In September 2020, the Institut Pasteur de la Guyane (IPG) (member of the French National Reference Laboratory for arboviruses) identified two cases of Mayaro virus infection (MAYV) confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) and one probable case found positive for Mayaro antibodies. The case-patients presented dengue-like symptoms and joint pains, and tested negative for dengue by RT-PCR.
Among the 37 clinically-compatible cases, most cases are male (60%) and the median age is 36 years (range 3-82 years). The most represented age range is 15 to 54-years-old (19 cases) followed by 0 to 14-years-old (10 cases). A peak of cases was observed in mid-September however, the outbreak investigation remains ongoing.
During the same period in 2019, 3,794 suspected cases and 73 deaths (CFR 1.9%) were reported in 120 health zones from 16 provinces while a total of 2,850 suspected cases (CFR 2.1%) were reported in 2018.
The case-patient had severe disability, and developed dengue-like symptoms on 12 July. On 16 July, he was hospitalized in an intensive care unit in Cayenne, French Guiana, with consciousness disorders and acute liver failure, and died on 19 July.
From 11 June though 15 July, six out of 22 health areas have been affected within Rethy health zone (11 villages), with a total of 45 cases including nine deaths (case fatality rate: 20%). All nine (9) cases who died presented with signs of headache, high fever, and painful nodes; four (4) out of the nine (9) cases had cough.
A real-time RT-PCR test conducted at the public health laboratory identified a non-subtypable influenza A virus. In May 2020, the specimen was forwarded to the Laboratory of Respiratory Virus and Measles, Oswaldo Cruz Institute (FIOCRUZ per its acronym in Portuguese), a national influenza reference laboratory, in Rio de Janeiro. On 22 June, genetic sequencing characterized this virus as an influenza A(H1N2)v virus.
The case is an 83-year-old male with no known vaccination history for yellow fever. He had onset of symptoms on 30 January 2020 and presented to a health facility on 2 February 2020 with abdominal pain and jaundice. Between 2 February and 9 April, he consulted the Urban Health Centre in Tchibanga, the Christian Alliance Hospital in Bongolo and the University hospital in the capital Libreville where the case received anti-malarial treatment and remained hospitalized until his death on 9 April 2020. On 14 April 2020, the laboratory results received from the WHO Regional Reference Laboratory at the Institute Pasteur in Dakar, Senegal, confirmed yellow fever infection, by seroneutralisation test. The additional differential diagnostic tests performed were negative for dengue, West Nile fever, chikungunya, Crimean-Congo Haemorrhagic fever, Zika and Rift Valley fever.
The case is a 55-year-old woman with no vaccination history for yellow fever. She had onset of symptoms on 31 January 2020 and presented to a health facility on 3 February 2020 with fever and aches. The following day she developed jaundice and a blood sample was taken. On 7 February , the blood sample was transported to the national laboratory. On 10 February , the sample from the case was received at the national laboratory and test results on 17 March were Immunoglobulin M (IgM) positive for yellow fever. The positive yellow fever result was confirmed by the Institute Pasteur in Dakar Senegal, a yellow fever reference laboratory on 14 April 2020 by seroneutralisation.