ABSTRACT
BACKGROUND: Outbreaks of eosinophilic meningitis are reported rarely, even in regions of endemic infestation with the roundworm Angiostrongylus cantonensis, such as the Pacific Basin. We report a cluster of eosinophilic meningitis presumably attributable to A. cantonensis among French policemen returning from French Polynesia. METHODS: A retrospective cohort study among French policemen who had stayed in Tahiti was conducted using a clinical definition of eosinophilic meningitis that included severe headache within 30 days after return and eosinophilia, and who consumed locally exotic ethnic dishes with uncooked freshwater prawns. RESULTS: Five persons met the case definition for eosinophilic meningitis. Corticosteroid therapy associated with antihelminthic regimen led to improvement of symptoms in one patient. Other patients were treated with albendazole alone. All patients recovered. CONCLUSION: Among travellers at risk, the presence of severe headache and eosinophilia combined with a consistent exposure history to exotic food should alert to the possibility of A. cantonensis infestation. Travellers should be aware of the risk of infection associated with eating exotic ethnic dishes.
Subject(s)
Eosinophilia/diagnosis , Meningitis/diagnosis , Strongylida Infections/diagnosis , Travel , Adult , Albendazole/administration & dosage , Albendazole/therapeutic use , Angiostrongylus cantonensis/immunology , Animals , Anthelmintics/therapeutic use , Cohort Studies , Eosinophilia/drug therapy , Eosinophilia/epidemiology , Food Contamination , Headache/etiology , Humans , Ivermectin/administration & dosage , Ivermectin/therapeutic use , Meningitis/complications , Meningitis/drug therapy , Meningitis/epidemiology , Police , Polynesia , Retrospective Studies , Seafood , Strongylida Infections/drug therapy , Strongylida Infections/epidemiologyABSTRACT
Protective devices against vectors are used by travelers in malaria-endemic areas but their efficacy for protection against mosquitoes has rarely been evaluated. The level of exposure to malaria transmission of 205 soldiers deployed in Africa and the efficacy of their anti-vector prophylaxis was evaluated by comparison of their IgM and IgG responses against five pre-erythrocytic Plasmodium falciparum antigens (circumsporozoite protein, sporozoite threonine- and asparagine-rich protein, sporozoite- and liver-stage antigen, liver stage antigen 1, and SR11.1) before and at the end of their deployment, and three months after returning to France for 106 of these soldiers. The immune responses increased significantly during the mission in 35% (95% confidence interval = 28-42%) of the individuals. The permanent use of insecticide-treated bed nets and long-sleeve battle dress at night were associated with protective efficacy. The analysis of these antibody responses was sensitive enough to evaluate exposure to malaria transmission and the efficacy of anti-vector devices in travelers using antimalarial chemoprophylaxis.
Subject(s)
Antibodies, Protozoan/biosynthesis , Antigens, Protozoan/immunology , Malaria, Falciparum/immunology , Military Personnel , Plasmodium falciparum/immunology , Travel , Adolescent , Adult , Animals , Bedding and Linens , Enzyme-Linked Immunosorbent Assay/methods , Humans , Immunoglobulin G/biosynthesis , Immunoglobulin M/biosynthesis , Incidence , Malaria, Falciparum/epidemiology , Malaria, Falciparum/prevention & control , Malaria, Falciparum/transmission , Male , Middle Aged , Mosquito Control/instrumentation , Mosquito Control/methods , Seroepidemiologic StudiesABSTRACT
Epidemiological surveillance within the French Armed Forces has had to take into account various changes in infectious diseases in recent years. The French Armed Forces are encountering new hazards, such as the spread of HIV infection, Plasmodium falciparum chemoresistance, and outbreaks of emerging diseases. Bioterrorism, industrial and occupational hazards are added concerns. For these reasons, the French Military Medical Service has introduced a new concept based on permanent epidemiological surveillance of communicable diseases. This is completed by a real-time spatial surveillance designed to detect very rapidly potential communicable diseases or new emerging diseases. This epidemiological system, based on data modeling, enhances the medical information available to staff commands before deployment to new areas.