Cultural contexts of swine-related infections in Polynesia.

Pig-raising is an inherent element of ancestral Polynesian culture, but pigs constitute a reservoir of potentially severe diseases for humans. Little research in this area from a social science perspective has been performed, particularly in Oceania. The objective of this study was to assess swine brucellosis awareness and protection measures in two remote Polynesian French islands. We applied quantitative methods to a small clinic-based population selected according to the presence of a history of brucellosis serology, and semistructured interviews about public health measures and veterinary access were used among key informants for qualitative methods. Most individuals interviewed did not know about brucellosis, despite repeated public awareness campaigns. Standard hygiene recommendations to protect humans and animals were not compatible with traditional practice. Innovative approaches are required for effective awareness campaigns, and to gain the confidence and close cooperation of the community, in order to implement successful control measures for communicable diseases such as brucellosis.

Epidemiological and clinical aspects of human Brucella suis infection in Polynesia.

High brucellosis seroprevalence rates in domestic swine herds have been reported in Wallis and Futuna Islands and are associated with a significant burden of human infection by Brucella suis, a species that is rarely incriminated in human disease. Between 2003 and 2010, seven patients had a positive blood culture for B. suis biovar 1, 11 symptomatic patients had a positive Rose Bengal test (RBT) and a positive serum agglutination test (SAT) and three asymptomatic cases were found to be positive for RBT, SAT or ELISA IgM (after systematic screening of 52 family members of 15 index cases). Overall, Brucella infection was diagnosed in 21 people, corresponding to a mean annual incidence of 19 cases/100 000 inhabitants. Compared to series of patients infected with other more commonly encountered Brucella spp. such as B. melitensis and B. abortus, clinical presentation and percentage and distribution of complications were similar, apart from a marked observation of significantly increased median alanine aminotransferase levels, 20 times greater than upper normal rates, but not accompanied by any particular hepatic pathology. Wallis and Futuna, where people live in close proximity to animals and where the cultural significance of pig-raising precludes the implementation of adequate veterinary preventive measures, thus represents one of the few known B. suis foci worldwide and allows for evaluation of the peculiarities of this infection.

Outbreak response immunisation: The experience of Chad during recurrent measles epidemics in 2005 and 2010.

Despite impressive gains in measles control globally, measles epidemics continue to occur in countries with insufficient vaccination coverage. WHO guidelines now recommend outbreak response immunisation (ORI) for controlling measles outbreaks in certain contexts. The objective of this study was to describe late and early response vaccination activities during two consecutive measles outbreaks that occurred in 2005 and 2010 in N'Djamena, Chad. Using Lot Quality Assurance Sampling, vaccination coverage was estimated to be low before the interventions. Following mass vaccination campaigns, measles cases declined. The timeliness and quality of ORI activities are crucial determinants of success. However, effective outbreak response should be accompanied by strong routine vaccination programmes to ensure sustainable high vaccination coverage.

[Respiratory sensitization to molds in children: myth or reality?]. / La sensibilisation respiratoire aux moisissures chez l'enfant: mythe ou réalité?

The authors have made a systematic study by PRICK-test and RAST, sometimes followed by a rhino-manometric provocation, of the frequency of sensitization to the two moulds Alternaria and Cladosporium in 200 "all comers" children in a paediatric consultation. The frequency was low, only 10% for those consulting in the groups of asthma, rhinitis, pollinosis, repeated respiratory infections and syndromes of obstructed expiration taken together, and 13% for allergic asthma only. This sensitivity is rarely isolated, but is most often accompanied, or complicated by, other pneumoallergens, such as dust, mites, pollens and sometimes cockroaches. It imposes certain particular clinical traits on asthma (summer asthma or recurring asthma) and in others appears to be strongly influenced by the habitat. The skin tests seem to be very weak and RAST insufficient to be sure of real sensitization. Diagnosis, always difficult, is probably best done by a provocation test (preferably rhino-manometry) and this jumps over the bundle of clinical and biological arguments, as well as being, at least in our country, the most useful mimic of atmospheric moulds. The authors insist on the importance of the interrogation which should be concerned with the chronological and environmental circumstances and all respiratory infections that are suspected of having an allergic factor.

[A simple test for the detection of respiratory allergy to current pneumallergens]. / Un test simple de dépistage de l'allergie respiratoire aux pneumallergènes courants.

Phadiatop is a new in vitro test used for screening patients with allergic respiratory diseases. This test, based on the RAST procedure, is performed with a paper disc to which a balanced mixture of relevant inhalant allergens has been coupled. One hundred and one adults ranging in age from 18 years to 73 years and 38 children (4 months to 15 years) were studied. We found a good correlation between this new test and total IgE (adults: 74.3 p. 100, children: 68.4 p. 100), specific IgE (adults: 91.1 p. 100, children: 100 p. 100) and skin test (adults: 79.2 p. 100, children: 97.1 p. 100). There was a high correlation between clinical atopy assessment and the result of Phadiatop, its efficiency was 83 p. 100 in adults and 97 p. 100 in children.

[History of hunting ... to cockroaches]. / Histoire de chasse ... aux cafards.

A 12.5 year old Cambodian boy had a chronic rhinitis with conjunctivitis since 5 years. Skin tests and RAST were positive only for cockroach allergen. The patient used to catch cockroaches to feed his fish. After disinfection of the apartment and desensitization therapy, the boy's symptoms disappeared within 7 months. The author recommends that skin tests and RAST for cockroaches may be used in the investigation of chronic rhinitis with conjunctivitis or asthma.

[Hymenoptera stings: the atopic person in danger. Allergy to Hymenoptera venoms]. / Piqûres d'hyménoptères: l'allergique en danger. L'allergie aux venins d'hyménoptères.

The author reviews the clinical and therapeutic aspects of hymenoptera sting diseases in children. Lethal anaphylactic reactions are very rare. Progresses in prophylactic treatments of patients with a history of anaphylactic reaction have been made through venom immunotherapy, but a careful analysis of the clinical data must be done before starting such a treatment.