Médecine tropicale : revue du Corps de santé colonial
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Although the WHO declared global smallpox eradication in 1980, the Orthopoxvirus remains a source of concern for several reasons. Firstly, stocks of the smallpox virus have been preserved for experimental use (at least officially in the USA and Russia) so that an escaped isolate could lead to reemergence and spread of the disease worldwide. Secondly discontinuation of smallpox vaccination programs has led to dwindling acquired immunity in the world population thus raising the risk of epidemic extension of several Orthopoxvirus zoonoses (e.g., monkeypox). ⋯ Adverse effects from earlier smallpox vaccine (vaccinia) in healthy people or immunocompromised people (congenital or acquired as in HIV infected patients) are absolute contraindications to smallpox vaccination at this time. Further research is needed to develop new vaccines (e.g., attenuated isolates of vaccinia) and effective treatment. This is the only valid reasons for postponing planned destruction of remaining Smallpox virus stocks.
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Between 1986 and 1998, 200 rigid bronchoscopic procedures under general anesthesia were carried out at the Principal Hospital in Dakar, Senegal for foreign body extraction from the distal airways of 194 children. For the study period, the incidence of this accident was 3.7 p. 1000. Sixty-three percent of patients were male and 77 p. 100 were under 4 years of age. ⋯ No deaths occurred in this series but cardiac arrest was observed in 6 patients during or immediately after endoscopy. This experience confirms the indication for immediate rigid bronchoscopy in cases involving aspiration or persistent respiratory symptoms. The high incidence of this accident suggests that information campaigns should be undertaken in health care facilities, households, and schools.
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Marine life in the waters of New Caledonia is extraordinarily rich. However some of the animals inhabiting this wonderland are dangerous including a number of venomous species. ⋯ Venomous species can be classified into 4 categories according to the mechanism of envenomation, i.e., biting animals such as sea snakes, cephalopoda, and eels; stinging animals including not only fish such as scorpion fish (Pterois, stonefish), sting-rays, saltwater catfish, surgeon fish, and flatfish but also cones and crown of thorns (Acanthaster planci); animals with contact venoms such as cnidaria (jellyfish, corals, sea anemones, and men-of-war), glaucus, sea cucumbers (holothurioidae), and sponges; and animals with more than one envenomation apparatus such as sea urchins and sea worms which can bite and sting. Study focused on the characteristics of each species including biology, envenomation apparatus, and chemical composition and action of the venom; pharmacological and clinical aspects of envenomation; and management and prevention of accidents.
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In 1996, malaria involving Plasmodium vivax, Plasmodium falciparum, and, to a lesser extent, Plasmodium malariae was endemic in 21 countries in the Americas. The Amazon river basin and bordering areas including the Guyanas were the most affected zones. Until the mid 1970s, endemic malaria appeared to be under control. ⋯ Implementation of adequate medical care and prevention measures has been hindered by a lack of money and sociopolitical unrest. Climatic phenomenon related the El Nino have also been favorable to the return of malaria to the region. Except with regard to financial resources and political unrest, the same risk factors for malaria are present in French Guiana.