Політична освіта як складова політичної соціалізації молоді

Політична освіта та виховання молоді є основою підвищення її політичної активності. Для досягнення відповідного рівня цієї активності необхідне світосприйняття, сформоване згідно з принципами демократії, національної ідеї, а також особиста зацікавленість молодої людини в прогресивному розвитку суспільства, її участь в суспільно політичній діяльності

Increased risk of chikungunya infection in travellers to Thailand during ongoing outbreak in tourist areas : cases imported to Europe and the Middle East, early 2019

We report nine travellers with confirmed chikungunya virus infection, returning from tourist areas of Thailand to Sweden, Switzerland, the United Kingdom, Romania, Israel and France, diagnosed in January and February 2019. These sentinel tourists support the intensification of chikungunya virus circulation in Thailand and highlight the potential for importation to areas at risk of local transmission

Coxiella burnetii : from culture to clinical manifestations

C. burnetii est une bactérie intracellulaire strcite. Récemment, un milieu axénique, nommé ACCM 2 a été développé, et permet la culture de cette bactérie en atmosphère microaérophile. Nous avons testé si l’ajout d’acide urique dans le milieu de culture pouvait permettre une culture en milieu aérobie. Nous avons observé une croissance de C. burnetii incubée en conditions aérobies dans le milieu ACCM2 enrichi en acide urique. A Cayenne, en Guyane Française, les pneumopathies causées par C. burnetii sont fréquentes et sévères. Nous avons analysé le génome d’une souche isolée à Cayenne. Ce travail a mis en évidence une délétion de 6105 pb intéressant le gène du système de sécrétion de type 1 (T1SS). Cette réduction de génome est probablement impliquée dans l’hypervirulence des souches de Cayenne. Enfin, nous avons testé la sensibilité aux antibiotiques de 6 souches isolées à partir de patients vivant à Cayenne. Ces souches étaient toutes sensibles à la doxycycline et résistantes aux macrolides. Dans une troisième partie nous avons analysé l’apport du TEP scanner dans le diagnostic des infections à C. burnetii. 167 patients atteints d’infections à C. burnetii ont bénéficié d’un TEP scanner. Nous avons retrouvé une proportion élevée de fixations ostéo-articulaires (21) et ganglionnaires (27), et nous avons proposé de nouvelles définitions pour ces localisations. Nous avons ensuite étudié l’impact du traitement chirurgical chez les patients atteints d’infections vasculaires. Une analyse rétrospective de 86 patients atteints d’infections vasculaires a montré que la chirurgie était associée à une diminution de la mortalité à 2,5 ans et à une meilleure évolution sérologiqueC. burnetii is an intracellular bacterium. Recently, an axenic medium, named ACCM 2, has been developed and allows the culture of this bacterium in a microaerophilic atmosphere. We tested if the addition of uric acid in the medium could allow an aerobic culture. We observed growth of C. burnetii incubated under aerobic conditions in the ACCM2 medium enriched with uric acid. In Cayenne, French Guiana, pneumonia caused by C. burnetii are frequent and severe. We analyzed the genome of a strain from Cayenne. This work revealed a 6105 bp deletion in the gene of the type 1 secretion system (T1SS). This genome reduction is probably involved in the hypervirulence of Cayenne strains. Finally, we tested the antibiotic suceptibility of 6 strains isolated from patients living in Cayenne. These strains were all susceptible to doxycycline and resistant to macrolides. In a third part we analyzed the contribution of PET scanner in the diagnosis of C. burnetii infections. 167 patients with C. burnetii infections benefited from a PET scan. We found a high proportion of osteo-articular (21) and lymphadenitis (27) fixations, and we proposed new definitions for these locations. We then investigated the impact of surgical treatment in patients with vascular infections. A retrospective analysis of 86 patients with vascular infections showed that surgery was associated with a lower mortality at 2.5 years and a better serological outcom

Rickettsioses as causes of CNS infection in southeast Asia

International audienceIn The Lancet Global Health, Sabine Dittrich and colleagues 1 report that scrub typhus caused by Orientia tsutsugamushi, murine typhus caused by Rickettsia typhi, and leptospirosis caused by various Leptospira species account for more than a third of CNS infections diagnosed over 8 years in Vientiane Hospital in Laos. The study is one more great contribution from this team in their investigation of undocumented syndromes, as well as in the public health challenge of rickettsial diseases in southeast Asia. The same investigators have previously reported that scrub typhus was the second most common microbial cause of fever of unknown origin in rural Laos (122 [15%] of 799 diagnosed cases). 2 In 2006, rickettsial infection was detected in 115 (27%) of 427 adults admitted to Vientiane Hospital for fever with negative blood culture. 3 The most common rickettsial agent was O tsutsugamushi followed by R typhi. Fewer data are available about the prevalence of these diseases in other southeast Asian countries. In Thailand, scrub and murine typhus has been reported 4 in 16% and 2%, respectively, of fever of unknown origin, with mortality of 3–17% for scrub typhus. Even if epidemiological data for the whole region are unavailable, the substantial presence of rickettsial infections is shown by frequent reports in travellers returning from this area. 5 Because ecotourism and adventure travel are increasingly popular, the incidence of tick-borne rickettsioses among travellers is likely to continue to increase. All patients with rickettsial infections reported by Dittrich and colleagues presented with fever at admission, and few patients presented with typical eschars of inoculation (only 3·6% of patients with murine typhus and 6·7% with scrub typhus). 1 This fi nding might be a result of poor awareness about pathognomonic signs of rickettsioses among clinicians rather than an absence of such disease. Rickettsioses are treatable but remain underestimated. Besides murine typhus and scrub typhus, tick-borne spotted fever group rickettsioses cause much fever of unknown origin in tropical countries. 6 R felis is one such rickettsia; it has been detected worldwide in arthropod hosts (mainly fl eas), with the cat fl ea Ctenocephalides felis the only confi rmed biological vector. A growing number of reports implicate R felis in human disease, particularly in the tropics. It has been detected in 3–4% of cases of fever of unknown origin in rural Mali 7 and Kenya, 8 and 6% of cases in rural Senegal. 7 R felis has also been detected in mosquitoes 7 and it is common in countries in Africa with high prevalences of malaria. 7 Cases of R felis infection in Thailand have also been reported. 9 Collaborations of investigators in the tropics combined with powerful diagnostic methods have increased the recognition of neglected pathogens in patients with acute undiff erentiated fever. However, when studying the causes of fever of unknown origin, inclusion of local negative controls is essential because the incidence of many pathogens in these regions is totally diff erent from their incidence in Europe, changing the predictive value of diagnostic tests. The lack of local negative controls causes false positives because of the commonness of asymptomatic forms of infectious diseases; therefore, European controls cannot be used to evaluate the specifi city of diagnostic techniques in tropical countries. Rickettsioses are severe diseases that can be fatal, yet in Dittrich and colleagues' study few patients with scrub and murine typhus received doxycycline (55% and 39%, respectively). 1 As a consequence, the use of an empirical doxycycline treatment for patients with fever of unknown origin should be discussed, especially when empirical treatment with β-lactams has failed or in cases with severe clinical presentation. Doxycycline is used for malaria prophylaxis in travellers. Only two prospective randomised studies 10 have shown the eff ectiveness of prophylactic doxycycline to prevent scrub typhus. Designing comparative studies to test the drug's eff ectiveness for preventing scrub typhus would be diffi cult. However, we propose that doxycycline be given as a priority for chemoprophylaxis against malaria in travellers to the tropics to thereby protect against rickettsioses and leptospirosis

[Rickettsioses].

International audienceRickettsioses. Rickettsioses are caused by intracellular bacteria from order of rickettsiales. They are transmitted by arthropods, mainly ticks, lice, fleas or other species close to chiggers, mainly in tropical areas. Some rickettsioses are endemic in France and others can be seen in patients returning from travel, including those presenting with "fever of unknown origin". Rickettsiae can't be isolated by conventional blood cultures in the laboratory. The diagnosis of rickettsial diseases is often made by serology, but specific PCR based on the swab of an inoculation eschar when it is present is a simple and rapid tool. The standard treatment for rickettsioses is doxycycline, that should be started as soon as clinical suspicion occurs, before diagnostic confirmation since some rickettsial diseases can be fatal

Update on Tick-Borne Bacterial Diseases in Travelers

International audiencePurpose of Review Ticks are the second most important vectors of infectious diseases after mosquitoes worldwide. The growth of international tourism including in rural and remote places increasingly exposes travelers to tick bite. Our aim was to review the main tick-borne infectious diseases reported in travelers in the past 5 years. Recent Findings In recent years, tick-borne bacterial diseases have emerged in travelers including spotted fever group (SFG) rickettsioses, borrelioses, and diseases caused by bacteria of the Anaplasmataceae family. Summary African tick-bite fever, due to Rickettsia africae, is the most frequent agent reported in travelers returned from Sub-Saharan areas. Other SFG agents are increasingly reported in travelers, and clinicians should be aware of them. Lyme disease can be misdiagnosed in Southern countries. Organisms causing tick-borne relapsing fever are neglected pathogens worldwide, and reports in travelers have allowed the description of new species. Infections due to Anaplasmataceae bacteria are more rarely described in travelers, but a new species of Neoehrlichia has recently been detected in a traveler. The treatment of these infections relies on doxycycline, and travelers should be informed before the trip about prevention measures against tick bites

Multiple itchy lesions after recent travel

International audienc

The contribution of genomics to the study of Q fever

International audienceCoxiella burnetii is the etiological agent of Q fever, a worldwide zoonosis that can result in large outbreaks. The birth of genomics and sequencing of C. burnetii strains has revolutionized many fields of study of this infection. Accurate genotyping methods and comparative genomic analysis have enabled description of the diversity of strains around the world and their link with pathogenicity. Genomics has also permitted the development of qPCR tools and axenic culture medium, facilitating the diagnosis of Q fever. Moreover, several pathophysiological mechanisms can now be predicted and therapeutic strategies can be determined thanks to in silico genome analysis. An extensive pan-genomic analysis will allow for a comprehensive view of the clonal diversity of C. burnetii and its link with virulence

[West Nile virus infection: an emerging arbovirosis in France and Europe].

International audienceWest nile virus infection: an emerging arbovirosis in france and europe. West Nile virus is a mosquito-borne flavivirus, transmitted to humans by mosquitoes of the genus Culex, from an avian reservoir. Humans are accidental hosts and there is no report of human-to-human transmission, except via blood transfusion or organ transplantation. In 2018, Europe experienced the largest outbreak of West Nile virus infection ever. In France, 27 cases were identified including 7 neuro invasive forms. This infection is asymptomatic in most cases but may also manifest as an isolated fever or flu-like syndrome. In about 1% of cases, neuro-invasive forms with meningitis, meningoencephalitis or flaccid paralysis can be observed. There is no specific treatment for this viral infection. Prevention is based on the prevention of mosquito bites, but also on enhanced epidemiological surveillance during the period of circulation of the virus in Europe (from spring to autumn)