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New Challenges in Infectious Diseases Pr Jean François Delfraissy Dr Bernadette Murgue Institut de Microbiologie et Maladies Infectieuses (IMMI) The Heavy Burden of Infectious Diseases Infectious diseases account for 26% of all deaths worldwide Leading cause of mortality in ressources limited countries 18% Two-thirds of worldwide deaths % of deaths 36% in children <5 years old 15% Pneumonia Diarrhoea Other infections Non infectious 31% CEA CHRU CNRS CPU INRA INRIA INSERM INSTITUT PASTEUR IRD 2 New pathogens and diseases: 1983-2010 Year Agent Disease 1983 HIV AIDS 1983 Helicobacter pylori Peptic ulcer disease 1985 Enterocytozoon bieneusi Microsporidiosis 1986 Cyclospora cayatenensis Cyclosporidiosis 1988 Human Herpes 6 Roseola infantum 1988 Hepatitis E virus Hepatitis E 1989 Ehrlichia chaffeensis Ehrlichiosis 1989 Hepatitis C virus Hepatitis C 1989 Guanarito virus Venezuelan hemorrhagic fever 1992 Bartonella henselae Cat scratch disease 1993 Sin nombre virus Hantavirus pulmonary syndrome 1 994 Sabia virus Brazilian hemorrhagic fever 1995 Human herpesvirus 8 Kaposi sarcoma 1997 H5N1 Avian influenza 1999 Nipah virus Nipah virus disease 2003 2009 SARS Coronavirus A/H1N1v SARS Influenza pandemic 2010… NDM-1 Multiresistant bacteria 2…. ??? CEA CHRU CNRS CPU ??? INRA INRIA INSERM INSTITUT PASTEUR IRD Emergence: a global threat – Newly apparent in the human population e.g. AIDS, Ebola, SRAS, H5N1, H1N1 – Rapidly increasing in incidence or geographic range e.g. dengue, chikungunya, West Nile – Multiresistant pathogens e.g Tuberculosis NDM-1, E. Coli (O 104) CEA CHRU CNRS CPU INRA INRIA INSERM INSTITUT PASTEUR IRD Medical and Scientific challenges (1) • Resistance : Tuberculosis, Bacteria, MDR… • Transmission of infection (mechanisms, nosocomial…) • Vaccination: new vaccines, immunity, SHS… • Emerging diseases; zoonosis, human ecology, biodiversity • Infectious agents and non infectious diseases: cancer, cardiovascular, obesity, allergy, inflammation,… • The commensal microbiota : from homeostasis to disease • The big 3 : HIV, Tuberculosis, Malaria CEA CHRU CNRS CPU INRA INRIA INSERM INSTITUT PASTEUR IRD Medical and Scientific challenges (2) • Discovery of new viruses, new bacteria • New technologies : deep sequencing, omics… • Molecular basis of host defense • Microbial and host biodiversity • Biomarkers, Point of care, Pharmacogenomics CEA CHRU CNRS CPU INRA INRIA INSERM INSTITUT PASTEUR IRD Microbiology and Infectious Diseases Key points : France 2011 • Main Institutions : Institut Pasteur, Inserm, CNRS, IRD • Others : ANRS, CEA, CIRAD, INRA, Universités • 12% of French research forces: 300 teams, 2000 Scientists & Technical staff • 18% French biomedical publications: 5000 publications per year • 1 Network of vaccine research centres • Translationnal and clinical research: 35 clinical units involved, including HIV and hepatits • 4 large research network in ressources limited countries CEA CHRU CNRS CPU INRA INRIA INSERM INSTITUT PASTEUR IRD French International Research Network