Ebola patients frequently exhibit behavioral modifications with ideation slowing and aggressiveness, sometimes contrasting with mild severity of Ebola disease. We performed lumbar punctures in 3 patients with this presentation and found Ebola virus in all cerebrospinal fluid samples. This discovery helps to discuss the concept of a specific Ebola virus encephalitis.

Rhabdomyolysis is a frequent disorder in EVD and seems to be more common than in other viral infections. It may contribute to the renal failure observed in nonsurviving patients. More studies are needed to determine the impact of rhabdomyolysis on EVD outcome.

Q fever is a cosmopolitan zoonosis caused by Coxiella burnetii, a gram-negative coccobacillus. Transmission occurs mainly through inhalation of contaminated particles present in the environment. Cattle, sheep, and goats constitute the main reservoirs worldwide, and afterbirth from infected animals is highly contagious. The incidence of Q fever is particularly high in French Guiana, an overseas entity of France located in the Amazon region of South America between Suriname and the state of Amapá in Brazil. Disease in French Guiana is caused by a unique genotype, C. burnetii multispacer sequence type 17 (MST17) (1-3). The disparities in incidence between French Guiana and its neighboring countries suggest that Q fever incidence is underestimated in that part of the world, potentially because of misdiagnosis or the unavailability of diagnostic tools (4). Cases occur mainly in Cayenne, the capital of French Guiana, and the surrounding areas (5). Outbreaks beyond the outskirts of Cayenne have not been described. Studies of multiple domestic and wild fauna in French Guiana have only revealed the 3-toed sloth (Bradypus tridactylus) as a potential C. burnetii reservoir (6-9). However, another wild animal reservoir is highly suspected for this bacterium (4), and the epidemiologic cycle in French Guiana remains incomplete. In this article, we describe an outbreak that occurred in 2014 among French Navy service members in a remote area of French Guiana and the outbreak investigation findings, which implicated another species as a potential C. burnetii reservoir. The Study During August-September 2014, a total of 5 Q fever cases were diagnosed among 12 French Navy service members. All had been deployed for 3 days in mid-August to a carbet (an open-sided wooden shelter surrounded by forest) located on the Comté River, 30 km south of Cayenne (4°37′57.44′′N, 52°23′49.5′′W). Q fever diagnostic tests (Q Fever IFA IgM and Q Fever IFA IgG; Focus Diagnostics, http://www.focusdx. com; 100% sensitivity and 99% specificity to C. burnetii Nine Mile strain) were performed at the Institut Pasteur in Cayenne.

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