Assurer la communication politique à l'étranger : enjeux et stratégies linguistiques au début du xviie siècle

Une langue commune est la condition sine qua non de tout dialogue, plus encore lorsque la communication politique se tourne vers l'extérieur. Mais, outre la dissension fréquente entre unités politiques et zones linguistiques, la recherche d'une langue commune doit intégrer des pré-requis diplomatiques comme la défense du prestige du souverain ou l'expression d'une certaine déférence. Si une langue commune est l'outil indispensable du travail diplomatique quotidien, la communication politique ne peut se faire sans la maîtrise de l'ensemble des langues de la zone concernée et nécessite alors un recours à des interprètes ou à des traductions avec leurs problèmes inhérents de transposition et de possible perversion de l'information originale. La question de l'usage des langues avant 1648 étant souvent ignorée des études diplomatiques, il s'agit de s'interroger sur les difficultés et les atouts des usages linguistiques dans la communication politique d'un État à l'étranger au début du xviie siècle

Comment réduire l'incidence de listériose humaine? (Bilan de 30 ans de surveillance épidémiologique en France)

La surveillance de la listériose en France s est construite par étapes depuis les années 1980 sur deux piliers, la microbiologie et l épidémiologie. Grâce à la création du Centre National de Référence des Listeria et à la mise au point de techniques de typage performantes, l Institut Pasteur assure une surveillance microbiologique depuis 1987. Une surveillance épidémiologique initiée entre 1984 et 1992 par le Laboratoire National de la Santé, a été développée par le Réseau National de Santé Publique de 1993 à 1999, puis amplifiée par l Institut de Veille Sanitaire à partir de 2000. Le premier objectif de cette thèse est de décrire les différentes phases de la construction de cette surveillance afin d analyser leurs contributions respectives au cours de ces 30 dernières années. Cette construction s est faite en 4 phases : 1. L étape fondatrice de 1982 à 1992 a été la reconnaissance et la prise en compte du rôle des aliments dans la transmission de la maladie et dans la survenue d épidémies. 2. La deuxième phase de 1993 à 2000 a été l édification d un système de surveillance opérationnel pour détecter et investiguer les épidémies en France. 3. La troisième phase de 2000 à 2005 a permis de consolider le système de surveillance et de le perfectionner en ajoutant un volet complémentaire avec des prélèvements alimentaires.4. Depuis 2005, nous sommes dans la quatrième phase avec comme objectif l optimisation du système. Cette optimisation repose sur l adaptation des outils de surveillance et d alerte aux connaissances. Ainsi, après avoir montré que la durée d incubation de la maladie varie selon la forme clinique de la maladie, nous avons proposé d intégrer cette variation pour déterminer la période d évaluation des expositions alimentaires à risque. L analyse des performances du système a permis à deux reprises de proposer de nouveaux seuils de signalement plus spécifiques afin d optimiser cette surveillance tout en réduisant son coût. Le deuxième objectif de cette thèse est de montrer la contribution des données de surveillance à une politique de santé publique. Un premier travail a consisté à mettre en perspective les variations temporelles d incidence observées avec les différentes sources de données disponibles afin d en analyser les déterminants. La phase de décroissance de 1987 à 1997 a été concomitante des mesures de contrôles prises par l industrie agro-alimentaire et de la réduction de la contamination des aliments. La phase d augmentation en 2006-2007 semble multifactorielle. L augmentation de la prescription de traitements de réduction de l acidité gastrique par des inhibiteurs de la pompe à protons pourrait être l un des déterminants majeurs de cette augmentation.Dans une deuxième analyse, nous avons hiérarchisé les groupes à risque de listériose sur la base de l estimation du taux d incidence de listériose et de sa mortalité dans ces groupes. Cela a permis d identifier les groupes les plus vulnérables : hémopathies, certains cancers (digestifs, cérébral et pulmonaire), maladie de Horton, cirrhose hépatique, les dialysés rénaux, les greffés, et les femmes enceintes. Une analyse épidémiologique des listérioses materno-néonatales (MN) a montré une association entre les régions avec une incidence plus faible de listérioses materno-néonatales et les régions où la séroprévalence toxoplasmique des femmes enceintes est la plus faible, ce qui suggère un effet positif des recommandations contre la toxoplasmose pour la prévention de la listériose MN.Listeriosis surveillance was built up stage by stage in France since the 1980s on a twofold basis: microbiology and epidemiology. Thanks to the creation of the Listeria National Reference Centre (Centre National de Référence des Listeria), the Pasteur Institute has been doing microbiological surveillance since 1987. Epidemiological surveillance was initiated by the National Health Laboratory, then conducted by the National Health Network and further developed by the National Institute of Health Surveillance. This thesis aims first of all to describe the different stages in the setting up of this surveillance system in order to analyze their respective inputs during these last thirty years. The four stages are:1. From 1982 to 1992: awareness and recognition of the role of food in the transmission of listeriosis and as the source of outbreaks. 2. From 1993 to 2000: building a reliable surveillance system in order to detect and investigate outbreaks in France. 3. From 2000 to 2005: strengthening and perfecting the surveillance system by taking additional measures, such as food sampling.4. Since 2005, we have reached the fourth stage, designed to optimize the surveillance system. This optimization involves adapting surveillance and early warning tools to new knowledge and information. For instance, having established that listeriosis incubation periods vary according to the clinical form of the illness, we suggested the integration of the variation of exposure period factor when interviewing patients with the food questionnaire. On two separate occasions, analysis of the surveillance system performance results made it possible to modify the criteria for early warning so as to optimize surveillance by increasing its specificity whilst reducing costs.The second aim of this thesis is to illustrate how surveillance data can contribute to public health policies. A first study analyzed temporal trends, using all available data in order to give some explanation as to major trends. The first trend was a reduction of incidence from 1987 to 1997 that was concomitant with control measures by the food industry and a drop in food contamination. The increased trend observed in 2006-2007 appears to be due to several factors. The increased rate of sales of proton pump inhibitors medication could be the major factor in this increase. In a second study, we ranked groups at risk of acquiring listeriosis based on the incidence of listeriosis and its lethality in each group. This enabled us to identify the most vulnerable groups : hematological malignancy, some cancers (digestive, lung, and brain cancer), dialysis, cirrhosis, organ transplantation and pregnancy. Epidemiological analysis of listeriosis cases associated with pregnancy indicated an association between regions with low rate listeriosis associated with pregnancy and regions where toxoplasmosis prevalence of pregnant women is low. This suggests that recommendations for avoiding toxoplasmosis have a positive effect on preventing listeriosis during pregnancy.PARIS11-SCD-Bib. électronique (914719901) / SudocSudocFranceF

Effect of prevention measures on incidence of human listeriosis, France, 1987-1997.

To assess the impact of preventive measures by the food industry, we analyzed food monitoring data as well as trends in the incidence of listeriosis estimated through three independent sources: the National Reference Center of Listeriosis; a laboratory-based active surveillance network; and two consecutive nationwide surveys of public hospital laboratories. From 1987 to 1997, the incidence of listeriosis decreased by an estimated 68%. A substantial reduction in the proportion of Listeria monocytogenes-contaminated products was observed at the retail level. The temporal relationship between prevention measures by the food industry, reduction in L. monocytogenes-contaminated foodstuffs, and reduction in listeriosis incidence suggests a causal relationship and indicates that a substantial part of the reduction in illness is related to prevention efforts

Predicting dengue fever outbreaks in French Guiana using climate indicators

Background Dengue fever epidemic dynamics are driven by complex interactions between hosts, vectors and viruses. Associations between climate and dengue have been studied around the world, but the results have shown that the impact of the climate can vary widely from one study site to another. In French Guiana, climate-based models are not available to assist in developing an early warning system. This study aims to evaluate the potential of using oceanic and atmospheric conditions to help predict dengue fever outbreaks in French Guiana. Methodology/Principal Findings Lagged correlations and composite analyses were performed to identify the climatic conditions that characterized a typical epidemic year and to define the best indices for predicting dengue fever outbreaks during the period 1991-2013. A logistic regression was then performed to build a forecast model. We demonstrate that a model based on summer Equatorial Pacific Ocean sea surface temperatures and Azores High sea-level pressure had predictive value and was able to predict 80% of the outbreaks while incorrectly predicting only 15% of the non-epidemic years. Predictions for 2014-2015 were consistent with the observed non-epidemic conditions, and an outbreak in early 2016 was predicted. Conclusions/Significance These findings indicate that outbreak resurgence can be modeled using a simple combination of climate indicators. This might be useful for anticipating public health actions to mitigate the effects of major outbreaks, particularly in areas where resources are limited and medical infrastructures are generally insufficient

Studies Needed to Address Public Health Challenges of the 2009 H1N1 Influenza Pandemic: Insights from Modeling

In light of the 2009 influenza pandemic and potential future pandemics, Maria Van Kerkhove and colleagues anticipate six public health challenges and the data needed to support sound public health decision making.The authors acknowledge support from the Bill & Melinda Gates Foundation (MDVK, CF, NMF); Royal Society (CF); Medical Research Council (MDVK, CF, PJW, NMF); EU FP7 programme (NMF); UK Health Protection Agency (PJW); US National Institutes of Health Models of Infectious Disease Agent Study program through cooperative agreement 1U54GM088588 (ML); NIH Director's Pioneer Award, DP1-OD000490-01 (DS); EU FP7 grant EMPERIE 223498 (DS); the Wellcome Trust (DS); 3R01TW008246-01S1 from Fogerty International Center and RAPIDD program from Fogerty International Center with the Science & Technology Directorate, Department of Homeland Security (SR); and the Institut de Veille Sanitaire Sanitaire funded by the French Ministry of Health (J-CD). The funders played no role in the decision to submit the article or in its preparation

Salmonellosis Outbreak Traced to Playground Sand, Australia, 2007–2009

A community outbreak of gastroenteritis in Australia during 2007–2009 was caused by ingestion of playground sand contaminated with Salmonella enterica Paratyphi B, variant Java. The bacterium was also isolated from local wildlife. Findings support consideration of nonfood sources during salmonellosis outbreak investigations and indicate transmission through the animal–human interface

VEB-1 Extended-Spectrum β-lactamase–producing Acinetobacter baumannii, France1

VEB-1 extended-spectrum β-lactamase–producing Acinetobacter baumannii was responsible for an outbreak in hospitals in France. A national alert was triggered in September 2003 when 4 hospitals reported clusters of A. baumannii infection with similar susceptibility profiles. Case definitions and laboratory guidelines were disseminated, and prospective surveillance was implemented; strains were sent to a single laboratory for characterization and typing. From April 2003 through June 2004, 53 hospitals reported 290 cases of A. baumannii infection or colonization; 275 isolates were blaVEB-1-positive and clonally related. Cases were first reported in 5 districts of northern France, then in 10 other districts in 4 regions. Within a region, interhospital spread was associated with patient transfer. In northern France, investigation and control measures led to a reduction of reported cases after January 2004. The national alert enabled early control of new clusters, demonstrating the usefulness of early warning about antimicrobial drug resistance

Human immunodeficiency virus type 1 incidence among blood donors in France, 1992 through 2006: use of an immunoassay to identify recent infections

BACKGROUND: In France, blood donations found to be positive for the presence of human immunodeficiency virus type 1 (HIV-1) are further tested to detect recent infections (≤180 days) using an enzyme immunoassay (EIA-RI) developed in 2002. The characteristics of recently infected donors, estimates of HIV-1 incidence, and the residual risk of transfusion-transmitted HIV-1 are presented, in both first-time and repeat donors. STUDY DESIGN AND METHODS: Of the 1027 donations found to be HIV-1–positive between 1992 and 2006, a total of 459 could be retrospectively tested with the EIA-RI. Multivariate analysis was performed to determine the donor characteristics associated with recent infection. Incidence rates and residual risk obtained with the EIA-RI were compared to classical cohort estimates derived from repeat donor histories. RESULTS: Of the 459 HIV-1–positive donors studied, 105 (22.9%; 95% confidence interval [CI], 19.2-27.0) were identified as recently infected. Factors independently associated with recent infection were repeat donor status (adjusted odds ratio [AOR], 4.0; 95% CI, 2.4-6.9) and non-B subtypes (AOR, 2.0; 95% CI, 1.2-3.6). Incidence decreased from 4.3 (95% CI, 1.9-9.4) in 1992 through 1994 to 1.3 (95% CI, 0.6-2.8) per 105 in 2004 through 2006 in first-time donors and from 3.2 (95% CI, 2.0-5.0) to 0.8 (95% CI, 0.4-1.4) per 105 in repeat donors. Incidence and residual risk estimates were similar to those obtained with the classical cohort method. CONCLUSION: This study suggests that the EIA-RI can be used to estimate HIV-1 incidence in a population with low HIV incidence. The estimated HIV-1 incidence in the blood donor population confirms the extremely low risk (1 in 3,350,000 donations) of HIV-infected blood donations entering the blood supply in France