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Henry K, Mayet A, Hernandez M, et al. Outbreak of Cutaneous Leishmaniasis among military personnel in French Guiana, 2020: Clinical, phylogenetic, individual and environmental aspects. PLoS Negl Trop Dis. 2021;15(11):e0009938doi: 10.1371/journal.pntd.0009938.
Henry, K., Mayet, A., Hernandez, M., Frechard, G., Blanc, P. A., Schmitt, M., André, N., Loreau, J. M., Ginouves, M., Prévot, G., Couppié, P., Demar, M., & Blaizot, R. (2021). Outbreak of Cutaneous Leishmaniasis among military personnel in French Guiana, 2020: Clinical, phylogenetic, individual and environmental aspects. PLoS neglected tropical diseases, 15(11), e0009938. https://doi.org/10.1371/journal.pntd.0009938
Henry, Kim, et al. "Outbreak of Cutaneous Leishmaniasis among military personnel in French Guiana, 2020: Clinical, phylogenetic, individual and environmental aspects." PLoS neglected tropical diseases vol. 15,11 (2021): e0009938. doi: https://doi.org/10.1371/journal.pntd.0009938
Henry K, Mayet A, Hernandez M, Frechard G, Blanc PA, Schmitt M, André N, Loreau JM, Ginouves M, Prévot G, Couppié P, Demar M, Blaizot R. Outbreak of Cutaneous Leishmaniasis among military personnel in French Guiana, 2020: Clinical, phylogenetic, individual and environmental aspects. PLoS Negl Trop Dis. 2021 Nov 19;15(11):e0009938. doi: 10.1371/journal.pntd.0009938. eCollection 2021 Nov. PMID: 34797836; PMCID: PMC8641862.
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PLoS Negl Trop Dis. 2021 Nov 19;15(11):e0009938. doi: 10.1371/journal.pntd.0009938. eCollection 2021 Nov.

Outbreak of Cutaneous Leishmaniasis among military personnel in French Guiana, 2020: Clinical, phylogenetic, individual and environmental aspects.

PLoS neglected tropical diseases

Kim Henry, Aurélie Mayet, Miguel Hernandez, Guillaume Frechard, Pierre-Antoine Blanc, Marion Schmitt, Nathalie André, Jean-Marie Loreau, Marine Ginouves, Ghislaine Prévot, Pierre Couppié, Magalie Demar, Romain Blaizot

Affiliations

  1. Laboratory of Parasitology-Mycology, Centre Hospitalier de Cayenne, Cayenne, French Guiana.
  2. French Military Health Service-Armed Forces Epidemiology and Public Health Center, Marseille, France.
  3. Aix Marseille University, INSERM, IRD, SESSTIM, Economic and Social Sciences of Health and Medical Information Processing, Marseille, France.
  4. National Reference Center for Leishmaniasis, associate laboratory, Cayenne, French Guiana.
  5. French Military Health Service-Kourou Medical Center, Kourou, French Guiana.
  6. French Military Health Service-Cayenne Medical Center, Cayenne, French Guiana.
  7. French Military Health Service-Inter Army Directorate of the Armed Forces Health Service, Cayenne, French Guiana.
  8. UMR 1019 Tropical Biomes and Immuno-Physiopathology, University of French Guiana, Cayenne, French Guiana.
  9. Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019-UMR 9017-CIIL-Center for Infection and Immunity of Lille, Lille, France.
  10. Dermatology Department, Centre Hospitalier de Cayenne, Cayenne, French Guiana.

PMID: 34797836 PMCID: PMC8641862 DOI: 10.1371/journal.pntd.0009938

Abstract

BACKGROUND: Cutaneous Leishmaniasis (CL) is endemic in French Guiana but cases are usually sporadic. An outbreak signal was issued on May 15th 2020 with 15 suspected cases after a military training course in the rainforest. An outbreak investigation was carried out.

METHODOLOGY/PRINCIPAL FINDINGS: Thirty cases were confirmed. Leishmania guyanensis was the most frequent species (90%). The most frequent presentation was ulcerative (90%). Lesions on the face and hands were frequent (40% each). Eight cases (26%) presented a poor outcome after treatment with pentamidine and required a second line with amphotericin B. Three of them required further treatments with meglumine antimoniate or miltefosine. Two spots within the training area were deemed as likely sites of contamination, due to illegal logging. The isolated Leishmania strains did not form a separate cluster. Participation in Week 13 of year 2020 was associated with infection (OR = 4.59 [1.10-19.83]; p = 0.016) while undergoing only the "Fighting" exercise was protective (OR = 0.1 [0-0.74]; p = 0.021). There was no association between infection and other risk factors at the individual level. The attack rate of Regiment B (14/105 = 13.3%) was significantly higher (OR = 4.22 [1.84-9.53], p = 0.0001) compared to Regiment A (16/507 = 3.2%). The attack rate during this training course (30/858 = 3.5%) was significantly higher (OR 2.29 [1.28-4.13]; p = 0.002) than for other missions in French Guiana during the same period (22/1427 = 1.5%).

CONCLUSIONS: This outbreak could be explained by a combination of factors: climatic conditions around week 13, at-risk activities including night trainings, absence of impregnation, a lesser experience of rainforest duties in Regiment B and illegal logging attracting sandflies on military training grounds.

Conflict of interest statement

The authors have declared that no competing interests exist.

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