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Le Touquet – Paris-Plage, France

Michot J.-M.,Assistance Publique Hopitaux de Paris AP HP | Michot J.-M.,University Paris - Sud | Madec Y.,Institute Pasteur Paris | Bulifon S.,AP HP | And 12 more authors.
Diagnostic Microbiology and Infectious Disease

Adenosine deaminase (ADA) activity measurement in pleural fluid is a relevant test to diagnose pleural tuberculosis (pTB) in high tuberculosis prevalence settings. We investigated the diagnostic utility of pleural ADA using a retrospective analysis of patients admitted with newly diagnosed pleural effusion without identified etiology between 2001 and 2008 in Paris suburb, a low to medium tuberculosis prevalence area. 104 adults (mean age 55 years; 34 with pTB, 70 with other diagnoses) were analyzed. Median follow-up was 15.6 months. Mean [interquartile range] pleural ADA was 119 U/L [IQR: 83-143] in pTB and 24 U/L [IQR: 15-31] in non-tuberculous effusions (P < 0.001). With an optimal pleural ADA cut-off value of 41.5 U/L for pTB diagnosis, sensitivity and specificity were 97.1% and 92.9%, while positive and negative predictive values were 86.8% and 98.5%, respectively. We conclude that pleural ADA activity could be integrated in the diagnostic procedures of pTB in low to medium tuberculosis prevalence settings. © 2015 Elsevier Inc. Source

Piarroux R.,Aix - Marseille University | Barrais R.,Port-au-Prince University | Faucher B.,Aix - Marseille University | Haus R.,Service de Sante des Armees | And 4 more authors.
Emerging Infectious Diseases

After onset of a cholera epidemic in Haiti in mid-October 2010, a team of researchers from France and Haiti implemented field investigations and built a database of daily cases to facilitate identification of communes most affected. Several models were used to identify spatiotemporal clusters, assess relative risk associated with the epidemic's spread, and investigate causes of its rapid expansion in Artibonite Department. Spatiotemporal analyses highlighted 5 significant clusters (p<0.001): 1 near Mirebalais (October 16-19) next to a United Nations camp with deficient sanitation, 1 along the Artibonite River (October 20-28), and 3 caused by the centrifugal epidemic spread during November. The regression model indicated that cholera more severely affected communes in the coastal plain (risk ratio 4.91) along the Artibonite River downstream of Mirebalais (risk ratio 4.60). Our findings strongly suggest that contamination of the Artibonite and 1 of its tributaries downstream from a military camp triggered the epidemic. Source

Tello G.,Antenne medicale de Maisons Alfort | Jouvion A.,Service de medecine physique et readaptation | Boulard J.-F.,Service medical CNEC | Marimoutou C.,Service de Sante des Armees | And 2 more authors.
Science and Sports

Objectives: Some sportsmen present a sport addiction with an irrepressible need to exercise. Is sport addiction protective or predisposing of injury risk during sustained exercises? Equipment and methods: It is a prospective cohort study. It took place at the " Centre national d'entraînement commando" (CNEC) from May 2009 to April 2010. All the trainees taking part in the 15 selected commando courses were included. The sport addiction diagnosis was based on the test EDS-R. Onset of injury was noticed by the CNEC doctors and by the trainees at the end of their course. Results: Six hundred and one people were included. Forty-seven (7.8%) presented a sport addiction. " Sport addicts" had 1.53 times more risk of injuring themselves during a commando course (P=0.004). On the other hand, no injuries " addict" stopped the course as against 25% of the injured " non-addicts" (P=0.003). Discussion: Sport addiction is a significant risk factor for injury. However this addiction is unfrequent, and the pathologies found in the sport " addicts" don't prevent the continuation of intensive exercise. This addiction could be found in the sportsmen regularly injuried in order to suggest an adapted treatment. © 2011 Elsevier Masson SAS. Source

Fernandez J.-C.,Institute Pasteur Paris | Billecocq A.,Institute Pasteur Paris | Durand J.P.,Service de Sante des Armees | Cetre-Sossah C.,CIRAD - Agricultural Research for Development | And 5 more authors.
Clinical and Vaccine Immunology

Rift Valley fever (RVF) is an emerging zoonosis in Africa which has spread to Egypt, the Arabian Peninsula, Madagascar, and Comoros. RVF virus (RVFV) (Bunyaviridae family, Phlebovirus genus) causes a wide range of symptoms in humans, from benign fever to fatal hemorrhagic fever. Ruminants are severely affected by the disease, which leads to a high rate of mortality in young animals and to abortions and teratogenesis in pregnant females. Diagnostic tests include virus isolation and genome or antibody detection. During RVFV infection, the nucleoprotein encapsidating the tripartite RNA genome is expressed in large amounts and raises a robust antibody response, while the envelope glycoproteins elicit neutralizing antibodies which play a major role in protection. Much less is known about the antigenicity/immunogenicity of the nonstructural protein NSs, which is a major virulence factor. Here we have developed a competitive enzyme-linked immunosorbent assay (ELISA) enabling detection of low levels of NSs-specific antibodies in naturally infected or vaccinated ruminants. Detection of the NSs antibodies was validated by Western blotting. Altogether, our data showed that the NSs antibodies were detected in only 55% of animals naturally infected by RVFV, indicating that NSs does not induce a consistently high immune response. These results are discussed in light of differentiation between infected and vaccinated animals (DIVA) tests distinguishing naturally infected animals and those vaccinated with NSs-defective vaccines. Copyright © 2012, American Society for Microbiology. All Rights Reserved. Source

Sow A.,Service de Sante des Armees | Van Gompel A.,Institute of Tropical Medicine | Vandeurzen K.,Maria Hospital
Journal of Travel Medicine

Flights departing from malarious areas are sprayed with pyrethroids. They are presumed to be safe since reports of adverse responses among passengers or crew were only anecdotal. However, asthmatic reactions after domestic and occupational exposure have been published. We present the first case description of pyrethroid allergy in an airplane. © 2010 International Society of Travel Medicine. Source

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