[First four cases of acute meningitis due to Toscana virus on monastir region]

Toscana virus [TOSV] has been identified as an important cause of acute meningitis in Italy where it was isolated for the first time. Currently, it is one of the major viral pathgens involved in acute meningitis in Mediterranean countries. We describe four cases of acute meningitis caused by TOSV concerning patients hospitalized in the department of infectious diseases, Fattouma Bourguiba university hospital, Monastir [Tunisia]. The demographic data, the clinical and laboratory features and the evolution were reviewed. All patients were male, living in coastal region. They were hospitalized in summer period. The mean age was 26 years. The diagnosis was suspected in the presence of fever and acute meningitis syndrome. Lumbar puncture showed clear cerebrospinal fluid [CSF] containing normal glucose and predominant lymphocyte. This diagnosis was confirmed by detection of anti-TOSV IgM in blood and CSF. The outcome was favorable in all cases. No specific treatment was administered. The mean follow-up was nine months

[Situation de la borreliose de Lyme au Maghreb]

Many epidemiological studies were conducted for studying Lyme borreliosis [LB] which represents a new global public health problem. It is now the most common vector-borne disease in Europe and North America. The causative agent Borrelia burgdorferi sl is a bacterial species complex comprising 12 delineated and named species. In North Africa, few studies based on clinical and serological features, have suggested that LB could occur. Indeed, recent studies conducted in Tunisia, Algeria and Morocco have shown that Ixodes ricinus is present in cooler and humid area of these regions. These studies also revealed that this species is a vector of B. burgdorferi sl with high prevalence of infection. Using IFI and PCR tests, the mean rate of Borrelia infection ranged from 50 to 60 % in I. ricinus adult collected in Tunisia and Morocco and from 30 to 40% in nymphs; in contrast, the prevalence in larvae is less than 2.5 %. Several strains of B. burgdorferi were isolated from adult and nymph I. ricinus collected in Tunisia and Morocco. The identification of these strains and DNAs directly extracted from Ixodes was done by PCRRFLP and sequence analysis. The results showed that B.lusitaniae [genotypes Poti B2 and Poti B3] is the predominant species circulating in I. ricinus in Tunisia and Morocco, B. garinii and B. burgdorferi ss and B lusitaniae were also present but very rare. These results provide the evidence for the existence of B. burgdorferi sl in North Africa; however, the impact of LB in the human population seem to be negligible and the seroprevalence of Borrelia in forest workers [considered as population at high risk] in Tunisia is less than 4%