Influenza pandemic preparedness in France: modelling the impact of interventions.

BACKGROUND: Influenza pandemics result in excess mortality and social disruption. To assist health authorities update the French pandemic plan, the authors estimated the number of health events (cases, hospitalisations, and deaths) in a pandemic and compared interventions in terms of impact and efficiency. METHOD: A Monte Carlo simulation model, incorporating probability distributions of key variables, provided estimates of health events (HE) by age and risk group. Input variables were set after literature and expert consultation. The impact of targeted influenza vaccination and antiviral prophylaxis/treatment (oseltamivir) in high risk groups (elderly, chronic diseases), priority (essential professionals), and total populations was compared. Outcome measures were HE avoided, number of doses needed, and direct cost per HE avoided. RESULTS: Without intervention, an influenza pandemic could result in 14.9 million cases, 0.12 million deaths, and 0.6 million hospitalisations in France. Twenty four per cent of deaths and 40% of hospitalisations would be among high risk groups. With a 25% attack rate, 2000-86,000 deaths could be avoided, depending on population targeted and intervention. If available initially, vaccination of the total population is preferred. If not, for priority populations, seasonal prophylaxis seems the best strategy. For high risk groups, antiviral treatment, although less effective, seems more feasible and cost effective than prophylaxis (respectively 29% deaths avoided; 1800 doses/death avoided and 56% deaths avoided; 18,500 doses/death avoided) and should be chosen, especially if limited drug availability. CONCLUSION: The results suggest a strong role for antivirals in an influenza pandemic. While this model can compare the impact of different intervention strategies, there remains uncertainty surrounding key variables

Data from: Characterizing and comparing the seasonality of influenza-like illnesses and invasive pneumococcal diseases using seasonal waveforms

The seasonalities of influenza-like illnesses (ILIs) and invasive pneumococcal diseases (IPDs) remain incompletely understood. Experimental evidence indicates that influenza-virus infection predisposes to pneumococcal disease, so that a correspondence in the seasonal patterns of ILIs and IPDs might exist at the population level. We developed a method to characterize seasonality by means of easily interpretable summary statistics of seasonal shape—or seasonal waveforms. Non-linear mixed-effects models were used to estimate those waveforms based on weekly case reports of ILIs and IPDs in five regions spanning continental France from July 2000 to June 2014. We found high variability of ILI seasonality, with marked fluctuations of peak amplitudes and peak times, but a more conserved epidemic duration. In contrast, IPD seasonality was best modeled by a markedly regular seasonal baseline, punctuated by two winter peaks in late December–early January and January–February. Comparing ILI and IPD seasonal waveforms, we found indication of a small, positive correlation. Direct models regressing IPDs on ILIs provided comparable results, even though they estimated moderately larger associations. The method proposed is broadly applicable to diseases with unambiguous seasonality and is well-suited to analyze spatially or temporally grouped data, which are common in epidemiology

Data and R codes associated with "Characterizing and Comparing the Seasonality of Influenza-Like Illnesses and Invasive Pneumococcal Diseases Using Seasonal Waveforms"

The zipped folder contains the data and the R scripts needed to perform the estimation of the influenza-like illness (ILI) seasonal waveforms, based on region-level weekly incidence data in France during 2000/01–2013/14

O dois e seu múltiplo: reflexões sobre o perspectivismo em uma cosmologia tupi

A partir da caça de porco do mato, este artigo é um ensaio etnográfico sobre uma noção indígena de ponto de vista, aplicada ao campo das relações entre o humano e o animal, na cosmologia de um povo Tupi, os Juruna. Além de revelar a complexidade particular dessas relações, a noção de ponto de vista permite mostrar como a noção de duplo é irredutível à noção de alma, como "natureza" e "sobrenatureza" são efeitos de perspectivas, e como, finalmente, a caça se insere em uma estrutura espaço-temporal bilinear múltipla, evocadora dos "labirintos" que os Juruna desenham na pele.<br>This article takes the wild boar hunt as the basis for an ethnographic essay on an indigenous notion of point of view, applied to the field of relations between humans and animals in the cosmology of a Tupi people, the Juruna. In addition to revealing the particular complexity of these relations, the concept of point of view shows how the notion of double is irreducible to that of soul, like "nature"and "supernature"are effects of perspectives, and finally how the hunt is included in a multiple bilinear spatial/temporal structure, evoking the "labyrinths" that the Juruna paint on their skin

First cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infections in France, investigations and implications for the prevention of human-to-human transmission, France, May 2013

International audienceIn May 2013, Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection was diagnosed in an adult male in France with severe respiratory illness, who had travelled to the United Arab Emirates before symptom onset. Contact tracing identified a secondary case in a patient hospitalised in the same hospital room. No other cases of MERS-CoV infection were identified among the index case’s 123 contacts, nor among 39 contacts of the secondary case, during the 10-day follow-up period

Representación matemática de una terapéutica: circulación de inscripciones tecnocientíficas en el tratamiento de la litotripsia extracorporal The mathematic representation of a treatment: the circulation of technoscientific inscriptions in extracorporeal lithotripsy

La noción estandarizada en las ciencias sociales en torno a la representación se refiere a los conocimientos expresados en el lenguaje provenientes de elaboraciones supraindividuales. Esta noción enfatiza el sustento social del conocimiento, pero minimiza los sustentos materiales y simbólicos que le son inherentes y sin los cuales no podría ser cabalmente comprendido. Sostengo que la circulación de inscripciones heterogéneas soporta la elaboración de las representaciones y para demostrarlo analizo las prácticas del mejoramiento de una terapéutica para cálculos renales, mostrando cómo los científicos ponen en circulación una serie de objetos, animales, modelos, textos, etc., hasta transformarlos en una representación matemática de una terapéutica.<br>Within the social sciences, the standardized notion of representation refers to knowledge expressed through language and sourced from supra-individual thought processes. This notion underscores the social foundation of knowledge while minimizing its inherent material and symbolic foundations, without which it cannot be wholly understood. The article argues that the circulation of heterogeneous inscriptions underpins the elaboration of representations. To demonstrate this, I analyze practices intended to improve a therapeutic treatment for kidney stones and show how scientists place a series of objects, animals, models, texts, and so on in circulation, eventually transformed into the mathematic representation of a treatment