FluAfrica

Return from Dakar 

I returned from Senegal where I was invited to doctoriales University Cheikh Anta Diop in Dakar to make a conference on pandemic influenza. Before the 135 first doctoral students that the University has undertaken training in its history (the graduate school of the university just a year), I thought preparing my speech with the words of Marc Gentilini and indecency evoked speaking sub-Saharan Africa the pandemic influenza. These young researchers should focus more on problems of malaria infection with HIV, MDR-TB, unhealthy environment, difficulties in access to care and health insurance, short of "real" health problems Public time. The reality was quite different. No case has yet been formally identified and reported to WHO from Senegal. The Pasteur Institute in Dakar, many researchers were present during these doctoriales is equipped to detect and isolate the virus in a laboratory H1N1pdm safety standards required (L3). Some detections season H3N2 viruses have been made in recent weeks, but no pandemic virus until now. This is not entirely accurate, the lab has identified the H1N1pdm, but these positive samples were from the islands of Cape Verde, independent state nearby that serves willingly Institut Pasteur in Dakar. It is possible under the Senegalese experts as inadequate surveillance system, it has not isolated the virus in the country, still is it that despite research on numerous samples, it has not yet been identified .

The authorities in Dakar, however, do not like this pandemic lightly. They do not dramatize, they saw what had happened in the southern hemisphere during the austral winter, they find the current developments in the Northern Hemisphere. What they fear is the effect of "Ukraine" if we want to simplify. That is to say, inadequate resources to implement over the situation even moderate to which they will face when the virus will land on the African continent, and panic in the population that this mismatch could generate. For H1N1pdm disembark, they are safe, from January until March, they are forecasting. The recent return from a pilgrimage to Mecca with their eyes a potential seeding present in many towns and villages. What they fear? This is exactly the face we've known this pandemic that strikes children, young adults, sometimes at random, healthy, or if not with risk factors frequently encountered in the country, asthma, diabetes ... "You 18 aircraft of ECMO (Editor's note: Technical cumbersome and expensive oxygen bypass) at the Salpetriere Hospital in Paris "they trusted me," then we do not have much of ICU beds available: how we save hundreds of patients who fall within the ICU and will need oxygen just, let alone those who will never have access to ECMO? ". Seasonal flu affects Senegal as probably all of Africa, but Africa does not see it, do not speak, do not diagnose. Even now, as fifty years ago, many cases of fever are too quickly labeled "malaria", while clinical trials on malaria show that less than 60% of people presenting themselves for fever in this region world are infected with Plasmodium (causes malaria). The other 40%? It is not known. We do not seek the cause. Maybe the flu. Probably the flu during the dry season (winter) during which temperatures drop considerably and the humidity too. "When killed, and the North, the very old or very sick also, so we said that going in the wrong field, but if the pandemic strain reaches young adults, we seek to revive, and l 'on lack of infrastructure to cope. An anti-pandemic committee has established and meets weekly in Dakar. It combines the health authorities and experts in the country. We are organizing a joint research program on the subject (WHO-CoPanFlu-Senegal), whose principal investigator is Professor Anta Tal Dia, director of the Institute for Health and Development at the University Cheikh Anta Diop in Dakar, involving Ecole des Hautes Etudes en Santé Publique (EHESP, Rennes), Institute of Development Research (IRD, Dakar, and Marseille) and the Institut Pasteur in Dakar. This project aims primarily to document the impact of the epidemic in Senegal, whether less than 1%, 10% or 50% of the population will be affected by the infection H1N1pdm if the seasonal virus gradually disappear as elsewhere, and how it will present clinical forms. We also assess the social and economic impact of the pandemic in the volunteer families suitable for this research. Senegal will be followed and 500 households (= households) around the city of Dakar, and followed for 2 years. The study will start in January. The financial closure is finally achieved entirely on public funds, thanks to support from the IRD, the new National Alliance for Life Sciences and Health Institute (multi-thematic bodies of Microbiology and Infectious Diseases, JF Delfraissy ) and EHESP. We can finally know a little better the impact of influenza in that part of the world if excluded from the radar screens of science and modern medicine. Let us remain vigilant in the coming weeks, and hopefully ready to assist if the resources and infrastructure were to fail temporarily. Without fear the death toll, 10 to 40% of hospitalizations were required intensive care (source: WHO, pdf in English and French), but mortality in the resuscitation was less than 20% in developed countries. This fear that developing countries with the same viral strain, a country whose population structure is composed mostly of young adults and children, are much less favorable developments in developed countries.