Aix-Marseille Université, Département Universitaire de Médecine Générale, Faculté des Sciences Médicales et Paramédicales, 13885, Marseille, France; Aix-Marseille Université, Institut des Neurosciences des Systèmes, INSERM UMR 1106, France; Comité Pédagogique, Pôle Formation-enseignement-recherche, Laveran Military Teaching Hospital, Marseille, France.
Centre D'épidémiologie et de Santé Publique des Armées. GSBDD Marseille Aubagne, 111 Avenue de La Corse BP40026, 13568, Marseille Cedex 02, France.
Travel Med Infect Dis. 2021 Jan-Feb;39:101951. doi: 10.1016/j.tmaid.2020.101951. Epub 2020 Dec 14.
The French military personnel may be exposed to leptospirosis during their training or on duty on the field in continental France, and most of all, in intertropical areas in the French departments and in Africa. The aim of this study was to assess the incidence of leptospirosis from epidemiological surveillance and cases data from 2004 to 2018, and to propose tools to assess leptospirosis risk prior to any mission or leisure activity.
A retrospective epidemiological study on leptospirosis cases among French Armed Forces was conducted. More data were collected for 2 clusters in Martinique, as most of leptospirosis cases among French military personnel were identified in Martinique.
Eighty-eight cases of leptospirosis were reported, 15 cases in continental France and 73 cases in overseas (including 42 cases in the French West Indies). The global leptospirosis incidence rate in continental France was 0.3/100,000 person-years and in overseas 24/100,000 person-years with the higher incidence rate in Martinique (99/100,000 person-years) and in Mayotte (36.9/100,000 person-years). For the clusters in Martinique, between January and June 2009, 7 cases were declared; between 2016 and 2018, 16 cases were reported, high proportions of severe cardiac, renal and neurological forms (6/16) and hospitalizations (9/16).
The occupational risk is real in French Armed Forces, particularly in malaria-free intertropical areas where chemoprophylaxis by doxycycline is not applied. Prevention can be optimized by the use of practical tools such as tables and cartographies, leading to a better leptospirosis risk assessment and application of preventive recommendations.
法国军人在法国本土训练或执行任务时，特别是在法属海外省和非洲的热带地区，可能会接触到钩端螺旋体病。本研究旨在评估 2004 年至 2018 年期间从流行病学监测和病例数据中得出的钩端螺旋体病的发病率，并提出在执行任何任务或休闲活动之前评估钩端螺旋体病风险的工具。
对法国武装部队钩端螺旋体病病例进行回顾性流行病学研究。对马提尼克的 2 个集群进行了更多的数据收集，因为法国军人中的大多数钩端螺旋体病病例都是在马提尼克发现的。
报告了 88 例钩端螺旋体病病例，其中 15 例在法国本土，73 例在海外（包括法属西印度群岛的 42 例）。法国本土的钩端螺旋体病总发病率为 0.3/100000 人年，海外的发病率为 24/100000 人年，其中马提尼克的发病率最高（99/100000 人年）和马约特（36.9/100000 人年）。对于马提尼克的集群，2009 年 1 月至 6 月期间报告了 7 例病例；2016 年至 2018 年期间报告了 16 例病例，严重的心脏、肾脏和神经系统形式（6/16）和住院治疗（9/16）的比例很高。
法国武装部队确实存在职业风险，特别是在没有疟疾的热带地区，那里不使用强力霉素化学预防。通过使用实用工具（如表格和地图），可以优化预防措施，从而更好地评估钩端螺旋体病风险并应用预防建议。
