Bull Acad Natl Med
· 2022 Feb · PMID 34931086
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As of today, September 2021, it is very difficult to predict how the SARS-CoV-2 pandemic will develop in France and around the world. The objective of this review is to analyze recent studies concerning SARS-CoV-2, espec...As of today, September 2021, it is very difficult to predict how the SARS-CoV-2 pandemic will develop in France and around the world. The objective of this review is to analyze recent studies concerning SARS-CoV-2, especially those looking for its origin, particularly in viruses from various bat populations. The ability of variants to escape vaccine responses is a real concern, as these variants show increased pathogenicity. Screening of infected subjects and large-scale sequencing are essential tools to be strengthened, for monitoring the risk of emergence of possible new variants and for the development of the second generation vaccines.
Bull Acad Natl Med
· 2022 Jan · PMID 34866635
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From its emergence in December 2019 and until the end of the fourth pandemic wave in October 2021, SARS-CoV-2 circulation has been associated with significant molecular evolutions of the virus. These were linked to mutat...From its emergence in December 2019 and until the end of the fourth pandemic wave in October 2021, SARS-CoV-2 circulation has been associated with significant molecular evolutions of the virus. These were linked to mutations that have led to new virus linages with replication advantages as a result of increased transmission, or partial immune escape in the context of progressively increasing global immunisation. The pandemic context with large scale epidemics massive outbreaks observed in highly populated areas has favoured this emergence of "variants". During the 20 months period, at least three evolutionary phases have been observed, leading to the situation observed in October 2021. For the first time, an unprecedented worldwide surveillance effort has been conducted to monitor the circulation of the emerging virus, with rapid data sharing. This molecular surveillance system has provided an accurate description of the circulating viruses, and their evolution. The implementation of these tools and skills able to provide SARS-CoV-2 molecular epidemiological data has upgraded the global capacity for surveillance worldwide, and may allow us to be better prepared for a future pandemic episode.
Bull Acad Natl Med
· 2022 Jan · PMID 34803168
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The concept of "one health" applies perfectly to human health and animal health because many diseases are zoonoses. There are many historical examples of effective collaboration between veterinary medicine and human medi...The concept of "one health" applies perfectly to human health and animal health because many diseases are zoonoses. There are many historical examples of effective collaboration between veterinary medicine and human medicine in the development of the first vaccines used in the world (smallpox, rabies, tetanus, diphtheria, tuberculosis, etc.). But when a new disease appears in animals, the risk of possible transmission to humans is difficult to estimate. In the latter case, the loss of consumer confidence in the face of scientific uncertainties can cause a health crisis (examples of bovine spongiform encephalopathy and H5N1 avian plague). But the most serious crisis that we have known since early 2020 is Covid-19 pandemic, which confirms that the modification of the ecosystems of certain wild species such as the horseshoe bats can have significant consequences for the public health. Animals infected with Covid-19 have been contaminated by humans but we cannot currently exclude an animal reservoir risk for SARS-CoV-2 which has circulated around the world.
Bull Acad Natl Med
· 2022 Jan · PMID 34744171
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The health crisis linked to COVID-19 has put the whole hospital under stress. Intensive care units (ICU) have been on the front line to manage the most serious cases. The number of new admissions together with cumulative...The health crisis linked to COVID-19 has put the whole hospital under stress. Intensive care units (ICU) have been on the front line to manage the most serious cases. The number of new admissions together with cumulative number of occupied intensive care beds have been and still are a key element in measuring the intensity of the crisis. Intensive care is a specialty largely unknown to the general public which is problematic when dealing with such difficult questions as should we give priority to health or to the economy; is there a loss of chance for non-COVID patients due to deprogramming? The increase in the demand for critical care has necessitated an extension of hospitalization capacities by transforming intermediate care beds into ICU beds, by creating neo-ICU, or in some regions by carrying out critical care, usually performed in ICU, in regular wards. Among the several limiting factors, human resources with qualified personnel was a key element together with the relative shortage of drugs. The mismatch between demand and supply has led to the establishment of rules for prioritizing access to ICU. This review deals with all these issues and can contribute to a reflection on the adaptation of the critical care department to cope with major sanitary crisis.
Brugère-Picoux J, Leroy E, Rosolen S
… +3 more, Angot JL, Buisson Y, l’Académie nationale de médecine et de l’Académie vétérinaire de France
Bull Acad Natl Med
· 2021 Oct · PMID 34305142
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Although the emergence of Covid-19 in China has not been clearly elucidated, the hypothesis of an animal origin remains the most likely. It is supported by the presence of the horseshoe bat suspected to be the progenitor...Although the emergence of Covid-19 in China has not been clearly elucidated, the hypothesis of an animal origin remains the most likely. It is supported by the presence of the horseshoe bat suspected to be the progenitor of SARS-CoV-2 and by the scarcity of pork, due to African swine fever, diverting consumers to exotic animals of breeding sold in the markets. During this pandemic, several animal species were affected by SARS-CoV-2. Sporadic cases were first reported in pets (dogs and cats) infected by their owners, then in large feline species and apes infected in zoos by their nurses. The most significant human-to-animal transmission has occurred in mink farms, especially in the Netherlands and Denmark, requiring the euthanasia of several million animals, with mink in turn having contaminated men and stray or nomadic cats. The study of natural or experimental transmissions of SARS-CoV-2 has made it possible to identify the most receptive animal species: American minks and raccoon dogs, and to a lesser extent stray or nomadic cats, which could become an animal reservoir due to their sensitivity to this virus and their extending prolificacy. The European Commission decided on May 17, 2021 to strengthen the surveillance of SARS-CoV-2 infections in minks and other mustelids, as well as in raccoon dogs, highlighting stressing that the epidemiological assessment of the risk presented by the he appearance of SARS-CoV-2 in these susceptible species was a public health priority.