In a prospective observational study, we recorded that 25.7% of 139 unaccompanied migrant minors arriving in Angers, Western France were colonized with extended-spectrum β-lactamase producing ...Enterobacteriaceae (ESBL-PE). Concurrently, we highlighted that some minors had acquired ESBL-PE after their arrival in France.
Ticks are arthropods and the most important vectors of major human diseases after mosquitoes. Due to their impact on public health, in vitro and in vivo assays have been developed to identify ...molecules with repellent activities on ticks. Repellents are useful to reduce tick bite exposure and the potential transmission of pathogens; they can be used topically or in impregnated clothing. Presently, mainly synthetic molecules are commercialized as skin repellents, e.g., N,N-diethyl-meta-toluamide (DEET), IR3535, picaridin or KBR 3023, and para-menthanediol. Permethrin is largely used for fabric impregnation. Intensive research has been conducted to identify new molecules with repellent activity and more recently, plant-derived molecules, as an alternative to synthetic molecules.
Although scabies is a common disease, questions concerning efficacy, safety, tolerance and galenic formulation persist, in particular regarding its treatment in young children under 15 kg and in ...pregnant or breastfeeding women. This manuscript reports the recommendations developed by the Centre of Evidence of the French Society of Dermatology. Ivermectin can be proposed as first-line treatment from 2 years on, especially if in doubt about compliance or damaged skin, or in grouped cases; ivermectin can also be proposed as second-line treatment, if necessary, after 2 months.
L’examen des selles ne doit pas être systématique au retour d’un séjour sous les tropiques. Il doit être guidé par des données cliniques, épidémiologiques ou biologiques. Toutefois quelques ...circonstances autorisent une démarche systématique : la maîtrise du risque de diffusion de l’antibiorésistance conduit ainsi à mettre en place un dépistage systématique des bactéries hautement résistantes chez les patients ayant été hospitalisés à l’étranger dans l’année précédent leur entrée à l’hôpital en France. La phase finale de l’éradication de la poliomyélite justifie le dépistage du virus polio chez les enfants adoptés ou migrants entrés récemment en France et originaires des deux pays dans lesquels le poliovirus sauvage circule encore. L’évolution des techniques de biologie moléculaire de type multiplex vers les parasites entériques ouvre des perspectives nouvelles mais actuellement limitées par le faible panel de parasites mis en évidence.
A stool sample examination should not be systematic when returning from a stay in the tropics. It must be guided by clinical, epidemiological or biological data. However, there are some circumstances that allow for a systematic approach: controlling the risk of spreading antibiotic resistance leads to the systematic screening of highly resistant bacteria in patients who have been hospitalized abroad in the year prior to their entry hospital in France. The final phase of poliomyelitis eradication justifies screening for poliovirus in adopted or migrant children who have recently entered France and originated from the two countries where wild poliovirus is still circulating. The evolution of the PCR techniques towards the enteric parasites opens new perspectives but currently limited by the low panel of parasites highlighted.
Abstract
Like Plasmodium vivax, both Plasmodium ovale curtisi and Plasmodium ovale wallikeri have the ability to cause relapse in humans, defined as recurring asexual parasitemia originating from ...liver-dormant forms subsequent to a primary infection. Here, we investigated relapse patterns in P ovale wallikeri infections from a cohort of travelers who were exposed to the parasite in sub-Saharan Africa and then experienced relapses after their return to France. Using a novel set of 8 highly polymorphic microsatellite markers, we genotyped 15 P ovale wallikeri relapses. For most relapses, the paired primary and relapse infections were highly genetically related (with 12 being homologous), an observation that was confirmed by whole-genome sequencing for the 4 relapses we further studied. This is, to our knowledge, the first genetic evidence of relapses in P ovale spp.
Using a novel set of 8 highly polymorphic microsatellite markers and whole-genome sequencing, we provide the first genetic evidence of relapses in Plasmodium ovale wallikeri.
We report the case of a French traveler who developed acute pulmonary schistosomiasis 2 months after visiting Benin. He presented with a 1-month history of fever, cough, and thoracic pain. Initial ...investigations revealed hypereosinophilia and multiple nodular lesions on chest computed tomography scan. Lung biopsies were performed 2 months later because of migrating chest infiltrates and increasing eosinophilia. Histological examination showed schistosomal egg-induced pulmonary granulomas with ova exhibiting a prominent terminal spine, resembling Schistosoma haematobium. However, egg shells were Ziehl-Neelsen positive, raising the possibility of a Schistosoma intercalatum or a Schistosoma guineensis infection. Moreover, involvement of highly infectious hybrid species cannot be excluded considering the atypical early pulmonary oviposition. This case is remarkable because of the rarity of pulmonary schistosomiasis, its peculiar clinical presentation and difficulties in making species identification. It also emphasizes the need to consider schistosomiasis diagnosis in all potentially exposed travelers with compatible symptoms.
Malaria is a leading cause of imported febrile illnesses in pediatric travelers, but few studies have addressed severe imported pediatric malaria. We aimed to determine the risk factors and the ...features of imported pediatric severe malaria.
We conducted a retrospective, descriptive study using the French National Reference Center for Imported Malaria database, in children aged 0-15 years who were hospitalized with a falciparum malaria from January 1st 1996 to December 31th 2005. Uncomplicated and severe cases of falciparum malaria were compared to identify risk factors for severe cases. In the hospitals that reported more than five severe cases during the study period, we evaluated severe cases for prognostic factors and assessed the accuracy WHO criteria for predicting severity. Given the rarity of deaths, adverse outcomes were defined as requiring major therapeutic procedures (MTPs)-e.g., sedation, mechanical ventilation, nasal oxygen therapy, blood transfusions, hemodialysis, fluid resuscitation-or pediatric intensive care unit (PICU) admission.
Of 4150 pediatric malaria cases included in the study, 3299 were uncomplicated and 851 (20.5%) were severe. Only one death was recorded during this period. Predictors for severe falciparum malaria were: age <2 years (OR = 3.2, 95% CI = 2.5-4.0, p <0.0001) and a travel in the Sahelian region (OR = 1.7, 95% CI = 1.3-2.0, p = 0.0001). Of 422 severe malaria cases, a stay in a Sahelian region, lack of chemoprophylaxis, age <2 years or thrombocytopenia <100 x 10^3/mm^3 predicted adverse outcomes. Except for the hyperparasitemia threshold of 4%, the main WHO 2000 criteria for severe malaria reliably predicted adverse outcomes. In our study, the threshold of parasitemia most predictive of a poor outcome was 8%.
In imported pediatric malaria, children younger than 2 years deserve particular attention. The main WHO 2000 criteria for severity are accurate, except for the threshold of hyperparasitemia, which should be revised.
Non-pharmaceutical forms of Artemisia annua (a Chinese plant containing artemisinin) are used by some travellers who believe these products are safer than anti-malarial drugs. We report two cases of ...severe Plasmodium falciparum malaria requiring hospitalization in an Intensive Care Unit following prophylaxis with non-pharmaceutical A. annua in French travellers.
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