Real-Time Assessment of Health-Care Requirements During the Zika Virus Epidemic in Martinique.

The spread of Zika virus in the Americas has been associated with a surge in Guillain-Barré syndrome (GBS) cases. Given the severity of GBS, territories affected by Zika virus need to plan health-care resources to manage GBS patients. To inform such planning in Martinique, we analyzed Zika virus surveillance and GBS data from Martinique in real time with a modeling framework that captured dynamics of the Zika virus epidemic, the risk of GBS in Zika virus-infected persons, and the clinical management of GBS cases. We compared our estimates with those from the 2013-2014 Zika virus epidemic in French Polynesia. We were able to predict just a few weeks into the epidemic that, due to lower transmission potential and lower probability of developing GBS following infection in Martinique, the total number of GBS cases in Martinique would be substantially lower than suggested by simple extrapolations from French Polynesia. We correctly predicted that 8 intensive-care beds and 7 ventilators would be sufficient to treat GBS cases. This study showcased the contribution of modeling to inform local health-care planning during an outbreak. Timely studies that estimate the proportion of infected persons that seek care are needed to improve the predictive power of such approaches

Recent Emergence of Dengue Virus Serotype 4 in French Polynesia Results from Multiple Introductions from Other South Pacific Islands

BACKGROUND: Infection by dengue virus (DENV) is a major public health concern in hundreds of tropical and subtropical countries. French Polynesia (FP) regularly experiences epidemics that initiate, or are consecutive to, DENV circulation in other South Pacific Island Countries (SPICs). In January 2009, after a decade of serotype 1 (DENV-1) circulation, the first cases of DENV-4 infection were reported in FP. Two months later a new epidemic emerged, occurring about 20 years after the previous circulation of DENV-4 in FP. In this study, we investigated the epidemiological and molecular characteristics of the introduction, spread and genetic microevolution of DENV-4 in FP. METHODOLOGY/PRINCIPAL FINDINGS: Epidemiological data suggested that recent transmission of DENV-4 in FP started in the Leeward Islands and this serotype quickly displaced DENV-1 throughout FP. Phylogenetic analyses of the nucleotide sequences of the envelope (E) gene of 64 DENV-4 strains collected in FP in the 1980s and in 2009-2010, and some additional strains from other SPICs showed that DENV-4 strains from the SPICs were distributed into genotypes IIa and IIb. Recent FP strains were distributed into two clusters, each comprising viruses from other but distinct SPICs, suggesting that emergence of DENV-4 in FP in 2009 resulted from multiple introductions. Otherwise, we observed that almost all strains collected in the SPICs in the 1980s exhibit an amino acid (aa) substitution V287I within domain I of the E protein, and all recent South Pacific strains exhibit a T365I substitution within domain III. CONCLUSIONS/SIGNIFICANCE: This study confirmed the cyclic re-emergence and displacement of DENV serotypes in FP. Otherwise, our results showed that specific aa substitutions on the E protein were present on all DENV-4 strains circulating in SPICs. These substitutions probably acquired and subsequently conserved could reflect a founder effect to be associated with epidemiological, geographical, eco-biological and social specificities in SPICs

Factors associated with excessively lengthy treatment of tuberculosis in the eastern Paris region of France in 2004.

International audienceOne-third of TB patients received excessively long treatment, reflecting inadequate awareness of management guidelines or unwillingness to implement them

Infant hypothyroidism as the first manifestation of pseudohypoparathyroidism type Ia

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Infant Primary Hypothyroidism as the First Manifestation of Pseudohypoparathyroidism Type 1a.

We report two boys in whom pseudohypoparathyroidism (PHP) type 1a was diagnosed at 3 and 2.5 years of age. Mild primary hypothyroidism was diagnosed prior to PHP, at the age of 1 and 15 months respectively Neonatal thyroid screening had been normal in both boys. One of them did not have the clinical features of Albright hereditary osteodystrophy (AHO) and had a severe hypocalcemia with increased serum intact parathyroid hormone (PTH) and PTH insensitivity. He had a chromosomal translocation 2; 18. The other child had several characteristics of AHO, a mild hypocalcemia and increased serum intact PTH and PTH insensitivity. He also had a nose hypoplasia which could suggest associated acrodysostosis. Both children had a decreased activity of the stimulatory guanine nucleotide-binding protein (Gs) of adenylate cyclase; only the first one had a decreased biological PTH activity in the renal cytochemical bioassay. In conclusion, although neonatal thyroid screening may be normal, hypothyroidism may develop in infancy as the first manifestation of the PHP type la. These two cases also illustrate the heterogeneity of the PHP type 1a syndrome. © 1995, The Japanese Society for Pediatric Endocrinology. All rights reserved.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

S1 Dataset for "Transmission Dynamics of Zika Virus in Island Populations: A Modelling Analysis of the 2013–14 French Polynesia Outbreak"

Raw data used for the analysis performed in the accompanying paper. Dataset contains number of suspected cases, number of sentinel sites reporting, and proportion of total sentinel sites reporting (i.e. κt) in each week for each of the six regions