Risk of maritime introduction of plague from Madagascar to Mayotte.

Plague is a rodent-borne disease caused by Yersinia pestis. Most human infections are bubonic plague, as a result of being bitten by infected rodent fleas. Madagascar, Democratic Republic of Congo and Peru are the three most affected countries. Plague was introduced into eastern Madagascar in 1898 by boat from India. It is estimated that the risk of introduction of plague from Madagascar to neighboring islands is very high due to the maritime links. We conducted a study of plague reservoirs and vectors in Longoni Port in Mayotte and Mahajanga Port in Madagascar during two seasons to highlight a non-negligible risk of introduction of Y. pestis to Mayotte. The results showed that two main reservoirs of plague in Madagascar Suncus murinus and Rattus rattus and the main flea vector Xenopsylla cheopis exists in and surrounding the port of Longoni. Y. pestis was isolated from Rattus norvegicus captured close to the port of Mahajanga during this study. Plague bacteria circulate within populations of rodent without causing rodent die-off in Mahajanga. The risk of introduction of plague from Madagascar to Mayotte exists due to the regular exchanges. Continuous surveillance of rat, shrew and flea populations is therefore necessary in all the surrounding countries that have regular exchanges with Madagascar to prevent the spread of the plague.

[Distribution of drinking water in French Guyana: issues and solutions for improving access]. / L'alimentation en eau potable en Guyane: problématique et solutions appropriées.

French Guyana is located in South America, and it is confronted with an endemic situation where waterborne diseases are widespread, especially among those 30,000 people without access to drinking water. In 2007, two notices of the French High Council for Public Health were issued, one concerning vaccination against typhoid and the other on conditions for improving water supply in Guyana. The latter served as a basis for proposing and implementing actions to "improve water quality for those who did not have access to it". Some foundation for further action was provided due to actions developed during the 1991 cholera outbreak there, when hand pumps and fountains were installed, and rainwater collection was promoted at the household level. Top priority is given to water supply provided by public facilities, especially through hand pumps. Rainwater harvest and storage is promoted for remote and very isolated households, including tools for purification through the use of a Brazilian-made ceramic filter. Important challenges are identified for the further, such as: conducting an evaluation of those technical choices made, developing a social and cultural understanding of drinking water and sanitation among the users, distribution and training for the use of water quality test kits, data sharing and exchange of good practice with neighbouring countries and an accurate mapping of enteric disease cases recorded in local health facilities.