RESUMO
BACKGROUND AND AIM: Several symptomatic cases of hepatitis E virus (HEV) infections were reported to the New Caledonia Island Public Health Service between August and December 2023. This prompted epidemiological and virological investigations to identify the source of infection. APPROACH AND RESULTS: HEV RNA was assessed in symptomatic patients, various food items and pig farms on the island. HEV strains were characterised by sequencing. A seroprevalence study was also conducted on asymptomatic blood donors before and after the outbreak. 127 symptomatic cases were reported. Hospitalisation was required for 29/127 patients (22.8%). Hospitalised patients presented more frequently with comorbidities including liver and cardiovascular diseases, (80.7% vs. 27%, p<0.01) and 3 persons died (2.3%). Among the 100 HEV RNA-positive samples received at the French National Refence Centre for HEV, viral sequencing was possible for 76 samples. All strains were identified as HEV genotype 3 and 74/76 strains were grouped together (nucleotide identity: 98-100%). Full-length sequencing indicated a new HEV-3 subtype within HEV-3 subclade abk. Only genotype 3f strains were detected on the island's pig farms. No food items tested positive for HEV RNA. The seroprevalence of HEV IgG and IgM in blood donors was 9.2% (9/98) and 0%, respectively, in 2020, rising to 17.3% (17/98) and 2% (2/98) in 2024. CONCLUSIONS: Although all previous large-scale epidemics in Asia and Africa were associated with HEV-1 or 2, the New Caledonia outbreak was linked to HEV-3. A high number of symptomatic cases were admitted to hospital with a case fatality rate of 2.3%.
RESUMO
HLA-DQA1*03:01:12 differs from HLA-DQA1*03:01:01:01 by one nucleotide substitution in codon 21 in exon 2.
Assuntos
Sequenciamento de Nucleotídeos em Larga Escala , População das Ilhas do Pacífico , Humanos , Alelos , Análise de Sequência de DNA , Cadeias alfa de HLA-DQ/genéticaRESUMO
The French Society of Clinical Biology (SFBC) set up a working group "Biochemical markers of Covid-19" whose main objective is to review, analyse and monitor biological prescriptions according to the patient's care path. This study covers all public and private sectors of medical biology in metropolitan France and overseas and extends to the French-speaking world. We present a summary of feedbacks after 2 years of the pandemic. At the early stage of Covid-19, with regard to the regions surveyed, a common symptomatology with local zoonosis (dengue fever, zika, malaria, leptospirosis, etc.) complicates the diagnosis of Covid-19. At a more advanced stage, it is a question of managing an influx of patients suffering from acute respiratory distress syndrome. In this case, the biology is then simpler and delocalized medical biology devices have proven their effectiveness. As a result, ICU clinicians can better manage the frequent comorbidities encountered in these regions: obesity, diabetes, chronic renal failure, cardiovascular diseases.
La Société française de biologie clinique (SFBC) a mis en place un groupe de travail « Marqueurs biochimiques de Covid-19 ¼ dont l'objectif principal est de revoir, d'analyser et de suivre les prescriptions biologiques en fonction du parcours de soins du patient. Cette étude couvre tous les secteurs publics et privés de la biologie médicale en métropole et en Outre-mer et s'étend à la Francophonie. Nous présentons une synthèse des retours d'expériences après 2 ans de pandémie. Au stade précoce de la Covid-19, pour les régions interrogées, une symptomatologie commune avec des zoonoses locales (dengue, zika, paludisme, leptospirose ) complique le diagnostic de la Covid-19. À un stade plus avancé, il s'agit de gérer un afflux de patients atteints de syndrome de détresse respiratoire aiguë. La biologie est alors plus simple, et les dispositifs de biologie médicale délocalisée ont prouvé leur efficacité. De ce fait, les réanimateurs peuvent mieux gérer les comorbidités fréquentes rencontrées dans ces régions : obésité, diabète, insuffisance rénale chronique ou maladies cardiovasculaires.
Assuntos
COVID-19 , Falência Renal Crônica , Infecção por Zika virus , Zika virus , Animais , COVID-19/epidemiologia , Retroalimentação , Humanos , Pandemias , ZoonosesRESUMO
Arthrocladium fulminans is the only species in the Arthrocladium genus that has been involved in a previous human infection. To date, only one case of A. fulminans infection in a patient with GATA-2 immunodeficiency has been reported. We here report the second human case and the first case of septic arthritis and osteomyelitis due to A. fulminans in an immunocompetent patient, living in Mayotte, a French island in western Indian Ocean. He was successfully treated with surgical debridement and 6 months of antifungal treatment. This second observation of human invasive disease caused by A. fulminans is an additional argument for the pathogenicity of this rare species.