INTERVIEW – A four-year-old girl died of tuberculosis in Brittany. According to infectious disease specialist Jean-Paul Stahl, cases remain frequent in the country.
She was only four years old. The Southern Hospital of Rennes (Ille-et-Vilaine) announced the death of a girl last week. She suffered from tuberculous meningitis, according to information from the regional daily West France. The child was from Côtes-d’Armor, where she was educated. Informed of this case, the Brittany Regional Health Agency launched targeted screening.
The campaign targets anyone who came into contact with the victim for more than eight hours in the last trimester. Chest x-rays are at the heart of the device. Relatives of the girl will have to pass one immediately and a second in three months. This strategy allows for rapid treatment.
Tuberculosis has fallen sharply in France, thanks to vaccination, but the infectious disease causes around 900 annual deaths, according to the Pasteur Institute. It seems to be experiencing a recent resurgence: in recent months, several cases have been reported in schools – especially in Laon and Limoges. Prof. Jean-Paul Stahl, infectious disease specialist at Grenoble University Hospital (Isère) reviews the strategies developed to deal with this pathology.
Are cases of tuberculosis frequent in France?
Prof. Jean-Paul Stahl : Yes it is a disease which remains frequent (4,800 cases were identified in 2014, editor’s note) and which is potentially serious. All populations can be affected. There are two different tuberculosis: that of primary infection, which mainly affects children, and that of the elderly, which results rather from a resurgence of contamination that occurred earlier in life.
The diagnosis is based on a fever, and usually lung involvement, but not always; there may also be meningitis and encephalitis. In general, it is not acute but is prolonged. This also explains why the diagnosis is sometimes made a little late.
Listen to the full interview with Prof. Jean-Paul Stahl:
Who is affected by BCG vaccination?
Prof. Jean-Paul Stahl : BCG is no longer mandatory, it now concerns people at risk, either because they go to endemic regions, or because they belong to a social environment that favors the disease. These people must be targeted as a priority.
What is the strategy to adopt after the detection of a case?
Prof. Jean-Paul Stahl : Tuberculosis is a reportable infection. The regional epidemiology centers therefore anticipate who the contact persons are and offer them follow-up, and sometimes treatment. By definition, screening is for people who are not sick, or have very minor symptoms. Given the speed of progression of the disease, we are therefore not in a vital emergency.
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