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Virus De La Dengue, Flavivirus  Virus Zika, Flavivirus

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Virus De La Dengue, Flavivirus  Virus Zika, Flavivirus Actualités sur les émergences virales 2012‐2014 Les arboviroses : Pr Rémi CHARREL, Université d’Aix Marseille ‐ Institut de Recherche pour le Développement , Marseille, France IHU Méditerranée Infection, Marseille, France ACNBH 43ème Colloque National des Biologistes des Hôpitaux Marseille, 5‐7 novembre 2014 ODPC N°1495 DECLARATION D’INTERET DANS LE CADRE DE MISSIONS DE FORMATION REALISEES POUR L’ACNBH Pr. Rémi CHARREL Exerçant au CHU APHM Timone et IHU Méditerranée –Infection déclare sur l’honneur ne pas avoir d'intérêt, direct ou indirect (financier) avec les entreprises pharmaceutiques, du diagnostic ou d’édition de logiciels susceptible de modifier mon jugement ou mes propos, concernant le DMDIV et/ou le sujet présenté. Modalités de la recherche bibliographique dans le journal Eurosurveillance, édité par le ECDC o Gratuit o hebdomadaire o Open Access o www.eurosurveillance.org/ o dans PubMED 2012‐2014: www.ncbi.nlm.nih.gov/pubmed/ dans ProMED: www.promedmail.org/ Les virus dont nous allons parler: les arbovirus ARthropod‐BOrne virus transmis par les moustiques du genre Culex virus West Nile, flavivirus Virus Usutu, flavivirus transmis par les moustiques du genre Aedes virus de la dengue, flavivirus virus Zika, flavivirus virus Chikungunya, alphavirus Les virus dont nous allons parler: les arbovirus ARthropod‐BOrne virus transmis par les phlébotomes virus Toscana, Phlebovirus, Bunyaviridae Les virus dont nous allons parler: les virus non vectorisés transmis par contact avec le sang et fluides biologiques virus Ebola, filovirus transmis par voie respiratoire et manuportage MERS Coronavirus, coronavirus virus de la grippe, orthomyxovirus Virus West Nile transmited by Culex mosquitoes worldwide geographic dissemination since 1999 Virus West Nile Genetic lineages in the Old world Virus West Nile Genetic lineages in Europe Virus West Nile, 2012‐2014 Serbia: Aug‐Oct 2012: lineage 2 o WNV in humans: 58 cases, 9 deaths o WNV in birds Serbia: Apr‐Oct 2013: WNV in mosquitoes Czech Republic, 2013 : WNV lineage 2 isolated from Culex modestus Greece: 2012: epidemic in humans, 3rd consecutive year local transmission, virus established Italy, Jul‐Sept 2012, WNV in humans: 13 cases in northeastern Italy: lineage 1a Virus West Nile, 2012‐2014 Virus West Nile, 2012‐2014 En France RAS chez • moustiques • oiseaux • équidés • humains Virus Usutu, 2012‐2014 Usutu West Nile Virus Usutu, 2012‐2014 North Italy, 2012: USUV in Culex Usutu virus in bats, Germany, 2013 Piemont, 2012: USUV in Culex pipiens Croatia, 2013: USUV in humans: neuroinvasive cases Belgium, 2012: USUV in bird Czech Republic, 2012: USUV in birds Virus Toscana transmis par les phlébotomes virus Toscana, Phlebovirus, Bunyaviridae Journal of Infection, 2013 Age = 4 ‐ 76 year‐old (median= 40) 11 man, 6 women 2 children: 4‐ and 7‐year old All presented clinical signs compatible with TOSV infection fever 17/17 neuroinvasive disease: n= 13 ‐ Acute aseptic meningitis (n=6) ‐ encephalitis (n=4) ‐ left lower limb fasciitis (n=1) ‐ left uper limb hemiparesis (n=1) ‐ myositis (n=1) not neuroinvasive: (n=4) ‐ fever, headache, stiff neck Journal of Infection, 2013 13/17 cases (76%) during summertime (June to August), corresponding to the peak period of sandflies circulation in France and Europe 2/17 occurred in autumn (September and November 2009) 2/17 occurred in early spring (April 2007 and March 2010) 15/17 were autochthonous, whereas two patients reported were returning from Croatia and Tuscany (Italy), respectively Virus Toscana Greece, 2014: a case of severe encephalitis Czech Republic: imported case of meningo‐encephalitis in a returning traveler Morocco, Tunisia, Algeria: first evidence of the presence of Toscana virus and of the vector France: a series of 11 cases of Toscana virus infection France: evidence of the presence of Toscana virus in Corsica France, 2014: 2 cases of meningitis in Marseille France, 2012: atypical forms of Toscana virus infections: myositis, fasciitis Tunisia, 2013: Toscana virus isolated from sandflies Spain, Catalonia: reported cases Croatia, 2012: Toscana virus in humans and virus detected in sandflies Italy, Sicily, 2012‐2014: Toscana virus cases in humans Portugal: Toscana virus infections in humans Turkey: Toscana virus infections in humans, and virus detected in sandflies in several regions Virus Toscana : surveillance annuelle Période 2003 – 2010 Données CNR des Arbovirus et CIRE PACA (P. Despres, A. Armengaud) Cas neuroinvasifs (LCR et fièvre chez sujet > 15 ans) 50 cas 4 –10 cas de méningite ou d’encéphalite diagnostiqués / saison 28 hommes / 22 femmes Age médian 37 ans (17 ‐‐‐ 85 ans) Période 2011‐ 2013 en cours d'acquisition et d'analyse (I. Leparc‐Goffart) 2013: 6 cas 2014: 3 cas Virus Toscana : situation in 2014 Virus Toscana 250 millions persons exposed to Toscana virus Virus Toscana Toscana virus is the first arbovirus in Europe and in FRANCE Virus Toscana: étude épidémiologique EFS In FRANCE 0.75% > 8 million people0.8% at risk of0.37% 0.0% 0.7% 1.7% 7.3% Toscana virus infection5.5% 0.0% 2.5% 6.3% 10.2% 4.3% 1.8% 1.2% 7.9% 1.7% 3.7% 3% 9.7% 2.5% 0.8% 2.5% 2.8% Virus de la dengue –4 sérotypes – 4 infections possibles Madeira, Oct‐Nov 2012: human outbreak, dengue 1 serotype o 23,000 air travellers to Madeira in 2012 o originating from 29 dengue‐endemic countries; o 90% coming from Venezuela and Brazil o Madeira strain most closely related to strains isolated in Venezuela, Brazil and Columbia o 1,891 cases o vector is Aedes aegypti , established since 2005 o First epidemic of dengue fever in Europe since 1928 Virus de la dengue –4 sérotypes – 4 infections possibles Virus de la dengue –4 sérotypes – 4 infections possibles Madeira, Oct‐Nov 2012: human outbreak, dengue 1 serotype o 23,000 air travellers to Madeira in 2012 o originating from 29 dengue‐endemic countries; o 90% coming from Venezuela and Brazil o Madeira strain most closely related to strains isolated in Venezuela, Brazil and Columbia o 1,891 cases o vector is Aedes aegypti , established since 2005 o First epidemic of dengue fever in Europe since 1928 Reunion island, Jan‐Mar 2012: o 20 autochthonous cases DENV‐1 and DENV‐3 France, Oct 2013: autochthonous dengue: Jouques: 1 case France, été 2014: 4 autochthonous dengue: Var (2) and BdR (2) Virus ZIKA French Polynesia, Oct 2013: human outbreak: 30,000 cases o >40 cases of Guillain‐Barré syndrome o vector is Aedes polynensis, Ae. aegypti, Ae. Albopictus, Ae. Hensilli o neighboring countries affected: New Caledonia 1,400 cases, Cook islands 900 cases Virus ZIKA Imported cases of Zika, travelers from epidemic area Virus Chikungunya Alphavirus, transmitted by Ae albopictus and Ae aegypti massive outbreak in the Indian Ocean area in 2006: o 300,000 infected / 700,000 inhabitants of Reunion island never reported in the New World until December 2013 in Saint‐Martin island • Local transmission in 36 countries in the Caribbean, Central America, South America, or North America • 776,089 suspected and 14,810 laboratory‐confirmed chikungunya cases had been reported from these areas Surveillance Nationale et Régionale Collaboration étroite entre les laboratoires de CHU, le CNR et l’ARS / CIRE Le laboratoire du CHU de la Timone réalise près de 2,000 tests dengue et CHIK chaque été Surveillance Nationale et Régionale Collaboration étroite entre les laboratoires de CHU, le CNR et l’ARS / CIRE Surveillance Nationale et Régionale Surveillance Nationale et Régionale Situation en Paca‐Corse Surveillance Nationale et Régionale Situation en Paca‐Corse Depuis Mai 2014, o 623 cas suspects o 138 cas de chikungunya, 54 cas de dengue et 1 co‐infection confirmés o tous IMPORTES . CHIK (Caraïbes 127 cas) . DENGUE: Thailande, Indonésie, Caraïbes, Inde, Polynésie F, Costa Rica o SAUF 4 dengue autochtones (Var, BdR) Situation en dans les 16 départements en alerte (Ae. albopictus implanté) o 1,371 cas suspects / 580 confirmés o 419 CHIK, 155 dengue, 6 co‐infections o tous importés SAUF . 4 dengues autochtones . 7 CHIK près de Montpellier: patient Index from Cameroon, ECSA2 strain drastically different from the strain circulating in the Carribean Thank you contact: remi.charrel@univ‐amu.fr.
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