Dengue en la Guayana Francesa, 1965-1993 / Dengue in French Guiana, 1965-1993

Es probable que el dengue haya existido en la Guyana Francesa durante más de un siglo, pero no hay datos precisos sobre brotes que pudieran haber ocurrido antes de la erradicación temporal de Aedes aegypti, el mosquito vector del dengue, y su restablecimiento a comienzos de los años sesenta. En 1965 se confirmaron por primera vez casos de dengue mediante análisis serológicos. Desde entonces ha habido epidemias a intervalos de 2 a 6 años; las más importantes ocurrieron en 1968-1969, 1970, 1972, 1976, 1982 y 1992. Esos brotes se han atribuido a tres de los cuatro serotipos del virus: dengue-1, dengue-2 y dengue-4. Durante la epidemia de 1992, que parece haberse iniciado en 1991 y prolongado hasta 1993, se confirmaron casos de dengue hemorrágico por primaera vez. En total, se atribuyeron a esa epidemia por lo menos 40 casos de dengue hemorrágico y varias defunciones. Este acontecimiento ha sido motivo de profunda preocupación por la amenaza que representa el dengue para la salud pública en la Guyana Francesa. Esa inquietud se intensifica porque, si bien la lucha antivectorial es la única forma de prevenir o combatir los brotes de dengue, ha resultado muy difícil mantener reducida la densidad de vectores con las medidas de control empleadas en la actualidad

Dengue in French Guiana, 1965-1993

While it seems likely that dengue fever (DF) has existed in French Guiana for at least one century, data on outbreaks are sketchy before temporary eradication of the dengue vector mosquito Aedes aegypti and its reestablishment in the early 1960s. Dengue cases were serologically confirmed for the first time in 1965, and since then dengue epidemics have occurred at two to six year intervals, the most important occurring in 1968-1969, 1970, 1972, 1976, 1982, 1986, and 1992. Three of the four dengue virus serotypes (dengue-1, dengue-2, and dengue-4) have been implicated in these outbreaks. During the 1992 epidemic, which appears to have begun in 1991 and extended into 1993, cases of dengue hemorrhagic fever (DHF) were confirmed for the first time. In all, at least 40 DHF cases and several deaths were asociated with this epidemic. This development has raised considerable concern about the public health threat posed by DHF in French Guiana. Such concern only heightened by the fact that while vector control is the sole means of preventing of combating dengue outbreaks, it has proved difficult to maintain vector populations at low levels with the control measures currently employed

Dengue en la Guayana Francesa, 1965-1993 / Dengue in French Guiana, 1965-1993

Es probable que el dengue haya existido en la Guyana Francesa durante más de un siglo, pero no hay datos precisos sobre brotes que pudieran haber ocurrido antes de la erradicación temporal de Aedes aegypti, el mosquito vector del dengue, y su restablecimiento a comienzos de los años sesenta. En 1965 se confirmaron por primera vez casos de dengue mediante análisis serológicos. Desde entonces ha habido epidemias a intervalos de 2 a 6 años; las más importantes ocurrieron en 1968-1969, 1970, 1972, 1976, 1982 y 1992. Esos brotes se han atribuido a tres de los cuatro serotipos del virus: dengue-1, dengue-2 y dengue-4. Durante la epidemia de 1992, que parece haberse iniciado en 1991 y prolongado hasta 1993, se confirmaron casos de dengue hemorrágico por primaera vez. En total, se atribuyeron a esa epidemia por lo menos 40 casos de dengue hemorrágico y varias defunciones. Este acontecimiento ha sido motivo de profunda preocupación por la amenaza que representa el dengue para la salud pública en la Guyana Francesa. Esa inquietud se intensifica porque, si bien la lucha antivectorial es la única forma de prevenir o combatir los brotes de dengue, ha resultado muy difícil mantener reducida la densidad de vectores con las medidas de control empleadas en la actualidad

Publicado en inglés en el Bull. PAHO. Vol. 29(2), 1995

Dengue in French Guiana, 1965-1993

While it seems likely that dengue fever (DF) has existed in French Guiana for at least one century, data on outbreaks are sketchy before temporary eradication of the dengue vector mosquito Aedes aegypti and its reestablishment in the early 1960s. Dengue cases were serologically confirmed for the first time in 1965, and since then dengue epidemics have occurred at two to six year intervals, the most important occurring in 1968-1969, 1970, 1972, 1976, 1982, 1986, and 1992. Three of the four dengue virus serotypes (dengue-1, dengue-2, and dengue-4) have been implicated in these outbreaks. During the 1992 epidemic, which appears to have begun in 1991 and extended into 1993, cases of dengue hemorrhagic fever (DHF) were confirmed for the first time. In all, at least 40 DHF cases and several deaths were asociated with this epidemic. This development has raised considerable concern about the public health threat posed by DHF in French Guiana. Such concern only heightened by the fact that while vector control is the sole means of preventing of combating dengue outbreaks, it has proved difficult to maintain vector populations at low levels with the control measures currently employed

This article will also be published in Spanish in the BOSP. Vol. 119, 1995

Specific anti M. Leprae PHL-1 antibodies and mitsuda reactions in the management of household contacts in New Caledonia

Household contacts of leprosy patients have been tested for anti-phenolic glycolipid-I IgM antibodies (anti-PGL-I IgM) by an ELISA using the natural disaccharide (NDO) and natural trisaccharide (NTO) synthetic antigens. A group of healthy subjects without known exposure to Mycobacterium leprae served as controls. The percentages of positivity observed in multibacillary patients, paucibacillary patients, and household contacts were significantly higher than those of the negative controls. The absorbance values using NDO and NTO correlated well (range 0.59-0.91) when analysis of each subject group was performed. As reported here, NDO and NTO antigens seem to be equal in detecting leprosy cases; 100% of multibacillary and 21.43% of paucibacillary cases were detected as seropositive. For the screening of household contacts, NDO appears to be more sensitive and NTO more specific. There were more seropositive cases in the young age groups of household contacts, suggesting a higher rate of transmission of M. leprae infection in those age groups. Lepromin and anti-PGL-I IgG tests were also performed in contacts who were followed. The 2 paucibacillary subjects (1 borderline tuberculoid, 1 indeterminate) were Mitsuda negative. At diagnosis, their anti-PGL-I IgM levels were much higher than those of previous results; their anti-PGL-I IgG levels showed an increase in one and a decrease in the other. However, for the entire group anti-PGL-I IgM and anti-PGL-I IgG levels were positively correlated. The data reported here suggest that an increase in specific anti-M. leprae IgM levels in Mitsuda-negative household contacts could reveal the development of overt disease