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Biomedical subjects

J P Durand

Publications and source records attributed to J P Durand.

At least 19 recordsLinked to original sources

[West Nile virus infection: serological investigation among horses in France and in Africa].

This study was carried out in 2003 to detected serological evidence of West Nile virus infection in 190 Army horses kept nearby French troops stationed in Southeast France and in Africa (Chad, Côte d'Ivoire and Senegal). Both IgG and IgM antibodies were searched for using an ELISA assay. Specifiity of IgG antibodies was determined by western blot and plaque reduction seroneutraization. Finding showed that 79% of the Army horses (n=96) tested in Africa presented specific IgG antibodies. All horses that were seropositive for IgG were seronegative for IgM. None of the Army horses (n=94) tested in the Southeast France were seropositive for West Nile virus. This study indicates that West Nile virus has circulated in all three African countries but not recently. It also underscores the value of western blotting as a rapid, specific confirmation technique that could eliminate the need to use plaque reduction seroneutralization.

Africa↗

Epidemic resurgence of Chikungunya virus in democratic Republic of the Congo: identification of a new central African strain.

The resurgence of Chikungunya virus is described during an urban epidemic in Kinshasa Democratic Republic of the Congo, after 39 years without any isolation of the virus. Chikungunya virus was isolated in sera from nine patients with clinical symptoms. A 1,200 bp long partial sequence of the E1/3'UTR genomic region was determined for each isolate. All sequences clustered in the central African lineage. They constitute Chikungunya virus reference sequences for the Democratic Republic of the Congo.

Alphavirus Infections↗

[Exotic viral arthritis: role of alphavirus].

Only six of the many alphavirus known to affect humans can cause articular manifestations. They are the Ross River and Barmah Forest viruses from the South Pacific, the Chikungunya, O'Nyong Nyong and Sindbis viruses from tropical Africa, and the Mayaro virus from South America. In most cases, articular manifestations involve arthralgia or transient arthritis and are usually minor. However in some cases especially involving Ross River virus acute polyarthritis may be the most prominent clinical feature and even develop before fever. Although these joint symptoms may be severe and persist for weeks or months in a subacute mode with slightly inflammatory episodes that can be relieved using analgesics, they never cause permanent damage. Differential diagnosis of alphavirsus-related polyarthritis is simple to diagnosis especially in epidemic outbreaks as is frequently the case for Ross River virus epidemics in Australia. Imported cases should be suspected in patients presenting acute or subacute polyarthritis after a recent stay of any length of time in a tropical country and can be confirmed by ordering serology from a specialized reference laboratory.

Alphavirus↗

[Rift Valley fever: sporadic infection of French military personnel outside currently recognized epidemic zones].

For three years the arbovirus surveillance unit of the Tropical Medicine Institute of the French Army Medical Corps (French acronym IMTSSA) in Marseille, France has been investigating causes of benign non-malarial febrile syndromes in French military personnel serving outside mainland France. The methodology used in N'Djamena consisted of sending frozen specimens collected concomitant with viremia, to Marseille for culture. During the rainy season of 2001, specimens were collected from a total of 50 febrile soldiers. Cultures allowed isolation and identification of two strains of Rift Valley virus. The risk of contamination exists not only in the field but also in mainland hospital departments treating infected patients. Routine serological diagnosis for Rift Valley fever must be DISCUSSED for all patients in the field or returning from Africa.

Adult↗

[Evaluation of continuing medical training in private sector French cardiologists in 1999].

The authors present the results of a retrospective national enquiry which took place in 1999 and was mailed and faxed to the 3,800 cardiologists practising in the private sector in order to assess the different types of continuous, individual and collective postgraduate training which they had benefited from in the preceding 12 months. The data was analysed by comparison with that obtained from an individualized representative sample in a panel of private sector cardiologists. The results were then compared with the criteria of a yardstick proposed by the National Committee of Continuous Medical Education of 1997, according to the April 25th 1996 decree. The meeting of these criteria would require carrying out 114,000 to 76,000 hour-equivalents of continuous education whereas the present offer is about 100,000 hour-equivalents. The different forms of individual or collective training were compared in the 327 questionnaires which were exploitable following adhesion to the French Society of Cardiology, to the Cardiologists' Union, to local cardiological societies, by age, gender and type of practice. The average number of annual hours of collective education was 52.2 +/- 60.1 hours (25% quartile = 25 hours, 75% = 60 hours). The average value of hours of individual education was 89.7 +/- 89.3 hours (25% quartile = 25 hours; 75% = 120 hours). This evaluation indicates that about 15% of cardiologists practising in the private sector have inadequate continuous medical education and that 68% would satisfy the criteria laid down in 1997. Moreover, the present offer would seem to be adequate providing the criteria of accreditation have been met.

Adult↗

[Epidemiologic surveillance of dengue fever in the French army from 1996 to 1999].

Dengue fever is a widespread disease that can occur outside tropical areas. Several thousand French military personnel are exposed to this infectious risk each year and exposure is expected to rise with the creation of a professional army and the increasing number of foreign missions. As a result, dengue fever has become a major priority for the Armed Services Health Corps (ASHC). A system of epidemiological surveillance based on the active participation of all military physicians has been designed by the ASHC to collect and analyze all data relevant to cases of dengue fever involving French military personnel stationed overseas or at home. The purpose of this study is to present data compiled for the period from 1996 to 1999. Analysis of these data demonstrated that the incidence of dengue fever peaked in 1997 due to epidemic outbreaks occurring in French Polynesia and Martinique. In response to these outbreaks control measures were adapted especially in regard to vector control. This study shows that the system of surveillance implemented by the ASHC is an effective but still perfectible tool.

Adult↗

Complete genomic sequence of a dengue type 2 virus from the French West Indies.

Severe forms of dengue fever, dengue haemorrhagic fever, and dengue shock syndrome, were not prominent in the Americas until the epidemic of Cuba in 1981. Since that time, they have spread to other countries in Central and South America, correlating with the spread of dengue type 2 viruses related to Southeast Asian strains. We report here the complete genomic sequence of a dengue type 2 virus isolated during the epidemic in La Martinique in 1998. This constitutes the first complete genetic characterization of a dengue virus strain from French West Indies, and also the first molecular identification in this region of a dengue 2 strain phylogenetically related to the emerging American type 2 dengue viruses.

Amino Acid Substitution↗

[Imported dengue hemorrhagic fever: aprops of 1 case presenting with signs of acute alithiasic cholecystitis].

Dengue is prevalent in all subtropical areas. Hemorrhagic forms of the disease were first described in southeast Asia but have now been observed on several continents. Travelers are at risk for infection and the likelihood of imported dengue has grown in relation to volume of air traffic. In developed countries, dengue usually presents in the benign form, but sudden aggravation is always possible. The purpose of this report is to describe a case of imported dengue hemorrhagic fever associated with abdominal pain in a traveler returning from Asia. Radiological findings were suggestive of nonlithiasic cholecystitis. Similar ultrasound feature have been reported by pediatric groups during dengue outbreaks in Asia. Previous findings have shown that bladder involvement is a predictive sign of severe disease and impending shock. Surgery is contraindicated in these patients. Close clinical and laboratory surveillance is necessary due to the high risk of aggravation. The pathogenesis of this severe life-threatening form of the disease is unclear. A possible explanation is involvement of a more virulent strain of virus. Dengue should always be considered after malaria in the differential diagnosis of returning travelers patients presenting fever.

Abdominal Pain↗

[Molecular epidemiology of yellow fever].

Although the causative agent has long been identified and a safe, effective vaccine is available, yellow fever still poses a threat in South America and tropical areas of Africa where it mainly affects young people. The presentation of yellow fever has changed relatively little since description of the first outbreaks, but study has entered a new age thanks to development of more accurate techniques for characterization of viral strains. Comparison of the RNA sequences of virus from different geographical regions has demonstrated the existence of several stable genotypes which have been designated as topotypes. These topotypes have yet to be correlated with different viral activity but their recognition has allowed better epidemiologic surveillance of the disease. Study of the viral genome has also allowed improvement of diagnostic techniques, identification of factors influencing virulence, and enhancement of understanding of viral mutations. Ultimately knowledge of the processes underlying viral evolution could assist development of effective preventive strategies.

Genetic Variation↗

Genetic diversity of simian immunodeficiency viruses from West African green monkeys: evidence of multiple genotypes within populations from the same geographical locale.

High simian immunodeficiency virus (SIV) seroprevalence rates have been reported in the different African green monkey (AGM) subspecies. Genetic diversity of these viruses far exceeds the diversity observed in the other lentivirus-infected human and nonhuman primates and is thought to reflect ancient introduction of SIV in the AGM population. We investigate here genetic diversity of SIVagm in wild-living AGM populations from the same geographical locale (i.e., sympatric population) in Senegal. For 11 new strains, we PCR amplified and sequenced two regions of the genome spanning the first tat exon and part of the transmembrane glycoprotein. Phylogenetic analysis of these sequences shows that viruses found in sympatric populations cluster into distinct lineages, with at least two distinct genotypes in each troop. These data strongly suggest an ancient introduction of these divergent viruses in the AGM population.

Amino Acid Sequence↗