Le concept de maladies virales émergentes : quel risque de zoonose pour La Réunion ?

A La Réunion, le risque d'émergence de maladies virales est constitué par plusieurs zoonoses virales qu'il convient de surveiller: infections à virus Sindbis, virus de l'encéphalite japonaise, virus Wesselsbron, virus Nipah, virus Zika, virus West Nile, virus de la fièvre de la vallée du Rift. La lutte contre ces maladies virales émergentes (MVE) passe par une détection précoce des cas et donc un système de surveillance doté d'un véritable réseau d'information, d'alerte et de prévention international. (Résumé d'auteur

Survival Analysis to Estimate Association between Short-Term Mortality and Air Pollution

BACKGROUND: Ecologic studies are commonly used to report associations between short-term air pollution and mortality. In such studies, the unit of observation is the day rather than the individual. Moreover, individual data on the subjects are rarely available, which limits the assessment of individual risk factors. These associations can also be investigated using case–crossover studies. However, by definition, individual risk factors are not studied, and such studies analyze only dead subjects, which limits the statistical power. OBJECTIVE: We suggest that the survival analysis is more suitable when cohorts are examined with a time-dependent ecologic exposure. To our knowledge, to date this type of analysis has never been proposed. DESIGN, PARTICIPANTS, MEASUREMENTS: In the present study we used a Cox proportional hazards model to investigate the distribution over time of the short-term effect of black smoke and sulfur dioxide in 439 nonaccidental and 158 cardiorespiratory deaths among the 1,469 subjects of the Personnes Agées QUID (PAQUID) cohort in Bordeaux, France. The model has a delayed entry and a polynomial distributed lag from 0 to 5 days. Results are adjusted for individual risk factors, temperature, relative humidity, weekday, season, influenza epidemics, and a time function to control temporal trends. RESULTS: We identified a positive and significant association between cardiorespiratory mortality and black smoke, with a 24% increase in deaths 3 days after a 10-μg/m(3) increase in black smoke (95% confidence interval, 4–47%). CONCLUSIONS: We conclude that the Cox proportional hazards model with time-dependent covariates is very suitable to investigate simultaneously the short-term effect of air pollution on health and the effect of individual risk factors on a cohort study

Ressort d'orthodontie hélicoïdal et son procédé de fabrication

Les trois auteurs: Marie-Pierryle Filleul, Jean-Maxime Terrasse et George Olivier ont l'affiliation suivante: Faculté d'Odontologie de Nancy (Université de Lorraine)Ressort d'orthodontie hélicoïdal et son procédé de fabricatio

Ambient Air Pollution, Social Inequalities and Asthma Exacerbation in Greater Strasbourg (France) Metropolitan Area: the PAISA Study

International audienceThe socio-economic status (SES) of populations has an influence on the incidence or mortality rates of numerous health outcomes, among which respiratory diseases (Prescott et al., 2003; Ellison-Loschmann et al., 2007). Considering asthma, the possible contribution of SES to overall prevalence –regardless of asthma severity-, remains controversial in industrialized countries. Several studies indicate that allergic asthma is more prevalent in more well-off populations whereas the non-allergic forms of asthma are more common in the deprived ones (Cesaroni et al., 2003; Blanc et al., 2006). On the other hand, severe asthma whatever its etiology appears to be more frequent in the latter populations, as compared to the more affluent (Basagana et al., 2004). Risk factors for exacerbations (e.g., passive smoking (Wright Subramanian, 2007), psychosocial stress (Gold & Wright, 2005), cockroach allergens (Kitch et al., 2000), and suboptimal compliance with anti-inflammatory medication (Gottlieb et al., 1995)) are generally more common among people with asthma and low SES than their better-off counterparts. These observations support the hypothesis that some factors more present in deprived populations contribute to asthma exacerbation (Mielck et al., 1996)

A226V Strains of Chikungunya Virus, Réunion Island, 2010

International audienceChikungunya virus (CHIKV) first emerged in Indian Ocean islands off the eastern coast of Africa in 2005 and was responsible for large-scale epidemics on the islands of Réunion, Comoros, Mayotte, Mauritius, Madagascar, and Seychelles (1–4). On Réunion Island, a French overseas territory of 810,000 inhabitants, herd immunity reached 38% in October 2006 (5). Molecular epidemiology of the strain responsible for these outbreaks indicated that it had originated in Kenya (6). The epidemic on Réunion Island was associated with a mutation in the envelope protein gene (E1-A226V) that improves replication and transmission efficiency in Aedes albopictus mosquitoes (7)

The Relation Between Temperature, Ozone, and Mortality in Nine French Cities During the Heat Wave of 2003

BACKGROUND: During August 2003, record high temperatures were observed across Europe, and France was the country most affected. During this period, elevated ozone concentrations were measured all over the country. Questions were raised concerning the contribution of O(3) to the health impact of the summer 2003 heat wave. METHODS: We used a time-series design to analyze short-term effects of temperature and O(3) pollution on mortality. Counts of deaths were regressed on temperatures and O(3) levels, controlling for possible confounders: long-term trends, season, influenza outbreaks, day of the week, and bank holiday effects. For comparison with previous results of the nine cities, we calculated pooled excess risk using a random effect approach and an empirical Bayes approach. FINDINGS: For the nine cities, the excess risk of death is significant (1.01%; 95% confidence interval, 0.58–1.44) for an increase of 10 μg/m(3) in O(3) level. For the 3–17 August 2003 period, the excess risk of deaths linked to O(3) and temperatures together ranged from 10.6% in Le Havre to 174.7% in Paris. When we compared the relative contributions of O(3) and temperature to this joint excess risk, the contribution of O(3) varied according to the city, ranging from 2.5% in Bordeaux to 85.3% in Toulouse. INTERPRETATION: We observed heterogeneity among the nine cities not only for the joint effect of O(3) and temperatures, but also for the relative contribution of each factor. These results confirmed that in urban areas O(3) levels have a non-negligible impact in terms of public health

Intensive Care Unit Admission for Pandemic (H1N1) 2009, Reunion Island, 2009

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