Outbreak of diarrhoeal illness in participants in an obstacle adventure race, Alpes-Maritimes, France, June 2015.

An acute gastroenteritis (AG) outbreak occurred among participants in an obstacle race in France in the summer of 2015. An investigation in two phases was conducted to identify the source of infection and document the extent of the outbreak. First, a message on a social media website asked racers to report any symptoms by email to the Regional Health Agency of Provence-Alpes-Côte d'Azur. Second, a retrospective cross-sectional study was conducted through an interactive questionnaire for all participants, followed by an analytical study of potential risks factors. Of 8,229 persons registered, 1,264 adults reported AG resolved within 48 hours. Of adults who reported AG, 866 met the case definition. Age group, departure time and ingestion of mud were associated with AG. Twenty stool specimens tested negative for bacteria. All four stool samples tested for viruses were positive for norovirus genogroup I and genotype 2. No indicator bacteria for faecal contamination were found in drinking water but muddy water of ponds tested positive. The outbreak was possibly caused by human-to-human transmission of a norovirus introduced by one or more persons and transmitted through contaminated mud. Risks related to similar races should be assessed and recommendations be proposed to raise awareness among health authorities and organisers.

Low measles vaccination coverage among medical residents in Marseille, France: reasons for non-vaccination, March 2013.

BACKGROUND: During 2008-12, France and Europe experienced large measles outbreaks, involving also healthcare workers (HCW). We aimed to estimate the vaccination coverage (VC) of measles among medical residents of the University of Aix/Marseille, in South-Eastern France. METHODS: In March 2013, we conducted a cross-sectional study among all medical residents of the Medical Faculty of Aix/Marseille. We used a self-administered questionnaire to collect information on self-reported VC and reasons for vaccination and non-vaccination. We compared proportions, using the chi-squared test and prevalence ratios (PRs) with 95% confidence intervals (95% CIs). RESULTS: Of 1152 eligible residents, 703 (61%) participated in the study and 95 (14%; 95% CI: 12-17%) reported having had measles in the past. Of all participants, 613 (93%; 95% CI: 91-95%) reported having been vaccinated against measles and 389 (76%; 95% CI: 73-80%) received two doses. Only 268 (38%) reported having visited an occupational health physician. Vaccinated individuals were more likely to report easy access to vaccination as the main motivation for measles vaccination, compared with unvaccinated residents (435; 71% and 21; 45%; P < 0.001, respectively). CONCLUSIONS: VC among the medical residents of the University of Aix/Marseille was well below the recommended 95% coverage for two doses of measles vaccination. The majority of the study participants had not visited an occupational health doctor. Lack of easy access seems to represent major barriers to measles vaccination. We recommend that the student union, occupational health services and hospitals co-operate and address these problems in order to improve VC in this group.

[Increase of mortality associated with emergency relocation of elderly nursing homes residents following flooding in the Var district, France, 2010]. / Surmortalité associée à un déplacement en urgence des personnes âgées hébergées en institution suite aux inondations du Var en 2010.

On June 15th, 2010, the Var district was hit by heavy rain causing floods and mudslides. A nursing home for elderly people was subject to an emergency evacuation and had to relocate 140 residents in other hosting facilities in the region. A prospective cohort study was conducted through two evaluations of the residents' health conditions: before the flood and five months after they had returned in their homes. The monthly mortality data recorded in the facility in 2010 was compared with data from 2004 to 2009 of the same facility, and with the 2010 data from two other facilities located in the disaster area that had not evacuated their residents. The number of deaths recorded in the month following the floods was three times higher than the average number of expected deaths over the study period, and even twice higher during the second month. This excess mortality was not observed in the two other facilities studied in the disaster area. Most deceased arised in older people, more often in men, in state of high dependance and living in medical care units. These results suggest that despite the measures implemented by the rescue teams, the emergency displacement and relocation of elderly people, inevitable in this context, can have serious consequences. Where possible, the need for displacement must be discussed, prepared in advance, and followed by specific support for more vulnerable people.

Diagnostic value of reverse transcription-PCR of amniotic fluid for prenatal diagnosis of congenital rubella infection in pregnant women with confirmed primary rubella infection.

The diagnostic value of RT-PCR of amniotic fluid (AF) for prenatal diagnosis of congenital rubella virus infection in 45 pregnant women with confirmed primary infection was assessed. Specificity of RT-PCR was 100% and sensitivity ranged between 83 and 95%.

[Epidemiology of bacterial meningitis in France in 1999]. / Epidémiologie des méningites bactériennes en France en 1999.

In France, two sources of data, the mandatory notification and the laboratory network EPIBAC, allow the health authorities to follow the incidence of bacterial meningitis (BM) and to assess the relative frequency of the micro-organisms responsible for such infection. In 1999, more than 1,000 cases of BM were notified in France. The more common micro-organisms were: Streptococcus pneumoniae 46%, Neisseria meningitidis 32% and Streptococcus agalactiae(or Streptococcus B) 11%. Listeria monocytogenes and Haemophilus influenzae accounted for 6% and 5% of the cases respectively. In 1999, the incidence per 100,000 inhabitants of meningitis due to pneumococci (0.81), to streptococci B (0.19) and tuberculosis meningitis (0.17) were stable since 1995. The incidence rate of meningitis due to Listeria (0.10) and to H. influenzae (0.08) shows a regular decrease since 1992. The impact of preventive measures of meningitis due to Listeria and H. influenzae B has been clearly demonstrated through the dramatic decrease of meningitis due to these micro-organisms.