Outbreak of Cutaneous Leishmaniasis among military personnel in French Guiana, 2020: Clinical, phylogenetic, individual and environmental aspects.
<h4>Background</h4>Cutaneous Leishmaniasis (CL) is endemic in French Guiana but cases are usually sporadic. An outbreak signal was issued on May 15th 2020 with 15 suspected cases after a military training course in the rainforest. An outbreak investigation was carried out.<h4>Metho...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2021-11-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | https://doi.org/10.1371/journal.pntd.0009938 |
| _version_ | 1818974626912403456 |
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| author | Kim Henry Aurélie Mayet Miguel Hernandez Guillaume Frechard Pierre-Antoine Blanc Marion Schmitt Nathalie André Jean-Marie Loreau Marine Ginouves Ghislaine Prévot Pierre Couppié Magalie Demar Romain Blaizot |
| author_facet | Kim Henry Aurélie Mayet Miguel Hernandez Guillaume Frechard Pierre-Antoine Blanc Marion Schmitt Nathalie André Jean-Marie Loreau Marine Ginouves Ghislaine Prévot Pierre Couppié Magalie Demar Romain Blaizot |
| author_sort | Kim Henry |
| collection | DOAJ |
| description | <h4>Background</h4>Cutaneous Leishmaniasis (CL) is endemic in French Guiana but cases are usually sporadic. An outbreak signal was issued on May 15th 2020 with 15 suspected cases after a military training course in the rainforest. An outbreak investigation was carried out.<h4>Methodology/principal findings</h4>Thirty cases were confirmed. Leishmania guyanensis was the most frequent species (90%). The most frequent presentation was ulcerative (90%). Lesions on the face and hands were frequent (40% each). Eight cases (26%) presented a poor outcome after treatment with pentamidine and required a second line with amphotericin B. Three of them required further treatments with meglumine antimoniate or miltefosine. Two spots within the training area were deemed as likely sites of contamination, due to illegal logging. The isolated Leishmania strains did not form a separate cluster. Participation in Week 13 of year 2020 was associated with infection (OR = 4.59 [1.10-19.83]; p = 0.016) while undergoing only the "Fighting" exercise was protective (OR = 0.1 [0-0.74]; p = 0.021). There was no association between infection and other risk factors at the individual level. The attack rate of Regiment B (14/105 = 13.3%) was significantly higher (OR = 4.22 [1.84-9.53], p = 0.0001) compared to Regiment A (16/507 = 3.2%). The attack rate during this training course (30/858 = 3.5%) was significantly higher (OR 2.29 [1.28-4.13]; p = 0.002) than for other missions in French Guiana during the same period (22/1427 = 1.5%).<h4>Conclusions</h4>This outbreak could be explained by a combination of factors: climatic conditions around week 13, at-risk activities including night trainings, absence of impregnation, a lesser experience of rainforest duties in Regiment B and illegal logging attracting sandflies on military training grounds. |
| first_indexed | 2024-12-20T15:43:03Z |
| format | Article |
| id | doaj.art-1d6b8871ab7a444790bcff6da9141399 |
| institution | Directory Open Access Journal |
| issn | 1935-2727 1935-2735 |
| language | English |
| last_indexed | 2024-12-20T15:43:03Z |
| publishDate | 2021-11-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj.art-1d6b8871ab7a444790bcff6da91413992022-12-21T19:35:07ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352021-11-011511e000993810.1371/journal.pntd.0009938Outbreak of Cutaneous Leishmaniasis among military personnel in French Guiana, 2020: Clinical, phylogenetic, individual and environmental aspects.Kim HenryAurélie MayetMiguel HernandezGuillaume FrechardPierre-Antoine BlancMarion SchmittNathalie AndréJean-Marie LoreauMarine GinouvesGhislaine PrévotPierre CouppiéMagalie DemarRomain Blaizot<h4>Background</h4>Cutaneous Leishmaniasis (CL) is endemic in French Guiana but cases are usually sporadic. An outbreak signal was issued on May 15th 2020 with 15 suspected cases after a military training course in the rainforest. An outbreak investigation was carried out.<h4>Methodology/principal findings</h4>Thirty cases were confirmed. Leishmania guyanensis was the most frequent species (90%). The most frequent presentation was ulcerative (90%). Lesions on the face and hands were frequent (40% each). Eight cases (26%) presented a poor outcome after treatment with pentamidine and required a second line with amphotericin B. Three of them required further treatments with meglumine antimoniate or miltefosine. Two spots within the training area were deemed as likely sites of contamination, due to illegal logging. The isolated Leishmania strains did not form a separate cluster. Participation in Week 13 of year 2020 was associated with infection (OR = 4.59 [1.10-19.83]; p = 0.016) while undergoing only the "Fighting" exercise was protective (OR = 0.1 [0-0.74]; p = 0.021). There was no association between infection and other risk factors at the individual level. The attack rate of Regiment B (14/105 = 13.3%) was significantly higher (OR = 4.22 [1.84-9.53], p = 0.0001) compared to Regiment A (16/507 = 3.2%). The attack rate during this training course (30/858 = 3.5%) was significantly higher (OR 2.29 [1.28-4.13]; p = 0.002) than for other missions in French Guiana during the same period (22/1427 = 1.5%).<h4>Conclusions</h4>This outbreak could be explained by a combination of factors: climatic conditions around week 13, at-risk activities including night trainings, absence of impregnation, a lesser experience of rainforest duties in Regiment B and illegal logging attracting sandflies on military training grounds.https://doi.org/10.1371/journal.pntd.0009938 |
| spellingShingle | Kim Henry Aurélie Mayet Miguel Hernandez Guillaume Frechard Pierre-Antoine Blanc Marion Schmitt Nathalie André Jean-Marie Loreau Marine Ginouves Ghislaine Prévot Pierre Couppié Magalie Demar Romain Blaizot Outbreak of Cutaneous Leishmaniasis among military personnel in French Guiana, 2020: Clinical, phylogenetic, individual and environmental aspects. PLoS Neglected Tropical Diseases |
| title | Outbreak of Cutaneous Leishmaniasis among military personnel in French Guiana, 2020: Clinical, phylogenetic, individual and environmental aspects. |
| title_full | Outbreak of Cutaneous Leishmaniasis among military personnel in French Guiana, 2020: Clinical, phylogenetic, individual and environmental aspects. |
| title_fullStr | Outbreak of Cutaneous Leishmaniasis among military personnel in French Guiana, 2020: Clinical, phylogenetic, individual and environmental aspects. |
| title_full_unstemmed | Outbreak of Cutaneous Leishmaniasis among military personnel in French Guiana, 2020: Clinical, phylogenetic, individual and environmental aspects. |
| title_short | Outbreak of Cutaneous Leishmaniasis among military personnel in French Guiana, 2020: Clinical, phylogenetic, individual and environmental aspects. |
| title_sort | outbreak of cutaneous leishmaniasis among military personnel in french guiana 2020 clinical phylogenetic individual and environmental aspects |
| url | https://doi.org/10.1371/journal.pntd.0009938 |
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