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The burn intensive care unit (ICU) of the Queen Astrid Military Hospital experienced an outbreak with an extensively drug-resistant Acinetobacter baumannii (XDR-Ab) strain, which began when all burn wound patients from all over Belgium were sent there as part of the national COVID-19 action plan. The purpose of this study is to report on the investigation and strategies that were implemented to contain the outbreak. Between October 2020 and May 2021, five of the 72 patients admitted to the ICU met the acute outbreak case definition (attack rate 7%). Their median age was 46 years and their median total body surface area burned was 39%. All patients developed at least one XDR-Ab infection, with in total three pulmonary, three bloodstream and five burn wound infections. One patient died. All XDR-Ab isolates were only susceptible to colistin. Whole genome sequencing of the isolates from the first two patients revealed an identical A. baumannii ST2 genotype, suggesting an outbreak. XDR-Ab-positive patients were cohorted with dedicated staff. The infection control team intensified its training on hand hygiene, excreta management and bio-cleaning procedures. Concurrently, 30 environmental samples were collected, which proved negative for XDRAb. Spatio-temporal associations were found for all XDR-Ab-positive patients, suggesting cross-transmission via staff's hands. We describe an XDR-Ab outbreak in a burn ICU over a seven-month period, in a context of increased workload. This series underlines the importance of a correct staff-to-patient ratio, especially in outbreak situations. [ABSTRACT FROM AUTHOR]

Recenzja

La République Démocratique du Congo est l’un des pays répertoriés parmi ceux du « tiers monde », qui éprouve encore d’énormes difficultés conformément aux indices du sous-développement vu que la famine, l’instruction, l’accès aux soins de santé, les infrastructures et autres secteurs posent de sérieux problèmes dans la société congolaise. Dans le Secteur de la Santé, on peut observer que les fléaux, la flambée de plusieurs épidémies, endémies demeurent monnaie courante dans nos communautés, l’une des raisons qui expliquent la présence de plusieurs structures des actions humanitaires provenant de tous les horizons, qui nouent souvent un partenariat avec le gouvernement Congolais via le ministère de la Santé Publique, hygiène et environnement afin d’ y apporter une aide palliative. Ainsi le débat dans cette étude reste centré sur les interventions lors de l’urgence sanitaire de la riposte contre la flambée de l’épidémie à Virus Ebola qui a ravagé la communauté de Butembo depuis le 1 Aout 2018 jusqu’ en juin 2020.

Recent studies have focused on the bacterial pathogen Yersinia pestis (the infective cause of plague): its aDNA has been isolated, and sequenced, since about 5200 cal BP in Latvia (Eastern Europe). Plague afflicted human populations, spreading across Eurasia with a particular evidence during the European Late Neolithic/Bronze Age (LNBA). A dense and reliable pedigree of the pathogens has been reconstructed through direct sequencing of bacterial aDNA. The present paper proposes a procedure to isolate and trace the process of different epidemic outbreaks, by reconsidering the 14C datings of the 31 Eurasian individuals so far identified as affected by Yersinia pestis, in its LNBA- lineage, with sequenced genomes belonging to its different internal strains. The raw 14C dates are grouped by statistical compatibility through Student's t-test and calibrated with the IntCal20 curve, isolating the possible outbreaks and bracketing them through Bayesian analysis. The spread from Europe to Eurasia and the duration of epidemic waves are reviewed. [ABSTRACT FROM AUTHOR]

This paper centers on the infectious disease epidemics which swept through the Detva region, located in Upper Hungary (currently the territory of central Slovakia) in 1831-1920. The goal of this study is twofold: firstly, to examine the extent to which deaths caused by epidemics of infectious disease influenced life expectancy, the proportion of the deceased and survivors, and the probability of death in the Detva population, and secondly, to measure selection pressures through differential mortality, with a focus on deaths caused by infectious disease epidemics. We used individual information on age at death and causes of death in the Detva region, derived from the Detva parish records (N = 29,338). Infectious disease epidemics were the main regulator of mortality in the Detva region, as confirmed by our findings. Excluding deaths caused by infectious diseases from the dataset raised the life expectancy of a new-born and of an adult by 1-5 years and 1-2 years, respectively. The fraction of those surviving to the age of 5, the onset of maturity (15 years) and the onset of senility (60 years) also increased, while there was a decline in the proportion of deceased and the probability of dying. When deaths caused by infectious disease epidemics were removed from the analyses, selection pressures also weakened, as evidenced by the values of measures for the operation of natural selection. [ABSTRACT FROM AUTHOR]

The objective of the article is an attempt at a qualitative and quantitative analysis of the "incidental" material that is present in the pages of parish registers. This source is characterized by interdisciplinarity, but is most often used by genealogists and historical demographers. Polish historiography generally lacks a synthetic approach to this issue, especially in a broader territorial and chronological perspective. The paper uses the philological method, with elements of a geographic information system used for spatial data visualization. The source basis of the article is the record resource from the area of the former Lublin district. Over 600 archival units from 60 parishes were analyzed, including the two oldest parishes in Lublin. The oldest book begins with baptism records from 1582. The end point of the research was 1810. Based on an analysis of the content of the records, which went beyond the standard form of registering the vital statistics of the population, they were grouped. In total, nearly 100 entries were registered, classified as "casual" material. The highlighted content was assigned to six groups: spiritual life, economic life and parish administration; epidemics; war and politics; natural disasters and famine; extraordinary events; literary work. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to explore the lived experience of mental health professionals (mhPs) who had been redeployed on support teams (MHSTs) implemented in general hospital for patients with coronavirus disease 2019 (COVID-19) and their families, in order to scale up mental and physical health care integration in times of epidemic crisis. Methods: This multicentered qualitative study followed an IPSE (Inductive Process to analyze the Structure of lived Experience) research design. MhPs’ recruitment took place in three general hospitals of Seine-Seine-Denis department, in Paris suburbs (France). Results: Twenty-two participants were included. Data analysis produced three central axes: 1) the mhP in the epidemic crisis, underlying how participants confronted the unknown and adapted; 2) retrieving fundamentals of support therapy, that were: being present and listening, bonding with patients’ families, and ensuring care continuity; and 3) moving forward with other health professionals, highlighting the collaborative work they developed and experienced. Discussion: The epidemic prompted mhPs to rethink the values likely to guide the integration of their intervention with other individual and organizational care stakeholders, at different levels of health system. Normative integration based on shared appraisal of patients’ and families’ needs is highly required to overcome the multiple and sometimes contradictory health issues inherent in the crisis. Conclusion: Person- and family-centered approach of integrated care (IC) is essential to address fragmentation between mental and physical health care in times of epidemic crisis. Hospital and political leaders should support and draw from bottom-up mental health IC initiatives such as MHSTs, that embody this vision, in order to improve health systems preparedness for future crises. [ABSTRACT FROM AUTHOR]

Článek se věnuje způsobům vypořádání se s krizovou situací (epidemií) v dílech právně filosofických autorů sedmnáctého století (Hobbes, Spinoza, Mansvelt, Locke) a dílech krásné literatury (Mann, Camus, Čapek) a zkoumá možnosti jejich využití v současném prostředí právního řádu České republiky. Zjištěním článku je, že metody použité v této literatuře jsou přenositelné i do současnosti a mohou tak nabídnout alespoň kontury racionální regulace. Určité meze regulace, plynoucí nejen ze sféry ryze právního uvažování, ale také z literatury (včetně literatury počátku dvacátého století v ČR) jsou proto možným základem naší současné právní identity.

Für das Bundesland Tirol wurden im Zuge der Corona-Pandemie mehrfach besondere Maßnahmen von Bundes- und Landesseite erlassen. Im März 2020 wurden die österreichweit ersten Maßnahmen in Tirol gesetzt; als wenig später bundesweite Beschränkungen verhängt wurden, waren diese in Tirol strenger formuliert. Rund ein Jahr nach Beginn der Ausbreitung von COVID-19 in Österreich wurde Tirol erneut gesondert behandelt, indem für fast den gesamten Teil des Landesgebiets eine Ausreisetestpflicht festgelegt wurde. All diesen Maßnahmen ist gemein, dass sie selbst sowie deren Rechtsgrundlagen bei näherer Betrachtung einige verfassungsrechtliche Fragen und potenzielle Probleme aufweisen. Nicht zuletzt befasste sich auch der VfGH mit einigen dieser Tiroler Maßnahmen und stellte deren Gesetzwidrigkeit fest. Wenngleich sich eine derartig klare Aussage nicht für alle der behandelten Maßnahmen treffen lässt, so werfen diese doch Fragen auf, die es zu untersuchen gilt.

Lors d’une épidémie/pandémie causée par un virus inconnu comme le SRAS-CoV-2, agent responsable du COVID-19, les praticiens de la santé ne peuvent pas prédire le comportement du virus et donc l’évolution de la maladie. Ils ne peuvent pas aussi prédire la réaction des patients face aux différents traitements. Dans cet article on propose une architecture d’un système distribué de prédiction de l’évolution de la maladie et des réactions des patients pour les traitements, et ce en exploitant les données temps réel de patients atteints du même virus de partout dans le monde. Le système utilise une classification des patients basée sur les données géographiques et les questions dites « Patient, Intervention, Comparison, Outcome/s » (PICO). Il s’inspire des systèmes de téléchargement peer-to-peer pour le partage des informations et utilise un modèle sémantique pour la sauvegarde et la comparaison des questions cliniques. Le système propose aussi de générer des auto-tests personnalisés qu’on peut mettre à la disposition de la population pour diminuer la panique causée par l’épidémie. Un Le fonctionnement du système est illustré par un exemple d’un patient atteint du COVID-19.

Contexte : La transmission du virus de l’hépatite C (VHC) a été épidémiologiquement liée aux établissements de santé, en particulier aux établissements de soins externes, tels que les cliniques d’endoscopie et d’hémodialyse. Celles-ci ont été largement attribuées à des manquements concernant la prévention et le contrôle des infections. Objectif : Décrire les mesures de santé publique face à une épidémie du VHC détectée parmi les patients d’une clinique de coloscopie en Ontario, et souligner les risques liés à l’utilisation de flacons à doses multiples et la nécessité d’améliorer les pratiques de prévention et le contrôle des infections dans les établissements de soins externes. Méthodes : Le dépistage du VHC a été effectué chez les patients et le personnel qui ont fréquenté la clinique ou y ont travaillé en même temps que l’intervention du cas indexé. Les échantillons de sang des cas positifs ont été soumis à un séquençage viral. Des inspections de la clinique ont permis d’évaluer les pratiques de prévention et le contrôle des infections, et un examen des dossiers a été effectué pour cerner les mécanismes plausibles de transmission. Résultat : Au total, 38 % des patients qui ont subi des interventions à la clinique le même jour que le cas indexé a reçu un résultat positif pour le VHC. Le séquençage génétique a montré un haut degré de similarité dans la séquence génétique du VHC parmi les échantillons positifs pour le VHC. L’examen des dossiers et l’inspection des cliniques ont permis de désigner l’utilisation de flacons à doses multiples de médicaments d’anesthésie chez plusieurs patients comme mécanisme plausible de transmission. Conclusion : Les travailleurs de la santé, en particulier ceux qui se trouvent dans des établissements d’intervention ou chirurgicaux externes, devraient être vigilants et s’en tenir aux pratiques exemplaires de prévention et le contrôle des infections, notamment celles liées à l’utilisation de flacons à doses multiples, afin de prévenir la transmission d’infections hématogènes dans les établissements de soins de santé.

Ce que le monde subit, à nos jours, avec le Coronavirus qui est le cauchemar de l’humanité, avec une hausse d’inquiétude due au Covid-19, déclaré par l’Organisation Mondiale de la Santé comme une pandémie mondiale en décembre 2019 et à l’instar de ce qu'a déjà prévu Albert Camus, il y a 73 ans dans son célèbre roman La Peste. Ce roman est publié en 1947, où l’écrivain nous présente une ville touchée par une épidémie contagieuse qui la peste. Ce roman voit des ventes multipliées après la diffusion rapide et mondiale de la pandémie de Coronavirus dans le monde entier en raison de la grande ressemblance entre ses événements et sa coïncidence avec la réalité au cours de laquelle nous vivons à la lumière de cette crise sanitaire par l’infection, n’est pas seulement d’une ville mais du monde entier, due à l’épidémie de Coronavirus. Les événements du roman se déroulent en Oran, une ville algérienne touchée par la peste, cette maladie devient une épidémie locale dont les citoyens sont infectés par cette épidémie au début de l’année 1940. Aux yeux de Camus, ce fléau contagieux qui s’abat la ville d’Oran peut négativement désigner deux choses : soit l’occupation allemande sur la France au XXe siècle, soit l’absurdité de la condition humaine puisque cette épidémie est une vraie méditation sur le mal commit par les êtres humains. Néanmoins, ce fléau a un seul côté positif ; il peut témoigner la solidarité des Français contre l’occupation allemande à leur pays et la défaite de l’individualisme à l’égard de la souffrance collective à cause de l’occupation et de l’épidémie. Ainsi, la diffusion de l’épidémie dans cette ville incarne le danger qui surgit lors de l’occupation où tout le monde est confronté à une pandémie mondiale qui est la guerre.

Respiratory rehabilitation is the penultimate step in the medical management of patients with severe COPD-19. It is an essential step before patients' returning home, and is usually carried out in specialised Follow-up and Rehabilitation Clinics. When discharged from hospital, patients with post-severe COVID-19 usually progress in their medical condition. However, they may remain frail and have a constant fear of possible deterioration leading to (re)hospitalisation and a return to baseline. Psychological support in this phase can reduce patients' anxiety and increase their motivation to carry out daily rehabilitation activities. This support provides a stable and consistent basis for patients to focus on their progress, leaving the difficulties behind. Being aware of the improvements in their physical condition allows them to maintain their motivation to continue to be physically active. Psychological support during respiratory rehabilitation aims at preparing patients to return to the normal life they had before the disease. It is usually based on brief psychotherapies that focus on strengthening the patient's abilities through behavioural changes and through reducing risk behaviours. Only after this phase is it sometimes possible to deal with complex issues and to cope with personality mechanisms and maladaptive behaviour patterns. [ABSTRACT FROM AUTHOR]

This interview covers the clinical and psychological condition of patients afflicted with severe COVID-19 and their pulmonary rehabilitation process. For these patients, symptoms are medically urgent and life-threatening. The sequelae of this viral attack and immune response to it are significant, and often persist for months after discharge from intensive care. To understand the medical and psychological state of these patients, a description is given of the organs affected, the oxygen cycle in the body and the medical care procedures that are used to help patients with dysfunctional respiratory systems. The link between physical and psychological progress is described. Physical weakness results from pulmonary sequelae and deconditioning, and is often experienced by patients as mental fatigue similar to psychological depression. This may draw the patient into a downward spiral, with multiple health aspects deteriorating, independently of the resolution of initial problems. Conversely, a positive physical or psychological evolution may lead to the evolution of the other. Thus, reversing the negative trend for just one system component can delay, completely arrest the spiralling down, or transform it into an upward spiral, improving the patient's condition. In addition, for people undergoing severe COVID-19, the return to normal life could be destabilizing and memories that arise from their crisis state may trigger Post-Traumatic Stress Disorder (PTSD). Health and psychosocial professionals hold an important role both in post-hospital care and in secondary prevention, i.e. prevention of relapse and re-hospitalization. Physical rehabilitation work must take these psychological factors into account, in the same way that any psychological follow-up is supposed to consider physiological factors. [ABSTRACT FROM AUTHOR]

Ai tempi della pandemia da Covid-19 che stiamo vivendo ancora oggi, risulta ancora più necessario sottolineare come a livello letterario, storico e medico la diffusione di malattie infettive sia sempre stata documentata. La paura delle epidemie e del contagio sembra essere un vero e proprio topos narrativo che accompagna l’uomo sin dall’antichità; tuttavia, questi stessi concetti assumono caratteristiche e un significato diversi in base a un determinato contesto storico e allo sviluppo tecnologico presenti in esso. In tal senso, la scoperta della microbiologia della fine dell’Ottocento, che offre le evidenze empiriche del possibile contagio interumano, ha delle ricadute invitabili sulle paure dell’uomo, che incidono anche a livello narrativo. Contestualmente nasce il genere letterario distopico (sorto piuttosto tardivamente rispetto a quello utopico, sua controparte positiva) e con esso si apre l’immaginario catastrofico di una pandemia in grado di cambiare o sterminare per sempre l’umanità. Questo contributo sottolinea come la funzione neurocognitiva di immaginare mondi possibili (controfattualità) sia connaturata al genere umano e alla base del discorso distopico, che di volta in volta incarna le paure più recondite dell’uomo al fine di esorcizzarle. In relazione a ciò, viene altresì analizzato il cambiamento del tema del contagio in letteratura, con particolare attenzione alla distopia, mostrando come The Scarlet Plague di Jack London sembri canonizzare un genere prima sconosciuto, ossia la narrativa distopica dell’epidemia.__At the time of the Covid-19 pandemic that we are still experiencing today, it is even more necessary to emphasize how the spread of infectious diseases has always been documented at a literary, historical and medical level.The fear of epidemics and contagion seems to be a real narrative topos that has accompanied man since ancient times. However, these same concepts take on different characteristics and meaning according to a certain historical context and the technological development present in it. In this sense, the discovery of the microbiology of the late nineteenth century that offers empirical evidence of possible inter-human contagion has inviting repercussions on human fears, which also affect the narrative level. At the same time, the dystopian literary genre was born (which arose rather late than the utopian one, its positive counterpart) and with it the catastrophic imagery of a pandemic capable of changing or exterminating humanity forever. This contribution underlines how the neurocognitive function of imagining possible worlds (counterfactuality) is a specific characteristic of mankind. It is also the basis of the dystopian discourse, which from time to time embodies man’s most hidden fears in order to exorcise them. Therefore, it is also analyzed how the theme of contagion changes in literature, with particular attention to dystopia, showing how Jack London’s The Scarlet Plague seems to canonize a previously unknown genre, namely the dystopian narrative of the epidemic.

La découverte d'une bactérie hautement résistante émergente (BHRe) dans un prélèvement de dépistage ou un prélèvement bactériologique à visée diagnostique a des conséquences majeures pour l'équipe en charge des soins du patient. Tout doit être mis en œuvre pour éviter les transmissions croisées du microorganisme résistant vers d'autres personnes hospitalisées dans le service, à l'hôpital ou tout au long du parcours de soins du cas index. L'équipe opérationnelle d'hygiène (EOH) intervient, évalue le risque de dispersion selon les modalités de prise en charge du patient à son admission et les habitudes du service sur le plan de la prévention et de l'hygiène. Une réorganisation du fonctionnement du service peut s'imposer pour limiter les contacts sans réduire la qualité et la quantité de soins nécessaires au patient (pas de perte de chance). Une surveillance active des cas contact est réalisée en collaboration avec le service, le laboratoire de bactériologie et l'EOH pour détecter au plus tôt d'éventuels cas secondaires. La déclaration des nouveaux cas aux centres d'appui et de prévention de la lutte contre les infections associées aux soins (CPias) permet d'assurer la surveillance régionale et nationale de la situation épidémique. The discovery of an emerging extensively drug-resistant bacteria (eXDR) in a screening sample or a bacteriological sampling for diagnostic purposes has major consequences for healthcare workers. Everything must be done to prevent cross-transmission of the resistant microorganism to other hospitalized patient in the department, in the hospital or throughout the index case's course of care. The hygiene team intervenes, assesses the risk of spread according to the way the patient is taken care of on admission and the habits of the unit in terms of prevention and hygiene. A reorganization of care may be necessary to limit contact without reducing the quality and quantity of care needed by the patient (no loss of opportunity). Active surveillance of contact cases, carried out in collaboration with the service, the bacteriology laboratory and hygiene team to detect any secondary cases as early as possible. The notification of new eXDR cases to the Support and Prevention Centers for the Fight against Healthcare Associated Infections (CPias) allows regional and national surveillance of the epidemic situation to be ensured. [ABSTRACT FROM AUTHOR]

En France, dès la détection par le laboratoire de bactériologie de bactéries dites hautement résistantes aux antibiotiques émergentes (BHRe), un ensemble de mesures de prévention et de contrôle des infections (PCI) doivent être mises en place en regard des différentes voies de transmissions possibles. Les modalités de diffusion sont variées, allant du transport des BHRe par les mains contaminées des soignants, au transport des BHRe par un patient lors de transferts inter-établissements, en passant par la contamination de l'environnement. La maitrise de la diffusion des BHRe passe essentiellement par le suivi et par le dépistage des patients contacts et des patients porteurs. Les dépistages sont à effectuer au sein du service mais aussi après transfert dans un autre service ou dans un autre établissement, impliquant alors une autre équipe opérationnelle d'hygiène et un autre laboratoire de bactériologie pour l'application des mesures PCI. Ceci implique un suivi rapproché des cas et des contacts ainsi qu'une organisation et une communication entre les différents acteurs. In France, as soon as the bacteriology laboratory detects emerging extensively drug-resistant bacteria (eXDR), a bundle of infection prevention and control (IPC) measures must be implemented with regard to the different transmission routes of eXDR. The modes of transmission are varied, from the transport of eXDR by the contaminated hands of caregivers, to the transport of eXDR by a carrier patient transferred from one facility to another, to the environmental contamination. Controlling the spread of eXDR essentially involves followup and screening of contact patients and carrier patients. Screening should be performed within the department but also after transfer to another department or facility, involving another operational hygiene team and another bacteriology laboratory for the application of IPC measures. This implies a close follow-up of cases and contacts as well as organization and communication between the different actors. [ABSTRACT FROM AUTHOR]

În timpul călătoriei cu avionul, pasagerii şi piloţii trăiesc într-un microclimat controlat, parţial închis, încălzit şi filtrat astfel încât să ofere confort şi siguranţă. Cu toate acestea, din cauza numărului mare de persoane/m3 de aer şi a circulaţiei curenţilor de aer purtători de germeni, circulaţie uneori imprevizibilă, în special bolile infecţioase cu transmitere aerogenă pot constitui un pericol pentru pasageri; au fost dovedite şi descrise condiţiile de transmitere a tuberculozei, a gripei, rujeolei, a MERS, SARS şi a noului SARS-2-CoV în acest context. Bolile transmise prin vector reprezintă o altă ameninţare deoarece în special ţânţarii pot călători în bagajele sau in hainele pasagerilor şi pot răspândi la mari distanţe boli precum malaria, febra Chikungunya sau febra galbenă. Răspândirea de bacterii multidrog rezistente în cazul unor călători repatriaţi după spitalizări în afara graniţelor reprezintă o altă problemă. Chiar în lipsa transmiterii bolii pe timpul zborului, călătoria cu avionul face astăzi posibilă răspândirea extrem de rapidă, la nivelul unor ţări sau continente diferite, a unor boli precum Ebola, SARS sau afecţiuni ale animalelor domestice şi sălbatice. Dezinfecţia, dezinsecţia, folosirea unor metode mai eficiente de filtrare a aerului din cabină, controlul pasagerilor pre- şi postdebarcare constituie mijloace de luptă împotriva acestor riscuri, reprezentând măsuri a căror eficienţă rămâne a fi dovedită.

Reemergenţa actuală rujeolei este o problemă gravă de sănătate publică în întreaga lume, favorizată de scăderea acoperirii vaccinale. România se remarcă prin cel mai mare număr de îmbolnăviri şi decese din Uniunea Europeană. Studiul analizează caracteristicile clinico-epidemiologice ale cazurilor de rujeolă spitalizate într-un judeţul din sud-estul României, în care acoperirea vaccinală cu 2 doze de vaccin antirujeolic este de 79,6%. Au fost analizate 221 de cazuri spitalizate, confirmate conform definiţiei de caz, predominant la sugari, din mediul urban, nevaccinaţi, diagnosticaţi frecvent după a 4-a zi de boală, majoritatea cu forme complicate.

L’analisi dei Libri Mortuorum, registri mortuari redatti dall’Officio di Sanità di Milano, è alla base di questo saggio per uno studio della situazione sociosanitaria cittadina e delle conoscenze medico-scientifiche del tempo. Prendendo ad esempio l’anno 1478, ho deciso di raccogliere ed elaborare alcuni dati su mortalità e demografia nella Milano sforzesca. Riconoscendone un ruolo innanzitutto di controllo e prevenzione delle epidemie, ho deciso di affrontare il tema dell’attività dei medici milanesi, due in particolare, di fronte a possibili focolai di contagio. Infine, mi sono concentrato direttamente su chi fossero questi specialisti della medicina e quale fosse il loro ruolo nell’ambiente della sanità milanese di fine Quattrocento.

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Ebola est le virus le plus virulent en Afrique. Les organisations internationales ont œuvré afin de contenir les différentes épidémies et un vaccin est en phase d'administration aux populations. Ce virus survit dans un contexte où le continent africain doit faire face à la nouvelle pandémie de Covid-19. La présence concomitante de ces deux maladies est un enjeu de taille pour les communautés scientifiques. Ebola is the most vicious virus in Africa. International organisations have worked to contain the various outbreaks and a vaccine is being administered to the population. This virus survives in a context where the African continent must face the new Covid-19 pandemic. The concomitant presence of these two diseases is a major challenge for the scientific communities. [ABSTRACT FROM AUTHOR]

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Les maladies extrêmement contagieuses que sont la rougeole, les oreillons et la rubéole sont censées être contenues avec la vaccination, notamment dans les pays développés. Or, depuis quelques années, une recrudescence des cas de rougeole est observée en raison d'un infléchissement de la couverture vaccinale dû notamment au scepticisme ambiant vis-à-vis de cette démarche prophylactique. Highly contagious diseases such as measles, mumps and rubella are supposed to be restrained with vaccination, especially in developed countries. In recent years, however, there has been an upsurge in measles cases due to a drop in vaccination coverage, mainly due to scepticism about this prophylactic approach. [ABSTRACT FROM AUTHOR]

Aim: The study investigated the awareness of Ebola Virus Disease (EVD) and information seeking behaviour of rural dwellers in Nigeria. Methods: The survey type of the descriptive research design was used in conducting the study and the study group comprised adult rural dwellers (18 years and above) residing in six communities (Peretoru, Ekeremor, Obrigbene, Enougbene, Amabulou, and Aya-ama) in Bayelsa state, Nigeria. Data were collected from 600 respondents who were randomly selected from the six communities. The data from the study were then analysed using frequency count and percentages. The results were presented in charts (and graphs). Results: The study revealed that rural dwellers possess low awareness of EVD and many of them do not bother to seek EVD information because they do not believe it exists. Conclusion: Consequently, the study noted the need for the federal government to enhance structures that promote community engagements, especially at the time of the epidemic. [ABSTRACT FROM AUTHOR]

Une épidémie correspond à une augmentation brutale de l'incidence d'une maladie, généralement infectieuse, dans un repère spatio-temporel donné. Le terme pandémie est utilisé lorsqu'elle se propage à l'échelle mondiale. Par le passé, l'homme a fait face à plusieurs pandémies en développant des stratégies préventives et thérapeutiques. Les comportements sociétaux et économiques actuels favorisent la progression de maladies anciennes ou émergentes. Le développement de nouvelles approches multidisciplinaires est nécessaire pour lutter contre de futures pandémies. An outbreak means a sudden rise of the incidence of a disease, generally infectious, at a certain place over an extended period of time. The term pandemic is used when an outbreak is spreading on a global scale. By the past, Human has been able to face several pandemics by developing preventive and therapeutic strategies. The new societal and economic behaviour enhance the progression of old and new diseases. The development of new multidisciplinary approaches is necessary to prevent new pandemic episodes. [ABSTRACT FROM AUTHOR]

L’épidémie à Coronavirus COVID-19, qui touche la planète entière, oblige chaque pays et leurs habitants à adapter leurs modes de vie afin, à laLfois, de se préserver et de préserver son entourage. La prise en charge des personnes souffrant d’une maladie chronique associée doit évoluer durant cette période en fonction des pathologies et du lieu de traitement. Rapidement, en sus des directives ministérielles, les sociétés savantes ont proposé des recommandations qu’il importe à chacun d’adapter en fonction des possibilités et de l’environnement d’exercice. Certaines sont synthétiques et générales, d’autres concernent des groupes plus particuliers d’individus. Nous citerons ainsi les recommandations (en Anglais) de l’ERA-EDTA : https://www.era-edta.org/en/wp-content/uploads/2020/03/200311_Press-Release_SARS-CoV-2.pdf L’expérience de Wuhan en hémodialyse : https://doi.org/10.1101/2020.02.24.20027201 Les recommandations générales de la SFNDT : https://www.sfndt.org/sites/www.sfndt.org/files/medias/documents/Conseils%20SFNDT%20COVID-19%20-%20090320%20vDef.pdf Peu de recommandations étaient fournies concernant les patients traités par dialyse péritonéale en dehors de celles de l’ISPD récemment publiées en plusieurs langues: https://ispd.org/strategies-covid19/ (traduction française réalisée par le RDPLF) La France et certains pays francophones se caractérisent aussi par une proportion importante de patients en dialyse péritonéale non autonomes assistés par infirmière. Les responsables du Registre de Dialyse Péritonéale de Langue Française (RDPLF) ont rédigé, en accord avec la Société Francophone de Néphrologie Dialyse et Transplantation (SFNDT) des recommandations, volontairement simples, et spécifiques du mode de prise en charge dans nos régions. Ces recommandations complètent celles précédemment citées et ne concernent que le suivi du patient lors de son maintien à domicile pour le protéger et protéger son entourage de toute contamination. Il appartient à chaque professionnel de s’inspirer de ces recommandations et de les adapter en fonction de ses possibilités..

INTRODUCTION: Au Burkina Faso, le seul foyer de leishmaniose cutanée (LC) avec confirmation biologique dans la littérature à notre connaissance est celui de Ouagadougou au centre. Nous rapportons les résultats épidémiologiques, cliniques et biologiques de l´investigation d´un nouveau foyer épidémique à Larama, à l´ouest du Burkina. METHODES: la méthode du camp a été utilisée pour recevoir les cas. Les données sociodémographiques et cliniques ont été recueillies à l´aide d´un questionnaire. La confirmation a été faite par la microscopie puis par réaction en chaîne par polymérase (PCR). RESULTATS: au total, 108 cas suspects ont été recensés à Larama, soit un taux d´attaque de 5,8%. Le sex ratio était de 1,08. Les patients concernés étaient le plus souvent des cultivateurs (35,2%) et des commerçants (33,3%). La population active (15 à 49 ans) représentait 51,9%. Le nombre de lésion variait entre 1 et 5 dans 91,7% des cas. Les lésions qui se présentaient sous formes ulcéro-crouteuses surélevées et infiltrées, étaient localisées sur les membres (87%) avec une durée d´évolution entre un et cinq mois dans 96,3% des cas. Sur les deux cas prélevés, la microscopie a montré des leishmanies et la PCR a confirmé l´espèce Leishmania major. CONCLUSION: nos résultats confirment l´existence d´une épidémie de leishmaniose cutanée à L. major dans l´ouest du pays. Des enquêtes complémentaires sont nécessaires pour préciser la charge de morbidité des leishmanioses au Burkina Faso.

Introducere. Începând cu anul 2016, România se confruntă cu o epidemie importantă de rujeolă apărută pe fondul unui procent tot mai scăzut de vaccinare. Evoluţia epidemiei a fost marcată şi de o creştere alarmantă a numărului de complicaţii şi decese. Materiale şi metode. Am evaluat retrospectiv 632 pacienţi diagnosticaţi cu rujeolă, internaţi în Spitalul Clinic de Boli Infecţioase şi Tropicale „Dr. Victor Babeş“, în perioada ianuarie 2016 – decembrie 2017. Datele epidemiologice, caracteristicile clinice şi rezultatele probelor biologice au fost obţinute din fişele medicale ale pacienţilor. Rezultate. Din cei 632 de pacienţi, 341 (53,9%) au fost de sex masculin. Grupa de vârstă cea mai afectată a fost 1-4 ani (39,2%), urmată de cea a sugarilor cu un procent de 19,6%. O treime din cazuri (31,3%) au avut contactul infectant în cadrul familiei. În ceea ce priveşte statusul vaccinal, aproape jumătate din pacienţi (47,1%) nu au fost vaccinaţi, iar 44,3% nu cunoşteau istoricul de vaccinare (probabil nevaccinaţi sau incomplet vaccinaţi). Complicaţiile virale au fost prezente la majoritatea pacienţilor (84,1%) sub forma unei pneumonii interstiţiale. Pneumonia bacteriană a fost prezentă la 15% dintre pacienţi, iar dintre aceştia 45,2% au asociat şi insuficienţă respiratorie. Şase pacienţi au necesitat transfer în secţia de terapie intensivă pediatrie pentru suport respirator, înregistrându-se 2 decese. Laringita a fost prezentă în 8,2% cazuri, otita în 12% cazuri, în timp ce 61,7% dintre pacienţi au avut afectare gastrointestinală. Paraclinic, a fost evidenţiată citoliza hepatică la 101 (15,9%) pacienţi şi diselectrolitemia a fost prezentă la 94 (14,8%) din cazuri. Concluzii. Studiul prezent arată creşterea alarmantă a incidenţei bolii şi a complicaţiilor sale în ultimii 3 ani, mai ales la vârstele mici. Considerăm imperios necesară aplicarea programului de vaccinare pentru a asigura o acoperire vaccinală optimă, utilă atât în stoparea epidemiei actuale, cât şi în prevenirea unor viitoare epidemii.

Listeria monocytogenes, agentul cauzal al uneia dintre cele mai răspândite zoonoze cu transmitere prin intermendiul alimentelor contaminate, se caracterizează printr-o capacitate crescută de a rezista în condiţii precare de mediu şi de a forma biofilm. În populaţia generală se manifestă de cele mai multe ori ca toxiinfecţie alimentară, dar afectează în mod deosebit femeile gravide, nou-născuţii, vârstnicii şi persoanele imunodeprimate, în cazul cărora determină afectare cerebrală, sub formă de meningoencefalită şi, mai rar, afectare cardiacă, osteo-articulară etc. De-a lungul timpului, au fost descrise atât cazuri sporadice, cât şi izbucniri epidemice, cu distribuţie geografică largă, atât în Africa, Europa, cât şi în statele americane. În ultimii 3 ani, Europa s-a confruntat cu un număr crescut de cazuri de listerioză, răspândită prin intermediul legumelor congelate (mai ales porumb). Testele moleculare au identificat serotipul IVb cu secvenţa multiloculară ST6 ca fiind implicată în răspândirea acestor cazuri. Sursa de contaminare a fost identificată în Ungaria, la o companie care ambala şi distribuia pe piaţă legume congelate. Tulpina infectantă a persistat în ciuda măsurilor de curăţare şi dezinfecţie, ulterior fiind răspândită şi în alte state membre ale Uniunii Europene. Cazurile de listerioză umană au fost raportate în 5 state, deşi produsele au fost distribuite pe scară mai largă (inclusiv în România), iar tulpina a fost izolată în produsele vegetale în mult mai multe ţări. În prezent, sunt depuse eforturi considerabile în încercarea de a stopa răspândirea acestei epidemii, prin eficientizarea măsurilor de igienă, dezinfecţie şi control, respectiv prin retragerea de pe piaţă a produselor posibil contaminate.

Au mois de décembre 2019, l'Organisation Mondiale de la Santé (OMS) recense les premiers cas d'une maladie infectieuse apparue en Chine la même année. Générée par le nouveau coronavirus SARS-CoV2, elle est nommée COVID-19 pour COronaVirus Infectious Disease 2019. Rapidement, la diffusion de cette maladie inconnue a un retentissement planétaire : la contagiosité du virus est extrêmement importante et les suites sont potentiellement mortelles. En France, la population réagit initialement avec incrédulité, jusqu'à ce que la maladie atteigne l'Europe et que les premiers cas apparaissent sur le territoire français fin janvier 2020. Quelques semaines plus tard, le 16 mars 2020, le Président Macron déclare le pays « en guerre » contre le COVID-19. Le lendemain, la population est placée en confinement. L'activité du pays est à l'arrêt. Les écoles, les entreprises, les commerces sont fermés. Les Français sont sidérés. Ils doivent soudainement affronter la peur : celle qu'eux ou leurs proches puissent tomber malades, celle de l'enfermement et de la restriction de libertés, celle de la précarité économique. Et surtout, celle de l'inconnu. Afin de prévenir les conséquences désastreuses du séisme, des cellules d'écoute et de soutien psychologiques sont créées dans l'urgence, à l'échelon national. Elles sont destinées à soutenir le corps soignant, les malades et plus largement la population générale. Celle dédiée au département de la Gironde s'organise en quelques heures, sur le week-end du 21 mars 2020. La plateforme d'écoute COVIDPSY33 est ainsi mise en place à Bordeaux, par le Centre hospitalier Charles-Perrens, avec le soutien de l'Agence Régionale de Santé Nouvelle-Aquitaine (ARS). La cellule PSYCOVID-19 est créée de manière concomitante. Cette cellule de soutien d'aval travaille en collaboration avec la plateforme COVIDPSY33 et propose une aide psychologique à la population générale et aux soignants du secteur Bordeaux Rive Droite, Bordeaux Gare, Rives de Garonne, Rives d'Arcins et Sud Gironde. Elle couvre ainsi un territoire équivalent à environ la moitié du plus vaste département de France métropolitaine, la Gironde. Dans cet entretien, Samantha Al Joboory et Florence Monello, psychiatre et psychologue coordinatrices de PSYCOD-19, présentent ce dispositif de soutien psychologique. In December 2019 the World Health Organization (WHO) recorded the first cases of an infectious disease that appeared in China in November of the same year. Generated by the new coronavirus SARS-CoV2, it is quickly named COVID-19 for COronaVirus Infectious Disease 2019. The spread of this unknown disease will soon have worldwide consequences: the contagiousness of the virus is extremely high and potentially lethal. In France, the population initially reacted with disbelief until the disease reached Europe and the first cases appeared on French territory, at the end of January. A few weeks later, on 16 March 2020, President Macron declared the country "at war" against COVID-19. The next day the population was placed in lockdown. At the present time, the country's activity is at a standstill. Schools, businesses and shops are closed. The French citizens are astounded. They suddenly have to face fear: fear of falling ill or that a close relative may fall ill, fear of being locked up and experiencing restrictions of liberties, fear of economic precariousness. And, above all, fear of uncertainty. In order to prevent the mental consequences of this crisis, psychological support units have been created with urgency at national scale. These units are intended to support the healthcare professionals as well as the patients and more broadly, the general population. The unit responsible for the department of Gironde has been set up quickly, over the weekend of March 21, 2020. The COVIDPSY33 listening unit has thus been created in Bordeaux by the Charles Perrens Hospital with support from the Agence Régionale de Santé Nouvelle-Aquitaine (ARS). Simultaneously, the PSYCOVID-19 unit was created. This additional unit works in collaboration with the COVIDPSY33 platform and offers psychological assistance to the general population and caregivers in the sectors of Bordeaux Rive Droite, Bordeaux Gare, Rives de Garonne, Rives d'Arcins and Sud Gironde. It thus covers an area equivalent to approximately half of Gironde, the largest department in metropolitan France. In the present interview, Samantha Al Joboory and Florence Monello, psychiatrist and psychologist coordinating PSYCOD-19, present this psychological support unit. [ABSTRACT FROM AUTHOR]

At the beginning of March 2020, South Africa (59 million inhabitants) was hit by the pandemic of COVID-19 and soon became the most affected country in Africa by the SARS-CoV-2 virus. From one single case on March 5th, the number of cases increased rapidly, forcing the South-African Government to swiftly react and place the country under strict lockdown for six weeks. The strategy of the South African Government bore fruits with a contained spread of the virus. If the number of positive cases at the end of the lockdown reached 5647, the number of fatal casualties was limited to 103 deaths. The lockdown was overall well respected, even if serious problems of food supply soon occurred in informal settlements, leading to riots and confrontation with security forces. Indeed, populations were obedient, but not being able to practice sport or outdoors activities appeared heavy. The constant fear of the poorest not to have enough money to pay rent and buy food (even if the Government organised food parcels' distributions), and to find less and less work was echoed by the fear of losing jobs among those more privileged. Despite the risk of an economic crisis, the South African Government has continued on the reasonable path of containing the pandemic with ending the lockdown at a slow pace, in five phases. [ABSTRACT FROM AUTHOR]

L'auteur revient avec force, humour et parfois indignation sur les épisodes marquants de la pandémie au Covid 19 qui rappellent, pour lui, certains épisodes de la drôle de guerre puis du blitzkrieg dont Marc Bloch avait tiré de forts enseignements dans un ouvrage resté célèbre. Les défauts de notre cher peuple sont donc intemporels. This paper reevaluates firmly, humorously and at times indignantly the major events of the Covid 19 epidemics. They remind the author of certain episodes of the « phony war » and of the blitzkrieg from which Marc Bloch had drawn powerful lessons in a book which is still famous today. Our dear nation's failings thus prove timeless. [ABSTRACT FROM AUTHOR]

Les certificats de décès doivent mentionner la présence d'une prothèse fonctionnant avec une batterie et ses possibilités d'explantation. Cet acte ne peut être pratiqué que par un médecin ou un thanatologue. L'existence d'une infection par le SARS-CoV-2 ne modifie pas les exigences légales. In France, every death certificate must mention the presence of a prosthesis operating by means of a battery and its explantation or not. The explantation must be made regardless of the burial. Explantation can only be performed by a doctor or a thanatopractor. The health emergency related to covid-19 does not affect these principles of ordinary law. [ABSTRACT FROM AUTHOR]

Copyright of Epidemiological Review / Przegląd Epidemiologiczny is the property of National Institute of Public Health - National Institute of Hygiene and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

• Neisseria meningit idis group W is currently increasing in some European countries, including France, in relation to the expansion of an hypervirulent strain ("UK-2013 strain"). This article describes a cluster of serogroup W invasive meningococcal disease (IMD) caused by the "UK-2013 strain" in a French university in 2016. It illustrates the potential of this strain to cause clusters or local hyperendemic situations. A vaccination campaign was organized in the campus and 13,198 persons were vaccinated. • The article shows the importance of early notification of IMD cases to health authorities and the epidemiological and microbiological data used in the decision-making when considering large vaccination campaigns. Vaccine coverage data is presented and possible barriers for vaccination are discussed. The article provides useful lessons for future vaccination campaigns, particularly the organizational and communication challenges in large vaccination campaigns targeting students. In France, the expansion of an hypervirulent strain causing serogroup W invasive meningococcal disease (MenW) has been observed since 2015/16. We describe a cluster of three MenW cases, causing two deaths, at the end of 2016 in a university campus, and the vaccination campaign which was consequently organized. Epidemiological and microbiological analyses led a multidisciplinary expertise group to recommend the organization of a mass vaccination campaign using ACWY vaccine targeting more than 30,000 students and staff in the university campus. Individual data on vaccination was collected using the lists of students and staff registered at the university to estimate vaccine coverage. Three MenW cases occurred within a 2-month period among students in different academic courses. All three isolates were identical and belonged to the "UK-2013 strain" phylogenetic branch. The attack rate was 10.8/100,000 students. The vaccination campaign was organized only 15 days after the third case occurred. In total, 13,198 persons were vaccinated. Vaccine coverage was estimated at 41% for students of the university and 35% for university staff. Timely notification of cases to health authorities was essential for the detection of the cluster and the rapid implementation of the vaccination campaign. No further cases occurred in the campus in the year following the vaccination campaign. This episode is the second cluster of MenW caused by the "UK-2013 strain" in a university since 2016. [ABSTRACT FROM AUTHOR]

A bubonic plague epidemic broke out in the Portuguese city of Oporto in June 1899. Six months later, when it had come to an end, 132 deaths along 320 patients had been recorded. Although it was a city with industrial activity and the precursor of several technological innovations, the hygienic and sanitary conditions of the population of Oporto at that time left a lot to be desired. These features certainly made it easier for the plague to spread, which was detected by unusual deaths in those residing in dilapidated and dirty houses by the river Douro. Ricardo Jorge (1858-1939), the municipal doctor at the time, did not hesitate in stating that the outbreak showed clinical, epidemiological and technological signs of bubonic plague. Civil authorities and the press played down the event for more than a month. Finally, by order of the Government, a wide cordon sanitaire was established around the city, to prevent the spread of the epidemic to the rest of the country. As this resolution was not welcomed by the population, traders, and medical associations, the Government was forced to remove the city siege. Ricardo Jorge, who discovered the cause of the disease and was the main individual promoting the sanitary measures carried out, decided to abandon Oporto and settle in Lisbon after being unfairly misunderstood and subject to persecution. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The free ports of Rijeka and Trieste, along with their surrounding areas from which Ljubljana stood out, were part of a vast network where information was not only collected and exchanged but also created, thereby influencing the state institutions themselves. This article proves that these processes did not fall within the sole free port, but that they acted as a sort of propeller and accelerator in favoring reforms that also impacted the surrounding territory. Beginning with archival documents, the article summates the management of health information and the institutional reforms that derived from it in the 1750s. [ABSTRACT FROM AUTHOR]

Brucellosis is a major worldwide zoonosis. It is a reportable condition in Tunisia where the disease remains endemic especially in rural areas. The aim of this study was to describe epidemiological, clinical and bacteriological profile of humain brucellosis cases notified in the district of Tunis. It was a retrospective descriptive study of cases reported, in the district of Tunis which includes four gouvernorates (Tunis, Mannouba, Ariana and Ben Arous), through the national surveillance system between the 1st January and 31th December 2017. Simultaneously, the reporting form was revised to include additional data fields. During the study period, 133 brucellosis confirmed cases were notified. The cumulative incidence was 4.78 per 100000 population. More than four fifths (82.7%) of cases were reported in spring and summer with a peack in the month of May (36 cases). Wright agglutination test and Rose Bengale test were positive in 100% and 91% of cases respectively. Brucella Melitensis was the only identified specie (9 cases). Almost all cases (99.2%) reported the habit of consuming raw dairy products. Only 5 cases had a suspect contact with animals among them 3 persons were livestock breeders. Our study showed an epidemic of brucellosis during 2017 compared to 2015 and 2016. It is important to strengthen the brucellosis surveillance system in the district of Tunis and to carry out further studies in order to identify the mode of transmission and the risk factors and to put in place appropriate preventive measures. [ABSTRACT FROM AUTHOR]

La grippe est une infection respiratoire aiguë contagieuse due aux virus influenza, dont la particularité réside dans sa grande variabilité génétique. Par le nombre de patients atteints et l'excès de mortalité qui lui est attribuable, elle représente un enjeu de santé publique. Le risque pandémique associé à la grippe zoonotique constitue également une préoccupation majeure. Une politique de surveillance active est en place au niveau national et international. Influenza is an acute contagious respiratory infection caused by influenza viruses, which are unique in their vast genetic variability. By the number of patients affected and the excess of mortality attributable to it, it represents a public health issue. The pandemic risk associated with zoonotic influenza is also a major concern. An active monitoring policy is in place at national and international levels. [ABSTRACT FROM AUTHOR]

Psychotropic Substances, Devil Substances? From an historical perspective it is possible to outline a picture of the imaginary associated with the use of psychotropic substances in Western world. Although this specific imaginary is often very negatively connoted, is it actually an imaginary of evil? In the long run, depending on prevailing paradigms, we can detect two major interpretations: a religious paradigm in which the use of psychotropic substances is demonised as an archetype of evil; and a medical paradigm, associated with the emergence of modernity, which imposes a similar demonization, yet otherwise perceived under the terms of deviance and/or pathology.

Bolile infecţioase au urmărit dezvoltarea omului încă din cele mai fragede timpuri, deseori influenţând-o în mod esenţial. Considerate ca o „specie“ pe cale de dispariţie în a doua jumătate a secolului al XX-lea, acestea continuă să constituie o ameninţare considerabilă asupra sănătăţii individuale sau a celei publice. Perfecţionarea tehnicilor de diagnostic, schimbările climatice, creşterea mobilităţii populaţiei, scăderea acoperii vaccinale sunt doar câţiva factori care au contribuit în ultimii ani la apariţia şi răspândirea rapidă unor noi agenţi patogeni sau a reapariţiei unor boli considerate de acum istorice. Majoritatea acestor agenţi infecţioşi (Zika, Ebola, Chikungunya, MERS, SARS, noile virusuri gripale), pentru care există puţine resurse terapeutice, au stat la baza unor izbucniri epidemice cu caracter regional sau global, ce au generat îngrijorarea comunităţii medicale, deseori panică la nivelul populaţiei şi pierderi economice semnificative. Comunitatea internaţională şi medicală s-a mobilizat şi implicat din punct de vedere financiar, logistic, uneori cu sacrificiul propriei vieţi în combaterea acestor noi ameninţări. Înţelegerea rapidă a procesului epidemiologic, a patogeniei, dezvoltarea metodelor de diagnostic şi prevenţie au contribuit în multe cazuri la limitarea răspândirii bolilor emergente şi constituie baza pentru combaterea lor în viitor.

Il est difficile de prédire la taille finale d'une épidémie comme celle de dengue qui sévit actuellement à la Réunion, d'autant qu'il faut tenir compte de la saisonnalité. Dans cet article, on se propose d'étudier d'un point de vue théorique comment, dans le cadre d'un modèle très simple de type S–I–R pour une maladie à transmission directe, un environnement saisonnier périodique peut modifier la taille finale d'une épidémie. On obtient des résultats analytiques en supposant que l'amplitude de la saisonnalité est faible. [ABSTRACT FROM AUTHOR]

Résumé Contexte Une épidémie de coqueluche était survenue dans la sous-préfecture de Ouanda-Djallé dans un contexte de faible couverture vaccinale due aux multiples crises militaro-politiques en République Centrafricaine qui avaient entraîné le dysfonctionnement des structures de santé. Matériel et méthode Une équipe d'investigation a été déployée dans l'épicentre de l'épidémie en vue de confirmer l'existence de la maladie et de déterminer la stratégie de riposte. Cette mission avait établi une liste linéaire des cas et avait réalisé des écouvillonnages pharyngés ayant permis à l'Institut Pasteur de Bangui de confirmer l'épidémie de coqueluche. L'objectif de cette étude était de déterminer les caractéristiques épidémiologiques, cliniques et évolutives des cas de coqueluche chez les enfants atteints. Résultats Au total 213 malades avaient été enregistrés dont 13 décès soit un taux de létalité de 6,1 %. Les âges extrêmes étaient 0 et 144 mois avec un âge moyen de 33,7 mois (écart type = 19,7). Le taux d'attaque était de 10,3 % parmi les enfants de moins de 5 ans. Les symptômes observés étaient la toux quinteuse chez 211 (99 %) enfants, les vomissements dans 89,7 % (n = 191) des cas et la fièvre dans 14 % (n = 30). Parmi les malades, 184 soit 86,4 % avaient moins de 5 ans. Le sex-ratio masculin/féminin était de 1,08. Trente pourcents des enfants malades avaient été vaccinés comparativement au 70 % non vaccinés (p = 0,5). Conclusion Cette étude avait mis en évidence que la coqueluche demeure un problème de santé publique en République Centrafricaine et l'urgence de trouver une stratégie adaptée pour renforcer la couverture vaccinale en diphtérie-Tétanos-Coqueluche dans cette région presque inaccessible. Summary Context An outbreak of pertussis had occurred in the sub-prefecture of Ouanda-Djallé in a context of low immunization coverage due to the multiple military-political crises in the Central African Republic that had led to the dysfunction of Health structures. Material and method An investigative team was deployed to the epicenter of the epidemic to confirm the existence of the disease and to determine the response strategy. This mission had established a linear list of cases and had carried out swabs pharyngeal having enabled the Institut Pasteur in Bangui to confirm the pertussis epidemic. The objective of this study was to determine the epidemiological, clinical and evolutionary characteristics of pertussis cases in affected children. Total results In all, 213 patients had been registered with 13 deaths at a case fatality rate of 6.1%. The extreme ages were 0 and 144 months with an average age of 33.7 months (SD = 19.7). The attack rate was 10.3% among children under 5 years of age. The observed symptoms were severe cough in 211 (99%) children, vomiting in 89.7% (n = 191) of cases, and fever in 14% (n = 30). Among the patients, 184 or 86.4% were under 5 years of age. The male/female sex ratio was 1.08. Thirty percent of sick children were vaccinated compared to 70% unvaccinated (P = 0.5). Conclusion This study showed that pertussis remains a public health problem in the Central African Republic and the urgency of finding a suitable strategy to strengthen vaccination coverage in diphtheria-tetanus-whooping cough in this almost inaccessible region. [ABSTRACT FROM AUTHOR]

Objectives: To analyze the relationship between the occurrence of dengue and ovitrap positivity and dengue egg density in two Amazonas municipalities (Brazil) in 2016.Methods: We performed a case-control study using secondary data from the dengue fever surveillance system. Ovitraps distributed regularly in the urban area of two cities were used to monitor the presence of the vector. The relationship between egg positivity, egg density and the location of dengue cases was evaluated using two approaches as follows: (i) based on the result of the nearest neighbour ovitrap and (ii) based on the results of the set of ovitraps within the influence area of 300 m from the location of each case and control.Results: During the study period, 229 confirmed cases of dengue fever were reported in Tabatinga and 89 cases in Itacoatiara. In this study, we found that the positivity of ovitraps was related to the occurrence of dengue in Tabatinga and Itacoatiara. An association between egg density of Ae. aegypti and dengue occurrence was also observed in Itacoatiara. The temporal lags for ovitrap positivity measurements were predominantly 15 or 30 days. A dengue association for egg density for a 15-day time lag was detected for one of the case-control approaches.Conclusions: The location of dengue cases is related to ovitrap egg positivity, while a less evident possible association may exist for egg density. This indicates that these traps could be used to improve vector control actions. [ABSTRACT FROM AUTHOR]