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An assessment mission to Eau Claire, after deaths linked to rabies
Three doctors and two veterinarians went to the area where the
three people died of rabies between February 17 and March 1.
They found neither
symptomatic people or animals. Additional doses of vaccine were
delivered to the anti-rabies center of Cayenne hospital. A prefectural decree prohibits access to
Eau Claire.
“Due to the circulation of the rabies virus in the area”, access to the Eau Claire sector,
in the territory of Maripasoula, was banned by prefectural decree at the end of last week,
announced the prefecture of Guyana and the Regional Health Agency in a joint press release.
All people present in the area were invited “to leave the premises as soon as possible.
as fast as we can ".
Before that, a mission was carried out in the sector where, between February 17
and March 1, three illegal gold miners died of rabies – confirmed for one of them,
probably for the other two. Dr Francky Mubenga, monitoring and security doctor
health at the ARS, Benoît de Thoisy, veterinarian at the Pasteur Institute of Guyana and specialist in
rabies, Xavier Beaudrimont, veterinarian in the food service of the General Directorate of
territories and the sea, Dr Maylis Douine, doctor at the Cayenne Hospital Center and good
knowledgeable about the health problems of garimpeiros, as well as Professor Loïc Epelboin, of the unit
of infectious and tropical diseases (Umit), visited the site last Tuesday. The objective
was to carry out a risk analysis in animal health and human health, by identifying
possible symptomatic people, pets sick or not, and in questioning people living on
site based on a questionnaire prepared by Public Health France and its partners.
Frequent bites
The garimpeiros had been informed of this mission by
mediators, via WhatsApp groups and Facebook pages
common. About a hundred were seen out of the 200 to 250 who
would live there. The mission was secured by the Forces
armies in Guyana.
This mission made it possible to inform people about the
actions to follow.
When answering the questionnaire, most
reported having been bitten in recent months by bats, but neither
more nor less than in the past. On the other hand,
they did not report a dog bite. As part of
the Orpal 3 study carried out last year (Malakit – Curema project) garimpeiros had already been
questioned on these subjects: 60% said they owned a dog and 57% said they had been bitten
by a bat in the year preceding the study. Almost all (96.9%) reported having
been in contact with bats at the last extraction site they visited.
More HCC vaccines
During the mission, those interviewed confirmed the possibility of a fourth death linked to
the rage, but no more, of a person buried in the forest. No people or animals
symptomatic has not been identified. No garimpeiro had a health condition requiring treatment.
sanitary evacuation. On the other hand, many of them had skin problems.
Post-exposure prophylaxis consisting of several intramuscular injections of vaccine
spread over several days, it was not possible to carry it out on site. The people
met were informed that they can receive the rabies vaccine at the center
delocalized prevention and care (CDPS) in Saint-Georges and Oiapoque. The center of
anti-rabies treatment from the Cayenne hospital received an exceptional order of 300
doses of vaccine last week. Around a hundred were delivered to the CDPS.
In the forest, the importance of sleeping under a mosquito net
These cases of rabies serve as a reminder, if necessary, that it is essential to sleep under a mosquito net
in the forest, even in the absence of mosquitoes. These are likely to prevent bites from
bats and contact with various insects. Except for chiropterologists,
Bat bites remain rare in Guyana.
Last year, several bites were reported along the Shire. Before that, others were
occurred in the Nancibo sector, in Montsinéry-Tonnégrande, in 2014 and 2015. Due to
low radius of action of bats and cyclical circulation of the virus within colonies,
the spatial and temporal diffusion of rabies is very weak.
The only death linked to rabies in Guyana occurred in May 2008, in Rémire-Montjoly. Four years
later, researchers from the Pasteur Institute, Public Health France, the Department of
veterinary services, the Cayenne hospital and the ARS had concluded, in PLoS Neglected
Tropical Diseases, that “the origin of the contamination had not been formally established, even
if an undetected vampire bat bite is by far the most common route of transmission
likely ". They also indicated that one of the victim's cats had died two months earlier, after
was bitten by a bat and that it was possible that it was he who transmitted rabies to the
victim.
In the event of a bat or mammal bite, it is essential to contact the
anti-rabies center of Cayenne hospital, at 0594 39 51 00, Monday to Saturday, from 7 a.m. to
12 p.m. and from 2 p.m. to 5 p.m. Doses have also been placed in the centers
delocalized prevention and care (CDPS). On its website, the Institut Pasteur points out that
“preventative treatment includes cleaning all wounds, immediately after the bite or
scratch (water and soap for 15 minutes) then careful antisepsis (check of
tetanus immunity is also recommended as well as antibiotic prophylaxis in certain cases.
case). »
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