Etiology of Acute Febrile Illnesses in Adults in the Defense Community in French Guiana

Guillaume Velut Centre d’Epidémiologie et de Santé Publique des Armées, Marseille, France;

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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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Morgane Berry Centre Médical Interarmées de Cayenne, Cayenne, French Guiana;

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Frédérique Dufour Gaume Centre Médical Interarmées de Kourou, Kourou, French Guiana;

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Nathalie André Direction Interarmées du Service de Santé des Forces Armées en Guyane, Cayenne, French Guiana;

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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 Laboratoire des Interactions Virus-Hôtes, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana;

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Antoine Enfissi Laboratoire de Virologie, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana;

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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 Laboratoire de Virologie, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana;

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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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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 Direction Centrale du Service de Santé des Armées under grant number 2015PPRC14. The funding sources of this study had no role in protocol and study design, data collection, analysis, or data interpretation.

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.

Address correspondence to Sébastien Briolant, Aile Recherche, Bureau 206, UPE-IRBA-SSA, IHU–Méditerranée Infection, 19-21 Blvd. Jean Moulin, 13005 Marseille, France. E-mail: sbriolant@wanadoo.fr
  • 1.

    Crump JA , Kirk MD , 2015. Estimating the burden of febrile illnesses. PLoS Negl Trop Dis 9: e0004040.

  • 2.

    Kirk MD et al., 2015. World Health Organization estimates of the global and regional disease burden of 22 foodborne bacterial, protozoal, and viral diseases, 2010: a data synthesis. PLoS Med 12: e1001921.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Moreira J , Bressan CS , Brasil P , Siqueira AM , 2018. Epidemiology of acute febrile illness in Latin America. Clin Microbiol Infect 24: 827835.

  • 4.

    Prasad N , Murdoch DR , Reyburn H , Crump JA , 2015. Etiology of severe febrile illness in low- and middle-income countries: a systematic review. PLoS One 10: e0127962.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Maze MJ , Bassat Q , Feasey NA , Mandomando I , Musicha P , Crump JA , 2018. The epidemiology of febrile illness in sub-Saharan Africa: implications for diagnosis and management. Clin Microbiol Infect 24: 808814.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    INSEE Estimation de la Population au 1er Janvier 2023. Available at: https://www.insee.fr/fr/statistiques/1893198. Accessed January 26, 2023.

    • PubMed
    • Export Citation
  • 7.

    Musset L , Pelleau S , Girod R , Ardillon V , Carvalho L , Dusfour I , Gomes MSM , Djossou F , Legrand E , 2014. Malaria on the Guiana Shield: a review of the situation in French Guiana. Mem Inst Oswaldo Cruz 109: 525533.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Pommier de Santi V et al., 2016. Malaria in French Guiana linked to illegal gold mining. Emerg Infect Dis 22: 344346.

  • 9.

    Pommier de Santi V et al., 2016. Malaria hyperendemicity and risk for artemisinin resistance among illegal gold miners, French Guiana. Emerg Infect Dis 22: 903906.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 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.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 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: 561569.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 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.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 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.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Carme B et al., 2002. Severe acquired toxoplasmosis in immunocompetent adult patients in French Guiana. J Clin Microbiol 40: 40374044.

  • 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: e39e42.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Barthes N , Morin F , Pommier de Santi V , Briolant S , 2017. Lung nodule in French Guiana in a immunocompetent patient. Med Sante Trop 27: 2628.

  • 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.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Couppié P et al., 2019. The broad clinical spectrum of disseminated histoplasmosis in HIV-infected patients: a 30 years’ experience in French Guiana. J Fungi (Basel) 5: E115.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Sanna A , Andrieu A , Carvalho L , Mayence C , Tabard P , Hachouf M , Cazaux C-M , Enfissi A , Rousset D , Kallel H , 2018. Yellow fever cases in French Guiana, evidence of an active circulation in the Guiana Shield, 2017 and 2018. Euro Surveill 23: 1800471.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 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.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 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.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 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: 195201.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Mahamat A , Dussart P , Bouix A , Carvalho L , Eltges F , Matheus S , Miller MA , Quenel P , Viboud C , 2013. Climatic drivers of seasonal influenza epidemics in French Guiana, 2006–2010. J Infect 67: 141147.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Edouard S , Mahamat A , Demar M , Abboud P , Djossou F , Raoult D , 2014. Comparison between emerging Q fever in French Guiana and endemic Q fever in Marseille, France. Am J Trop Med Hyg 90: 915919.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Eldin C , Mahamat A , Demar M , Abboud P , Djossou F , Raoult D , 2014. Q fever in French Guiana. Am J Trop Med Hyg 91: 771776.

  • 28.

    Epelboin L , Chesnais C , Boullé C , Drogoul A-S , Raoult D , Djossou F , Mahamat A , 2012. Q fever pneumonia in French Guiana: prevalence, risk factors, and prognostic score. Clin Infect Dis 55: 6774.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Thill P , Eldin C , Dahuron L , Berlioz-Artaud A , Demar M , Nacher M , Beillard E , Djossou F , Epelboin L , 2022. High endemicity of Q fever in French Guiana: a cross sectional study (2007–2017). PLoS Negl Trop Dis 16: e0010349.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Le Turnier P et al., 2018. Epidemiology of human leptospirosis in French Guiana (2007–2014): a retrospective study. Am J Trop Med Hyg 99: 590596.

  • 31.

    Mosnier E et al., 2015. Épidémies multiples dans des camps d’orpaillage en forêt amazonienne (Guyane française) en 2013 : quelles leçons pour l’accès aux soins et à la prévention? Bull Epidémiol Hebd11–12: 181189.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    de Thoisy B et al., 2021. Ecology, evolution, and epidemiology of zoonotic and vector-borne infectious diseases in French Guiana: transdisciplinarity does matter to tackle new emerging threats. Infect Genet Evol 93: 104916.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    de Lavaissiere M , D’Ortenzio E , Dussart P , Fontanella JM , Djossou F , Carme B , Marchou B , 2008. Febrile illness at the emergency department of Cayenne Hospital, French Guiana. Trans R Soc Trop Med Hyg 102: 10551057.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Hayden FG et al., 2003. Efficacy and safety of oral pleconaril for treatment of colds due to picornaviruses in adults: results of 2 double-blind, randomized, placebo-controlled trials. Clin Infect Dis 36: 15231532.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    World Health Organization , 2021. WHO Information for the Molecular Detection of Influenza Viruses in Humans. Available at: https://cdn.who.int/media/docs/default-source/influenza/molecular-detention-of-influenza-viruses/protocols_influenza_virus_detection_feb_2021.pdf?sfvrsn=df7d268a_5. Accessed March 5, 2023.

    • PubMed
    • Export Citation
  • 36.

    Santiago GA , Vergne E , Quiles Y , Cosme J , Vazquez J , Medina JF , Medina F , Colón C , Margolis H , Muñoz-Jordán JL , 2013. Analytical and clinical performance of the CDC real time RT-PCR assay for detection and typing of dengue virus. PLoS Negl Trop Dis 7: e2311.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    Panning M , Grywna K , van Esbroeck M , Emmerich P , Drosten C , 2008. Chikungunya fever in travelers returning to Europe from the Indian Ocean region, 2006. Emerg Infect Dis 14: 416422.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    Lambert V , Enfissi A , Lefebvre M , Pomar L , Kedous S , Guimiot F , Carles G , Lavergne A , Rousset D , Hcini N , 2022. Tonate virus and fetal abnormalities, French Guiana, 2019. Emerg Infect Dis 28: 445448.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39.

    Naveca FG , do Nascimento VA , de Souza VC , Nunes BTD , Rodrigues DSG , Vasconcelos PFDC , 2017. Multiplexed reverse transcription real-time polymerase chain reaction for simultaneous detection of Mayaro, Oropouche, and Oropouche-like viruses. Mem Inst Oswaldo Cruz 112: 510513.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 40.

    Mutricy R et al., 2022. Mayaro virus infection in French Guiana, a cross sectional study 2003–2019. Infect Genet Evol 99: 105243.

  • 41.

    Lorenzi OD et al., 2013. Acute febrile illness surveillance in a tertiary hospital emergency department: comparison of influenza and dengue virus infections. Am J Trop Med Hyg 88: 472480.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 42.

    Manock SR et al., 2009. Etiology of acute undifferentiated febrile illness in the Amazon basin of Ecuador. Am J Trop Med Hyg 81: 146151.

  • 43.

    Forshey BM et al., 2010. Arboviral etiologies of acute febrile illnesses in Western South America, 2000–2007. PLoS Negl Trop Dis 4: e787.

  • 44.

    Mosnier E et al., 2020. Prevalence of Plasmodium spp. in the Amazonian border context (French Guiana-Brazil): associated factors and spatial distribution. Am J Trop Med Hyg 102: 130141.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 45.

    Douine M et al., 2021. Self-diagnosis and self-treatment of malaria in hard-to-reach and mobile populations of the Amazon: results of Malakit, an international multicentric intervention research project. Lancet Reg Health 4: 100047.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 46.

    Scully J et al., 2021. Spatio-temporal dynamics of Plasmodium falciparum and Plasmodium vivax in French Guiana: 2005–2019. Int J Environ Res Public Health 18: 1077.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 47.

    Takafuji ET , Kirkpatrick JW , Miller RN , Karwacki JJ , Kelley PW , Gray MR , McNeill KM , Timboe HL , Kane RE , Sanchez JL , 1984. An efficacy trial of doxycycline chemoprophylaxis against leptospirosis. N Engl J Med 310: 497500.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 48.

    About F et al., 2023. Novel species of Brucella causing human brucellosis, French Guiana. Emerg Infect Dis 29: 333340.

  • 49.

    Binetruy F , Buysse M , Barosi R , Duron O , 2020. Novel Rickettsia genotypes in ticks in French Guiana, South America. Sci Rep 10: 2537.

  • 50.

    Sakzabre D , Asiamah EA , Akorsu EE , Abaka-Yawson A , Dika ND , Kwasie DA , Ativi E , Tseyiboe C , Osei GY , 2020. Haematological profile of adults with malaria parasitaemia visiting the Volta Regional Hospital, Ghana. Adv Hematol 2020: 9369758.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 51.

    Epelboin L , Boullé C , Ouar-Epelboin S , Hanf M , Dussart P , Djossou F , Nacher M , Carme B , 2013. Discriminating malaria from dengue fever in endemic areas: clinical and biological criteria, prognostic score and utility of the C-reactive protein: a retrospective matched-pair study in French Guiana. PLoS Negl Trop Dis 7: e2420.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 52.

    Kalabamu FS , Maliki S , 2021. Use of haematological changes as a predictor of dengue infection among suspected cases at Kairuki Hospital in Dar Es Salaam, Tanzania: a retrospective cross sectional study. East Afr Health Res J 5: 9198.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 53.

    Lin I-F , Lin J-N , Tsai C-T , Wu Y-Y , Chen Y-H , Lai C-H , 2020. Serum C-reactive protein and procalcitonin values in acute Q fever, scrub typhus, and murine typhus. BMC Infect Dis 20: 334.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 54.

    Le Turnier P , Bonifay S , Mosnier E , Schaub R , Jollivet A , Demar M , Bourhy P , Nacher M , Djossou F , Epelboin L , 2019. Usefulness of C-reactive protein in differentiating acute leptospirosis and dengue fever in French Guiana. Open Forum Infect Dis 6: ofz323.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 55.

    da Costa Souza L , Bello EJM , Dos Santos EM , Nagata T , 2021. Molecular and clinical characteristics related to rhinovirus infection in Brasília, Brazil. Braz J Microbiol 52: 289298.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 56.

    Milligan R , Paul M , Richardson M , Neuberger A , 2018. Vaccines for preventing typhoid fever. Cochrane Database Syst Rev 5: CD001261.

  • 57.

    Massicard M , Drak Alsibai K , Nacher M , Sabbah N , 2022. Nutritional and socioeconomic determinants of overweight and obesity in the French Amazon: the Health Barometer Study. Front Endocrinol 13: 849718.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 58.

    Sabbah N , Massicard M , Mathieu N , 2022. Specificities of the diabetic population in French Guiana: the Health Barometer Survey. Curr Diabetes Rev 18: e012821190876.

    • PubMed
    • Search Google Scholar
    • Export Citation
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