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[Chikungunya virus: its recent spread to the southern Indian Ocean and Reunion Island (2005-2006)].

Chikungunya virus (alphavirus, Togaviridae) is transmitted by mosquitoes of the Aedes genus and responsible for a dengue-like acute disease characterized by severe arthralgias sometimes persisting during months and eventually years. Its geographical distribution is large, including west, central, east and southern tropical Africa, India and South-eastern Asia. Since 2005 february, Chikungunya disease invaded a number of islands in southern Indian Ocean, namely Comoro, Mauritius, Seychelles and Reunion islands. In this French department, it was responsible for 110000 to 200000 infections, neurological disorders, many deaths and some congenital infections not previously observed during preceding epidemics.

Alphavirus Infections↗

Infectivity of Echinostoma friedi miracidia to different snail species under experimental conditions.

The infectivity of Echinostoma friedi (Trematoda: Echinostomatidae) miracidia was studied experimentally in a range of laboratory-reared snails that coexist in the same natural locality, namely Radix peregra, Lymnaea fuscus, L. truncatula (Lymnaeidae), Gyraulus chinensis, Helisoma duryi (Planorbidae) and Physella acuta (Physidae), and snails from different geographical origins acting naturally or experimentally as intermediate hosts of Schistosoma spp., namely Planorbarius metidjensis (from Málaga, Spain), Biomphalaria glabrata (Guadeloupe), B. alexandrina (Egypt) (Planorbidae), Bulinus cernicus (Mauritius), B. globosus (Zambia), B. natalensis (South Africa) and B. truncatus (Niger) (Bulinidae). Six species of snails were found to be susceptible, with the rate of infection ranging from 0 to 36.7%. The highest infection was detected in R. peregra. The low host specificity of E. friedi might have an epidemiological significance as a requisite for a recent establishment in a new geographical area.

Animals↗

Demonstration projects for the integrated prevention and control of noncommunicable diseases (INTERHEALTH programme): epidemiological background and rationale. INTERHEALTH Sterring Committee.

Noncommunicable diseases--cardiovascular and cerebrovascular disease, pulmonary diseases, liver disease, cancer, diabetes, osteoporosis and trauma--constitute the major cause of death in developed countries and are predictably emerging as significant threats to health in countries at intermediate stages of the epidemiological transition. Based on the philosophy that diseases with common risk factors (inadequate prevention/control services, smoking, fat/salt diet, alcohol use, etc.) require common preventive strategies, the INTERHEALTH demonstration projects are designed to build regional capacities and to exchange social and medical technologies for broad-gauged noncommunicable disease prevention and control. Projects are at various stages of planning and implementation in all WHO regions: Africa (Mauritius, United Republic of Tanzania); the Americas (Chile, Cuba, United States); Eastern Mediterranean (Cyprus); Europe (Finland, Malta, USSR); South-East Asia (Sri Lanka, Thailand); the Western Pacific (Australia, China, Fiji, Japan). This article presents selected data which illustrate the long-term mortality trends and present noncommunicable disease risk-factor levels in participating countries at different stages of the epidemiological transition. The shift towards noncommunicable diseases as a cause of death is readily apparent and combinations of risk factors are present in each of the populations studied in the baseline phase of this research and demonstration programme. The use of data to estimate the noncommunicable disease-related mortality burden from different lifestyles and risk factors is illustrated and findings from the most advanced demonstration studies are briefly outlined.

Global Health↗

The historical background and global importance of heartwater.

The first written record of what probably could have been heartwater originates from South Africa and dates back to 1838. Since then, the disease was described from almost all the African countries south of the Sahara as well as from Madagascar, São Tome, Reunion, Mauritius and a number of islands in the Caribbean. Most research on the disease, at least until recently, was conducted in South Africa. Progress in research was slow but a few outstanding findings are mentioned in this paper. Despite inadequate information on its actual economic impact on livestock production, it is generally accepted that heartwater is either the most or second most important tick-borne disease in Africa. Depending on the area, heartwater ranks either second or third amongst diseases such as East Coast fever, tsetse-transmitted trypanosomiasis, rinderpest and perhaps also schistosomiasis. Heartwater is a major obstacle with regard to the introduction of highly producing animals intended for the upgrading of local breeds. Furthermore, it remains a major threat to areas such as the American mainland, where potential vectors are present but where the disease does not occur.

Animals↗

The tick vectors of Cowdria ruminantium (Ixodoidea, Ixodidae, genus Amblyomma) and their distribution.

Twelve species of Amblyomma are presently known to be capable of transmitting Cowdria ruminantium. Of these A. variegatum is the most important and widely distributed vector in Africa. It has also extended its range considerably outside this continent, eastward to the Yemen Arab Republic and to the islands of Madagascar, Réunion and Mauritius, and westward to the Cape Verde islands and to some of the West Indian islands. A. hebraeum is probably the only field vector in most parts of southern Africa. A 3rd species, A. lepidum, is known to have been involved in field outbreaks of heartwater in the Sudan. Two other species are also currently regarded as field vectors of Cowdria: A. astrion on the islands of São Tomé and Principe, and A. pomposum in Angola. Another 5 African species (A. cohaerens, A. gemma, A. tholloni, A. sparsum and A. marmoreum) have proved to be capable of transmitting heartwater in the laboratory, as have 2 American species (A. maculatum and A. cajennense), but none of these ticks have been implicated in field outbreaks of the disease.

Africa↗

Genetics of Aedes albopictus.

Aedes albopictus is an important vector of dengue fever and dengue hemorrhagic fever in Southeast Asia. Its distribution extends from Madagascar to Hawaii and is currently expanding. From its proposed origin in Southeast Asia, Ae. albopictus has migrated as far as Mauritius and Madagascar to the west and Korea, Japan, Guam, Hawaii and other Pacific Islands to the east. In the continental United States, it was originally reported in the Texas area in August 1985 and is now well established in several states. This paper reviews information on distribution, cytology and genetics of Aedes albopictus. In addition, it includes comments on its competitive interaction with several other species. Relevant information on evolutionary genetics of certain other related sibling species is also included for comparative purposes.

Aedes↗

A consideration of economic impact of schistosomiasis.

An attempt is made to estimate the economic effects of schistosomiasis, a disease known to be endemic in 71 countries or islands with a total population of about 1 362 million persons, of whom approximately 124 905 800 are infected. These data are based on prevalence rates representing, for the most part, single stool or urine examinations; the actual number of cases is undoubtedly much greater. This analysis refers only to resource loss attributable to reduced productivity. The annual loss from complete and partial disability is estimated to be US $445 866 945 in Africa, US $755 480 in Mauritius, US $16 527 275 in South-West Asia, US $118 143 675 in South-East Asia, and US $60 496 755 for the Americas. The total estimated annual world loss amounts to US $641 790 130 but this sum does not include the cost of public health programmes, medical care, or compensation for illness.

Africa↗

[Cardiovascular mortality in industrial and developing countries (author's transl)].

In developing countries when causes of death are registered cardiovascular mortality levels revealed themselves surprising. For instance, they appear to be more important in Tebessa (Algeria) during 1974-1975, Mauritius (1973-1976) or Egypt (1971-1973) than in france, United States or Sweden before the age of 45 and very near after this age. These results are consistent with the mortality patterns by causes of death proposed by Preston according to life expectancy at birth. Before the age of 45, rheumatic heart diseases can explain this overmortality. After this age the recent observations in the Third-World, especially in Africa, show that cardiomyopathy, cardiomegaly and principally hypertension are widely spread to-day. On the other hand, ischemic heart diseases are still rare. For many authors, cardiovascular diseases are increasing in Africa because ways of life in developing and developed countries are becoming identical. In fact, this trend could be a little artificial. Formerly indeed, disparity in population age structures and mortality differences for all other causes were not enough taken into account.

Adolescent↗

Is Planorbarius metidjensis compatible with Schistosoma haematobium and S. bovis?

On the basis of laboratory snail infection experiments it is concluded that Planorbarius metidjensis is unimportant in the epidemiology of Schistosoma haematobium in North West Africa. 410 P. metidjensis Spain were exposed to 8 isolates of S. haematobium from Ghana, Kenya, Madagascar, Mauritius, Morocco, Tanzania, South Africa and Sudan. 50 P. metidjensis Morocco and 50 P. metidjensis Algarve were exposed to S. haematobium Morocco. All infections failed to develop to maturity. Serial sections of P. metidjensis Morocco infected with S. haematobium Morocco at 24 h, 48 h and 72 h post infection showed that 34% of the miracidia penetrated the snail epithelium, but young sporocysts were encapsulated and killed by an ameobocytic host response. Two hypotheses are postulated to explain the reports in the literature that P. metidjensis transmits S. haematobium. The dual infectivity of B. truncatus and B. africanus by S. haematobium from Guinea Bissau suggests that this isolate is probably an infraspecific hybrid with enhanced intermediate host infectivity. By analogy with work on Biomphalaria glabrata and S. mansoni, field observations of P. metidjensis transmitting S. haematobium could be explained if the snail had been previously infected with a compatible digenean, thus rendering a refractory snail into a susceptible snail. S. bovis Spain is compatible with P. metidjensis Morocco, Portugal and Spain with 14.3%, 29.2% and 73.3% of the snails respectively surviving the prepatent period becoming infected. P. metidjensis Spain is refractory to S. bovis Iran and Sudan. Thus, P. metidjensis may be important in the epidemiology of S. bovis in the Iberian Peninsula and North West Africa.

Animals↗

[Presence of Angiostrongylus cantonensis at la Réunion].

The eosinophilic meningitis due to Angiostrongylus cantonensis is well known on Madagascar and on Mauritius Island, but was never described on Reunion Island. Two cases have been lately oberved in Doctor Jay's department at Gabriel Martin's hospital. Local achatines were dissected and contained larvae which, when absorbed by rats, were found in there brains ten days later. These larvae belong certainly to Angiostrongylus genus, but the species has not yet been found with certitude. Lately infested rats are passing through the normal laps of time for adult maturation until they will be sacrified for further examinations.

Adult↗

The role of forensic dentistry in South Africa.

Forensic dentistry has become an integral part of forensic medicine over the past 100 years. This has been due to the dedication of people like Amoedo, Gustafson, Sognaes, Keiser-Nielsen and Suzuki, to name but a few. They established the essential role which forensic dentistry plays mainly in the identification of human remains. Dental hard tissues are extremely resistant to fire and are usually the only remains after an extended period of burial. If antemortem dental records are available for an individual then dental identification is as certain as those of fingerprints. In South Africa forensic dentistry had its beginning in 1969 during the Windhoek air disaster. Since then there have been several cases of interest throughout the country, one of which was the crash of the Helderberg off the coast of Mauritius. Other aspects of forensic dentistry are the examination of bite marks and the recognition of facial trauma especially in cases of child abuse; the determination of age, sex and race of skeletal remains; dental ethics and jurisprudence as well as malpractice also form part of the duties of the forensic dentist. The five dental schools in South Africa each have a forensic team which is consulted on a regular basis by forensic pathologists and district surgeons. Forensic dentists are active members of the medicolegal team and should be consulted on a regular basis especially in cases where identification is concerned.

Forensic Dentistry↗

[Human diffusion of arthropod disease vectors throughout the world].

The present distribution of animals and plants throughout the world is the result of an evolutionary process involving tectonic, climatic and biotic factors. Humans, since their appearance, have contributed to the spreading of many species including disease vectors and pests. When humans left their native African home, they brought with them ectoparasites such as lice and acarids. During the neolithic era, humans were leading domesticated animals which carried their own parasites into new areas. Dwelling commensals, flea, bugs, triatomids, flies, and cockroaches followed human migrations. In the second millennium, sailboats transported mosquito species which were resistant and reproduced on board, including Culex quinquefasciatus, Aedes aegypti, and Ae. albopictus. Steamers further shortened the length of trips and allowed the transport of anophelines. The opening of the Tamatave-Port-Louis line was immediately followed by the transport of An. gambiae from Madagascar to Mauritius and Reunion, and epidemics of malaria occurred on the two islands which had been free of the disease. Also, An. gambiae was transported from Senegal to Brazil. Old tires destined for recycling carried Ae. albopictus to the USA, Brazil, and then Italy. The pandemic of the plague at the end of the nineteenth century was propagated from harbour to harbour by steamers carrying both infected rats and their fleas Xenopsylla cheopsis. Aircrafts have reduced the travel time so much that in less than two days an insect could reach every point of the world. As soon as the airports had been built on the islands of French Polynesia, they were all colonized by Ae. aegypti. The same phenomenon occurred with midges (Fig. 2). Also, the construction of the airport on a Galapagos Island coincided with the importation of the blackfly Simulium bipunctatum from the continent. In addition, infected malaria mosquitos imported from tropical countries reached Europe and contaminated airport employees and local inhabitants. Six cases of malaria were recorded during the summer of 1994 around the Charles de Gaulle Airport, north of Paris, suggesting that the anophelines could have been imported from West and Central African countries which are served by this airport. The serious threat of vector importation is moderated by the vector's difficulty in adapting to new conditions. However any prediction is questionable.

Animals↗

Overview of non-insulin-dependent diabetes mellitus (NIDDM) in different population groups.

There are remarkable world-wide differences in the prevalence of diabetes, ranging from virtually 0% in Papua, New Guinea, to over 50% in the Pimas of Arizona. There are also notable rural-urban (e.g. Polynesians in rural and urban Western Samoa) and native-migrant (eg Chinese in China and in Mauritius) differences. The reporting of a high prevalence of diabetes in many populations that have undergone either urbanization or migration suggests that environmental factors related to lifestyle are contributory. Two such factors may be physical inactivity and dietary animal fat. There are also remarkable differences in ethnic susceptibility to non-insulin dependent diabetes mellitus (NIDDM), indicative of a strong genetic factor. Obesity is a risk factor for NIDDM. In addition to body weight, however, the pattern of distribution of body fat must also be considered. In some ethnic groups a central pattern of body fat distribution has been shown to be a significant risk factor even in the absence of obesity. This is particularly true in many Asian populations. It is proposed that genetic predisposition plus environment (lifestyle) interact and lead to visceral adiposity and insulin resistance, and that heredity and lifestyle also interact to cause a beta-cell lesion that affects insulin production and secretion. Development of insulin resistance facilitates the emergence of the beta-cell lesion. A consequence of this sequence of events is the development of glucose intolerance, and eventually, NIDDM.

Arizona↗

PCR detection of the two 'Candidatus' Liberobacter species associated with greening disease of citrus.

Greening is a severe and widespread disease of citrus in two main citrus growing areas of the world, Asia and Africa. It is caused by an uncultured phloem restricted bacterium that we have recently characterized from the sequence of its 16S ribosomal DNA. The bacterium is a new "Candidatus' genus, Liberobacter, in the alpha subdivision of the proteobacteria, and two 'Candidatus species' have been recognized: Liberobacter asiaticum and Liberobacter africanum. In this paper we describe a PCR method to detect the two liberobacter species in citrus trees by amplification of a 1160 bp fragment of their 16S rDNA. Distinction between the two species has also been achieved by Xbal digestion of the amplicons.

Citrus↗