PubMed · 6763888
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A Clement. [André Boucher].. https://pubmed.ncbi.nlm.nih.gov/6763888/
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The Mediterranean population of tomato leaf curl New Delhi virus (ToLCNDV-ES) is characterized by a high genetic uniformity, distinguishing it from its Asian counterparts. ToLCNDV-ES is thought to have a monophyletic origin, likely resulting from a single recombination event, prior to its spread throughout the Mediterranean region. Following its first detection in southeastern France in 2020, ToLCNDV-ES re-emerged in France in 2022. Our analysis based on advanced long-read sequencing, circular DNA profiling, and phylogeny indicates both local persistence of French ToLCNDV-ES and multiple independent introduction events. Signatures of positive selection were identified in French ToLCNDV-ES populations, whereas no clear evidence of recombination was found. Bayesian time-structured phylogenetic analyses suggest that introductions in France occurred between 2018 and 2021 from the major ToLCNDV-ES clade, while several Italian ToLCNDV-ES isolates diverged prior to the virus introduction in the Mediterranean basin. Overall, this study demonstrates the value of an optimized long-read sequencing approach for resolving circular DNA virus diversity, and sheds light on the complex evolutionary history of ToLCNDV-ES in the Mediterranean Basin, particularly in southeastern France.
PREVALENCE: Latrogenic-related morbidity and mortality rates are difficult to determine. Certain estimations in France and other countries have suggested that drug-related accidents alone could account for 5 to 10% of all acute hospitalizations. This would mean that in France, several thousand deaths are caused annuallty by drugs. COST CONSIDERATIONS: Independent of the human aspect, health care expenditures related to iatrogenic accidents are substantial. In France, the cost would be several ten billion francs. Although the cost/benefit ratio remains highly positive, statistically speaking one cannot ignore the high cost of severe accidents. THE NOTION OF RISK: There is an urgent need to persuade the public opinion that all effective medicines, like all surgical procedures, carry a risk. Zero risk does not exist. Patients, and the public in general, should come to realize that the objective is to minimize risk inherent in all therapies. PREVENTION: It is the duty of the entire health care team to calculate the level of acceptable risk and take all the necessary preventive measures. One of the objectives of the French National Educational Association for Training in Therapeutics (APNET) is to define means of reducing latrogenic effects.