Functional signs in patients consulting for presumed Lyme borreliosis.

INTRODUCTION: Little is known about the functional symptoms associated with Lyme borreliosis (LB) in Europe. We aimed to assess functional symptoms associated with presumed LB and to compare patients with and without confirmed LB. MATERIALS AND METHODS: We performed a retrospective monocenter study. Patients consulting for presumed LB were included. RESULTS: Between November 2015 and June 2018, 355patients were included (mean age: 51years, 52% of women) of which 48had LB: erythema migrans (42%), early disseminated LB (50%; 35% of neuroborreliosis cases), and late disseminated LB (8%). The most frequently reported functional symptoms were neuropathic pain (23%), arthralgia (23%), and asthenia (17%). Other functional symptoms were rare (≤10%). Three hundred and seven (86%) patients did not have LB. Patients with confirmed LB reported fewer functional symptoms than patients without LB (1.8 (±1.7) vs. 3.6 (±2.5), P<0.001) with a shorter duration of symptoms (< 3 months in 48% vs. 16% of cases, P<0.001). They less often reported asthenia (17% vs. 59%, P<0.001), widespread pain (10% vs. 31%, P=0.003), myalgia (10% vs. 32%, P=0.002), memory disorders (4% vs. 16%, P=0.03), irritability (2% vs. 23%, P±0.001), and sadness (0% vs. 16%, P=0.003). CONCLUSION: In patients consulting for presumed LB, patients diagnosed with LB had fewer and shorter functional symptoms than patients without LB.

Current practice of French health professionals regarding Japanese encephalitis vaccination.

OBJECTIVE: Japanese encephalitis (JE) is a rare but severe disease. It is a potential threat for people traveling to endemic areas. The risk of developing JE is low (<1%), but the associated case fatality is high (30%). There is no specific treatment for JE, but a vaccine is available. We performed an observational survey to assess practices of French health professionals regarding JE vaccination. METHODS: Standardized questionnaires were sent by email to a sample of French health professionals practicing in vaccination centers. Participation was on a voluntary and anonymous basis. The questionnaires requested socio-demographic details, and included multiple choice questions. RESULTS: The response rate was 38.5%. Most participating health professionals had been working for more than three years in a vaccination center and declared not to be reluctant to perform JE vaccination. Reluctance was mostly based on the vaccine cost and on the difficulty to properly assess the risk for patients. The rapid protocol was largely preferred except in the overseas regions (P<0.05, Fisher's exact test). Traveling to South Asia and backpacking were considered at-risk conditions. Participants proposed the vaccination all year round. Most participants would not have proposed the JE vaccination for the concrete case outlined in the questionnaire. CONCLUSIONS: French health professionals are globally favorable to JE vaccination. However, assessing the risk of exposure is difficult in routine practice.