Zika emergence in the French Territories of America and description of first confirmed cases of Zika virus infection on Martinique, November 2015 to February 2016.

Following of the emergence of Zika virus in Brazil in 2015, an epidemiological surveillance system was quickly implemented in the French overseas Territories of America (FTA) according to previous experience with dengue and chikungunya and has detected first cases of Zika. General practitioners and medical microbiologists were invited to report all clinically suspected cases of Zika, laboratory investigations were systematically conducted (RT-PCR). On 18 December, the first autochthonous case of Zika virus infection was confirmed by RT-PCR on French Guiana and Martinique, indicating introduction of Zika virus in FTA. The viral circulation of Zika virus was then also confirmed on Guadeloupe and Saint-Martin. We report here early findings on 203 confirmed cases of Zika virus infection identified by RT-PCR or seroneutralisation on Martinique Island between 24 November 2015 and 20 January 2016. All cases were investigated. Common clinical signs were observed (maculopapular rash, arthralgia, fever, myalgia and conjunctival hyperaemia) among these patients, but the rash, the foundation of our case definition, may be absent in a significant proportion of patients (16%). These results are important for the implementation of a suspected case definition, the main tool for epidemiological surveillance, in territories that may be affected by ZIKV emergence, including Europe.

Outbreak of Chikungunya in the French Caribbean Islands of Martinique and Guadeloupe: Findings from a Hospital-Based Surveillance System (2013-2015).

Chikungunya virus (CHIKV) emerged in the Caribbean island of Saint-Martin in December 2013. We implemented a hospital-based surveillance system to detect and describe CHIKV cases including severe forms of the infection and deaths in the islands of Martinique and Guadeloupe. A case was defined as a patient with a CHIKV laboratory confirmation cared for in a public hospital for chikungunya for at least 24 hours, and a severe CHIKV case was defined as a CHIKV case presenting one or more organ failures. Sociodemographic, clinical, and laboratory data were collected and cases classified into severe or nonsevere based on medical records. From December 2013 to January 2015, a total of 1,836 hospitalized cases were identified. Rate of hospital admissions for CHIKV infection was 60 per 10,000 suspected clinical CHIKV cases and severity accounted for 12 per 10,000. A total of 74 deaths related to CHIKV infection occurred. Infants and elderly people were more frequently hospitalized compared with others and severity was more frequently reported in elderly subjects and subjects with underlying health condition. Fifteen neonatal infections consecutive to mother-to-child transmission were diagnosed, seven of which were severe. The most vulnerable groups of the population, such as the elderly, infants, individuals with comorbidities, and pregnant women, should remain the main targets of public health priorities.

Gender differences in circulating bubble production after SCUBA diving.

OBJECTIVE: Differences in circulating bubble production have been described after exposures in altitude chambers between men and women. The present study was designed to examine gender differences in circulating bubble production after a dive. METHODS: Fifty-two men and 52 women performed the same dive profile (25 min to 35 m). Circulating bubbles were detected by continuous wave Doppler. Tests were conducted at sea in a boat, at 10-min intervals for 1 h after surfacing. Signals were graded according to the Spencer scale. The categorical data were then converted to a single number reflecting total bubble activity using the KISS index. RESULTS: Considering each measurement period, bubble grade was higher in men than women 30, 40 and 50 min postdive. On the contrary, bubble grade was comparable between men and women 10, 20 and 60 min after the dive. KISS index was significantly higher in men than women (6.77 [0.65-32.3] versus 0.91 [0-22.9], P<0.02). KISS index was significantly correlated with age, weight and body fat mass in the whole population and in the men and women separately. Postmenopausal women had a higher KISS index (42 [15-47]) when compared with premenopausal women and men older than 50 years. No difference in bubble production was found according to the use of oral contraceptive pills or the phase of the menstrual cycle. CONCLUSION: Overall, we observed fewer circulating bubbles in women than in men after an open sea SCUBA dive. This difference disappeared in the postmenopausal women.