I Parent du Châtelet

A 2-year study on cytomegalovirus infection during pregnancy in a French hospital.

Objectives  To evaluate the proportion of pregnant women agreeing to cytomegalovirus (CMV) serologic screening. To collect data on CMV infection during pregnancy.

Prolonged outbreak of B meningococcal disease in the Seine-Maritime department, France, January 2003 to June 2005.

Between January 2003 and June 2005, an outbreak of meningococcal disease occured in the department of Seine-Maritime in northern France. Eighty six cases were notified, giving an average annual incidence of 2.7 cases per 100 000 inhabitants, compared with 1.6 in France. An especially affected area was defined as the city of Dieppe and its surrounding area (26 cases, giving an annual incidence of 12 cases per 100 000). This outbreak was due to N. meningitidis phenotype B:14:P1.7,16 belonging to the clonal complex ST-32/ET-5. Over the 31 B14:P1.7,16 cases confirmed by phenotyping methods at the national reference centre for meningococci (CNR, Centre National de Référence des méningocoques) the case-fatality rate (19%) and the proportion of purpura fulminans (42%) were especially high. Teenagers aged between 15 and 19 years and children aged 1 to 9 years were the most affected. In 2003, health authorities put in place enhanced epidemiological surveillance and informed practitioners and population about the disease. In 2004, the national vaccination advisory board studied the opportunity of using a non licensed outer membrane vesicle vaccine developed in Norway which may be effective against the B14:P1.7,16 strain. The Ministry of health decided in 2006 to offer vaccination with this vaccine to people aged 1 to 19 years in Seine- Maritime.

Serogroup C invasive meningococcal disease among men who have sex with men and in gay-oriented social venues in the Paris region: July 2013 to December 2014.

In November 2014, French public health authorities renewed the recommendation to target for vaccination against invasive meningococcal disease men who have sex with men (MSM) and all individuals ≥25 years attending social venues associated with the gay community. This policy was extended beyond the Paris region as a reaction to the continuing spread of serogroup C isolates belonging to a new lineage within clonal complex cc11 since the recommendation was first issued in July 2013.

Rubella control in France.

In the pre-vaccination era, rubella was regarded as only a mild exanthematous acute viral infection of children. The devastating effects of the disease were first identified in the early 1940s by an Australian ophthalmologist, and further confirmed during the 1962-65 rubella pandemic in Europe and the United States. They result from the transmission of the virus by infected pregnant women to their fetus. The resulting congenital rubella syndrome (CRS) comprises a lengthy list of abnormalities. The most common ones are deafness, ocular and cardiac defects and mental retardation. The objective of rubella vaccination, to which France has subscribed, is the elimination of CRS [1].

N-02: Critères d’alerte et d’intervention vaccinale avec le vaccin Bexsero® en situation de cas groupés d’infection invasive à méningocoque B

Introduction – objectifs Le vaccin Bexsero ® a obtenu une AMM europeenne debut 2013 pour la prevention des infections invasives a meningocoque (IIM) B. Le Haut Conseil de la Sante Publique n’a pas recommande la vaccination en routine ni la vaccination des sujets contacts d’un cas sporadique. Une analyse des regroupements temporo-spatiaux d’IIM B identifies en France au cours des 15 dernieres annees a permis de definir des criteres d’alerte ou d’intervention vaccinale. Materiels et methodes Les grappes de cas survenues en collectivite entre 1998 et 2012, les epidemies et les foyers d’hyperendemie recenses entre 2003 et 2012 ont ete inclus dans l’analyse. Des criteres d’intervention ont ete identifies a posteriori en termes de sensibilite ou d’impact attendu en tenant compte de l’efficacite vaccinale et de la couverture des souches par le vaccin. Resultats La vaccination autour des cas sporadiques d’IIM B ou au sein d’une collectivite ou seraient survenues deux IIM B, aurait evite au mieux 1 cas secondaire par an en moyenne. La vaccination au sein d’une communaute ou les criteres d’alerte epidemique (incidence de 10/100 000 sur 3 mois avec au moins 3 cas lies a un meme clone) sont remplis et si la souche est couverte par le vaccin apparait justifiee. Des criteres d’alerte pour la detection de foyers d’hyperendemie (taux d’incidence ≥ a 3/100 000 sur 52 semaines, avec 4 cas, rattachables a des souches identiques) auraient permis d’identifier plus precocement 4 des 8 foyers identifies depuis 2003. Conclusion Certaines situations comme les grappes de cas en collectivite ou les epidemies justifient une intervention vaccinale. Des criteres conduisant a mettre en œuvre une expertise multidisciplinaire, lors de foyers hyperendemiques afin d’evaluer la pertinence d’une intervention vaccinale, ont ete proposes.