Epidemiology of food-borne disease outbreaks in the French armed forces: a review of investigations conducted from 1999 to 2009.

OBJECTIVE: Aim of this study was to describe the main characteristics of food-borne disease outbreaks (FBDOs) in the French armed forces from 1999 to 2009. METHODS: FBDOs are reported to the military epidemiological surveillance system, which concerns all active military personnel. Investigation reports published from 1999 to 2009 were reviewed. RESULTS: Among the 180 FBDOs reported, 48.3% occurred overseas. The mean reporting rate was 2.4 outbreaks p.100,000 in France and 26.7 p.100,000 overseas, reaching to 39.3 p.100,000 in Africa. Digestive symptoms were predominant among cases. Laboratory analyses on cases were positive in 29.4% of FBDOs. The most frequently isolated agents were shigella (15.4%). Laboratory analyses on food samples were positive in 18.9% of outbreaks, the most frequently isolated agent being Clostridium perfringens (15.7%). Only 7 FBDOs were documented by concordant analyses in both patients and food samples. CONCLUSIONS: The reporting rate was much higher among military deployed overseas, which can be the consequence of a lack of hygiene due to operational imperatives and the consumption of local food which does not meet safety standards. In operational settings, laboratory evidence may be difficult to obtain and a timely epidemiological investigation in some cases proves valuable to identify the likely vehicle of infection and to guide targeted intervention measures.

[Toxic food infection caused by Shigella flexneri in a military unit]. / Toxi-infection alimentaire à Shigella flexneri dans une collectivité militaire.

Food borne disease outbreaks have increased in France, but outbreaks caused by Shigella are rare, accounting for only 73 cases (1.62%) in 1993. We report a food borne outbreak of Shigella flexneri strain 3 infection in a fire fighting unit in Paris between July 13th and 17th 1995. Forty of the 127 firemen suffered symptoms including acute diarrhea (80%), fever (50%) and blood and mucus in stools (1 case, 2.5%). Epidemiological investigation generated an unimodal epidemic curve suggesting a single source of contamination with no secondary cases. The median incubation period was between 43 hours 30 minutes and 51 hours 30 minutes. This is consistent with food borne Shigella infection. Statistical analysis of a case-control study implicated a mixed salad containing frozen shellfish from Asia (shrimps and mussels), served at lunch and dinner on July 13th 1995. Shigella was not detected in this salad by microbiological methods. However, inoculation with as little as 100 organisms can cause symptoms. There was low-level contamination with Escherichia coli (940 cfu/g) due to cross-contamination. Shigella flexneri strain 3 was isolated from 11 of 18 stool cultures, but was never isolated from cultures of stools provided by the cooks. All isolates had identical antibiotic resistance profiles. They were resistant to ampicillin and ticarcillin, moderately sensitive to amoxicillin-clavulanic acid, highly sensitive to aminosides, erythromycin and quinolones. This identical pattern in all isolates suggests a common source of contamination. Plasmid-based multiple resistance is common in this organism. Therefore, antibiotics should only be given to patients with evident clinical signs of infection. Treatment was symptom-based in all but 4 patients, who had acute diarrhea and were treated with ciprofloxacin. This antibiotic is well tolerated, has rapid bactericidal action and significantly reduces the duration of the symptoms and excretion of Shigella, thus preventing secondary contamination with this highly infectious bacterium. Thus, food borne outbreaks of Shigella can occur in countries with a high standard of living because of the increase in mass catering (e.g. fast food restaurants) and importation of foodstuffs from developing countries with endemic shigellosis. This is a public health problem because of the morbidity and absenteeism due to illness, particularly when the patients are firemen responsible for emergency management.

Biotelemetric investigation of the regulation of the cardiac frequency in animals with use of telestimulation. Model examinations in the neat.

A method for the assessment of behaviour of the cardiac frequency regulation in freely moving animals by means of telestimulation and biotelemetry is described. The results of the examinations allow, in spite of individual variability, a classification of the animals into different types of regulation by consideration of the biorhythm. The assessment of the individual type of regulation in correlation to the biorhythmic structure of the organism is of basic significance for the evaluation of its capacity of performance and adapation.