Outbreak of Cutaneous Leishmaniasis among military personnel in French Guiana, 2020: Clinical, phylogenetic, individual and environmental aspects.
Background Cutaneous Leishmaniasis (CL) is endemic in French Guiana but cases are usually sporadic. An outbreak signal was issued on May 15th 2020 with 15 suspected cases after a military training course in the rainforest. An outbreak investigation was carried out. Methodology/principal findings Thi...
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ftdoajarticles:oai:doaj.org/article:1d6b8871ab7a444790bcff6da9141399 2023-05-15T15:12:33+02:00 Outbreak of Cutaneous Leishmaniasis among military personnel in French Guiana, 2020: Clinical, phylogenetic, individual and environmental aspects. Kim Henry Aurélie Mayet Miguel Hernandez Guillaume Frechard Pierre-Antoine Blanc Marion Schmitt Nathalie André Jean-Marie Loreau Marine Ginouves Ghislaine Prévot Pierre Couppié Magalie Demar Romain Blaizot 2021-11-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0009938 https://doaj.org/article/1d6b8871ab7a444790bcff6da9141399 EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0009938 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0009938 https://doaj.org/article/1d6b8871ab7a444790bcff6da9141399 PLoS Neglected Tropical Diseases, Vol 15, Iss 11, p e0009938 (2021) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2021 ftdoajarticles https://doi.org/10.1371/journal.pntd.0009938 2022-12-31T11:06:18Z Background Cutaneous Leishmaniasis (CL) is endemic in French Guiana but cases are usually sporadic. An outbreak signal was issued on May 15th 2020 with 15 suspected cases after a military training course in the rainforest. An outbreak investigation was carried out. Methodology/principal findings Thirty cases were confirmed. Leishmania guyanensis was the most frequent species (90%). The most frequent presentation was ulcerative (90%). Lesions on the face and hands were frequent (40% each). Eight cases (26%) presented a poor outcome after treatment with pentamidine and required a second line with amphotericin B. Three of them required further treatments with meglumine antimoniate or miltefosine. Two spots within the training area were deemed as likely sites of contamination, due to illegal logging. The isolated Leishmania strains did not form a separate cluster. Participation in Week 13 of year 2020 was associated with infection (OR = 4.59 [1.10-19.83]; p = 0.016) while undergoing only the "Fighting" exercise was protective (OR = 0.1 [0-0.74]; p = 0.021). There was no association between infection and other risk factors at the individual level. The attack rate of Regiment B (14/105 = 13.3%) was significantly higher (OR = 4.22 [1.84-9.53], p = 0.0001) compared to Regiment A (16/507 = 3.2%). The attack rate during this training course (30/858 = 3.5%) was significantly higher (OR 2.29 [1.28-4.13]; p = 0.002) than for other missions in French Guiana during the same period (22/1427 = 1.5%). Conclusions This outbreak could be explained by a combination of factors: climatic conditions around week 13, at-risk activities including night trainings, absence of impregnation, a lesser experience of rainforest duties in Regiment B and illegal logging attracting sandflies on military training grounds. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 15 11 e0009938 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Kim Henry Aurélie Mayet Miguel Hernandez Guillaume Frechard Pierre-Antoine Blanc Marion Schmitt Nathalie André Jean-Marie Loreau Marine Ginouves Ghislaine Prévot Pierre Couppié Magalie Demar Romain Blaizot Outbreak of Cutaneous Leishmaniasis among military personnel in French Guiana, 2020: Clinical, phylogenetic, individual and environmental aspects. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background Cutaneous Leishmaniasis (CL) is endemic in French Guiana but cases are usually sporadic. An outbreak signal was issued on May 15th 2020 with 15 suspected cases after a military training course in the rainforest. An outbreak investigation was carried out. Methodology/principal findings Thirty cases were confirmed. Leishmania guyanensis was the most frequent species (90%). The most frequent presentation was ulcerative (90%). Lesions on the face and hands were frequent (40% each). Eight cases (26%) presented a poor outcome after treatment with pentamidine and required a second line with amphotericin B. Three of them required further treatments with meglumine antimoniate or miltefosine. Two spots within the training area were deemed as likely sites of contamination, due to illegal logging. The isolated Leishmania strains did not form a separate cluster. Participation in Week 13 of year 2020 was associated with infection (OR = 4.59 [1.10-19.83]; p = 0.016) while undergoing only the "Fighting" exercise was protective (OR = 0.1 [0-0.74]; p = 0.021). There was no association between infection and other risk factors at the individual level. The attack rate of Regiment B (14/105 = 13.3%) was significantly higher (OR = 4.22 [1.84-9.53], p = 0.0001) compared to Regiment A (16/507 = 3.2%). The attack rate during this training course (30/858 = 3.5%) was significantly higher (OR 2.29 [1.28-4.13]; p = 0.002) than for other missions in French Guiana during the same period (22/1427 = 1.5%). Conclusions This outbreak could be explained by a combination of factors: climatic conditions around week 13, at-risk activities including night trainings, absence of impregnation, a lesser experience of rainforest duties in Regiment B and illegal logging attracting sandflies on military training grounds. |
format |
Article in Journal/Newspaper |
author |
Kim Henry Aurélie Mayet Miguel Hernandez Guillaume Frechard Pierre-Antoine Blanc Marion Schmitt Nathalie André Jean-Marie Loreau Marine Ginouves Ghislaine Prévot Pierre Couppié Magalie Demar Romain Blaizot |
author_facet |
Kim Henry Aurélie Mayet Miguel Hernandez Guillaume Frechard Pierre-Antoine Blanc Marion Schmitt Nathalie André Jean-Marie Loreau Marine Ginouves Ghislaine Prévot Pierre Couppié Magalie Demar Romain Blaizot |
author_sort |
Kim Henry |
title |
Outbreak of Cutaneous Leishmaniasis among military personnel in French Guiana, 2020: Clinical, phylogenetic, individual and environmental aspects. |
title_short |
Outbreak of Cutaneous Leishmaniasis among military personnel in French Guiana, 2020: Clinical, phylogenetic, individual and environmental aspects. |
title_full |
Outbreak of Cutaneous Leishmaniasis among military personnel in French Guiana, 2020: Clinical, phylogenetic, individual and environmental aspects. |
title_fullStr |
Outbreak of Cutaneous Leishmaniasis among military personnel in French Guiana, 2020: Clinical, phylogenetic, individual and environmental aspects. |
title_full_unstemmed |
Outbreak of Cutaneous Leishmaniasis among military personnel in French Guiana, 2020: Clinical, phylogenetic, individual and environmental aspects. |
title_sort |
outbreak of cutaneous leishmaniasis among military personnel in french guiana, 2020: clinical, phylogenetic, individual and environmental aspects. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2021 |
url |
https://doi.org/10.1371/journal.pntd.0009938 https://doaj.org/article/1d6b8871ab7a444790bcff6da9141399 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 15, Iss 11, p e0009938 (2021) |
op_relation |
https://doi.org/10.1371/journal.pntd.0009938 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0009938 https://doaj.org/article/1d6b8871ab7a444790bcff6da9141399 |
op_doi |
https://doi.org/10.1371/journal.pntd.0009938 |
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PLOS Neglected Tropical Diseases |
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15 |
container_issue |
11 |
container_start_page |
e0009938 |
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