title: First human rabies case in French Guiana, 2008: epidemiological investigation and control.
abstract: BACKGROUND
  Until 2008, human rabies had never been reported in French Guiana. On 28 May 2008, the French National Reference Center for Rabies (Institut Pasteur, Paris) confirmed the rabies diagnosis, based on hemi-nested polymerase chain reaction on skin biopsy and saliva specimens from a Guianan, who had never travelled overseas and died in Cayenne after presenting clinically typical meningoencephalitis.
  
  
  RESULTS
  Molecular typing of the virus identified a Lyssavirus (Rabies virus species), closely related to those circulating in hematophagous bats (mainly Desmodus rotundus) in Latin America. A multidisciplinary Crisis Unit was activated. Its objectives were to implement an epidemiological investigation and a veterinary survey, to provide control measures and establish a communications program. The origin of the contamination was not formally established, but was probably linked to a bat bite based on the virus type isolated. After confirming exposure of 90 persons, they were vaccinated against rabies: 42 from the case's entourage and 48 healthcare workers. To handle that emergence and the local population's increased demand to be vaccinated, a specific communications program was established using several media: television, newspaper, radio.
  
  
  CONCLUSIONS
  This episode, occurring in the context of a Department far from continental France, strongly affected the local population, healthcare workers and authorities, and the management team faced intense pressure. This observation confirms that the risk of contracting rabies in French Guiana is real, with consequences for population educational program, control measures, medical diagnosis and post-exposure prophylaxis.
authors.affiliation: Institut Pasteur de la Guyane, Cayenne, French Guiana. jb.meynard@wanadoo.fr
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Meynard
authors.forename: Claude
authors.initials: C
authors.lastname: Flamand
authors.forename: Céline
authors.initials: C
authors.lastname: Dupuy
authors.forename: Aba
authors.initials: A
authors.lastname: Mahamat
authors.forename: Françoise
authors.initials: F
authors.lastname: Eltges
authors.forename: Frederic
authors.initials: F
authors.lastname: Queuche
authors.forename: Julien
authors.initials: J
authors.lastname: Renner
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Fontanella
authors.forename: Didier
authors.initials: D
authors.lastname: Hommel
authors.forename: Philippe
authors.initials: P
authors.lastname: Dussart
authors.forename: Claire
authors.initials: C
authors.lastname: Grangier
authors.forename: Félix
authors.initials: F
authors.lastname: Djossou
authors.forename: Laurent
authors.initials: L
authors.lastname: Dacheux
authors.forename: Maryvonne
authors.initials: M
authors.lastname: Goudal
authors.forename: Franck
authors.initials: F
authors.lastname: Berger
authors.forename: Vanessa
authors.initials: V
authors.lastname: Ardillon
authors.forename: Nicolas
authors.initials: N
authors.lastname: Krieger
authors.forename: Hervé
authors.initials: H
authors.lastname: Bourhy
authors.forename: André
authors.initials: A
authors.lastname: Spiegel
mesh_terms: D000818:Animals; D002685:Chiroptera / Q000821:virology; D005260:Female; D005616:French Guiana / Q000453:epidemiology; D006282:Health Personnel; D006801:Humans; D008297:Male; D056990:Post-Exposure Prophylaxis / Q000379:methods; D011818:Rabies / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D011819:Rabies Vaccines / Q000008:administration & dosage; D011820:Rabies virus / Q000302:isolation & purification*; D012463:Saliva / Q000821:virology; D012867:Skin / Q000821:virology
chemical_list: D011819:Rabies Vaccines