Strengthened Ebola surveillance in France during a major outbreak in West Africa: March 2014-January 2016.

Introduction An unprecedented outbreak of Ebola virus diseases (EVD) occurred in West Africa from March 2014 to January 2016. The French Institute for Public Health implemented strengthened surveillance to early identify any imported case and avoid secondary cases. METHODS: Febrile travellers returning from an affected country had to report to the national emergency healthcare hotline. Patients reporting at-risk exposures and fever during the 21st following day from the last at-risk exposure were defined as possible cases, hospitalised in isolation and tested by real-time polymerase chain reaction. Asymptomatic travellers reporting at-risk exposures were considered as contact and included in a follow-up protocol until the 21st day after the last at-risk exposure. RESULTS: From March 2014 to January 2016, 1087 patients were notified: 1053 were immediately excluded because they did not match the notification criteria or did not have at-risk exposures; 34 possible cases were tested and excluded following a reliable negative result. Two confirmed cases diagnosed in West Africa were evacuated to France under stringent isolation conditions. Patients returning from Guinea (n = 531; 49%) and Mali (n = 113; 10%) accounted for the highest number of notifications. CONCLUSION: No imported case of EVD was detected in France. We are confident that our surveillance system was able to classify patients properly during the outbreak period.

Unusual increase in reported cases of paratyphoid A fever among travellers returning from Cambodia, January to September 2013.

From January to September 2013, a marked increase in notifications of Salmonella Paratyphi A infections among travellers returning from Cambodia occurred in France. An investigation revealed 35 cases without a common source: 21 in France, five in Germany, three in the Netherlands, one in Norway, one in the United Kingdom, four in New-Zealand. Data suggest an ongoing event that should trigger further investigation. Travellers to Cambodia should observe preventive measures including good personal hygiene and food handling practices.

[Ten-year incidence of high blood pressure in the general population: influence of clinical parameters, and implication for screening strategies]. / Incidence à 10 ans de l'HTA dans la population générale: rôle des paramètres démographiques et cliniques, et implication pour la surveillance des normotendus.

BACKGROUND: International guidelines recommend to modulate the periodicity of hypertension screening according to the initial level of blood pressure (BP). The aim of our study was to evaluate other factors that could be useful to optimise the screening for hypertension. METHODS: 9777 normotensive volunteers (4151 men, 5626 women) aged 16 to 68, studied at a 10 year interval during systematic health check ups (standardised questionnaire, clinical examination, biological tests) were included. We determined the 10-year incidence of high BP (systolic BP >or=140 mmHg and/or diastolic BP >or=90 mmHg and/or anti-hypertensive treatment). The role of potential risk factors for hypertension was assessed. RESULTS: The 10 year incidence of high BP was 19.9%. It was associated with the initial level of BP (OR=2.02 and 1.81 per +10 mmHg of systolic and diastolic BP, respectively, p<0.0001). Initial age and BMI were strongly associated with the incidence of a high BP (OR=1.88 / + 10 years and 1.18 / + 1 kg/m2, p<0.0001) after adjustment for the initial systolic BP. In men, a low reported physical activity level, alcohol consumption, and current smoking were independent risk factors (Table1). [table: see text] CONCLUSION: These results suggest that the recommendations for the screening of hypertension should not be based solely on the initial level of BP.

Plant poisoning outbreak in the western area of Cambodia, 2005.

An outbreak investigation was conducted during February-March 2005 to determine the cause of several sudden deaths occurring in Pailin Province, Cambodia. Sixty-seven patients presented with non-febrile poisoning-like symptoms and 15 died of coma, including 53% children under 10 years old. Symptoms included sore throat (92%), sore lips (73%), swollen tongue (54%) and gastrointestinal signs (41%). A plant locally called prik was the source of poisoning (97.0 vs. 28.7%, odds ratio 74.3, P<0.001). Patients may have confused the edible Melientha suavis Pierre with Urobotrya siamensis Hiepko, both from the Opiliaceae family. This was the first report of Urobotrya poisoning and its clinical manifestations.