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INTRODUCTION: This study was conducted to assess the difference in biosafety behaviors among nurses working in a levels 2 and 3 hospital unit in Morocco and the need for additional biosafety training before working in a high-containment facility. METHODS: A prospective cross-sectional and observational study was conducted among new and experienced nurses in the Center of Virology and Tropical Infectious Diseases of the Military Teaching Hospital Mohammed V of Rabat, Morocco, between December 1, 2017 and February 28, 2018 (3 months). We compared behaviors in biosafety practices (donning gloves, handwashing, etc) between the 2 groups, and data were collected by observing workers directly or via camera. RESULTS: A total of 31 nurses, 14 newly graduated nurses (45.2%) and 17 experienced and trained (54.8%) nurses, were observed during 89 entries into high-containment hospital rooms. Among the behaviors observed, only donning an inner pair of gloves was observed consistently between the 2 groups. Experienced and trained nurses washed their hands (100%) and observed the antiseptic contact time (71%), whereas recently graduated nurses ignored these activities significantly (79% and 32%, respectively). During handling of the patient, the trained and experienced nurses were significantly better than the new ones in the practices of biosafety and personal protection. Gaps in biosafety were observed more frequently among newly graduated workers, especially donning outer gloves before patient contact, nurses touching their faces, and the act of wearing jewelry while working. CONCLUSION: Safety training should begin early in the training curriculum with theoretical and practical courses. It must be introduced into the general biosafety policy as part of a safety and standard working culture. It is recommended that personnel be required to pass a proficiency exam in critical biosafety tasks before working with high-risk patients.

Dengue is a significant mosquito-borne infection in humans, and its worldwide prevalence is rapidly increasing. The vector aedes albopictus has been revealed recently in the town of Rabat. Morocco established a program of active surveillance of dengue fever comprising many hospitals and laboratories across the kingdom. The purpose of this work is to describe the result of the surveillance of the dengue virus (DENV) infection during the year of 2017 among Moroccans and tourists who presented in our hospital with clinical signs of infection and to report the first confirmed positive cases of Dengue.From 20 December 2016 to 20 December 2017, 21 patients were hospitalized for suspicion of DENV infection. Half of them were returning from Côte d’Ivoire which is a popular tourist and business country for Moroccans and where an outbreak of DENV was confirmed on July 2017. Fever, headache, arthralgia-myalgia and malaise in addition to the notion of return from an endemic country justify in clinicians the demand for analysis of detection of dengue virus by RT-PCR.Dengue infection was confirmed in two patient both coming from Côte d’Ivoire, a Moroccan and an Ivorian who were staying in Abidjan during the period of the outbreak of 2017.

Recently, several countries reported imported cases of infection with chikungunya virus (CHIKV). We report the first case of chikungunya virus infection in Morocco. A 37-year old woman returned to Morocco on 15 August 2017, after she stayed in Dhaka-Bangladesh for 18months. She developed severe arthralgias and rash, fever up to 39°c. In next day’s symptoms progressively subsided but arthralgias remained for 3weeks. Laboratory findings didn't show lymphopenia, thrombocytopenia or elevated liver transaminases. Serological tests were positive for CHIKV IgM and negative for IgG antibodies. CHIKV-RNA was detected by RT-PCR. The patient was treated with non-steroid anti-inflammatory drugs and paracetamol. After 15days of hospitalization, symptoms ameliorated but arthralgias persists. The vector is established in Morocco and since the virus is diagnosed in returning travellers, chikungunya has a potential for autochthonous transmission in Morocco, that’s why CHIKV must be included in the differential diagnosis of arthralgia in all travellers returning from countries with documented transmission of the virus.