Chikungunya outbreak in Montpellier, France, September to October 2014.

In October 2014, an outbreak of 12 autochthonous chikungunya cases, 11 confirmed and 1 probable, was detected in a district of Montpellier, a town in the south of France colonised by the vector Aedes albopictus since 2010. A case returning from Cameroon living in the affected district was identified as the primary case. The epidemiological investigations and the repeated vector control treatments performed in the area and around places frequented by cases helped to contain the outbreak. In 2014, the chikungunya and dengue surveillance system in mainland France was challenged by numerous imported cases due to the chikungunya epidemic ongoing in the Caribbean Islands. This first significant outbreak of chikungunya in Europe since the 2007 Italian epidemic, however, was due to an East Central South African (ECSA) strain, imported by a traveller returning from West Africa. Important lessons were learned from this episode, which reminds us that the threat of a chikungunya epidemic in southern Europe is real.

Anxiety or depressive disorders and risk of ischaemic heart disease among French power company employees.

BACKGROUND: The aim of this study was to determine whether depression and anxiety are predictive factors for ischaemic heart disease among adults <60 years. Method A case-control study among active employees of the French nationwide power company (Electricité de France-Gaz de France) analysed men aged 31-55 years who presented an initial clinical form of ischaemic heart disease from 1993 through 1997, collected from the company registry. These 660 men were each matched by age to 10 controls per case. Adjusted odds ratios (OR) were calculated by logistic regression. RESULTS: There was a significant association between ischaemic heart disease and sick-leave for any medical reason in the 3 years before its onset (OR = 1.79; 95% CI: 1.50, 2.14). This association was strengthened when only absences for depression and anxiety were considered (OR = 3.10; 95% CI: 2.29, 4.19) and remained important and significant when adjusted for socioeconomic status: OR = 2.66 (95% CI: 1.95, 3.63). A previous sick-leave for depression or anxiety in the 10 years before the heart disease strengthened the association (OR = 3.61; 95% CI: 2.39, 4.45), which was further reinforced by an elevated number (> or =4) of such sick-leaves (OR = 5.11; 95 % CI: 3.11, 8.40). CONCLUSION: Depressive and anxiety disorders that lead to absenteeism seem to be associated with an increased risk of ischaemic heart disease in the 3 years thereafter, especially when depression and anxiety were severe and chronic; this association is independent of socioeconomic status.

Thyroid cancers in France and the Chernobyl accident: risk assessment and recommendations for improving epidemiological knowledge.

From 1975 to 1995, the incidence of thyroid cancer in the French population increased by a factor of 5.2 in men and 2.7 in women, thereby raising public concerns about its association with the nuclear accident at Chernobyl. A study performed at the request of French health authorities sought to quantify the potential risk of thyroid cancer associated with the Chernobyl fallout in France in order to determine if this risk could be observed through an epidemiological approach. The study focused on the most exposed population: those living in eastern France and younger than 15 y at the time of the Chernobyl nuclear power plant accident (26 April 1986). The number of spontaneous thyroid cancers in this population was predicted from French cancer registry data, and the thyroid doses were estimated from all available data about contamination in France. Associated risks were calculated with different risk models, all based on a linear no-threshold dose-effect relationship. Under this hypothesis, from 1.3 to 22 excess thyroid cancer cases were predicted for the 1991-2000 period, compared with the 212 spontaneous cases (0.5 to 10.5%) predicted, and from 11.2 to 55.2 excess cases were predicted for 1991-2015, compared with the 1,342 spontaneous cases (0.8 to 4.1%) predicted. These risk calculations indicate that the Chernobyl fallout cannot explain the entire increase in thyroid cancers in France, and that it is improbable that an epidemiological study could demonstrate such an excess. The surveillance of thyroid cancers in France should be enhanced.