In most conflicts there is the potential that there will be Captured Persons (CPERS) whose medical care is the responsibility of the capturing army. The standard of this care should be to the same standard as that afforded to one's own troops. However the medical practicalities of maintaining such standards can be difficult. This article reviews the practicalities of the medical care of CPERS as part of the UK deployment in Afghanistan on Operation HERRICK.

Patients with immunosuppression are at increased risk for occurrence, delayed diagnosis, and progression of AE.

The largest described outbreak of chikungunya virus has been occurring on the islands of the southwest Indian Ocean since March 2005. We describe the manifestations of chikungunya virus infection in travelers returning from these islands, with focus on skin manifestations.

Pertussis is routinely diagnosed with real-time PCR based on insertion sequence IS481, which is not specific for Bordetella pertussis. We conducted a retrospective study using real-time PCRs specific for Bordetella pertussis and for Bordetella holmesii on 177 samples positive for IS481 PCR. Bordetella holmesii DNA was detected in 20.3% samples collected from adolescents and adults.Bordetella holmesii is known to be responsible for bacteremia in hyposplenic patients, including those affected by sickle cell anemia, and has also been isolated from the sputum of patients with pertussis symptoms (4, 6, 10). The diagnosis of Bordetella infections routinely involves real-time PCR (9). Two insertion sequences, IS481 and IS1001, are commonly used as PCR targets because numerous copies are present in the bacterial genomes and this contributes to the sensitivity of these tests. However, (i) IS481 is present in the genome of B. holmesii isolates and some B. bronchiseptica isolates and is therefore not specific for B. pertussis and (ii) IS1001 is present in the genome of some B. bronchiseptica and is therefore not specific for B. parapertussis (9).The aim of this retrospective study was to identify the Bordetella species in biological samples positive for IS481 collected between 2009 and 2010 in four French laboratories. To identify the species, we used previously developed specific "in-house" real-time PCR. These real-time PCRs are based on the amplification of the promoter of the pertussis toxin operon (ptxAPr-based PCR) specific for B. pertussis (1) and of the recA gene (RecA-based PCR) specific for B. holmesii (2). We also used a real-time PCR based on the BP3385 gene (BP3385-based PCR), which was initially described as specific for B. pertussis (5) but was subsequently shown to score positive for some B. bronchiseptica isolates (8). This PCR can replace the ptxA-Prbased PCR to detect B. pertussis carrying a deletion of the whole ptx operon, which is pertinent because such B. pertussis isolates can circulate (3). We also used the IS1001 PCR to analyze coinfections (9). The primers used to perform the "in-house" PCRs are listed in Table 1.The analytical sensitivity of the different assays was determined by using a series of 10-fold dilutions of B. pertussis Tohama, B. parapertussis 12822, and B. holmesii BHO1 DNAs (7, 9). Each dilution was tested three times independently. The limits of detection per PCR in our conditions were 0.5 CFU and 1 CFU for IS481-and IS1001-based PCRs, respectively, using the Argene kits (catalog no. 69-0011B for IS481-based PCR and 71-012 for IS1001-based PCR; Argene, Verniolle, France), 30 CFU for the in-house ptxA-Pr-based PCR, 30 CFU for the in-house BP3385-based PCR, and 50 CFU for the in-house RecA-based PCR. Because of the difference of sensitivity between the routine IS481-and IS1001-based PCRs and the specific in-house PCRs we decided to analyze only biological samples with a threshold cycle (C T ) of Ͻ30 as assessed with IS481 PCR. We selected 177 biological samples from nasopharyngeal a...

During the summer of 2014, all the pre-requisites for autochthonous transmission of chikungunya virus are present in southern France: a competent vector, Aedes albopictus, and a large number of travellers returning from the French Caribbean islands where an outbreak is occurring. We describe the system implemented for the surveillance of chikungunya and dengue in mainland France. From 2 May to 4 July 2014, there were 126 laboratory-confirmed imported chikungunya cases in mainland France.