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Collard J.-M.,Scientific Institute of Public Health | Zaneidou M.,Direction de la Surveillance et de la Riposte aux Epidemies | Hugonnet S.,World Health Organization | Nicolas P.,Institute Of Medecine Tropicale Du Service Of Sante Des Armees | And 2 more authors.
BMC Infectious Diseases | Year: 2013

Background: The epidemiology of bacterial meningitis in the African 'meningitis belt' changes periodically. In order to design an effective vaccination strategy, we have examined the epidemiological and microbiological patterns of bacterial meningitis, and especially that of meningococcal meningitis, in Niger during the period 2008-2011. During this period a mass vaccination campaign with the newly developed meningococcal A conjugate vaccine (MenAfriVac®) was undertaken.Method: Cerebrospinal fluid samples were collected from health facilities throughout Niger and analysed by culture, seroagglutination and/or speciation polymerase chain reaction, followed by genogrouping PCR for Neisseria meningitidis infections. A sample of strains were analysed by multi-locus sequence typing.Results: N. meningitidis serogroup A cases were prevalent in 2008 and 2009 [98.6% and 97.5% of all N. meningitidis cases respectively]. The prevalence of serogroup A declined in 2010 [26.4%], with the emergence of serogroup W Sequence Type (ST) 11 [72.2% of cases], and the serogroup A meningococcus finally disappeared in 2011. The geographical distribution of cases N. meningitidis serogroups A and W within Niger is described.Conclusion: The substantial decline of serogroup A cases that has been observed from 2010 onwards in Niger seems to be due to several factors including a major polysaccharide A/C vaccination campaign in 2009, the introduction of MenAfriVac® in 10 districts at risk in December 2010, the natural dynamics of meningococcal infection and the persistence of serogroup A sequence-type 7 for about 10 years. The emergence of serogroup W strains suggests that there may be a need for serogroup W containing vaccines in Niger in the coming years. © 2013 Collard et al.; licensee BioMed Central Ltd.


Hassing R.-J.,Institute of Tropical Medicine | Hassing R.-J.,Erasmus University Rotterdam | Leparc-Goffart I.,Institute Of Medecine Tropicale Du Service Of Sante Des Armees | Blank S.N.,Maxima Medical Center Eindhoven | And 5 more authors.
Journal of Infection | Year: 2010

A Dutch couple, presenting with persisting arthralgias, temporary fever and rash after a stay in Surinam were diagnosed with Mayaro virus infection. Mayaro virus is a relatively unknown South American . Alphavirus responsible for dengue-like clinical features and persisting arthralgias. An important, but probably underappreciated cross-reactivity with other Alphaviruses like Chikungunya virus is present, which may become of clinical importance in the event the various Alphaviruses will have overlapping geographical distributions and in seroprevalence studies. © 2010 The British Infection Society.


Depaquit J.,University of Reims Champagne Ardenne | Grandadam M.,Institute Of Medecine Tropicale Du Service Of Sante Des Armees | Grandadam M.,Institute Pasteur Paris | Fouque F.,Institute Pasteur Paris | Andry P.E.,University of Reims Champagne Ardenne
Eurosurveillance | Year: 2010

Phlebotomine sandflies are known to transmit leishmaniases, bacteria and viruses that affect humans and animals in many countries worldwide. These sandfly-borne viruses are mainly the Phlebovirus, the Vesiculovirus and the Orbivirus. Some of these viruses are associated with outbreaks or human cases in the Mediterranean Europe. In this paper, the viruses transmitted by Phlebotomine sandflies in Europe (Toscana virus, Sicilian virus, sandfly fever Naples virus) are reviewed and their medical importance, geographical distribution, epidemiology and potential spreading discussed. Data on vertebrate reservoirs is sparse for sandfly fever viruses. The factor currently known to limit the spread of diseases is mainly the distribution areas of potential vectors. The distribution areas of the disease may not be restricted to the areas where they have been recorded but could be as wide as those of their vectors, that is to say Larroussius and P. papatasi mainly but not exclusively. Consequently, field work in form of viral isolation from sandflies and possible reservoirs as well as laboratory work to establish vectorial competence of colonised sandflies need to be encouraged in a near future, and epidemiological surveillance should be undertaken throughout the European Union.


Koeck J.-L.,Laboratoire Of Biologie Clinique | Fabre M.,Laboratoire Of Biologie Clinique | Simon F.,Service des maladies infectieuses et tropicales | Daffe M.,CNRS Institute of Pharmacology and Structural Biology | And 6 more authors.
Clinical Microbiology and Infection | Year: 2011

Over a 3-year follow-up, 30 out of the 318 unique Mycobacterium tuberculosis complex isolates recovered in the Republic of Djibouti had a smooth-type morphology and were Niacine-negative, the characteristics of 'Mycobacterium canettii' strains. Unlike M. tuberculosis, 'M. canettii' grew on nutrient-poor media at 30°C, and possessed characteristic lipids. They were isolated from respiratory and extra-respiratory sites from patients with typical forms of tuberculosis. Most cases resolved with antibiotic therapy but in two human immunodeficiency virus-positive patients 'M. canettii' infection led to septicaemia and death. No cases of human-to-human transmission were observed. The proportion of tuberculosis cases caused by 'M. canettii' was higher among French patients than among Djiboutian patients. Patients with 'M. canettii' were significantly younger than those with tuberculosis caused by other M. tuberculosis complex strains. Smooth tubercle bacilli could be misidentified as non-tuberculous mycobacteria and appear to be limited to the Horn of Africa. Their characteristics are consistent with the existence of non-human sources of infection. © 2010 The Authors. Clinical Microbiology and Infection © 2010 European Society of Clinical Microbiology and Infectious Diseases.


Pradines B.,Institute Of Medecine Tropicale Du Service Of Sante Des Armees | Pradines B.,Center National Of Reference Du Paludisme | Bertaux L.,Center National Of Reference Du Paludisme | Bertaux L.,Institute Of Medecine Tropicale Du Service Of Sante Des Armees | And 6 more authors.
Malaria Journal | Year: 2011

Decreased in vitro susceptibility to dihydroartemisinin (21.2 nM) and artesunate (16.3 nM) associated with decreased susceptibility or resistance to quinine (1131 nM), mefloquine (166 nM), lumefantrine (114 nM), pyronaridine (70.5 nM) and piperaquine (91.1 nM) is reported in a patient returning from South-East Asia after trekking along the Mekong from the south of Laos to the north of Thailand. Decreased in vitro susceptibility to artemisinin derivatives did not appear to be mediated by the number of copies of pfmdr1 or pfATPase6, pfcrt, pfmdr1 or pfmrp polymorphism. The high IC50to mefloquine of this Asian isolate was not associated with pfmdr1 copy number. Pfnhe-1 microsatellite ms4760 showed a profile 7 (ms4760-7) with three repeats of DNNND and one repeat of DDDNHNDNHNN, which is associated with high quinine reduced susceptibility. The patient recovered in three days without relapse after treatment with the association of quinine and doxycycline. Decreased in vitro susceptibility to quinine and the delayed effect of doxycycline may both have contributed to the delayed parasite clearance time, D4 (0.5%) and D7 (0.004%). The in vitro data, with IC50for dihydroartemisinin and artesunate were up to ten times those of the reference clone W2, which suggests that this isolate may be resistant to artemisinin derivatives, associated with a decreased susceptibility to quinine. © 2011 Pradines et al; licensee BioMed Central Ltd.


Khlif M.,Laboratoire Of Biologie Moleculaire Parasitaire Et Fongique | Bogreau H.,Institute Of Medecine Tropicale Du Service Of Sante Des Armees | Michel-Nguyen A.,Aix - Marseille University | Ayadi A.,Laboratoire Of Biologie Moleculaire Parasitaire Et Fongique | Ranque S.,Aix - Marseille University
Antimicrobial Agents and Chemotherapy | Year: 2010

Multilocus microsatellite polymorphisms in 27 clinical Candida albicans isolates were found to be clearly unrelated to in vitro paradoxical growth or trailing effect with caspofungin. These findings suggest that such in vitro phenotypes are either gained or lost too rapidly to be predicted by more stable genomic markers. Copyright © 2010, American Society for Microbiology. All Rights Reserved.


Hoarau J.-J.,University of Reunion Island | Bandjee M.-C.J.,University of Reunion Island | Trotot P.K.,University of Reunion Island | Das T.,University of Reunion Island | And 22 more authors.
Journal of Immunology | Year: 2010

Alphaviruses, including Chikungunya virus (CHIKV), produce a transient illness in humans, but severe forms leading to chronic incapacitating arthralgia/arthritis have been reported by mechanisms largely ill-characterized. The pathogenesis of CHIKV was addressed in a prospective cohort study of 49 hospitalized patients from Reunion Island subsequently categorized into two distinct groups at 12 mo postinfection. Comprehensive analyses of the clinical and immunological parameters throughout the disease course were analyzed in either the "recovered" or the "chronic" groups to identify prognostic markers of arthritis-like pathology after CHIKV disease.We found that the chronic group consisted mainly of more elderly patients (>60 y) and with much higher viral loads (up to 1010 viruses per milliliter of blood) during the acute phase. Remarkably, a rapid innate immune antiviral response was demonstrated by robust dendritic/NK/CD4/CD8 cell activation and accompanied by a rather weak Th1/Th2 cytokine response in both groups. Interestingly, the antiviral immune response witnessed by high levels of IFN-α mRNA in PBMCs and circulating IL-12 persisted for months only in the chronic group. CHIKV (RNA and proteins) was found in perivascular synovial macrophages in one chronic patient 18 mo postinfection surrounded by infiltrating NK and T cells (CD4 ++ but rare cytotoxic CD8). Fibroblast hyperplasia, strong angiogenesis, tissue lesions given the high levels of matrix metalloproteinase 2, and acute cell death [high cleaved poly (ADP-ribose) polymerase staining] were observed in the injured synovial tissue. These observed cellular and molecular events may contribute to chronic arthralgia/arthritis targeted by methotrexate used empirically for effective treatment but with immunosuppressive function in a context of viral persistence. Copyright © 2010 by The American Association of Immunologists, Inc.


Avaro J.-P.,British Petroleum | Mardelle V.,Hopital DInstruction des Armees A. Laveran | Roch A.,Aix - Marseille University | Gil C.,Hopital DInstruction des Armees A. Laveran | And 4 more authors.
Journal of Trauma - Injury, Infection and Critical Care | Year: 2011

BACKGROUND:: To evaluate the feasibility of aortic balloon catheter occlusion in intra-abdominal hemorrhage. METHODS:: Effects of transfemoral diaphragmatic aortic balloon occlusion (ABO) have been evaluated in 25 pigs. The animals were submitted to incontrollable hemorrhage by a splenic trauma. Group 1 (n = 9) received fluid resuscitation with normal saline (NS) without aortic occlusion; group 2 (n = 8) underwent 60 minutes ABO and NS. Groups 3 (n = 4) and 4 (n = 4) underwent ABO during 40 minutes and 60 minutes, respectively, NS, and splenectomy. RESULTS:: Aortic balloon location was adequate in all animals. ABO increased the portion of 2-hour survivors significantly (7/16 vs. 0/9; p = 0.03). ABO increased mean arterial blood pressures (p < 0.05). There was a significant decrease of bleeding and volume of fluid resuscitation (p < 0.05) in ABO groups. Blood potassium and lactate levels at death were significantly higher in groups 2 and 4 compared with those of the control group: 29 ± 0.54 and 6.08 mmol/L ± 0.44 mmol/L versus 4.16 mmol/L ± 0.35 mmol/L (p < 0.02), and 11.39 mmol/L ± 0.37 mmol/L and 9.59 mmol/L ± 1.19 mmol/L versus 6.43 mmol/L ± 0.57 mmol/L (p < 0.001), respectively. There were no significant differences between group 3 and the control group: 4.83 mmol/L ± 0.32 mmol/L versus 6.43 mmol/L ± 0.57 mmol/L and 5.2 mmol/L ± 0.13 mmol/L versus 4.16 mmol/L ± 0.35 mmol/L, respectively. At necropsy, there were no significant differences in terms of visceral (bowel and kidney) ischemia between the different experimental groups. CONCLUSION:: A 40-minute ABO followed by surgical damage control improved survival in this animal model of uncontrolled hemorrhagic shock caused by abdominal trauma. ABO could be considered for the management of severe abdominal trauma. Copyright © Lippincott Williams & Wilkims.


Colson P.,Center Hospitalo University Timone | Colson P.,Aix - Marseille University | Borentain P.,Center Hospitalo University Conception | Queyriaux B.,Institute of Veille Sanitaire | And 9 more authors.
Journal of Infectious Diseases | Year: 2010

Background: The source and route of autochthonous hepatitis E virus (HEV) infections are not clearly established in industrialized countries despite evidence that it is a zoonosis in pigs. We investigated the role of figatellu, a traditional pig liver sausage widely eaten in France and commonly consumed raw, as a source of HEV infection. Methods: A case-control study was conducted of 3 patients who presented autochthonous hepatitis E and 15 members of their 3 different families. Anti-HEV immunoglobulin G and immunoglobulin M antibody testing was performed with commercial assays. HEV RNA was detected in serum samples of patients and in pig liver sausages by means of real-time polymerase chain reaction and sequenced by means of in-house sequencing assays. Genetic links between HEV sequences were analyzed. Results: Acute or recent HEV infection, defined by detection of anti-HEV immunoglobulin M antibodies and/ or HEV RNA, was observed in 7 of 13 individuals who ate raw figatellu and 0 of 5 individuals who did not eat raw figatellu ( ). Moreover, HEV RNA of genotype Pp.041 3 was recovered from 7 of 12 figatelli purchased in supermarkets, and statistically significant genetic links were found between these sequences and those recovered from patients who ate raw figatellu. Conclusion: Our findings strongly support the hypothesis of HEV infection through ingestion of raw figatellu. © 2010 by the Infectious Diseases Society of America. All rights reserved.


Marimoutou C.,Institute Of Medecine Tropicale Du Service Of Sante Des Armees | Marimoutou C.,Aix - Marseille University | De Santi V.P.,Institute Of Medecine Tropicale Du Service Of Sante Des Armees | Attrait X.,21e Regiment dInfanterie de Marine | And 3 more authors.
Journal of Travel Medicine | Year: 2011

Self-reporting seems more appropriate than medical-based surveillance to estimate true incidence of diarrhea during deployment of military troops.Most soldiers self-reported multiple episodes, 42% leading to medical care, mainly the first episode, resulting in a threefold higher incidence. Mathematical models integrating self-reported data should better predict outbreaks during military deployments and define a more complete assessment of disease burden. © 2011 International Society of Travel Medicine.

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