[Global management of patients with ebola viral disease, experience of the Healthcare workers Treatment of Conakry, Guinea]. / Prise en charge globale du patient contaminé par le virus Ebola, expérience du Centre de traitement des soignants de Conakry, Guinée.

The Healthcare Workers Treatment Center of Conakry, Guinea, was inaugurated in january 2015. It is dedicated to the diagnosis and the treatment of healthcare workers with probable or confirmed Ebola viral disease. It is staffed by the french army medical service. The french military team may reconcile their medical practice and the ethno-cultural imperatives to optimise the patient adherence during his hospitalization.

[Characterisation of viral agents with potential to cause diarrhea in Djibouti]. / Caractérisation des virus agents potentiels des diarrhées chez l'adulte à Djibouti.

Due to limited laboratory facilities in the tropics, the exact role of enteric viruses in causing diarrhea among adults in the tropics is unknown. The purpose of this report is to describe a multicenter study undertaken in Djibouti to determine the prevalence of a large panel of enteric viruses using immunochromatography; antigenic detection by ELISA, RT-PCR cellular inoculation, sequence analysis; and indirect serology. Study samples were collected from 108 patients presenting acute and sporadic diarrhea. Although they are well known causes of diarrhea in children, rotavirus and adenovirus were identified in only 2 and 5% of adults respectively. In contrast human caliciviruses (HuCVs) and enterovirus were identified in 25 and 42% of adult cases respectively. Uncommon genotypes of HuCVs and recombinant forms (junction pol/l cap) as well as a significant number of sapovirus (30%) were identified. Further study is needed to clarify the role of enterovirus (echovirus) in the etiology of acute diarrhea in adults. No polivirus was identified. These new data from the Horn of Africa increase our knowledge about the epidemiology of acute infectious diarrhea that is a major public health problem and potential danger for travelers.

Caracterisation des virus agents potentiels des diarrhees chez l'adulte a Djibouti

Chez l'adulte; en zone tropicale; la part exacte des virus enteriques dans les diarrhees infectieuses aigues; demeure inconnue faute de moyens diagnostiques. Une etude multicentrique a permis de preciser la prevalence virale; chez des patients presentant des diarrhees aigues sporadiques a Djibouti. A partir d'un echantillon de 108 sujets; un large panel de virus enteriques a ete recherche par immunochromatographie; detection antigenique en ELISA immunocapture; RT-PCR; inoculation sur cellules permissives; analyse de sequences; et methodes indirectes en serologie. Les rotavirus et adenovirus agents principaux des gastroenterites chez l'enfant representent respectivement 2 et 5des cas. Les astrovirus; 5des cas. En revanche; les calicivirus humains (HuCVs) et enterovirus sont retrouves dans 25et 42des cas respectivement. Des genotypes inhabituels de HuCVs et des formes recombinantes (jonction pol / cap) ont ete mis en evidence; ainsi qu'un nombre relatif eleve de sapovirus (30). La participation des enterovirus (echovirus) dans l'etiologie des diarrhees sporadiques de l'adultemerite d'etre approfondie.Aucune souche de poliovirus n'a etemise en evidence. Ces nouvelles donnees concernant la Corne de l'Afrique renforcent nos connaissances epidemiologiques sur les diarrhees infectieuses aigues; probleme majeur de sante publique; et danger potentiel pour les voyageurs

Caracterisation des virus agents potentiels des diarrhees chez l'adulte a Djibouti

Chez l'adulte; en zone tropicale; la part exacte des virus enteriques dans les diarrhees infectieuses aigues; demeure inconnue faute de moyens diagnostiques. Une etude multicentrique a permis de preciser la prevalence virale; chez des patients presentant des diarrhees aigues sporadiques a Djibouti. A partir d'un echantillon de 108 sujets; un large panel de virus enteriques a ete recherche par immunochromatographie; detection antigenique en ELISA immunocapture; RT-PCR; inoculation sur cellules permissives; analyse de sequences; et methodes indirectes en serologie. Les rotavirus et adenovirus agents principaux des gastroenterites chez l'enfant representent respectivement 2 et 5des cas. Les astrovirus; 5des cas. En revanche; les calicivirus humains (HuCVs) et enterovirus sont retrouves dans 25 et 42des cas respectivement. Des genotypes inhabituels de HuCVs et des formes recombinantes (jonction pol / cap) ont ete mis en evidence; ainsi qu'un nombre relatif eleve de sapovirus (30). La participation des enterovirus (echovirus) dans l'etiologie des diarrhees sporadiques de l'adulte merite d'etre approfondie.Aucune souche de poliovirus n'a ete mise en evidence. Ces nouvelles donnees concernant la Corne de l'Afrique renforcent nos connaissances epidemiologiques sur les diarrhees infectieuses aigues; probleme majeur de sante publique; et danger potentiel pour les voyageurs

[Management of American cutaneous leishmaniasis. Outcome apropos of 326 cases treated with high-dose pentamidine isethionate]. / Thérapeutique des leishmanioses tégumentaires du Nouveau Monde. Expérience à propos de 326 cas traités par iséthionate de pentamidine à fortes doses.

The purpose of this retrospective analysis was to evaluate the outcome of pentamidine isethionate treatment (4 mg/kg of Pentamidine by the intramuscular route on Days 1 and 3) of cutaneous leishmaniasis in 326 cases that occurred during an outbreak among French military personnel in French Guyana from 1998 to 1999. A great difference was found between the 205 patients treated in French Guyana (series G) and 32 patients treated at the Laveran Military Hospital in Marseille, France (series L). Failure rate, i.e. 25% in series L versus 5% in series G, was significantly correlated with the delay to treatment which was much longer in series L. Extensive rhabdomyolysis was observed in all cases tested: this side-effect has not been reported. Based on these findings and a review of the literature on pentamidine isethionate, the authors recommend prompt treatment using lower doses. Other treatment alternatives for American cutaneous leishmaniasis are also presented including two of the latest developments in the field, i.e., oral treatment using miltefosine and topical treatment using agents such as paromomycine.

["Epidemic" of plantar dermatitis during military maneuvers in the rain forest of Guyana]. / Dermite plantaire "épidémique" durant une mission profonde en Guyane.

The purpose of this report is to describe an "epidemic" outbreak of plantar dermatitis that occurred in 30 soldiers on mission in the rain forest of Guyana. The contingent was forced to stop twice and operational readiness was seriously reduced. The first episode affecting 43% (13/30) of the contingent occurred after 4 days of march. In the second episode 70% (21/30) of the contingent was affected. Manifestations were characterized by the appearance of distinct, dry, nonpruriginus, erythematous papules followed a few hours later by quasi-exfoliating, noncoalescing, nonoozing, nonmalodorous lesions measuring several centimeters in diameter. Symptoms regressed quickly within 48 to 72 hours with only symptomatic treatment. A combination of microtrauma and maceration is the most likely mechanism. However identification of an offending microbial, viral or fungal agent or of a cause in the environment, clothing or products could not be made. A tempting hypothesis involves an inflammatory reaction caused by an organism in ground water or the soil. A prospective study could be undertaken at the Rain Forest Training Camp in Regina where similar clinical manifestation have been observed.

[Epidemiologic surveillance of cutaneous leishmaniasis in Guiana. Summary of military data collected over 10 years]. / Surveillance épidémiologique des leishmanioses tégumentaires en Guyane. Synthése de données militaires sur 10 ans.

This report describes the results of epidemiological surveillance of cutaneous leishmaniasis in French military personnel in French Guiana. Data was collected regarding microscopic diagnosis, clinical manifestations, and lesion location as well as compliance with vector control measures. Year-to-year variations in the incidence in the general population have been attributed to changes in climatic conditions. Monitoring incidence and density curves, correlation of findings with local epidemiological data, and analysis of the most recent epidemic in 1998/99 (326 cases, attack rate 3.2% men years) highlight the importance of behavioral factors. The proportion of total cases involving military personnel varied widely from 20 to 85%. Investigation consistently showed that failure to apply elementary protective measures against sandfly bites was the most determinant factor in this proportion. Strict compliance with these measures appears to reduce the risk of infection considerably.

[Clinical overview of New World tegumentary leishmaniasis]. / Panorama clinique des leishmanioses tégumentaires du Nouveau Monde.

This richly illustrated article (80 color photographs) based on the authors' experience in French Guyana documents the clinical diversity of American tegumentary leishmaniasis. Main highlights include the often outstanding aspect of lesions, the high frequency of forms not associated with ulceration or scab formation that must be recognized to achieve diagnosis in travellers returning from endemic zones, and the special prognosis of clinical forms associated with intradermic, lymphatic or hematogenous spread. The article also reviews an original diagnostic method based on culture of cutaneous biopsy specimens on specific nutrient mediums that provides isolates in a high percentage of cases (80%) and thus allows identification of offending parasite.