RESUMO
We developed mathematical models to analyze a large dengue virus (DENV) epidemic in Reunion Island in 2018-2019. Our models captured major drivers of uncertainty including the complex relationship between climate and DENV transmission, temperature trends, and underreporting. Early assessment correctly concluded that persistence of DENV transmission during the austral winter 2018 was likely and that the second epidemic wave would be larger than the first one. From November 2018, the detection probability was estimated at 10%-20% and, for this range of values, our projections were found to be remarkably accurate. Overall, we estimated that 8% and 18% of the population were infected during the first and second wave, respectively. Out of the 3 models considered, the best-fitting one was calibrated to laboratory entomological data, and accounted for temperature but not precipitation. This study showcases the contribution of modeling to strengthen risk assessments and planning of national and local authorities.
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Aedes , Vírus da Dengue , Dengue , Epidemias , Animais , Humanos , Reunião/epidemiologia , Tempo (Meteorologia)RESUMO
BackgroundWastewater surveillance is an effective approach to monitor population health, as exemplified by its role throughout the COVID-19 pandemic.AimThis study explores the possibility of extending wastewater surveillance to the Paris 2024 Olympic and Paralympic Games, focusing on identifying priority pathogen targets that are relevant and feasible to monitor in wastewater for these events.MethodsA list of 60 pathogens of interest for general public health surveillance for the Games was compiled. Each pathogen was evaluated against three inclusion criteria: (A) analytical feasibility; (B) relevance, i.e. with regards to the specificities of the event and the characteristics of the pathogen; and (C) added value to inform public health decision-making. Analytical feasibility was assessed through evidence from peer-reviewed publications demonstrating the detectability of pathogens in sewage, refining the initial list to 25 pathogens. Criteria B and C were evaluated via expert opinion using the Delphi method. The panel consisting of some 30 experts proposed five additional pathogens meeting criterion A, totalling 30 pathogens assessed throughout the three-round iterative questionnaire. Pathogens failing to reach 70% group consensus threshold underwent further deliberation by a subgroup of experts.ResultsSix priority targets suitable for wastewater surveillance during the Games were successfully identified: poliovirus, influenza A virus, influenza B virus, mpox virus, SARS-CoV-2 and measles virus.ConclusionThis study introduced a model framework for identifying context-specific wastewater surveillance targets for a mass gathering. Successful implementation of a wastewater surveillance plan for Paris 2024 could incentivise similar monitoring efforts for other mass gatherings globally.
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COVID-19 , SARS-CoV-2 , Águas Residuárias , Humanos , Águas Residuárias/virologia , Águas Residuárias/microbiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/transmissão , SARS-CoV-2/isolamento & purificação , França/epidemiologia , Esportes , Saúde Pública , Pandemias , Esgotos/virologia , Paris/epidemiologia , Aniversários e Eventos Especiais , Vigilância em Saúde Pública/métodosRESUMO
BackgroundTravellers are generally considered good sentinels for infectious disease surveillance.AimTo investigate whether health data from travellers arriving from Africa to Europe could provide evidence to support surveillance systems in Africa.MethodsWe examined disease occurrence and estimated risk of infection among travellers arriving from Africa to Europe from 2015 to 2019 using surveillance data of arthropod-borne disease cases collected through The European Surveillance System (TESSy) and flight passenger volumes from the International Air Transport Association.ResultsMalaria was the most common arthropod-borne disease reported among travellers from Africa, with 34,235 cases. The malaria travellers' infection rate (TIR) was 28.8 cases per 100,000 travellers, which is 36 and 144 times higher than the TIR for dengue and chikungunya, respectively. The malaria TIR was highest among travellers arriving from Central and Western Africa. There were 956 and 161 diagnosed imported cases of dengue and chikungunya, respectively. The highest TIR was among travellers arriving from Central, Eastern and Western Africa for dengue and from Central Africa for chikungunya in this period. Limited numbers of cases of Zika virus disease, West Nile virus infection, Rift Valley fever and yellow fever were reported.ConclusionsDespite some limitations, travellers' health data can efficiently complement local surveillance data in Africa, particularly when the country or region has a sub-optimal surveillance system. The sharing of anonymised traveller health data between regions/continents should be encouraged.
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Artrópodes , Febre de Chikungunya , Dengue , Infecção por Zika virus , Zika virus , Animais , Humanos , Febre de Chikungunya/epidemiologia , Viagem , Europa (Continente)/epidemiologia , Infecção por Zika virus/epidemiologia , África/epidemiologia , Dengue/epidemiologiaRESUMO
BackgroundLyme borreliosis (LB) is the most common tick-borne disease (TBD) in France. Forestry workers are at high risk of TBD because of frequent exposure to tick bites.AimWe aimed to estimate the seroprevalence of Borrelia burgdorferi sensu lato and tick-borne encephalitis virus (TBEV) antibodies among forestry workers in northern France. We compared seroprevalence by geographical area and assessed factors associated with seropositivity.MethodsBetween 2019 and 2020, we conducted a randomised cross-sectional seroprevalence survey. Borrelia burgdorferi sl seropositivity was defined as positive ELISA and positive or equivocal result in western blot. Seropositivity for TBEV was defined as positive result from two ELISA tests, confirmed by serum neutralisation. We calculated weighted seroprevalence and adjusted prevalence ratios to determine association between potential risk factors and seropositivity.ResultsA total of 1,778 forestry workers participated. Seroprevalence for B. burgdorferi sl was 15.5% (95% confidence interval (CI): 13.9-17.3), 3.5 times higher in the eastern regions than in the western and increased with seniority and with weekly time in a forest environment. Seroprevalence was 2.5 times higher in forestry workers reporting a tick bite during past years and reporting usually not removing ticks rapidly. Seroprevalence for TBEV was 0.14% (95% CI: 0.05-0.42).ConclusionWe assessed for the first time seroprevalence of B. burgdorferi sl and TBEV antibodies among forestry workers in northern France. These results will be used, together with data on LB and tick-borne encephalitis (TBE) incidence and on exposure to tick-bites, to target prevention programmes.
Assuntos
Mordeduras e Picadas , Borrelia burgdorferi , Vírus da Encefalite Transmitidos por Carrapatos , Encefalite Transmitida por Carrapatos , Doença de Lyme , Doenças Transmitidas por Carrapatos , Carrapatos , Animais , Humanos , Doença de Lyme/epidemiologia , Estudos Soroepidemiológicos , Agricultura Florestal , Estudos Transversais , Anticorpos Antibacterianos , Anticorpos Antivirais , Doenças Transmitidas por Carrapatos/epidemiologia , Encefalite Transmitida por Carrapatos/epidemiologia , Fatores de Risco , França/epidemiologiaRESUMO
BackgroundLocally-acquired mpox cases were rarely reported outside Africa until May 2022, when locally-acquired-mpox cases occurred in various European countries.AimWe describe the mpox epidemic in France, including demographic and behavioural changes among a subset of cases, during its course.MethodsData were retrieved from the enhanced national surveillance system until 30 September 2022. Laboratory-confirmed cases tested positive for monkeypox virus or orthopoxviruses by PCR; non-laboratory-confirmed cases had clinical symptoms and an epidemiological link to a laboratory-confirmed case. A subset of ≥ 15-year-old male cases, notified until 1 August, was interviewed for epidemiological, clinical and sexual behaviour information. Association of symptom-onset month with quantitative outcomes was evaluated by t- or Wilcoxon tests, and with binary outcomes, by Pearson's chi-squared or Fisher exact tests.ResultsA total of 4,856 mpox cases were notified, mostly in Île-de-France region (62%; 3,025/4,855). Cases aged ≥ 15 years were predominantly male (97%; 4,668/4,812), with 37 years (range: 15-81) as mean age. Between May and July, among the subset interviewed, mpox cases increased in regions other than Île-de-France, and mean age rose from 35 (range: 21-64) to 38 years (range: 16-75; p = 0.007). Proportions of cases attending men-who-have-sex-with-men (MSM) meeting venues declined from 60% (55/91) to 46% (164/359; p = 0.012); median number of sexual partners decreased from four (interquartile range (IQR): 1-10) to two (IQR: 1-4; p < 0.001).ConclusionChanges in cases' characteristics during the epidemic, could reflect virus spread from people who were more to less behaviourally vulnerable to mpox between May and July, or MSM reducing numbers of sexual partners as recommended.
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Mpox , Minorias Sexuais e de Gênero , Masculino , Humanos , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Adolescente , Feminino , Homossexualidade Masculina , Comportamento Sexual , Surtos de Doenças , França/epidemiologiaRESUMO
BackgroundDengue is a disease with major impacts on public health in tropical and subtropical countries. In Europe, in the past decade, few autochthonous outbreaks were described.AimWe aimed to identify factors associated with frequency of dengue virus infection among European travellers and at assessing how surveillance data could support preparedness against autochthonous outbreaks within Europe.MethodsWe performed a descriptive analysis of travel-related dengue cases reported by European countries from 2015 through 2019. Using flight passenger data, we calculated travellers' infection rates (TIR). We investigated the following associations: (i) between TIR and incidence rate in selected countries of infection and (ii) between number of travel-related cases and occurrence of autochthonous outbreaks within Europe.ResultsThere were 11,478 travel-related dengue cases and the TIR was 2.8 cases per 100,000 travellers. Most cases were infected in Asia (71%), predominantly in south-eastern Asia. The TIR was highest among travellers returning from Asia (6.1/100,000). There was an association between the incidence rate in the country of infection and the TIR but no association between the number of travel-related cases and occurrence of autochthonous outbreaks in Europe.ConclusionsThe likelihood of infection in travellers is a function of the ongoing epidemiological situation in the country of exposure. The number of travel-related cases alone is not sufficient to estimate the likelihood of autochthonous outbreaks where vectors are present in Europe. Additional contributing factors such as adequate vectorial capacity and suitable environmental conditions are required.
Assuntos
Dengue , Viagem , Dengue/epidemiologia , Surtos de Doenças , Europa (Continente)/epidemiologia , Humanos , Doença Relacionada a ViagensRESUMO
An extensive multi-country outbreak of multidrug-resistant monophasic Salmonella Typhimurium infection in 10 countries with 150 reported cases, predominantly affecting young children, has been linked to chocolate products produced by a large multinational company. Extensive withdrawals and recalls of multiple product lines have been undertaken. With Easter approaching, widespread product distribution and the vulnerability of the affected population, early and effective real-time sharing of microbiological and epidemiological information has been of critical importance in effectively managing this serious food-borne incident.
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Chocolate , Salmonella typhimurium , Criança , Pré-Escolar , Surtos de Doenças , Humanos , Salmonella typhimurium/genética , Reino Unido/epidemiologiaRESUMO
BACKGROUND: Lyme borreliosis (LB) is the most frequent tick-borne disease in France. In the absence of a vaccine, LB prevention mainly relies on reducing tick bites. In 2016, the French Ministry of Health launched a national plan against tick-borne infections, including a prevention component. To evaluate the impact of this prevention strategy, we assessed knowledge and practices of tick bite prevention using the 2016 and 2019 national surveys on health attitudes and beliefs known as the French Health Barometer. METHODS: The Health Barometer is a repeated nationwide phone survey conducted annually on a random sample aged 18 to 75 years living in mainland France. In 2016 and 2019, participants were asked, among others, about their exposure to ticks, their behavior and practices regarding tick bites, and their knowledge about LB and its prevention. RESULTS: In 2019, 30% of the population reported a lifetime tick bite and 6% in the last year, an increase from 25% and 4%, respectively, in 2016 (p < 0.001). In 2019, 25% of the population felt exposed to tick bites compared to 23% in 2016 (p < 0.001). The proportion of participants who had heard about LB and who considered themselves well informed respectively increased from 66% and 29% in 2016 to 79% and 41% in 2019, (p < 0.001). In 2019 compared to 2016, a greater part of the French population applied protective measures against tick bites, particularly wearing protective clothing (74% vs 66%, p < 0.001) and regular tick checks and prompt tick removal after exposure (54% vs 47%, p < 0.001). CONCLUSIONS: A substantial proportion of French residents are exposed to tick bites and apply protective measures. Our findings indicate a trend toward an increased knowledge and awareness of tick bites and LB between 2016 and 2019 in France. Our results can be used to target future information campaigns to specific age groups or at-risk areas in addition to the general population. However, we need to further study the barriers to the use of preventive measures.
Assuntos
Doença de Lyme , Picadas de Carrapatos , Doenças Transmitidas por Carrapatos , França/epidemiologia , Humanos , Doença de Lyme/epidemiologia , Doença de Lyme/prevenção & controle , Inquéritos e Questionários , Picadas de Carrapatos/prevenção & controleRESUMO
BackgroundToxoplasmosis during pregnancy can result in congenital anomalies or fetal death. Universal antenatal screening is recommended in France, a strategy in place since the 1970s.AimWe determined the seroprevalence of toxoplasmosis among pregnant women participating in the 2016 national perinatal survey (ENP), compared results with previous ENPs, and investigated factors associated with Toxoplasma gondii infection.MethodsUsing the 2016 ENP data, which contain sociodemographic and clinical information from all women giving birth during a one week period, we calculated adjusted prevalence ratios (aPR) by sociodemographic factors. Using available data from prior ENPs (1995, 2003 and 2010), we calculated age-standardised seroprevalences and aPRs for French women.ResultsIn 2016, seroprevalence was 31.3% overall. Among French women, associations with increasing age (aPR: 1.54; 95% CI: 1.39-1.70), residence in Paris (aPR: 1.19; 95% CI: 1.08-1.31) or south-western regions (aPR: 1.19; 95% CI: 1.08-1.31), and higher professional status (aPR: 1.12; 95%CI 1.04-1.21) were observed. An association with increasing age was also evident among women from North Africa and sub-Saharan Africa. Age-standardised seroprevalence decreased from 55.0% in 1995 to 33.7% in 2016. Among French women, significant associations with age, Paris and south-west regions persisted across all ENPs.ConclusionHigher prevalences in older women may reflect a higher past risk of exposure while persistent geographical differences may reflect dietary or environmental differences. Toxoplasma seroprevalence among pregnant women continues to fall and will impact screening effectiveness. This warrants a comprehensive review to determine the appropriate future of prevention in France.
Assuntos
Toxoplasma , Toxoplasmose , África do Norte , Idoso , Anticorpos Antiprotozoários , Estudos Transversais , Feminino , França/epidemiologia , Humanos , Paris , Políticas , Gravidez , Gestantes , Fatores de Risco , Estudos Soroepidemiológicos , Toxoplasmose/diagnóstico , Toxoplasmose/epidemiologiaRESUMO
On 27 December 2019, the French Public Health Agency identified a large increase in the number of acute gastroenteritis and vomiting visits, both in emergency departments and in emergency general practitioners' associations providing house-calls. In parallel, on 26 and 27 December, an unusual number of food-borne events suspected to be linked to the consumption of raw shellfish were reported through the mandatory reporting surveillance system. This paper describes these concomitant outbreaks and the investigations' results.
Assuntos
Surtos de Doenças/estatística & dados numéricos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Doenças Transmitidas por Alimentos/virologia , Gastroenterite/epidemiologia , Vigilância da População/métodos , Vigilância de Evento Sentinela , Frutos do Mar/virologia , Vômito/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Fezes/virologia , Feminino , Contaminação de Alimentos , Doenças Transmitidas por Alimentos/epidemiologia , França/epidemiologia , Humanos , Masculino , Notificação de Abuso , Pessoa de Meia-Idade , Norovirus/genética , Norovirus/isolamento & purificação , Ostreidae/virologia , Saúde Pública , Vômito/epidemiologia , Adulto JovemRESUMO
We describe a Salmonella Poona outbreak involving 31 infant cases in France. Following outbreak detection on 18 January 2019, consumption of rice-based infant formula manufactured at a facility in Spain was identified as the probable cause, leading to a recall on 24 January. Whole genome sequencing analysis linked present outbreak isolates to a 2010-11 S. Poona outbreak in Spain associated with formula manufactured in the same facility, indicating a persistent source of contamination.
Assuntos
Surtos de Doenças/estatística & dados numéricos , Contaminação de Alimentos/análise , Fórmulas Infantis/microbiologia , Intoxicação Alimentar por Salmonella/epidemiologia , Salmonella enterica/isolamento & purificação , Feminino , França/epidemiologia , Estudo de Associação Genômica Ampla , Humanos , Lactente , Masculino , Instalações Industriais e de Manufatura , Intoxicação Alimentar por Salmonella/diagnóstico , Infecções por Salmonella/diagnóstico , Infecções por Salmonella/epidemiologia , Salmonella enterica/classificação , Salmonella enterica/genética , Sorogrupo , Sorotipagem , Espanha , Sequenciamento Completo do GenomaRESUMO
IntroductionHaemolytic uraemic syndrome (HUS) related to Shiga toxin-producing Escherichia coli (STEC) is the leading cause of acute renal failure in young children. In France, HUS surveillance in children aged < 15 years was implemented starting from 1996.AimWe present the results of this surveillance between 2007 and 2016.MethodsA voluntary nationwide network of 32 paediatric departments notifies cases. Two national reference centres perform microbiological STEC confirmation.ResultsOver the study period, the paediatric HUS incidence rate (IR) was 1.0 per 100,000 children-years, with a median of 116 cases/year. In 2011, IR peaked at 1.3 per 100,000 children-years, and decreased to 1.0 per 100,000 children-years in 2016. STEC O157 associated HUS peaked at 37 cases in 2011 and decreased to seven cases in 2016. Cases of STEC O26-associated HUS have increased since 2010 and STEC O80 associated HUS has emerged since 2012, with 28 and 18 cases respectively reported in 2016. Four STEC-HUS food-borne outbreaks were detected (three STEC O157 linked to ground beef and raw-milk cheese and one STEC O104 linked to fenugreek sprouts). In addition, two outbreaks related to person-to-person transmission occurred in distinct kindergartens (STEC O111 and O26).ConclusionsNo major changes in HUS IRs were observed over the study period of 10 years. However, changes in the STEC serogroups over time and the outbreaks detected argue for continuing epidemiological and microbiological surveillance.
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Surtos de Doenças , Infecções por Escherichia coli/microbiologia , Fezes/microbiologia , Síndrome Hemolítico-Urêmica/epidemiologia , Síndrome Hemolítico-Urêmica/microbiologia , Escherichia coli Shiga Toxigênica/isolamento & purificação , Criança , Infecções por Escherichia coli/diagnóstico , Infecções por Escherichia coli/epidemiologia , Proteínas de Escherichia coli , França/epidemiologia , Síndrome Hemolítico-Urêmica/complicações , Humanos , Incidência , Lactente , Masculino , Vigilância da População , Testes Sorológicos , Distribuição por Sexo , Toxinas ShigaRESUMO
We report an outbreak of Shiga toxin-producing Escherichia coli (STEC) associated paediatric haemolytic uraemic syndrome linked to the consumption of raw cow's milk soft cheeses. From 25 March to 27 May 2019, 16 outbreak cases infected with STEC O26 (median age: 22 months) were identified. Interviews and trace-back investigations using loyalty cards identified the consumption of raw milk cheeses from a single producer. Trace-forward investigations revealed that these cheeses were internationally distributed.
Assuntos
Queijo/intoxicação , Infecções por Escherichia coli/diagnóstico , Síndrome Hemolítico-Urêmica/diagnóstico , Leite/intoxicação , Escherichia coli Shiga Toxigênica/isolamento & purificação , Animais , Bovinos , Queijo/microbiologia , Pré-Escolar , Infecções por Escherichia coli/epidemiologia , Proteínas de Escherichia coli/isolamento & purificação , Feminino , França/epidemiologia , Síndrome Hemolítico-Urêmica/epidemiologia , Humanos , Lactente , Masculino , Leite/microbiologiaRESUMO
On 1 October 2019, a locally-acquired Zika virus disease case was laboratory confirmed in Hyères, Var department. Active case finding identified two additional locally-acquired cases living within 90 m, with symptom onset 8 days before the index case. Extensive patient interviews did not yield information supporting transmission through sexual contact or substances of human origin. Vector-borne transmission by local Aedes albopictus mosquitoes is the most likely mode of transmission. Here we describe the public health response.
Assuntos
Aedes/virologia , Mosquitos Vetores/virologia , Saliva/virologia , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/transmissão , Zika virus/isolamento & purificação , Animais , França , Humanos , Controle de Mosquitos/métodos , Infecção por Zika virus/virologiaRESUMO
On 1 December 2017, an outbreak of Salmonella Agona infections among infants was identified in France. To date, 37 cases (median age: 4 months) and two further international cases have been confirmed. Five different infant milk products manufactured at one facility were implicated. On 2 and 10 December, the company recalled the implicated products; on 22 December, all products processed at the facility since February 2017. Trace-forward investigations indicated product distribution to 66 countries.
Assuntos
Surtos de Doenças/estatística & dados numéricos , Contaminação de Alimentos/estatística & dados numéricos , Leite/microbiologia , Intoxicação Alimentar por Salmonella/epidemiologia , Infecções por Salmonella/epidemiologia , Salmonella/isolamento & purificação , Animais , Bovinos , Eletroforese em Gel de Campo Pulsado , Feminino , Microbiologia de Alimentos , França/epidemiologia , Humanos , Incidência , Lactente , Masculino , Salmonella/classificação , Salmonella/genética , Intoxicação Alimentar por Salmonella/microbiologia , Infecções por Salmonella/microbiologia , SorotipagemRESUMO
BackgroundClusters of dengue cases have recently become more frequent in areas of southern France colonised by the vector mosquito Aedes albopictus. In July 2015, a 2-month outbreak of dengue virus serotype 1 (DENV-1) was reported in Nîmes. Aim: We conducted a serosurvey in the affected area at the end of the vector activity period to determine the true extent of dengue transmission. Methods: We collected capillary blood from consenting household members, and information on their medical and travel histories, and exposure to mosquito bites. Recent infections were identified using IgM and IgG anti-DENV ELISA, followed, when positive, by plaque reduction neutralisation tests on serum against DENV 1-4 and West Nile virus. The prevalence estimator was calibrated on reference demographic data. We quantified the spatial clustering of dengue cases within the affected community and inferred the transmission tree. Results: The study participation rate was 39% (564/1,431). Three of 564 participants tested positive for DENV-1 infection (after marginal calibration, 0.41%; 95% confidence interval: 0.00-0.84). The spatial analysis showed that cases were clustered at the household level. Most participants perceived the presence of mosquitos as abundant (83%) and reported frequent mosquito bites (57%). We incidentally identified six past West Nile virus infections (0.9%; 95% CI: 0.2-1.6). Conclusion: This serosurvey confirms the potential for arboviral diseases to cause outbreaks - albeit limited for now - in France and Europe.
Assuntos
Aedes/virologia , Vírus da Dengue/isolamento & purificação , Dengue/diagnóstico , Surtos de Doenças , Mosquitos Vetores , Animais , Dengue/epidemiologia , Vírus da Dengue/classificação , Vírus da Dengue/genética , Surtos de Doenças/estatística & dados numéricos , Feminino , França/epidemiologia , Humanos , Masculino , Prevalência , Estudos Soroepidemiológicos , Análise EspacialRESUMO
Since mid-2016, hepatitis A virus (HAV) outbreaks, involving predominantly men who have sex with men (MSM), have affected countries in Europe and overseas. In France, HAV screening of blood donations in 2017 revealed a HAV-RNA prevalence ca fivefold higher than during 2015-16 (4.42/106 vs 0.86/106; p = 0.0005). In 2017, despite a higher male-to-female ratio (5.5 vs 0.7) and the identification of MSM-associated outbreak strains, only one of 11 infected male donors self-reported being a MSM.
Assuntos
Vírus da Hepatite A/isolamento & purificação , Hepatite A/epidemiologia , Homossexualidade Masculina/estatística & dados numéricos , Adolescente , Adulto , Idoso , Doadores de Sangue , Surtos de Doenças , Feminino , França/epidemiologia , Vírus da Hepatite A/genética , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
Estimates of the annual numbers of foodborne illnesses and associated hospitalizations and deaths are needed to set priorities for surveillance, prevention, and control strategies. The objective of this study was to determine such estimates for 2008-2013 in France. We considered 15 major foodborne pathogens (10 bacteria, 3 viruses, and 2 parasites) and estimated that each year, the pathogens accounted for 1.28-2.23 million illnesses, 16,500-20,800 hospitalizations, and 250 deaths. Campylobacter spp., nontyphoidal Salmonella spp., and norovirus accounted for >70% of all foodborne pathogen-associated illnesses and hospitalizations; nontyphoidal Salmonella spp. and Listeria monocytogenes were the main causes of foodborne pathogen-associated deaths; and hepatitis E virus appeared to be a previously unrecognized foodborne pathogen causing ≈68,000 illnesses in France every year. The substantial annual numbers of foodborne illnesses and associated hospitalizations and deaths in France highlight the need for food-safety policymakers to prioritize foodborne disease prevention and control strategies.
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Infecções Bacterianas/epidemiologia , Microbiologia de Alimentos , Doenças Transmitidas por Alimentos/epidemiologia , Hospitalização/estatística & dados numéricos , Viroses/epidemiologia , Infecções Bacterianas/mortalidade , Campylobacter/isolamento & purificação , Campylobacter/patogenicidade , Inocuidade dos Alimentos , Doenças Transmitidas por Alimentos/mortalidade , França/epidemiologia , Vírus da Hepatite E/isolamento & purificação , Vírus da Hepatite E/patogenicidade , Humanos , Listeria monocytogenes/isolamento & purificação , Listeria monocytogenes/patogenicidade , Norovirus/isolamento & purificação , Norovirus/patogenicidade , Vigilância em Saúde Pública , Salmonella/isolamento & purificação , Salmonella/patogenicidade , Análise de Sobrevida , Viroses/mortalidadeRESUMO
During 2015-2016, we evaluated the performance of whole-genome sequencing (WGS) as a routine typing tool. Its added value for microbiological and epidemiologic surveillance of listeriosis was compared with that for pulsed-field gel electrophoresis (PFGE), the current standard method. A total of 2,743 Listeria monocytogenes isolates collected as part of routine surveillance were characterized in parallel by PFGE and core genome multilocus sequence typing (cgMLST) extracted from WGS. We investigated PFGE and cgMLST clusters containing human isolates. Discrimination of isolates was significantly higher by cgMLST than by PFGE (p<0.001). cgMLST discriminated unrelated isolates that shared identical PFGE profiles and phylogenetically closely related isolates with distinct PFGE profiles. This procedure also refined epidemiologic investigations to include only phylogenetically closely related isolates, improved source identification, and facilitated epidemiologic investigations, enabling identification of more outbreaks at earlier stages. WGS-based typing should replace PFGE as the primary typing method for L. monocytogenes.
Assuntos
Genoma Bacteriano , Listeria monocytogenes/genética , Sequenciamento Completo do Genoma/métodos , Surtos de Doenças , Monitoramento Epidemiológico , Microbiologia de Alimentos , França/epidemiologia , Humanos , Listeria monocytogenes/classificação , Listeria monocytogenes/isolamento & purificação , Listeriose/epidemiologia , Listeriose/microbiologia , Tipagem Molecular/métodosRESUMO
No specific surveillance system of cystic echinococcosis infections in humans exists in France. The incidence and trends over time have not been documented since the last decade of the twentieth century. We performed the current analysis to assess human cystic echinococcosis epidemiology over a 10-year period in France (including the island of Corsica but excluding the overseas territories) using a nationwide hospital medical information database. A total number of 2629 patients were identified in this database between 2005 and 2014. The average annual incidence rate was 0.42 hospitalized cases/100,000 inhabitants. It was highest in the Island of Corsica (1.76 cases/100,000) and in the region Provence-Alpes-Côte d'Azur (0.85 cases/100,000). This retrospective analysis of hospital records provides a population-based estimate of cystic echinococcosis incidence and trends over a 10-year period at a national level. It indicates a significant decrease of the incidence between 2005 and 2014 at the national level and in the area that reported the highest incidence. It stresses the fact that in France, cystic echinococcosis is not re-emerging and that the incidence remains low in comparison with similar studies in other Mediterranean countries.