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BackgroundOn 7 February 2020, French Health authorities were informed of a confirmed case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in an Englishman infected in Singapore who had recently stayed in a chalet in the French Alps. We conducted an investigation to identify secondary cases and interrupt transmission.MethodsWe defined as a confirmed case a person linked to the chalet with a positive reverse-transcription polymerase chain reaction sample for SARS-CoV-2.ResultsThe index case stayed 4 days in the chalet with 10 English tourists and a family of 5 French residents; SARS-CoV-2 was detected in 5 individuals in France, 6 in England (including the index case), and 1 in Spain (overall attack rate in the chalet: 75%). One pediatric case, with picornavirus and influenza A coinfection, visited 3 different schools while symptomatic. One case was asymptomatic, with similar viral load as that of a symptomatic case. Seven days after the first cases were diagnosed, 1 tertiary case was detected in a symptomatic patient with from the chalet a positive endotracheal aspirate; all previous and concurrent nasopharyngeal specimens were negative. Additionally, 172 contacts were monitored; all contacts tested for SARS-CoV-2 (N = 73) were negative.ConclusionsThe occurrence in this cluster of 1 asymptomatic case with similar viral load as a symptomatic patient suggests transmission potential of asymptomatic individuals. The fact that an infected child did not transmit the disease despite close interactions within schools suggests potential different transmission dynamics in children. Finally, the dissociation between upper and lower respiratory tract results underscores the need for close monitoring of the clinical evolution of suspected cases of coronavirus disease 2019.

En progression rapide dans toutes les régions chaudes, la dengue ou « fièvre dengue » est la maladie à vecteur la plus répandue dans le monde. L’expansion de ses formes hémorragiques, qui peuvent être mortelles, est devenue particulièrement inquiétante, d’autant qu’en l’absence de vaccins ou de nouveaux traitements, l’unique moyen d’enrayer la maladie consiste à lutter contre le moustique vecteur. Il ressort des contributions réunies dans cette expertise collégiale qu’à côté des techniques de démoustication présentées en détail dans le volume, un travail en réseau est indispensable pour surveiller et prendre en charge cette pathologie. Il apparaît également nécessaire, ce qui n’est pas le plus facile, de convaincre les populations d’éliminer elles-mêmes les réserves d’eau (mares, flaques, récipients...) où le moustique se reproduit, une autre mesure essentielle proposée dans cette expertise. Dengue, or dengue fever, is the most widespread vector-borne disease on the planet and is spreading rapidly in all the world’s hot regions. The spread of its hemorrhagic forms, which can be fatal, is particularly worrying, especially as without a vaccine or a new treatment, the only way to halt the disease is to control the mosquito that carries it. From the papers that make up this report, it emerges that alongside the mosquito-control methods described by the authors, networking is essential for surveillance and medical care of dengue. The report also highlights the need to persuade the population (and this is not the easiest task) to take on themselves the essential work of eradicating pools, puddles and receptacles where water collects and mosquitoes can breed.

Abréviations ARN = Acide ribonucléique BD = Base de données CHU = Centre hospitalier universitaire CIRE = Cellule interrégionale d’épidémiologie D1, D2, D3 et D4 = Sérotypes des virus de la fièvre dengue de 1 à 4 DASS = Direction de l’action sanitaire et sociale DENV = Virus de la dengue virus (en anglais : dengue virus) DFA = Départements français d’Amérique DH = Dengue hémorragique DSDS : Direction de la santé et du développement social DSS = Dengue avec syndrome de choc ELISA = Enzyme Link...