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Etiology of Acute Febrile Illnesses in Adults in the Defense Community in French Guiana
Guillaume Velut
Guillaume Velut
Centre d’Epidémiologie et de Santé Publique des Armées, Marseille, France;
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Franck de Laval
Franck de Laval
Centre d’Epidémiologie et de Santé Publique des Armées, Marseille, France;
Aix-Marseille Université, INSERM, Institut de Recherche pour le Développement, Economic and Social Sciences, Health Systems, and Medical Informatics, Marseille, France;
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Aix-Marseille Université, INSERM, Institut de Recherche pour le Développement, Economic and Social Sciences, Health Systems, and Medical Informatics, Marseille, France;
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Morgane Berry
Morgane Berry
Centre Médical Interarmées de Cayenne, Cayenne, French Guiana;
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Frédérique Dufour Gaume
Frédérique Dufour Gaume
Centre Médical Interarmées de Kourou, Kourou, French Guiana;
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Nathalie André
Nathalie André
Direction Interarmées du Service de Santé des Forces Armées en Guyane, Cayenne, French Guiana;
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Loïc Epelboin
Loïc Epelboin
Service des Maladies Infectieuses et Tropicales, et Centre d’investigation Clinique (CIC INSERM 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana;
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Anne Lavergne
Anne Lavergne
Laboratoire des Interactions Virus-Hôtes, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana;
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Antoine Enfissi
Antoine Enfissi
Laboratoire de Virologie, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana;
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Felix Djossou
Felix Djossou
Service des Maladies Infectieuses et Tropicales, et Centre d’investigation Clinique (CIC INSERM 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana;
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Dominique Rousset
Dominique Rousset
Laboratoire de Virologie, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana;
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Sébastien Briolant
Sébastien Briolant
Aix Marseille Université, Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Service de Santé des Armées, Vecteurs – Infections Tropicales et Méditerranéennes, Marseille, France;
Institut Hospitalo-Universitaire – Méditerranée Infection, Marseille, France;
Unité de Parasitologie Entomologie, Département de Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, Marseille, France
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Institut Hospitalo-Universitaire – Méditerranée Infection, Marseille, France;
Unité de Parasitologie Entomologie, Département de Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, Marseille, France
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ABSTRACT.
In tropical countries, acute febrile illnesses represent a complex clinical problem for general practitioners. We describe the prevalence of different etiologies of acute febrile illnesses occurring among French service members and their families, excluding children, in general practice in French Guiana. From June 2017 to March 2020, patients with a fever ≥37.8°C with a duration of less than 15 days who sought medical care at the army medical centers in Cayenne and Kourou were prospectively enrolled. Based on clinical presentation, blood, urine, nasopharyngeal, and stool samples were collected for diagnostic testing for viruses, bacteria, and parasites (by direct examination, microscopic examination of blood smears, culture, serology, or polymerase chain reaction), and standardized biological tests were systematically performed. Among 175 patients retained for analysis, fever with nonspecific symptoms was predominant (46.9%), with 10 Plasmodium vivax malaria cases, 8 dengue infections, and 6 cases of Q fever. The second most frequent cause of acute febrile illness was upper respiratory tract infections (32.0%) due to influenza virus (n = 18) or human rhinovirus (n = 10). Among the causes of acute febrile illness in French Guiana, clinicians should first consider arboviruses and malaria, as well as Q fever in cases of elevated C-reactive protein with nonspecific symptoms and influenza in cases of signs and symptoms associated with upper respiratory tract infections. Despite an expanded microbiological search, the etiology of 51.4% of acute febrile illnesses remain unknown. Further investigations will be necessary to identify the etiology of acute febrile illnesses, including new pathogens, in French Guiana.
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Author Notes
Financial support: This research was funded by the
Disclosure: This study, referred to as “Etude descriptive prospective et étiologique des fièvres au sein de la communauté de défense des Forces Armées en Guyane – 2FAG,” was reviewed and approved by the institutional research ethics board, Comité de Protection des Personnes Ile-de-France VI Groupe Hospitalier Pitié-Salpêtrière, and was registered on March 28, 2017 under number RCB: 2016-A01607-44. Written informed consent was obtained from all participants.
Authors’ addresses: Guillaume Velut, Centre d’Epidémiologie et de Santé Publique des Armées, Marseille, France, E-mail: gvelut@wanadoo.fr. Franck de Laval, Centre d’Epidémiologie et de Santé Publique des Armées, Marseille, France, and Aix-Marseille Université, INSERM, Institut de Recherche pour le Développement, Economic and Social Sciences, Health Systems, and Medical Informatics, Marseille, France, E-mail: f_de_laval@hotmail.com. Morgane Berry, Centre Médical Interarmées de Cayenne, Cayenne, French Guiana, E-mail: morgane_berry@yahoo.fr. Frédérique Dufour Gaume, Centre Médical Interarmées de Kourou, Kourou, French Guiana, E-mail: frederique.dufour-gaume@intradef.gouv.fr. Nathalie André, Direction Interarmées du Service de Santé des Forces Armées en Guyane, Cayenne, French Guiana, E-mail: nathalie.andre@intradef.gouv.fr. Loïc Epelboin and Felix Djossou, Service des Maladies Infectieuses et Tropicales, et Centre d’Investigation Clinique (CIC INSERM 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana, E-mails: epelboincrh@hotmail.fr and felix.djossou@orange.fr. Anne Lavergne, Laboratoire des Interactions Virus-Hôtes, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana, E-mail: alavergne@pasteur-cayenne.fr. Antoine Enfissi and Dominique Rousset, Laboratoire de Virologie, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana, E-mails: aenfissi@pasteur-cayenne.fr and drousset@pasteur-cayenne.fr. Sébastien Briolant, Aix Marseille Université, Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Service de Santé des Armées, Vecteurs – Infections Tropicales et Méditerranéennes, Marseille, France, Institut Hospitalo-Universitaire – Méditerranée Infection, Marseille, France, and Unité de Parasitologie Entomologie, Département de Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, Marseille, France, E-mail: sbriolant@wanadoo.fr.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
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-
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-
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-
8.
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9.
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-
10.
Pommier de Santi V et al., 2016. Epidemiological and entomological studies of a malaria outbreak among French armed forces deployed at illegal gold mining sites reveal new aspects of the disease’s transmission in French Guiana. Malar J 15: 35.
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11.
Vezenegho SB , Adde A , Pommier de Santi V , Issaly J , Carinci R , Gaborit P , Dusfour I , Girod R , Briolant S , 2016. High malaria transmission in a forested malaria focus in French Guiana: how can exophagic Anopheles darlingi thwart vector control and prevention measures? Mem Inst Oswaldo Cruz 111: 561–569.
-
12.
Douine M , Sanna A , Hiwat H , Briolant S , Nacher M , Belleoud D , Le Tourneau FM , Bogreau H , De Laval F , 2019. Investigation of a possible malaria epidemic in an illegal gold mine in French Guiana: an original approach in the remote Amazonian forest. Malar J 18: 91.
-
13.
Mosnier E et al., 2020. Resurgence risk for malaria, and the characterization of a recent outbreak in an Amazonian border area between French Guiana and Brazil. BMC Infect Dis 20: 373.
-
14.
Carme B et al., 2002. Severe acquired toxoplasmosis in immunocompetent adult patients in French Guiana. J Clin Microbiol 40: 4037–4044.
-
15.
Blaizot R , Nabet C , Blanchet D , Martin E , Mercier A , Dardé M-L , Elenga N , Demar M , 2019. Pediatric Amazonian toxoplasmosis caused by atypical strains in French Guiana, 2002–2017. Pediatr Infect Dis J 38: e39–e42.
-
16.
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-
17.
Nabet C , Belzunce C , Blanchet D , Abboud P , Djossou F , Carme B , Aznar C , Demar M , 2018. Histoplasma capsulatum causing sinusitis: a case report in French Guiana and review of the literature. BMC Infect Dis 18: 595.
-
18.
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-
19.
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-
20.
Adde A , Roucou P , Mangeas M , Ardillon V , Desenclos J-C , Rousset D , Girod R , Briolant S , Quenel P , Flamand C , 2016. Predicting dengue fever outbreaks in French Guiana using climate indicators. PLoS Negl Trop Dis 10: e0004681.
-
21.
de Laval F , Matheus S , Maquart M , Yvrard E , Barthes N , Combes C , Rousset D , Leparc-Goffart I , Briolant S , 2016. Prospective Zika virus disease cohort: systematic screening. Lancet 388: 868.
-
22.
Bailly S et al., 2021. Spatial distribution and burden of emerging arboviruses in French Guiana. Viruses 13: 1299.
-
23.
Mutricy R et al., 2022. Mayaro virus infection in French Guiana, a cross sectional study 2003–2019. Infect Genet Evol 99: 105243.
-
24.
Mutricy R , Djossou F , Matheus S , Lorenzi-Martinez E , De Laval F , Demar M , Nacher M , Rousset D , Epelboin L , 2020. Discriminating tonate virus from dengue virus infection: a matched case-control study in French Guiana, 2003–2016. Am J Trop Med Hyg 102: 195–201.
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