actualités surles émergences virales 2012 2014 · données cnr des arbovirus et cire paca (p....
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Actualités sur les émergences virales 2012‐2014Les arboviroses
Pr Rémi CHARREL, Université d’Aix Marseille ‐ Institut de Recherche pour le Développement , Marseille, France IHU Méditerranée Infection, Marseille, France
ACNBH
ODPC N°1495
DECLARATION D’INTERETDANS LE CADRE DE MISSIONS DE FORMATION
REALISEES POUR L’ACNBH
43ème Colloque National des Biologistes des HôpitauxMarseille, 5‐7 novembre 2014
Pr. Rémi CHARREL Exerçant au CHU APHM Timone et IHU Méditerranée – Infection déclare sur l’honneur
ne pas avoir d'intérêt, direct ou indirect (financier) avec les entreprises pharmaceutiques, du diagnostic ou d’édition de logiciels susceptible de modifier mon jugement ou mes propos, concernant le DMDIV et/ou le sujet présenté.
dans le journal Eurosurveillance, édité par le ECDC
o Gratuit
o hebdomadaire
o Open Access
o www.eurosurveillance.org/
o
dans PubMED 2012‐2014: www.ncbi.nlm.nih.gov/pubmed/
dans ProMED: www.promedmail.org/
Modalités de la recherche bibliographique
transmis par les moustiques du genre Culex
virus West Nile, flavivirus
Virus Usutu, flavivirus
Les virus dont nous allons parler: les arbovirusARthropod‐BOrne virus
transmis par les moustiques du genre Aedes
virus de la dengue, flavivirus
virus Zika, flavivirus
virus Chikungunya, alphavirus
transmis par les phlébotomes
virus Toscana, Phlebovirus, Bunyaviridae
Les virus dont nous allons parler: les arbovirusARthropod‐BOrne virus
transmis par contact avec le sang et fluides biologiques
virus Ebola, filovirus
Les virus dont nous allons parler: les virus non vectorisés
transmis par voie respiratoire et manuportage
MERS Coronavirus, coronavirus
virus de la grippe, orthomyxovirus
Serbia: Aug‐Oct 2012: lineage 2
o WNV in humans: 58 cases, 9 deaths
o WNV in birds
Serbia: Apr‐Oct 2013: WNV in mosquitoes
Czech Republic, 2013 : WNV lineage 2 isolated from Culex modestus
Greece: 2012: epidemic in humans, 3rd consecutive year local transmission, virus established
Italy, Jul‐Sept 2012, WNV in humans: 13 cases in northeastern Italy: lineage 1a
Virus West Nile, 2012‐2014
Virus Usutu, 2012‐2014
North Italy, 2012: USUV in Culex
Usutu virus in bats, Germany, 2013
Piemont, 2012: USUV in Culex pipiens
Croatia, 2013: USUV in humans: neuroinvasive cases
Belgium, 2012: USUV in bird
Czech Republic, 2012: USUV in birds
Age = 4 ‐ 76 year‐old (median= 40)
11 man, 6 women
2 children: 4‐ and 7‐year old
All presented clinical signs compatible with TOSV infection
fever 17/17
neuroinvasive disease: n= 13‐ Acute aseptic meningitis (n=6)‐ encephalitis (n=4)‐ left lower limb fasciitis (n=1)‐ left uper limb hemiparesis (n=1)‐myositis (n=1)
not neuroinvasive: (n=4)‐ fever, headache, stiff neck
Journal of Infection, 2013
13/17 cases (76%) during summertime (June to August), corresponding to the peak period of sandflies circulation in France and Europe
2/17 occurred in autumn (September and November 2009)
2/17 occurred in early spring (April 2007 and March 2010)
15/17 were autochthonous, whereas two patients reported were returning from Croatia and Tuscany (Italy), respectively
Journal of Infection, 2013
Greece, 2014: a case of severe encephalitis
Czech Republic: imported case of meningo‐encephalitis in a returning traveler
Morocco, Tunisia, Algeria: first evidence of the presence of Toscana virus and of the vector
France: a series of 11 cases of Toscana virus infection
France: evidence of the presence of Toscana virus in Corsica
France, 2014: 2 cases of meningitis in Marseille
France, 2012: atypical forms of Toscana virus infections: myositis, fasciitis
Tunisia, 2013: Toscana virus isolated from sandflies
Spain, Catalonia: reported cases
Croatia, 2012: Toscana virus in humans and virus detected in sandflies
Italy, Sicily, 2012‐2014: Toscana virus cases in humans
Portugal: Toscana virus infections in humans
Turkey: Toscana virus infections in humans, and virus detected in sandflies in several regions
Virus Toscana
Virus Toscana : surveillance annuelle
Période 2003 – 2010Données CNR des Arbovirus et CIRE PACA (P. Despres, A. Armengaud)
Cas neuroinvasifs (LCR et fièvre chez sujet > 15 ans)50 cas4 – 10 cas de méningite ou d’encéphalite diagnostiqués / saison28 hommes / 22 femmesAge médian 37 ans (17 ‐‐‐ 85 ans)
Période 2011‐ 2013en cours d'acquisition et d'analyse (I. Leparc‐Goffart)
2013: 6 cas2014: 3 cas
0.37%
7.3%
2.5%
0.75%
1.7%
3%
6.3%
5.5%
10.2%
9.7%
1.8%
7.9%
4.3%
3.7%
0.8%
2.8%
2.5%
1.2%
1.7%
2.5%
0.0% 0.7%
0.8%
0.0%
In FRANCE > 8 million people at risk of
Toscana virus infection
Virus Toscana: étude épidémiologique EFS
Virus de la dengue – 4 sérotypes – 4 infections possibles
Madeira, Oct‐Nov 2012: human outbreak, dengue 1 serotype
o 23,000 air travellers to Madeira in 2012o originating from 29 dengue‐endemic countries; o 90% coming from Venezuela and Brazilo Madeira strain most closely related to strains isolated in Venezuela, Brazil and Columbia
o 1,891 cases o vector is Aedes aegypti , established since 2005o First epidemic of dengue fever in Europe since 1928
Virus de la dengue – 4 sérotypes – 4 infections possibles
Madeira, Oct‐Nov 2012: human outbreak, dengue 1 serotype
o 23,000 air travellers to Madeira in 2012o originating from 29 dengue‐endemic countries; o 90% coming from Venezuela and Brazilo Madeira strain most closely related to strains isolated in Venezuela, Brazil and Columbia
o 1,891 cases o vector is Aedes aegypti , established since 2005o First epidemic of dengue fever in Europe since 1928
Reunion island, Jan‐Mar 2012: o 20 autochthonous cases DENV‐1 and DENV‐3
France, Oct 2013: autochthonous dengue: Jouques: 1 case
France, été 2014: 4 autochthonous dengue: Var (2) and BdR (2)
Virus ZIKA
French Polynesia, Oct 2013: human outbreak: 30,000 cases
o >40 cases of Guillain‐Barré syndromeo vector is Aedes polynensis, Ae. aegypti, Ae. Albopictus, Ae. Hensillio neighboring countries affected: New Caledonia 1,400 cases, Cook islands 900 cases
Virus Chikungunya
Alphavirus, transmitted by Ae albopictus and Ae aegyptimassive outbreak in the Indian Ocean area in 2006:
o 300,000 infected / 700,000 inhabitants of Reunion island never reported in the New World until December 2013 in Saint‐Martin island
• Local transmission in 36 countries in the Caribbean, Central America, South America, or North America• 776,089 suspected and 14,810 laboratory‐confirmed chikungunya cases had been reported from these areas
Surveillance Nationale et Régionale
Collaboration étroite entre leslaboratoires de CHU, le CNR et
l’ARS / CIRE
Le laboratoire du CHU de la Timone réalise près de 2,000
tests dengue et CHIK chaque été
Surveillance Nationale et Régionale
Collaboration étroite entre les
laboratoires de CHU, le CNR et l’ARS / CIRE
Surveillance Nationale et Régionale
Situation en Paca‐Corse Depuis Mai 2014,
o 623 cas suspectso 138 cas de chikungunya, 54 cas de dengue et 1 co‐infection confirméso tous IMPORTES
CHIK (Caraïbes 127 cas) DENGUE: Thailande, Indonésie, Caraïbes, Inde, Polynésie F, Costa Rica
o SAUF 4 dengue autochtones (Var, BdR)
Situation en dans les 16 départements en alerte (Ae. albopictus implanté)
o 1,371 cas suspects / 580 confirméso 419 CHIK, 155 dengue, 6 co‐infectionso tous importés SAUF
4 dengues autochtones 7 CHIK près de Montpellier: patient Index from Cameroon, ECSA2 straindrastically different from the strain circulating in the Carribean