[The history of flu in Madagascar]. / Historique de la grippe à Madagascar.

The purpose of this paper is to actualize the historical data on influenza in Madagascar. The first outbreak of flu probably occurred in 1890. The first epidemic fully described was in 1893. Between 1890 and 1957, 11 outbreaks of influenza were registered. Since 1978, the unit of virology of the Institut Pasteur de Madagascar is the National Reference Center of the World Health Organization for influenza in Madagascar. Between 1975 and 2002, 12 epidemics of flu were registered confirmed by viral isolation. Madagascan terms used to design fever diseases are discussed.

Historique de la grippe a Madagascar

"The history of flu in Madagascar"" : The purpose of this paper is to actualize the historical data on influenza in Madagascar. The first outbreak of flu probably occured in 1890. The first epidemic fully described was in 1893. Between 1890 and 1957; 11 outbreaks of influenza were registered. Since 1978; the unit of virology of the Institut Pasteur de Madagascar is the National Reference Center of the World Health Organization for influenza in Madagascar. Between 1975 and 2002; 12 epidemics of flu were registered confirmed by viral isolation. Madagascan terms used to design fever diseases are discussed."

Multicenter study of street foods in 13 towns on four continents by the food and environmental hygiene study group of the international network of pasteur and associated institutes.

An international multicenter study of ready-to-eat foods, sandwiches, and ice creams or sorbets sold in the streets and their vendors was carried out to assess the microbiological quality of these foods and to identify characteristics of the vendors possibly associated with pathogens. Thirteen towns in Africa, America, Asia, and Oceania were involved in the study. A single protocol was used in all 13 centers: representative sampling was by random selection of vendors and a sample of foods bought from each of these vendors at a time and date selected at random. Microbiological analyses were carried out using standardized Association Française de Normalisation methods, and the use of a standardized questionnaire to collect data concerning the characteristics of the vendors. Fifteen surveys were carried out, with 3,003 food samples from 1,268 vendors. The proportion of unsatisfactory food samples was between 12.7 and 82.9% for ice creams and sorbets and between 11.3 and 92% for sandwiches. For ice creams and sorbets, the sale of a large number of units (>80 per day) increased the risk of unsatisfactory food by a factor of 2.8 (95% confidence interval [CI]: 1.5 to 5.1), lack of training in food hygiene by 6.6 (95% CI: 1.1 to 50). and by a factor of 2.8 (95% CI: 1.4 to 5.4) for mobile vendors. These risk factors were not identified for sandwiches, this difference may be due to the presence of a cooking step in their preparation. These results show that the poor microbiological quality of these street foods constitutes a potential hazard to public health, that the extent of this hazard varies between the cities studied, and that vendors' health education in food safety is a crucial factor in the prevention of foodborne infections.

[Puffer fish poisoning in Madagascar: four case reports]. / Intoxication après consommation de poisson globe à Madagascar: à propos de 4 cas.

An outbreak of puffer fish poisoning in a family with four cases of which one was fatal is reported. The outbreak occurred in July 1998 in Nosy Be, an island located at the north-western part of Madagascar. Diagnostic investigation with application of the mouse bioassay suggested poisoning with a tetrodotoxin as the etiology. The amount of the toxin was 16 MU (mouse unit) per gram meal. A continuing surveillance of the seafood intoxications either in the country or in the west Indian Ocean region is needed.

Intoxication apres consommation de poisson globe a Madagascar :a propos de 4 cas

"An outbreak of puffer fish poisoning in Madagascar"" : An outbreak of puffer fish poisoning in a family with four cases of which one was fatal is reported. The outbreak occurred in July 1998 in Nosy Be; an island located at the north-western part of Madagascar. Diagnostic investigation with application of the mouse bioassay suggested poisoning with a tetrodotoxin as the etiology. The amount of the toxin was 16 MU (mouse unit) per gram meal. A continuing surveillance of the seafood intoxications either in the country or in the west Indian Ocean region is needed."

Identification of putative palytoxin as the cause of clupeotoxism.

In 1994 in Madagascar a woman died after eating a sardine, Herklotsichthys quadrimaculatus. Two heads removed, respectively, from a toxic and a nontoxic fish before cooking were retrieved, kept frozen, and used for toxin analysis. The causative toxin was identified as palytoxin or its analogs based on its cytotoxicity, delayed hemolysis, neutralization with an anti-palytoxin antibody, chromatographic properties on different columns, and MS data. The gill and esophagus of the fish contained large amount of bottom sediments indicating that the fish had fed on the bottom and thus probably obtained the toxin from a benthic organism. The benthic dinoflagellate Ostreopsis siamensis that produces palytoxin and its analogs was inferred as the probable toxin source. This is the first study to shed light on clupeotoxism, a highly fatal form of human intoxication due to ingestion of clupeoid fish.

[Street-vendor foods: quality of ice creams, sherbets and sorbets sold in the urban agglomeration of Antananarivo]. / Aliments de rue: qualité des glaces, crèmes glacées et sorbets commercialisés dans l'agglomération urbaine d'Antananarivo.

A survey of selling conditions and bacteriological examinations of ice-cream was carried-out in Antananarivo from June 1996 to May 1997. The way of investigation by vendors and of bacteriological examinations were widely described. Sellers had classic features of a street-vended food vendor: uneducated, no having professional training and mishandling foodstuffs. 202 samples of ice-cream were collected. The contamination prevalence rate was of 95% +/- 3.7%. Salmonella typhimurium was isolated from one sample. Immediate and rigourous measures ought to be put into effect by authorities to right this alarming situation.

[Literature search in the biomedical domain: basic principles and tools]. / La recherche documentaire dans le domaine biomédical: principes et outils de base.

At the very first glance, literature research in medical biology seems hard to some scientists. This paper aims to give an overall view of basic principles permitting to exploit correctly all existing equipments of information systems. Several definitions allow to familiarize with the documentary vocabulary.

Fatal mass poisoning in Madagascar following ingestion of a shark (Carcharhinus leucas): clinical and epidemiological aspects and isolation of toxins.

In November 1993, 188 people were admitted to hospital after eating the meat from a single shark (Carcharhinus leucas) in Manakara, a medium-sized town on the south-east coast of Madagascar. This shark and its meat had no unusual characteristics. The attack rate was about 100%. The first clinical signs appeared within 5-10 hr after ingestion. The patients presented with neurological symptoms almost exclusively, the most prominent being a constant, severe ataxia. Gastrointestinal troubles, like diarrhoea and vomiting, were rare. The overall case mortality ratio was close to 30% among the 200 poisoned inhabitants. There were no reports of previous similar poisonings in this area, and fishermen in Manakara usually eat this kind of shark without problems. Bacteriological and chemical causes were eliminated. Two liposoluble toxins were isolated from the liver and tentatively named carchatoxin-A and -B, respectively. They were distinct from ciguatoxin in their chromatographic properties.

[Fatal ichthyosarcotoxism after eating shark meat. Implications of two new marine toxins]. / Ichtyosarcotoxisme mortel après consommation de requin. Mise en cause de deux nouvelles toxines marines.

A fish poisoning involving 188 hospitalizations occurred in November 1993, in Manakara, a middle-sized town on the south-east coast of Madagascar, following the ingestion of shark. A single shark was involved in this poisoning and was identified as Carcharinus leucas. There was no unusual characteristic of this shark or its meat. The attack rate was about 100%. First clinical signs appeared within five to ten hours after ingestion. The patients presented neurological symptoms almost exclusively, the most prominent being a constant, severe ataxia. Gastrointestinal troubles, like diarrhoea and vomiting were rare. The overall case-fatality ratio was close to 30% among the 200 poisoned inhabitants. Search for similar poisoning previously reported in this area was negative, and fishermen in Manakara usually eat that kind of shark without mistrust. Bacteriological and chemical origins were eliminated. Two liposoluble toxins were isolated from the shark liver and tentatively named carchatoxin-A and -B respectively. They were distinct from ciguatoxin in chromatographic properties.

[Scalp pediculosis and its treatment: bioclinical trials of different pediculicides and repellents in Antananarivo]. / La pédiculose du cuir chevelu et son traitement: essais bio-cliniques de différents pédiculicides, lenticides et répulsifs à Antananarivo.

After a recall of different existing kinds of louse, pediculicides and their mode of action, the authors report the bio-clinical trials they carried out in Antananarivo using different associations and galenic forms of medicines. The objectives of these studies on the treatment of scalp pediculosis is either the development of efficient insecticides or the application for the official permit of sale.

[Bacterial quality of the water supply in Madagascar]. / Qualité bactériologique des eaux d'adduction à Madagascar.

The results of 14371 drinking water analysis carried out in Madagascar between 1986 and 1993 by the water analysis and food microbiology laboratory of the Pasteur Institute of Madagascar are reported. After a history of the water analysis laboratory, methods and frequency of sampling, methods of analysis and standards applied are quoted and documented. Results for each province are reported and particularly indicated: the development of water samples and their portability along the years, the respective frequency of pollutant bacteria and their amounts according to sampling points. In spite of the lack of means in the country, the authors consider the results are satisfactory but they stress the importance of an organized surveillance system of drinking water quality.

[The plague: disease and vaccine?]. / La peste: maladie et vaccin?

Plague has existed in Madagascar since 1896, with epidemic control achieved by GIRARD with an EV vaccine in 1937. Plague persists in Madagascar, however, due to the large animal reservoir. With a predilection for nodal tissues, Yersinia pestis is a virulent bacteria that is potent inducer of antibody synthesis. Immunity mechanisms stimulated by infection were studied: 1. In human by immunoenzymatic methods 2. In mice by seroprotection and vaccinating tests. Induced immunity for people in endemic and endemic-epidemic areas, is significant, affecting approximately 70% of these populations. In non endemic areas, immunity is found in only 33% of the population, perhaps this explains the persistence of epidemic? In all cases, this immunity is a quick onset (6 days), is persistent (> 2 years), and has demonstrable serious recognition of YOP (Yersinia Outer Proteins) by Western Blot method. Human antibodies were shown to be protective for mice. Animals vaccinated by YOP were protected equally well, when compared to animals infected with Yersinia pestis and subsequently treated with antibiotics. Finally, YOP aerosols were also shown to induce antibodies. In conclusion, plague is a vaccinatable bacterial disease and YOP can be used as an animal vaccine to permit plague control in the rat reservoir.

[Sensitivity of Yersinia pestis to antibiotics: 277 strains isolated in Madagascar between 1926 and 1989]. / Sensibilité de Yersinia pestis aux antibiotiques: 277 souches isolées à Madagascar entre 1926 et 1989.

The antimicrobial susceptibility of 277 strains of Yersinia pestis was studied using broth microdilution panel. In recent strains, trimethoprim, cotrimoxazole and ampicillin were the most active of the antibiotics tested (MICs less than 2 mg/l). All strains were inhibited by 16 mg/l of kanamycin and sulfamethoxazole, 32 mg/l of sulphadiazine and sulfanilamide, and 64 mg/l of sulfamethoxypyridazine. Doxycycline, minocycline, chloramphenicol, demeclocycline, tetracycline, oxytetracycline and chlortetracycline were equally active but some of strains were resistant (13% for tetracycline; 32.5% for oxytetracycline; 84.5% for chlortetracycline). Analysis of MICs in relation with time (comparison of the two period: 1926-1948 and 1948-1989) evidenced a trend towards a decrease in susceptibility to cyclines prime generation. Sulphonamides and streptomycin preserve the some efficacity on Y. pestis but we have to notice the possible existence of resistant strain on high level with streptomycin.

[Rift valley fever and Zinga virus: a pathogenic arbovirus in man and animal new for Madagascar]. / Fievre de la vallee du Rift et virus Zinga: un arbovirus pathogene pour l'homme et l'animal nouveau pour Madagascar.

Virus Zinga strains have been isolated from several pools of mosquitoes collected in Perinet area, 130 km far from Tananarive, at the Institut Pasteur of Madagascar in 1980. Although this virus is pathogenic for man, it seemed to give only a mild illness and did not appear to constitute a problem of Public Health. But today it is seen in quite a different way; since the WHO Center for Arbovirus Reference and Research of New Haven has shown the serologic identity between virus Zinga and an another arbovirus, Rift Valley Fever virus. This latter is in fact very pathogenic for man and domestic animal, he is responsible of important epizootics characterized by many abortions in pregnancies and death of newborn animals, many infections have occurred in man during these epizootics and the disease is able to give a mortal haemorragic syndrome. Until now, no particular aggressivity has been shown by virus Zinga in Madagascar, but it remains a real potential danger for man and for domestic animals.