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