Seroprevalence of Crimean-Congo hemorrhagic fever virus among people living with HIV in Brazzaville, Congo and among blood donors in Bamako, Mali.

Crimean-Congo hemorrhagic fever virus (CCHFV) is the causative agent of Crimean-Congo hemorrhagic fever (CCHF), a highly contagious and potentially fatal emerging disease. We assessed CCHFV seroprevalence by conducting a serological survey of two cohorts from Brazzaville, Congo and Bamako, Mali. We retrospectively screened 581 sera samples, including 352 from monitoring centers for people living with HIV (PLWH) in Brazzaville and 229 provided by the Blood Transfusion Center at Gabriel Touré Hospital in Bamako. An ELISA kit (ID Screen® CCHF Double Antigen Multi-species, Innovative Diagnostics) was used to detect total anti-CCHFV antibodies in serum. CCHFV seroprevalence was 0.6% in the PLWH cohort in Brazzaville, all in a peri­urban area near livestock/agriculture, and 1.75% in a cohort of blood donors in Bamako, half living in a peri­urban area near livestock/agriculture and the others performing risk-exposure activities, such as working as a butcher or with frequent rural travels. PLWH from Brazzaville were mostly female, older, and more highly educated, with a tertiary sector activity and living in an urban biotope without livestock/agricultural activities in the surroundings, in contrast to the blood donors of Bamako, who were younger and more likely to live in peri­urban/rural areas with livestock/agricultural activities in the surroundings. Despite a low CCHFV seroprevalence, our study indicates human contact with CCHFV in sub-urban areas of the capital cities of Congo and Mali associated with previously described CCHFV risk factors.

[Covid19 in a polypathological subject]. / Pneumopathie a covid19 chez un sujet polypathologique.

In December 2019, an outbreak of pneumonia due to the 2019 novel coronavirus, SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), broke out in Wuhan, Hubei, China. This betacoronavirus causes a sometimes severe respiratory pathology, named COVID-19 by the World Health Organization (WHO). The WHO declared COVID-19 as a pandemic in March 2020. It is Mrs. RM, 71 years old of French nationality who consults for dyspnea on exertion for 8 days associated with a dry cough, an intermittent fever with periods of spontaneous remissions, a chest pain accentuated by the efforts of cough, a physical asthenia, non-selective anorexia, diarrhea and vomiting. The physical examination found respiratory distress with 72% desaturation in ambient air, requiring oxygen-requisition with 96% oxygen saturation under 10 liters with no sign of respiratory struggle; crackling rales with 2 more predominant lung fields on the right, mucocutaneous jaundice, edema of the lower limbs. The management was intubation upon admission with mechanical ventilation, oral administration of hydroxychloroquine 200 mg due to 2 tablets morning and evening for 24 hours then 1 tablet morning and evening for 04 days, antibiotic therapy based on ceftriaxone 1g morning and evening was implemented, in the absence of bacteriological evidence. The course was unfavorable with a death with the absence of clinical improvement and a very precarious hematosis escaping any treatment alternative. CONCLUSION: Covid19 is a very serious virus with a poor prognosis in multiple pathological patients.

En décembre 2019, une épidémie de pneumonie due au nouveau coronavirus 2019, le SARS-CoV-2 (sévère acute respiratory syndrome coronavirus 2) a éclaté à Wuhan, Hubei, Chine. Ce bétacoronavirus provoque une pathologie respiratoire parfois sévère, nommée COVID-19 par l'organisation mondiale de la santé (OMS). L'OMS a déclaré en mars 2020, la COVID-19 comme une pandémie. Il s'agit de madame RM, 71 ans de nationalité française qui consulte pour dyspnée d'effort depuis 8 jours associée à une toux sèche, une fièvre intermittente avec des périodes de remissions spontanées, une douleur thoracique accentuée par les efforts de toux, une asthénie physique, une anorexie non sélective, des diarrhées et vomissements. L'examen physique retrouve une détresse respiratoire avec une désaturation à 72% en air ambiant, nécessitant une oxygeno-réquerance avec une saturation en oxygène à 96% sous 10 litres sans signe de lutte respiratoire ; des rales crépitants aux 2 champs pulmonaires plus prédominants à droite, un ictère cutanéomuqueux, des œdèmes des membres inférieurs. La prise en charge a été une intubation dès son admission avec ventilation mécanique, l'administration par la voie orale de l'hydroxychloroquine 200 mg en raison de 2 comprimés matin et soir pendant 24heures puis 1comprimé matin et soir pendant 04 jours, l'antibiothérapie à base de ceftriaxone 1g matin et soir a été mis en place, en l'absence de preuve bactériologique. L'évolution fut défavorable par un décès avec l'absence d'amélioration clinique et une hématose très précaire échappement à toute alternative thérapeutique. CONCLUSION: La covid19 est une virose très grave au pronostic sombre chez les patients poly- pathologiques.