayenne, Guyane
- Centre d'investigation clinique Guyane (Inserm CIC 1424), Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Philippe Abboud
- Unité des maladies infectieuses et tropicales, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Karim Abdelmoumen
- Département des maladies infectieuses, Centre hospitalier de Mayotte, Mamoudzou, Mayotte
| | - Frédégonde About
- Unité des maladies infectieuses et tropicales, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Antoine Adenis
- Centre d'investigation clinique Guyane (Inserm CIC 1424), Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Théo Blaise
- Centre d'investigation clinique Guyane (Inserm CIC 1424), Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Romain Blaizot
- Unité carcérale de soins ambulatoires, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Timothée Bonifay
- Unité carcérale de soins ambulatoires, Centre hospitalier de Cayenne, Cayenne, Guyane
| | | | - Mathilde Boutrou
- Unité des maladies infectieuses et tropicales, Centre hospitalier de Cayenne, Cayenne, Guyane
- Centre d'investigation clinique Guyane (Inserm CIC 1424), Centre hospitalier de Cayenne, Cayenne, Guyane
- Département des maladies infectieuses, Centre hospitalier de Mayotte, Mamoudzou, Mayotte
- Unité carcérale de soins ambulatoires, Centre hospitalier de Cayenne, Cayenne, Guyane
- Service de dermatologie, Centre hospitalier de Cayenne, Cayenne, Guyane
- Service de gynécologie-obstétrique, Centre hospitalier de l'ouest guyanais, Saint-Laurent-du-Maroni, Guyane
- Laboratoire de biologie médicale, Centre hospitalier de l'ouest guyanais, Saint-Laurent-du-Maroni, Guyane
- Agence régionale de santé de Guyane, Cayenne, Guyane
- Santé publique France, Cayenne, Guyane
- Service de neurologie, Centre hospitalier de Cayenne, Cayenne, Guyane
- TBIP (Tropical Biome and ImmunoPhysiopathology), Université de Guyane, Cayenne, Guyane
- Laboratoire hospitalo-universitaire de parasitologie et mycologie, Centre hospitalier de Cayenne Andrée-Rosemon, Cayenne, Guyane
- Université Claude Bernard Lyon 1 et Centre Léon Bérard, Lyon, France
- Service de pédiatrie, Centre hospitalier de Cayenne, Cayenne, Guyane
- Laboratoire de virologie, Institut Pasteur de la Guyane
- Service de cardiologie, Centre hospitalier de Cayenne, Cayenne, Guyane
- Service d'accueil des urgences et SAMU, Centre hospitalier de Cayenne, Cayenne, Guyane
- Pôle des Centres délocalisés de prévention et de soins, Centre hospitalier de Cayenne, Cayenne, Guyane
- Service de réanimation, Centre hospitalier de Cayenne, Cayenne, Guyane
- Service de médecine, Centre hospitalier de Kourou, Kourou, Guyane
- Laboratoire des interactions virus-hôtes, Institut Pasteur de la Guyane, Cayenne, Guyane
- Croix-Rouge française de Guyane, Cayenne, Guyane
- Laboratoire Écologie, évolution, interactions des systèmes amazoniens (LEEISA), CNRS, Université de Guyane, IFREMER, Cayenne, Guyane
- COREVIH (Comité de coordination de la lutte contre les infections sexuellement transmissibles et le virus de l'immunodéficience humaine), Centre hospitalier de Cayenne, Cayenne, Guyane
- Service d'endocrinologie-diabétologie et maladies métaboliques, Centre hospitalier de Cayenne, Cayenne, Guyane
- Service de médecine, Centre hospitalier de l'ouest guyanais, Saint-Laurent-du-Maroni, Guyane
- Direction interarmées du service de santé (DIASS)
- Laboratoire Eurofins Guyane, site de Kourou, Centre hospitalier de Kourou, Guyane
- Service de radiologie, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Gabriel Carles
- Service de gynécologie-obstétrique, Centre hospitalier de l'ouest guyanais, Saint-Laurent-du-Maroni, Guyane
| | | | - Jean-François Carod
- Laboratoire de biologie médicale, Centre hospitalier de l'ouest guyanais, Saint-Laurent-du-Maroni, Guyane
| | | | - Pierre Couppié
- Service de dermatologie, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Bertrand De Toffol
- Centre d'investigation clinique Guyane (Inserm CIC 1424), Centre hospitalier de Cayenne, Cayenne, Guyane
- Service de neurologie, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - François Delon
- Laboratoire Eurofins Guyane, site de Kourou, Centre hospitalier de Kourou, Guyane
| | - Magalie Demar
- TBIP (Tropical Biome and ImmunoPhysiopathology), Université de Guyane, Cayenne, Guyane
- Laboratoire hospitalo-universitaire de parasitologie et mycologie, Centre hospitalier de Cayenne Andrée-Rosemon, Cayenne, Guyane
| | - Justin Destoop
- Service de dermatologie, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Maylis Douine
- Centre d'investigation clinique Guyane (Inserm CIC 1424), Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Jean-Pierre Droz
- Université Claude Bernard Lyon 1 et Centre Léon Bérard, Lyon, France
| | - Narcisse Elenga
- Service de pédiatrie, Centre hospitalier de Cayenne, Cayenne, Guyane
| | | | - Yves-Kénol Franck
- Service de cardiologie, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Alexis Fremery
- Service d'accueil des urgences et SAMU, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Mélanie Gaillet
- Pôle des Centres délocalisés de prévention et de soins, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Hatem Kallel
- Service de réanimation, Centre hospitalier de Cayenne, Cayenne, Guyane
| | | | - Anne Lavergne
- Laboratoire des interactions virus-hôtes, Institut Pasteur de la Guyane, Cayenne, Guyane
| | - Paul Le Turnier
- Unité des maladies infectieuses et tropicales, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Lucas Maisonobe
- Unité des maladies infectieuses et tropicales, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Céline Michaud
- Pôle des Centres délocalisés de prévention et de soins, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Rémi Mutricy
- Service d'accueil des urgences et SAMU, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Mathieu Nacher
- Centre d'investigation clinique Guyane (Inserm CIC 1424), Centre hospitalier de Cayenne, Cayenne, Guyane
| | | | | | - Guillaume Odonne
- Laboratoire Écologie, évolution, interactions des systèmes amazoniens (LEEISA), CNRS, Université de Guyane, IFREMER, Cayenne, Guyane
| | - Lindsay Osei
- Service de pédiatrie, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Jean Pujo
- Service d'accueil des urgences et SAMU, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Sébastien Rabier
- Centre d'investigation clinique Guyane (Inserm CIC 1424), Centre hospitalier de Cayenne, Cayenne, Guyane
- COREVIH (Comité de coordination de la lutte contre les infections sexuellement transmissibles et le virus de l'immunodéficience humaine), Centre hospitalier de Cayenne, Cayenne, Guyane
| | | | - Cyril Rousseau
- Santé publique France, Cayenne, Guyane
- Pôle des Centres délocalisés de prévention et de soins, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Dominique Rousset
- Laboratoire hospitalo-universitaire de parasitologie et mycologie, Centre hospitalier de Cayenne Andrée-Rosemon, Cayenne, Guyane
| | - Nadia Sabbah
- Service d'endocrinologie-diabétologie et maladies métaboliques, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Vincent Sainte-Rose
- Laboratoire hospitalo-universitaire de parasitologie et mycologie, Centre hospitalier de Cayenne Andrée-Rosemon, Cayenne, Guyane
| | - Roxane Schaub
- Centre d'investigation clinique Guyane (Inserm CIC 1424), Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Karamba Sylla
- Service de médecine, Centre hospitalier de l'ouest guyanais, Saint-Laurent-du-Maroni, Guyane
| | - Marc-Alexandre Tareau
- Centre d'investigation clinique Guyane (Inserm CIC 1424), Centre hospitalier de Cayenne, Cayenne, Guyane
- Laboratoire Écologie, évolution, interactions des systèmes amazoniens (LEEISA), CNRS, Université de Guyane, IFREMER, Cayenne, Guyane
| | | | - Camille Thorey
- Service de médecine, Centre hospitalier de l'ouest guyanais, Saint-Laurent-du-Maroni, Guyane
| | - Véronique Vialette
- Laboratoire Eurofins Guyane, site de Kourou, Centre hospitalier de Kourou, Guyane
| | - Gaëlle Walter
- Unité des maladies infectieuses et tropicales, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Magaly Zappa
- Service de radiologie, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Félix Djossou
- Unité des maladies infectieuses et tropicales, Centre hospitalier de Cayenne, Cayenne, Guyane
| | - Nicolas Vignier
- Centre d'investigation clinique Guyane (Inserm CIC 1424), Centre hospitalier de Cayenne, Cayenne, Guyane
- COREVIH (Comité de coordination de la lutte contre les infections sexuellement transmissibles et le virus de l'immunodéficience humaine), Centre hospitalier de Cayenne, Cayenne, Guyane
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Douine M, Bonifay T, Lambert Y, Mutricy L, Galindo MS, Godin A, Bourhy P, Picardeau M, Saout M, Demar M, Sanna A, Mosnier E, Blaizot R, Couppié P, Nacher M, Adenis A, Suarez-Mutis M, Vreden S, Epelboin L, Schaub R. Zoonoses and gold mining: A cross-sectional study to assess yellow fever immunization, Q fever, leptospirosis and leishmaniasis among the population working on illegal mining camps in French Guiana. PLoS Negl Trop Dis 2022; 16:e0010326. [PMID: 35969647 PMCID: PMC9410546 DOI: 10.1371/journal.pntd.0010326] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 08/25/2022] [Accepted: 06/12/2022] [Indexed: 11/28/2022] Open
Abstract
Background Most emerging pathogens are zoonoses and have a wildlife origin. Anthropization and disruption of ecosystems favor the crossing of inter-species barriers. We hypothesize that the marginalized population of undocumented goldminers in the Amazon is at risk of acquiring zoonoses. Method A multicentric cross-sectional study included consenting gold-mining adult workers in 2019. A clinical examination recorded dermatological signs of leishmaniosis and past history of yellow fever vaccination. Biological tests were performed for yellow fever, Q fever and leptospirosis serologies. Additional blood samples from a previous study in 2015 were also tested for leptospirosis. Results In 2019, 380 individuals were included in the study, along with 407 samples from the 2015 biological collection. The seroprevalence of leptospirosis was 31.0% [95%CI = 26.4–35.5] in 2015 and 28.1% [23.5–32.7] in 2019. The seroprevalence of Q fever was 2.9% [1.2–4.6]. The majority of participants reported being vaccinated against yellow fever (93.6%) and 97.9% had seroneutralizing antibodies. The prevalence of suspected active mucocutaneous leishmaniasis was 2.4% [0.8–3.9]. Discussion These unique data shed new light on the transmission cycles of zoonoses still poorly understood in the region. They support the existence of a wild cycle of leptospirosis but not of Q fever. Leishmaniasis prevalence was high because of life conditions and tree felling. High yellow fever vaccine coverage was reassuring in this endemic area. In the era of global health, special attention must be paid to these vulnerable populations in direct contact with the tropical ecosystem and away from the health care system. Many pathogens are zoonotic in origin and human transmission can occur via vector, direct contact, inhalation, absorption, among other routes enabling human-reservoir interaction. In Amazonia, the cycle of these pathogens (the reservoir, the mode of transmission …) is not always well known. It is important to better understand these cycles in order to evaluate and anticipate the potential risk for human health, both on an individual and collective scale (risk of epidemic). In French Guiana, a French territory located in the Amazon, undocumented gold miners represent several thousand people mainly from Brazil who work in very remote areas in the middle of the rainforest. Documenting several zoonotic diseases among this population living in the middle of biodiversity is very valuable to better understand these cycles but also to assess the impact for their own health and to identify risks for public health. This article provides new data for four zoonoses: Q-fever, leptospirosis, leishmaniasis and yellow fever in this population and discusses the contributions to the understanding of cycles and public health issues.
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Affiliation(s)
- Maylis Douine
- Centre d’Investigation Clinique Antilles-Guyane (Inserm 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
- TBIP, Université de la Guyane, Cayenne, French Guiana
- Centre de Ressources Biologiques Amazonie, Cayenne, French Guiana
- * E-mail:
| | - Timothée Bonifay
- Centre d’Investigation Clinique Antilles-Guyane (Inserm 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Yann Lambert
- Centre d’Investigation Clinique Antilles-Guyane (Inserm 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Louise Mutricy
- Centre d’Investigation Clinique Antilles-Guyane (Inserm 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Muriel Suzanne Galindo
- Centre d’Investigation Clinique Antilles-Guyane (Inserm 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Audrey Godin
- Centre d’Investigation Clinique Antilles-Guyane (Inserm 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Pascale Bourhy
- National Reference Center for Leptospirosis, Biology of Spirochetes unit, Institut Pasteur, Paris, France
| | - Mathieu Picardeau
- National Reference Center for Leptospirosis, Biology of Spirochetes unit, Institut Pasteur, Paris, France
| | - Mona Saout
- TBIP, Université de la Guyane, Cayenne, French Guiana
| | - Magalie Demar
- TBIP, Université de la Guyane, Cayenne, French Guiana
- University Laboratory of Mycology-Parasitology, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Alice Sanna
- Centre d’Investigation Clinique Antilles-Guyane (Inserm 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Emilie Mosnier
- Delocalized Health Centers, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Romain Blaizot
- TBIP, Université de la Guyane, Cayenne, French Guiana
- Department of Dermatology, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Pierre Couppié
- TBIP, Université de la Guyane, Cayenne, French Guiana
- Department of Dermatology, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Mathieu Nacher
- Centre d’Investigation Clinique Antilles-Guyane (Inserm 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
- TBIP, Université de la Guyane, Cayenne, French Guiana
- Centre de Ressources Biologiques Amazonie, Cayenne, French Guiana
| | - Antoine Adenis
- Centre d’Investigation Clinique Antilles-Guyane (Inserm 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
- TBIP, Université de la Guyane, Cayenne, French Guiana
- Centre de Ressources Biologiques Amazonie, Cayenne, French Guiana
| | - Martha Suarez-Mutis
- Laboratory of Parasitic Diseases, Institute Oswaldo Cruz/Fiocruz, Rio de Janeiro, Brazil
| | - Stephen Vreden
- Foundation for Scientific Research Suriname, Paramaribo, Suriname
| | - Loïc Epelboin
- Centre d’Investigation Clinique Antilles-Guyane (Inserm 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
- TBIP, Université de la Guyane, Cayenne, French Guiana
- Infectious and Tropical Diseases Unit, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Roxane Schaub
- Centre d’Investigation Clinique Antilles-Guyane (Inserm 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
- TBIP, Université de la Guyane, Cayenne, French Guiana
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Osei L, Basurko C, Nacher M, Vignier N, Elenga N. About the need to address pediatric health inequalities in French Guiana : a scoping review. Arch Pediatr 2022; 29:340-346. [DOI: 10.1016/j.arcped.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 02/26/2022] [Accepted: 03/26/2022] [Indexed: 11/17/2022]
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Kakita T, Okano S, Kyan H, Miyahira M, Taira K, Kitashoji E, Koizumi N. Laboratory diagnostic, epidemiological, and clinical characteristics of human leptospirosis in Okinawa Prefecture, Japan, 2003-2020. PLoS Negl Trop Dis 2021; 15:e0009993. [PMID: 34905535 PMCID: PMC8670671 DOI: 10.1371/journal.pntd.0009993] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 11/12/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Leptospirosis is considered an endemic disease among agricultural workers in Okinawa Prefecture, which is the southernmost part of Japan and has a subtropical climate, but data on the current status and trend of this disease are scarce. METHODOLOGY/PRINCIPAL FINDINGS We conducted a retrospective study of clinically suspected leptospirosis patients whose sample and information were sent to the Okinawa Prefectural Institute of Health and Environment from November 2003 to December 2020. Laboratory diagnosis was established using culture, nested polymerase chain reaction (PCR), and/or microscopic agglutination test (MAT) with blood, cerebrospinal fluid, and/or urine samples. Statistical analyses were performed to compare the epidemiological information, clinical features, and sensitivities of diagnostic methods among laboratory-confirmed cases. Serogroups and the species of Leptospira isolates were determined by MAT using 13 antisera and flaB sequencing. A total of 531 clinically suspected patients were recruited, among whom 246 (46.3%) were laboratory confirmed to have leptospirosis. Among the confirmed cases, patients aged 20-29 years (22.4%) and male patients (85.7%) were the most common. The most common estimated sources of infection were recreation (44.5%) and labor (27.8%) in rivers. Approximately half of the isolates were of the L. interrogans serogroup Hebdomadis. The main clinical symptoms were fever (97.1%), myalgia (56.3%), and conjunctival hyperemia (52.2%). Headache occurred significantly more often in patients with Hebdomadis serogroup infections than those with other serogroup infections. The sensitivities of culture and PCR exceeded 65% during the first 6 days, while the sensitivity of MAT surpassed that of culture and PCR in the second week after onset. PCR using blood samples was a preferable method for the early diagnosis of leptospirosis. CONCLUSIONS/SIGNIFICANCE The results of this study will support clinicians in the diagnosis and treatment of undifferentiated febrile patients in Okinawa Prefecture as well as patients returning from Okinawa Prefecture.
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Affiliation(s)
- Tetsuya Kakita
- Department of Biological Sciences, Okinawa Prefectural Institute of Health and Environment, Uruma, Okinawa, Japan
| | - Sho Okano
- Department of Biological Sciences, Okinawa Prefectural Institute of Health and Environment, Uruma, Okinawa, Japan
| | - Hisako Kyan
- Department of Biological Sciences, Okinawa Prefectural Institute of Health and Environment, Uruma, Okinawa, Japan
| | - Masato Miyahira
- Department of Biological Sciences, Okinawa Prefectural Institute of Health and Environment, Uruma, Okinawa, Japan
| | - Katsuya Taira
- Department of Biological Sciences, Okinawa Prefectural Institute of Health and Environment, Uruma, Okinawa, Japan
| | - Emi Kitashoji
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Nagasaki, Japan
| | - Nobuo Koizumi
- Department of Bacteriology I, National Institute of Infectious Disease, Shinjuku, Tokyo, Japan
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de Thoisy B, Duron O, Epelboin L, Musset L, Quénel P, Roche B, Binetruy F, Briolant S, Carvalho L, Chavy A, Couppié P, Demar M, Douine M, Dusfour I, Epelboin Y, Flamand C, Franc A, Ginouvès M, Gourbière S, Houël E, Kocher A, Lavergne A, Le Turnier P, Mathieu L, Murienne J, Nacher M, Pelleau S, Prévot G, Rousset D, Roux E, Schaub R, Talaga S, Thill P, Tirera S, Guégan JF. Ecology, evolution, and epidemiology of zoonotic and vector-borne infectious diseases in French Guiana: Transdisciplinarity does matter to tackle new emerging threats. INFECTION GENETICS AND EVOLUTION 2021; 93:104916. [PMID: 34004361 DOI: 10.1016/j.meegid.2021.104916] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 05/09/2021] [Accepted: 05/12/2021] [Indexed: 02/06/2023]
Abstract
French Guiana is a European ultraperipheric region located on the northern Atlantic coast of South America. It constitutes an important forested region for biological conservation in the Neotropics. Although very sparsely populated, with its inhabitants mainly concentrated on the Atlantic coastal strip and along the two main rivers, it is marked by the presence and development of old and new epidemic disease outbreaks, both research and health priorities. In this review paper, we synthetize 15 years of multidisciplinary and integrative research at the interface between wildlife, ecosystem modification, human activities and sociodemographic development, and human health. This study reveals a complex epidemiological landscape marked by important transitional changes, facilitated by increased interconnections between wildlife, land-use change and human occupation and activity, human and trade transportation, demography with substantial immigration, and identified vector and parasite pharmacological resistance. Among other French Guianese characteristics, we demonstrate herein the existence of more complex multi-host disease life cycles than previously described for several disease systems in Central and South America, which clearly indicates that today the greater promiscuity between wildlife and humans due to demographic and economic pressures may offer novel settings for microbes and their hosts to circulate and spread. French Guiana is a microcosm that crystallizes all the current global environmental, demographic and socioeconomic change conditions, which may favor the development of ancient and future infectious diseases.
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Affiliation(s)
- Benoît de Thoisy
- Laboratoire des Interactions Virus-Hôtes, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana.
| | - Olivier Duron
- UMR MIVEGEC, IRD, CNRS, Université de Montpellier, Centre IRD de Montpellier, Montpellier, France; Centre de Recherche en Écologie et Évolution de la Santé, Montpellier, France
| | - Loïc Epelboin
- Infectious Diseases Department, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Lise Musset
- Laboratoire de Parasitologie, Centre Collaborateur OMS Pour La Surveillance Des Résistances Aux Antipaludiques, Centre National de Référence du Paludisme, Pôle zones Endémiques, Institut Pasteur de la Guyane, Cayenne, French Guiana
| | - Philippe Quénel
- Université de Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR-S 1085 Rennes, France
| | - Benjamin Roche
- UMR MIVEGEC, IRD, CNRS, Université de Montpellier, Centre IRD de Montpellier, Montpellier, France; Centre de Recherche en Écologie et Évolution de la Santé, Montpellier, France
| | - Florian Binetruy
- UMR MIVEGEC, IRD, CNRS, Université de Montpellier, Centre IRD de Montpellier, Montpellier, France
| | - Sébastien Briolant
- Unité Parasitologie et Entomologie, Département Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, Marseille, France; Aix Marseille Université, IRD, SSA, AP-HM, UMR Vecteurs - Infections Tropicales et Méditerranéennes (VITROME), France; IHU Méditerranée Infection, Marseille, France
| | | | - Agathe Chavy
- Laboratoire des Interactions Virus-Hôtes, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana
| | - Pierre Couppié
- Dermatology Department, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Magalie Demar
- TBIP, Université de Guyane, Cayenne, French Guiana; Université de Lille, CNRS, Inserm, Institut Pasteur de Lille, U1019-UMR 9017-CIIL Centre d'Infection et d'Immunité de Lille, Lille, France
| | - Maylis Douine
- Centre d'Investigation Clinique Antilles-Guyane, Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Isabelle Dusfour
- Département de Santé Globale, Institut Pasteur, Paris, France; Institut Pasteur de la Guyane, Vectopôle Amazonien Emile Abonnenc, Cayenne, French Guiana
| | - Yanouk Epelboin
- Institut Pasteur de la Guyane, Vectopôle Amazonien Emile Abonnenc, Cayenne, French Guiana
| | - Claude Flamand
- Epidemiology Unit, Institut Pasteur de la Guyane, Cayenne, French Guiana; Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR 2000, CNRS, Paris, France
| | - Alain Franc
- UMR BIOGECO, INRAE, Université de Bordeaux, Cestas, France; Pleiade, EPC INRIA-INRAE-CNRS, Université de Bordeaux Talence, France
| | - Marine Ginouvès
- TBIP, Université de Guyane, Cayenne, French Guiana; Université de Lille, CNRS, Inserm, Institut Pasteur de Lille, U1019-UMR 9017-CIIL Centre d'Infection et d'Immunité de Lille, Lille, France
| | - Sébastien Gourbière
- UMR 5096 Laboratoire Génome et Développement des Plantes, Université de Perpignan Via Domitia, Perpignan, France
| | - Emeline Houël
- CNRS, UMR EcoFoG, AgroParisTech, Cirad, INRAE, Université des Antilles, Université de Guyane, Cayenne, France
| | - Arthur Kocher
- Transmission, Infection, Diversification & Evolution Group, Max-Planck Institute for the Science of Human History, Kahlaische Str. 10, 07745 Jena, Germany; Laboratoire Evolution et Diversité Biologique (UMR 5174), Université de Toulouse, CNRS, IRD, UPS, Toulouse, France
| | - Anne Lavergne
- Laboratoire des Interactions Virus-Hôtes, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana
| | - Paul Le Turnier
- Service de Maladies Infectieuses et Tropicales, Hôtel Dieu - INSERM CIC 1413, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Luana Mathieu
- Université de Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR-S 1085 Rennes, France
| | - Jérôme Murienne
- Laboratoire Evolution et Diversité Biologique (UMR 5174), Université de Toulouse, CNRS, IRD, UPS, Toulouse, France
| | - Mathieu Nacher
- Centre d'Investigation Clinique Antilles-Guyane, Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Stéphane Pelleau
- Université de Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR-S 1085 Rennes, France; Malaria: Parasites and Hosts, Institut Pasteur, Paris, France
| | - Ghislaine Prévot
- TBIP, Université de Guyane, Cayenne, French Guiana; Université de Lille, CNRS, Inserm, Institut Pasteur de Lille, U1019-UMR 9017-CIIL Centre d'Infection et d'Immunité de Lille, Lille, France
| | - Dominique Rousset
- Laboratoire de Virologie, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana
| | - Emmanuel Roux
- ESPACE-DEV (Institut de Recherche pour le Développement, Université de la Réunion, Université des Antilles, Université de Guyane, Université de Montpellier, Montpellier, France; International Joint Laboratory "Sentinela" Fundação Oswaldo Cruz, Universidade de Brasília, Institut de Recherche pour le Développement, Rio de Janeiro RJ-21040-900, Brazil
| | - Roxane Schaub
- TBIP, Université de Guyane, Cayenne, French Guiana; Université de Lille, CNRS, Inserm, Institut Pasteur de Lille, U1019-UMR 9017-CIIL Centre d'Infection et d'Immunité de Lille, Lille, France; Centre d'Investigation Clinique Antilles-Guyane, Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Stanislas Talaga
- UMR MIVEGEC, IRD, CNRS, Université de Montpellier, Centre IRD de Montpellier, Montpellier, France; Institut Pasteur de la Guyane, Vectopôle Amazonien Emile Abonnenc, Cayenne, French Guiana
| | - Pauline Thill
- Service Universitaire des Maladies Infectieuses et du Voyageur, Centre Hospitalier Dron, Tourcoing, France
| | - Sourakhata Tirera
- Laboratoire des Interactions Virus-Hôtes, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana
| | - Jean-François Guégan
- UMR MIVEGEC, IRD, CNRS, Université de Montpellier, Centre IRD de Montpellier, Montpellier, France; UMR ASTRE, INRAE, CIRAD, Université de Montpellier, Montpellier, France.
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Kallel H, Bourhy P, Mayence C, Houcke S, Hommel D, Picardeau M, Caro V, Matheus S. First report of human Leptospira santarosai infection in French Guiana. J Infect Public Health 2020; 13:1181-1183. [PMID: 32307314 DOI: 10.1016/j.jiph.2020.03.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/24/2020] [Accepted: 03/28/2020] [Indexed: 11/17/2022] Open
Abstract
Leptospirosis is a zoonotic disease with worldwide distribution. In French Guiana, a French overseas department of South America, this bacterial infection is endemic with the increase of human cases since the last 5 years. Nevertheless, the epidemiological data on the circulating infecting strain remains scarce due to the lack of specific symptoms and the used diagnostic approaches. We report a severe case of leptospirosis in a 52-years-old male, working as a street cleaner, hospitalized at the Intensive Care Unit of city capital hospital of French Guiana because of hemodynamic, neurological, renal, and respiratory failure. At ICU admission, the patient was comatose, his temperature was 37.3°C, heart rate 104 beats per minute, blood pressure 84/45mmHg, and oxygen saturation 95% while under mechanical ventilation. Retrospective exploration using molecular and serological approaches from the samples allowed reporting an infection by Leptospira santarosai serogroup Sejroe serovar Hardjo. To our knowledge, this is the first human case infected with this species in French Guiana. Through these analyses, this report provides new epidemiological information about the Leptospira strains circulating in French Guiana. In particular, this emphasizes the importance of accurate diagnosis to characterize with more precision the circulating Leptospira strains in this department.
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Affiliation(s)
- Hatem Kallel
- Centre Hospitalier Andrée Rosemon, Service de Réanimation Polyvalente, Cayenne, French Guiana
| | - Pascale Bourhy
- Institut Pasteur, Centre National de Référence de la Leptospirose, Biology of Spirochetes Unit, Paris, France
| | - Claire Mayence
- Centre Hospitalier Andrée Rosemon, Service de Réanimation Polyvalente, Cayenne, French Guiana
| | - Stéphanie Houcke
- Centre Hospitalier Andrée Rosemon, Service de Réanimation Polyvalente, Cayenne, French Guiana
| | - Didier Hommel
- Centre Hospitalier Andrée Rosemon, Service de Réanimation Polyvalente, Cayenne, French Guiana
| | - Mathieu Picardeau
- Institut Pasteur, Centre National de Référence de la Leptospirose, Biology of Spirochetes Unit, Paris, France
| | - Valérie Caro
- Institut Pasteur, Environment and Infectious Risks Unit, Paris, France
| | - Séverine Matheus
- Institut Pasteur, Environment and Infectious Risks Unit, Paris, France.
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12
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Jagadesh S, Combe M, Couppié P, Le Turnier P, Epelboin L, Nacher M, Gozlan RE. Emerging human infectious diseases of aquatic origin: a comparative biogeographic approach using Bayesian spatial modelling. Int J Health Geogr 2019; 18:23. [PMID: 31694656 PMCID: PMC6833193 DOI: 10.1186/s12942-019-0188-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 10/25/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With the increase in unprecedented and unpredictable disease outbreaks due to human-driven environmental changes in recent years, we need new analytical tools to map and predict the spatial distribution of emerging infectious diseases and identify the biogeographic drivers underpinning their emergence. The aim of the study was to identify and compare the local and global biogeographic predictors such as landscape and climate that determine the spatial structure of leptospirosis and Buruli Ulcer (BU). METHODS We obtained 232 hospital-confirmed leptospirosis (2007-2017) cases and 236 BU cases (1969-2017) in French Guiana. We performed non-spatial and spatial Bayesian regression modeling with landscape and climate predictor variables to characterize the spatial structure and the environmental drivers influencing the distribution of the two diseases. RESULTS Our results show that the distribution of both diseases is spatially dependent on environmental predictors such as elevation, topological wetness index, proximity to cropland and increasing minimum temperature at the month of potential infection. However, the spatial structure of the two diseases caused by bacterial pathogens occupying similar aquatic niche was different. Leptospirosis was widely distributed across the territory while BU was restricted to the coastal riverbeds. CONCLUSIONS Our study shows that a biogeographic approach is an effective tool to identify, compare and predict the geographic distribution of emerging diseases at an ecological scale which are spatially dependent to environmental factors such as topography, land cover and climate.
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Affiliation(s)
- Soushieta Jagadesh
- ISEM, UMR226, CNRS, Université de Montpellier, IRD, EPHE, 34090, Montpellier, France.
- Equipe EPAT 3593 Ecosystèmes amazoniens et pathologie tropicale, Université de Guyane, Cayenne, French Guiana.
| | - Marine Combe
- ISEM, UMR226, CNRS, Université de Montpellier, IRD, EPHE, 34090, Montpellier, France
| | - Pierre Couppié
- Equipe EPAT 3593 Ecosystèmes amazoniens et pathologie tropicale, Université de Guyane, Cayenne, French Guiana
- Service de Dermatologie, Centre hospitalier Andrée Rosemon, av des Flamboyants, 97304, Cayenne Cedex, French Guiana
| | - Paul Le Turnier
- Unité des maladies infectieuses et tropicales, Centre hospitalier Andrée Rosemon, av des Flamboyants, 97304, Cayenne Cedex, French Guiana
| | - Loïc Epelboin
- Unité des maladies infectieuses et tropicales, Centre hospitalier Andrée Rosemon, av des Flamboyants, 97304, Cayenne Cedex, French Guiana
| | - Mathieu Nacher
- Equipe EPAT 3593 Ecosystèmes amazoniens et pathologie tropicale, Université de Guyane, Cayenne, French Guiana
- Centre d'investigation clinique (CIC Inserm 1424), Centre hospitalier Andrée Rosemon, Avenue des Flamboyants, 97304, Cayenne Cedex, French Guiana
| | - Rodolphe Elie Gozlan
- ISEM, UMR226, CNRS, Université de Montpellier, IRD, EPHE, 34090, Montpellier, France
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13
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Le Turnier P, Bonifay T, Mosnier E, Schaub R, Jolivet A, Demar M, Bourhy P, Nacher M, Djossou F, Epelboin L. Usefulness of C-Reactive Protein in Differentiating Acute Leptospirosis and Dengue Fever in French Guiana. Open Forum Infect Dis 2019; 6:ofz323. [PMID: 31660403 PMCID: PMC6735690 DOI: 10.1093/ofid/ofz323] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 07/03/2019] [Indexed: 02/06/2023] Open
Abstract
Objective Leptospirosis and dengue fever (DF) are hard-to-differentiate diseases in cocirculating areas, especially during DF epidemics. Misdiagnosis and ensuing lack of antibiotic therapy can be detrimental in leptospirosis. The objective of this study was to identify factors that help differentiate acute leptospirosis from dengue fever on admission. Method Patients with leptospirosis (positive serology or polymerase chain reaction) were compared with patients with DF (positive nonstructural 1 [NS1] antigen) in a case-control study with age matching. Data on admission were compared using bivariate analysis and multivariate analysis. Results Seventy-two patients with leptospirosis were compared to 216 patients with DF. In bivariate analysis, the factors associated with leptospirosis were male gender, cough, anemia, and elevated blood levels of C-reactive protein (CRP), leukocytes, creatinine, bilirubin, and creatine phosphokinase. Exanthema, purpura, myalgia, headache, and neutropenia were associated with DF. In multivariate analysis, elevated blood levels of leukocytes, bilirubin, and CRP were associated with leptospirosis. The CRP threshold of 50 mg/L taken alone had elevated sensitivity and specificity. Conclusions The CRP level, an easy-to-obtain biomarker, was a powerful tool to differentiate on admission leptospirosis and DF. Facing a dengue-like syndrome in cocirculating areas and awaiting new specific rapid diagnostic tests, CRP dosing could help the clinician to promptly consider the diagnosis of leptospirosis and initiate antibiotic therapy early.
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Affiliation(s)
- Paul Le Turnier
- Unité des Maladies Infectieuses et Tropicales, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - Timothée Bonifay
- Unité des Maladies Infectieuses et Tropicales, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana.,Département de Médecine Générale, Université Antilles Guyane, Pointe-à-Pitre, Guadeloupe
| | - Emilie Mosnier
- Unité des Maladies Infectieuses et Tropicales, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana.,Ecosystèmes Amazoniens et Pathologie Tropicale, Université de la Guyane, Cayenne, French Guiana.,Centres Délocalisés de Prévention et de Soins, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - Roxane Schaub
- Ecosystèmes Amazoniens et Pathologie Tropicale, Université de la Guyane, Cayenne, French Guiana.,Centre d'Investigation Clinique Antilles Guyane, INSERM CIC 1424, Cayenne, French Guiana
| | - Anne Jolivet
- Service de Santé Publique, Hopital Franck Joly, Saint-Laurent du Maroni, French Guiana
| | - Magalie Demar
- Ecosystèmes Amazoniens et Pathologie Tropicale, Université de la Guyane, Cayenne, French Guiana.,Laboratoire Hospitalo-Universitaire de Parasitologie Mycologie, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - Pascale Bourhy
- Institut Pasteur, Centre National de Référence de la Leptospirose, Paris, France
| | - Mathieu Nacher
- Ecosystèmes Amazoniens et Pathologie Tropicale, Université de la Guyane, Cayenne, French Guiana.,Centre d'Investigation Clinique Antilles Guyane, INSERM CIC 1424, Cayenne, French Guiana
| | - Félix Djossou
- Unité des Maladies Infectieuses et Tropicales, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana.,Ecosystèmes Amazoniens et Pathologie Tropicale, Université de la Guyane, Cayenne, French Guiana
| | - Loïc Epelboin
- Unité des Maladies Infectieuses et Tropicales, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana.,Ecosystèmes Amazoniens et Pathologie Tropicale, Université de la Guyane, Cayenne, French Guiana
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14
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Combe M, Gozlan RE, Jagadesh S, Velvin CJ, Ruffine R, Demar MP, Couppié P, Djossou F, Nacher M, Epelboin L. Comparison of Mycobacterium ulcerans (Buruli ulcer) and Leptospira sp. (Leptospirosis) dynamics in urban and rural settings. PLoS Negl Trop Dis 2019; 13:e0007074. [PMID: 30615683 PMCID: PMC6336349 DOI: 10.1371/journal.pntd.0007074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 01/17/2019] [Accepted: 12/13/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Zoonotic pathogens respond to changes in host range and/or pathogen, vector and host ecology. Environmental changes (biodiversity, habitat changes, variability in climate), even at a local level, lead to variability in environmental pathogen dynamics and can facilitate their transmission from natural reservoirs to new susceptible hosts. Whilst the environmental dynamics of aquatic bacteria are directly linked to seasonal changes of their habitat they also rely on the ecological processes underpining their transmission. However data allowing the comparison of these ecological processes are lacking. Here we compared the environmental dynamics of generalist and vector-borne aquatic bacterial pathogens in the same unit of time and space, and across rural and urban habitats in French Guiana (South America). PRINCIPAL FINDINGS Using Leptospira sp. and Mycobacterium ulcerans we performed an environmental survey that allowed the detection of both pathogens in urban vs. rural areas, and during rainy vs. dry weather conditions. All samples were subjected to qPCR amplifications of LipL32 (Leptospira sp.) and IS2404 and KR (M. ulcerans) genetic markers. We found (i) a greater presence of M. ulcerans in rural areas compared with Leptospira sp., (ii) that modified urban environments were more favourable to the establishment of both pathogens, (iii) that Leptospira sp. presence was enhanced during the rainy season and M. ulcerans during the dry period, and (iv) differences in the spatial distribution of both bacteria across urban sites, probably due to the mode of dissemination of each pathogen in the environment. CONCLUSIONS We propose that in French Guiana simplified and modified urban ecosystems might favour leptospirosis and Buruli ulcer emergence and transmission. Moreover, disease risk was also constrained by seasonality. We suggest that the prevention of aquatic bacterial disease emergence in impoverished urban areas of developing countries would benefit from seasonal diseases targeted surveys, which would maximise limited budgets from cash-strapped health agencies.
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Affiliation(s)
- Marine Combe
- ISEM UMR226, Université de Montpellier, CNRS, IRD, EPHE, Montpellier, France
| | | | - Soushieta Jagadesh
- ISEM UMR226, Université de Montpellier, CNRS, IRD, EPHE, Montpellier, France
| | | | - Rolland Ruffine
- MIVEGEC, IRD, CNRS, Université de Montpellier, Montpellier, Centre IRD de Cayenne, Guyane française
| | - Magalie Pierre Demar
- Equipe EA 3593, Ecosystèmes amazoniens et pathologie tropicale, Université de la Guyane, Cayenne, Guyane française
- Laboratoire hospitalo-universitaire de parasitologie mycologie, Centre hospitalier Andrée Rosemon, Guyane française
| | - Pierre Couppié
- Equipe EA 3593, Ecosystèmes amazoniens et pathologie tropicale, Université de la Guyane, Cayenne, Guyane française
- Service de Dermatologie, Cayenne Hospital, rue des Flamboyant, Cayenne, French Guiana, France
| | - Felix Djossou
- Equipe EA 3593, Ecosystèmes amazoniens et pathologie tropicale, Université de la Guyane, Cayenne, Guyane française
- Unité des maladies infectieuses et tropicales, Centre hospitalier Andrée Rosemon, av des Flamboyants, Guyane française
| | - Mathieu Nacher
- Centre d’investigation clinique (CIC Inserm 1424), Centre hospitalier Andrée Rosemon, Guyane française
| | - Loïc Epelboin
- Equipe EA 3593, Ecosystèmes amazoniens et pathologie tropicale, Université de la Guyane, Cayenne, Guyane française
- Unité des maladies infectieuses et tropicales, Centre hospitalier Andrée Rosemon, av des Flamboyants, Guyane française
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15
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Le Turnier P, Epelboin L. [Update on leptospirosis]. Rev Med Interne 2018; 40:306-312. [PMID: 30591382 DOI: 10.1016/j.revmed.2018.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/19/2018] [Accepted: 12/06/2018] [Indexed: 12/13/2022]
Abstract
Leptospirosis is a worldwide spirochetal zoonosis whose global incidence is increasing and is probably underestimated. Leptospirosis has long been associated with occupational contact with animals (rats and cattle) and has become in developed countries a pathology more related to recreational activities with exposure to fresh water (canoeing, swimming, canyoning) and to an environment contaminated by urine from leptospires excretory rodents. Leptospirosis should be one of the differential diagnoses to be considered when returning from travel to tropical areas, particularly Southeast Asia, and particularly during the rainy season. The clinical symptoms, particularly in the initial phase, are not specific and can limit to a flu-like syndrome or "dengue-like" making diagnosis often difficult. It is then necessary to look carefully for clinical (muscle pain, cough, conjunctival involvement, jaundice) and biological arguments (thrombocytopenia, cholestasis, rhabdomyolysis, frank elevation of CRP) that will help to diagnose leptospirosis and lead to quick antibiotic therapy before the progression to a severe icterohaemorrhagic (Weil's disease) or respiratory form associated with significant mortality. Treatment is based on injectable beta-lactams in severe forms (mainly cephalosporins) and amoxicillin, doxycycline or azithromycin in non-severe forms. Some atypical or delayed forms of leptospirosis occurring in the late immune phase of the disease are to know. Rapid diagnostic tools are currently being studied to improve diagnosis in remote areas and facilitate access to early treatment.
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Affiliation(s)
- P Le Turnier
- Inserm, service des maladies infectieuses et tropicales, centre hospitalier universitaire de Nantes et CIC 1413, 44000 Nantes, France.
| | - L Epelboin
- Unité des maladies infectieuses et tropicales, centre hospitalier Andrée-Rosemon, Cayenne, Guyane; Équipe EA 3593, ecosystèmes amazoniens et pathologie tropicale, université de la Guyane, Cayenne, Guyane
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