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D Lévy-Bruhl

Publications and source records attributed to D Lévy-Bruhl.

At least 19 recordsLinked to original sources
PubMed2006

[BCG vaccine and place of tuberculin skin test in 2006].

COMMENT: Today in France, except some contra-indications BCG remains a compulsory vaccination. However a modification of BCG vaccine policy is in progress. Primo-vaccination remains but revaccination was recently abandoned, then totally abandon of BCG is the challenge. This article states the art of the BCG and of the tuberculin skin test. KEY POINTS: This approach is incorporated in a globally thought of necessary adaptations for organising fight against tuberculosis and more treatment of latent tuberculosis infections is urged on. These measures set back again tuberculin skin test in the tuberculosis infection screening process. PERSPECTIVES: New diagnosis blood tests would bring more reliability. Their place and their spread should be confirmed.

Antigens, Bacterial↗
PubMed2006

[Role of antiviral drugs in containing pandemic influenza. Contribution of recent modelling exercises synthesis prepared by the InVS/Inserm "epidemiology" group - November 2005].

The growing threat of influenza pandemic has lead many countries to stockpile specific antiviral drugs, mainly oseltamivir, as it can be used both for prophylaxis and therapy. Several recently published studies, based on mathematical modelling, have assessed the impact of a large scale use of this drug to contain an emerging pandemic, slow its spread within a country or reduce its epidemiological impact. They conclude that ring antiviral prophylaxis around the first cases, combined with social distancing measures, may halt a nascent pandemic, if the human-to-human transmissibility of the virus is limited and the control measures implemented promptly and with a high coverage. In case of failure, these same strategies could delay the spread of the virus within a country. The use of influenza antiviral drugs would reduce the burden of disease and even the clinical attack rate, under the assumption of a shorter infectious period for treated patients. These studies are in favour of stockpiling influenza antiviral drugs, at least to cover the curative needs and, even better, to contribute to the global effort to contain an emergent pandemic and to allow an intervention around the first chains of indigenous transmission in a country, thus slowing the virus spread. These results are based on the hypothesis of the effectiveness of oseltamivir on the pandemic virus and confirm the critical importance of a sensitive and reactive surveillance.

Antiviral Agents↗
PubMed2006

Prospects for the BCG vaccination programme in France.

Until recently, the French BCG vaccination programme consisted of a mandatory BCG vaccination before children started at daycare centres, and of re-vaccination of tuberculin-negative children. A re-assessment of this programme has been undertaken in recent years. It has led in 2004 to the discontinuation of all revaccinations and post-vaccination tuberculin tests except those post-vaccination tuberculin tests performed as part of a diagnosis of tuberculosis infection or disease or of the follow-up of health or social workers for whom BCG vaccination remains mandatory. Based on an estimate of the epidemiological impact of either selective vaccination of high risk children or discontinuation of BCG vaccination, and taking into account the risk-benefit balance that can be made of the two options, the Conseil Supérieur d'Hygiène Publique de France (CSHPF, national high committee of public hygiene) has recommended a change to selective vaccination. However, the committee has proposed the strengthening of other control measures aimed at decreasing the risk of infection for children, as a pre-requisite to the implementation of this strategy. This position is made more complex by the withdrawal of the multipuncture technique in early 2006, previously used in France in more than 90% of BCG primary vaccinations.

Adolescent↗
PubMed2006

[Successes and failures of anti-HBV vaccination in France: historical background and questions for research].

The promotion in France, in the mid 90s of hepatitis B vaccination for pre-teenagers and high-risk individuals has been very successful. Between 1994 and 1998, vaccination coverage in pre-teenagers was over 75% and more than one third of the French population has been immunized, indicating that vaccination went well beyond its target. Vaccination of infants has been much less successful. Epidemiological studies, undertaken following notifications of neurological events following vaccination, could neither confirm nor totally disprove an association between the two events, even if the hypothesis of a coincidental temporal relationship remains by far the most likely explanation. This situation led to the stagnation or the decrease of the vaccination coverage for its various target-populations. However other factors may have contributed to this situation. Research in social sciences would be useful to study the contribution of a negative perception of the epidemiological relevancy of hepatitis B vaccination, especially in infants, as well as of the shortcomings in the management of the implementation of the vaccination strategies. The results would help to tailor communication strategies that are needed to support an active promotion of hepatitis B vaccination in France.

Adolescent↗
PubMed2005

[Estimation of the epidemiological impact of various BCG vaccination scenarios in France].

BACKGROUND: Within the current process of revising the vaccination policy against tuberculosis in France, we have estimated the epidemiological impact of three future possible options for BCG primo-vaccination: continuation of routine vaccination of all children, targeting on high risk children or discontinuation. METHODS: We have used tuberculosis mandatory notification data to estimate the number of cases currently prevented each year through BCG vaccination, corresponding to the excess incidence, in case of discontinuation of the vaccination. The proportion of cases occurring in high risk children has been estimated through data from a study carried out in 1997 in the Paris region. The contribution of high risk children to the French child population has been estimated using data from INSEE and INED. RESULTS: In the most favorable scenario for vaccination, up to 800 additional cases would have occurred annually, considering all BCG vaccination activities in children were interrupted. The selective vaccination strategy would induce around 200 additional cases each year considering the coverage remained at its current level. Therefore the vaccination of less than 15% of each annual birth cohort would allow prevention of around three quarters of the cases currently occurring. CONCLUSION: BCG vaccination of high risk children seems to be an efficient strategy. However, its current effectiveness would depend on the capacity to maintain a high vaccination coverage in this population in the context of the abrogation of mandatory vaccination and the impending disappearance of BCG administered by multipuncture, which is the technique used in France for the vast majority of primo-vaccinations. Beyond the economical and epidemiological parameters, the decision will have to consider the operational, social and ethical issues raised by a vaccination strategy targeting children mainly of foreign origin.

BCG Vaccine↗
PubMed2005

The seroepidemiology of Bordetella pertussis infection in Western Europe.

High titres of pertussis toxin (PT) antibody have been shown to be predictive of recent infection with Bordetella pertussis. The seroprevalence of standardized anti-PT antibody was determined in six Western European countries between 1994 and 1998 and related to historical surveillance and vaccine programme data. Standardized anti-PT titres were calculated for a series of whole-cell and acellular pertussis vaccine trials. For the serological surveys, high-titre sera (> 125 units/ml) were distributed throughout all age groups in both high- (> 90%) and low-coverage (< 90%) countries. High-titre sera were more likely in infants in countries using high-titre-producing vaccines in their primary programme (Italy, 11.5%; Western Germany, 13.3%; France, 4.3%; Eastern Germany, 4.0%) compared to other countries (The Netherlands, 0.5%; Finland, 0%). Recent infection was significantly more likely in adolescents (10-19 years old) and adults in high-coverage countries (Finland, The Netherlands, France, East Germany), whereas infection was more likely in children (3-9 years old) than adolescents in low-coverage (< 90%; Italy, West Germany, United Kingdom) countries. The impact and role of programmatic changes introduced after these surveys aimed at protecting infants from severe disease by accelerating the primary schedule or vaccinating older children and adolescents with booster doses can be evaluated with this approach.

Adolescent↗
PubMed2004

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.

Adolescent↗
PubMed2003

The cost of measles in industrialised countries.

The aim of this study is to estimate the costs of measles and measles control in 11 industrialised countries with varying levels of measles vaccine coverage. Country-specific annual incidence of measles, measles immunization policy, coverage and costs data were collected. The average societal costs of measles cases and immunisation programme per capita were calculated. These 11 countries spend together over US$ 151 million every year to treat and control measles. Per capita costs of measles control tend to be higher in countries with poorer measles control programmes (for instance, Italy has the highest incidence and highest overall costs), though many other factors, such as the number of antigens given per clinic visit and the local price of MMR also affect the efficiency of the programme. The costs estimates presented here can be used to estimate potential savings that might accrue from changes to measles control programmes.

Costs and Cost Analysis↗
PubMed2003

Vaccine coverage of pre-school age children in France in 2000.

This article presents results of the main measures on vaccine coverage carried out in France in children up to six years of age. Vaccine coverage is very high for diphtheria, tetanus, pertussis, and poliomyelitis, and satisfactory for vaccination against Haemophilus influenzae b invasive infections. It will be necessary, however, to increase vaccine coverage against measles, mumps and rubella in infants and to ensure efficient catch up. Hepatitis B vaccine coverage is deficient in infants and could be improved when the vaccine is available in a combined form.

BCG Vaccine↗
PubMed2002

Vaccination campaign following an increase in incidence of serogroup C meningococcal diseases in the department of Puy-de-Dôme (France).

In the department of Puy-de-Dôme, France, 17 cases of invasive meningococcal disease C were notified between March 2001 and the first week of 2002. Among the 15 confirmed cases, 11 (73%) were serogroup C, 2 (13%) serogroup B, and 2 could not be identified. The rapid increase in the number of cases in a period of low endemicity for the rest of the country and the severity of the disease (case fatality ratio 27%, purpura fulminans 64%) led the health authorities to initiate a vaccination campaign targeting children and young adults from 2 months up to 20 years living in a limited area of the department. Around 80,000 people were immunised between 16/01/02 and 09/02/02. More than half of the 1390 immediate side effects were headache and dizziness. As of mid-March, no further case of meningococcal disease has been notified since 6 January.

Adolescent↗
PubMed2001

The seroepidemiology of measles in Western Europe.

The European Regional Office of WHO has targeted measles for elimination from the region in 2007. Large national, age and sex stratified serological surveys of measles antibody were conducted in seven Western European countries from 1994-8 as part of the European Seroepidemiology Network. Three patterns were observed in the country-specific measles seroprofiles, ranging from (very) low susceptibility (four countries) to high susceptibility (one country). Susceptibility levels amongst 2-4-year-olds ranged from 2.9 to 29.8%, in 5-9-year-olds from 2.5 to 25% and 10-19-year-olds from 2.1% to 13.9%. A country's susceptibility profile was highly associated with vaccine coverage for the first dose. First dose coverage ranged from 91 to 97.5% for low susceptibility countries, 75 to 85% for intermediate susceptibility countries and 55% for the high susceptibility country. Only the high susceptibility country still reports epidemic measles. In low susceptibility countries, which have achieved or are very close to measles elimination, the priority will be to maintain high MMR vaccine coverage in all geopolitical units for both vaccine doses. In moderate susceptibility countries there is still some endemic transmission, but also risk of outbreaks as pools of susceptibles accumulate. In the high susceptibility country the priority will be to increase infant vaccine coverage and reduce regional variation in coverage levels.

Adolescent↗
PubMed2001

Estimation of measles reproduction ratios and prospects for elimination of measles by vaccination in some Western European countries.

The objective of this study is to estimate the measles reproduction ratio for eight Western European vaccination programmes. Because many plausible age-structured transmission patterns result in a similar description of the observations, it is not possible to estimate a unique value of the reproduction ratio. A method is developed to estimate bounds and confidence intervals for plausible values of the reproduction ratios using maximum likelihood methods. Lower and upper bounds for plausible values of the basic reproduction ratio are estimated to be 7.17 (95% CI 7.14-7.20) and 45.41 (95% CI 9.77-49.57), corresponding to lower and upper bounds on critical vaccine coverage of 86.6% and 98.1%. Of the eight evaluated vaccination programmes, four have vaccine coverage below the lower bound and allow measles to persist, and four have vaccine coverage at the upper bound and may eventually eliminate measles.

Adolescent↗
PubMed2001

The use of smallpox virus as a biological weapon: the vaccination situation in France.

In the context of its plan to fight against bioterrorism, the Ministry of Health asked the Institut de Veille Sanitaire to evaluate the epidemic risk from a release of the small pox virus, and to make recommendations on potential vaccination strategies to be implemented. A benefit/risk assessment of various vaccination scenarios, including vaccination of the whole French population, was carried out to evaluate the severity of a terrorist action threat. This analysis concludes that at this stage, vaccination action does not seem to be justified. Even in the case of a real threat, the vaccination of frontline healthcare personnel, and in particular of contacts of cases, must be given priority.

Age Factors↗