A Large Outbreak of Thiamine Deficiency Among Illegal Gold Miners in French Guiana

Emilie Mosnier Pôle des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana, France.
Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université des Antilles et de la Guyane, Cayenne, French Guiana, France.
Unité de Maladies Infectieuses et Tropicales, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana, France.

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Florence Niemetzky Pôle des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana, France.

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Juliette Stroot Pôle des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana, France.

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Vincent Pommier de Santi Direction Inter-armées du Service de Santé en Guyane, Base de Défense de Guyane, Cayenne, French Guiana, France.

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Paul Brousse Pôle des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana, France.

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Basma Guarmit Pôle des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana, France.

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Denis Blanchet Laboratoire Hospitalo Universitaire de Parasitologie et Mycologie, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana, France.

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Muriel Ville Pôle des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana, France.

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Philippe Abboud Unité de Maladies Infectieuses et Tropicales, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana, France.

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Felix Djossou Unité de Maladies Infectieuses et Tropicales, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana, France.

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Mathieu Nacher Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université des Antilles et de la Guyane, Cayenne, French Guiana, France.
Centre d'Investigation Clinique Epidémiologie Clinique Antilles Guyane, Cayenne, French Guiana, France.

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From September 2013 to July 2014, several gold miners working in the tropical forest consulted the Maripasoula Health Center in French Guiana for edema and findings consistent with right-sided cardiac failure. Of the 42 cases of beriberi that were diagnosed, one patient died. The laboratory and clinical investigation demonstrated vitamin B1 deficiency in most of the patients tested. Furthermore, 30 of 42 patients responded favorably to 500 mg of intravenous or intramuscular thiamine supplementation. In addition, dietary investigation showed insufficient thiamine intake in these patients. We concluded that patients had acquired beriberi because of diet restrictions, hard labor, and infectious diseases, notably malaria. In 2016, cases were still being reported. We recommend screening for compatible symptoms in gold miners, thiamine supplementation, and nutritional intervention.

Author Notes

* Address correspondence to Emilie Mosnier, Pôle des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier Andrée Rosemon, Rue des Flamboyants, Cayenne 97306, French Guiana, France, E-mail: emilie.mosnier@ch-cayenne.fr or Mathieu Nacher, Centre d'Investigation Clinique Epidémiologie Clinique Antilles Guyane (CIC INSERM 1424), Centre Hospitalier Andrée Rosemon, Rue des Flamboyants, Cayenne 97306, French Guiana, France, E-mail: mathieu.nacher@ch-cayenne.fr.

Authors' addresses: Emilie Mosnier, Unité de Maladie Infectieuses et Tropicales, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana, France, E-mail: emilie.mosnier@gmail.com. Florence Niemetzky, Juliette Stroot, Paul Brousse, Basma Guarmit, and Muriel Ville, Departement des Centres de Santé, Centre Hospitalier de Cayenne, Cayenne, French Guiana, France, E-mails: florenceniem@gmail.com, juliette1046@hotmail.com, paul.brousse@ch-cayenne.fr, basma.guarmit@ch-cayenne.fr, and muriel.ville@ch-cayenne.fr. Vincent Pommier de Santi, Direction Inter-armées du Service de Santé des Armées (Diass), Cayenne, French Guiana, France, E-mail: vincent.pommierdesanti@gmail.com. Denis Blanchet, Laboratoire Hospitalo Universitaire de Parasitologie et Mycologie, Centre hospitalier de Cayenne, Cayenne, French Guiana, France, E-mail: denis.blanchet@ch-cayenne.fr. Philippe Abboud and Felix Djossou, Department of Infectious and Tropical Diseases, Cayenne General Hospital, Cayenne, French Guiana, France, E-mails: philippe.abboud@ch-cayenne.fr and felix.djossou@ch-cayenne.fr. Mathieu Nacher, Epidémiologie des Parasitoses et Mycoses Tropicales (EPAT), Université des Antilles et de la Guyane, Cayenne, French Guiana, France, Centre d'Investigation Clinique Epidémiologie Clinique Antilles Guyane (CIC-EC INSERM CIE 802), Cayenne General Hospital, Cayenne, French Guiana, France, E-mail: mathieu.nacher@ch-cayenne.fr.

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