National campaign against hepatitis C in France (1999-2002).

Since 1988, several measures have been applied in France to control HCV infection. HCV seroprevalence in the adult population is estimated at 1.1% (500,000 to 650,000 persons) and the number of chronically infected at 400,000 to 500,000 persons. In 1994, most of them might not be aware of their infection. Blood products administration and injecting-drug use are identified as the main transmission routes. The national hepatitis C plan (1999-2002) was based on scientific data and developed after a consensus conference and several expert consultations. It involves six programs and quantified objectives: prevention of new infections, enforcement of screening access; improvement of care management; implementation of a surveillance system, clinical research and evaluation. Specific financial supports were attributed for the implementation of the plan. The 2001 progress report confirmed a major increase in national and regional actions. In 2000, considering the high proportion of persons still unaware of their infection (at least one third) and the increase of treatment efficacy, the target population of the screening strategy was considerably extended after scientific analysis. A national consciousness-raising campaign directed at general practitioners was launched in June 2000. In 2001, a media campaign directed to the general population was developed, in newspapers and on radio stations. Since the end of 1999, a national toll free phone number provides information to the public. In order to improve access to screening, a new regulation added HCV testing to the missions of anonymous and free HIV testing centres, as well as of family planning centres. The hepatitis C prevention strategy is still included in a national public health program and improved in view of its renewal.

[Prevention of Listeria infections]. / La prophylaxie des listérioses.

Listeriosis is a rare but very serious foodborne disease. The non-contamination of food products is the best prevention of listeriosis. In spite of notable efforts to improve the microbiologic quality of food products through surveillance and control of food contaminations, the prevention has still to be based upon the information of consumers. This information can take different forms. When a food product is found to be contaminated with Listeria monocytogenes, if the withdrawal of this product does not occur as early as to prevent its commercialisation, a consumers alert is necessary to avoid any subsequent human case and to allow a rapid medical care of exposed persons in case of occurrence of symptoms of the disease. A specific information from health professionals to persons with risk factors of contracting listeriosis is a point of debate. Immunocompromised persons, for instance do not represent an easily defined group. On the other hand, pregnant women that are specially at risk of developing listeriosis, with potentially life threatening consequences for their foetus, represent a well identified population. They are medically monitored, and, because they feel concerned, most of them accept, during their pregnancy, to follow some simple rules that, sometimes, change their habits. At present, information is given to pregnant women by different ways: documents, leaflets, posters. The health authorities have decided to reinforce this information. They are also working on a special advisory meeting, specially targeted at foodborne diseases (including listeriosis), that could take place, for pregnant women, during the first months of their pregnancy.