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. 2007 Oct 22;14:S132–S144. [Article in French] doi: 10.1016/S0929-693X(07)80017-0

Épidémiologie des diarrhées aiguës infectieuses en France et en Europe

Epidemiology of infectious acute diarrhoea in France and Europe

S Alain 1,*, F Denis 1
PMCID: PMC7133232  PMID: 17961805

Résumé

Le terme de diarrhée infectieuse recouvre des pathologies dues à des agents pathogènes d'une grande diversité. Les virus représentent plus de la moitié des étiologies et parmi eux, les rotavirus et les calicivirus sont responsables de près de 60 % des gastroentérites virales. Les rotavirus sont à l'origine de plus de la moitié des gastro-entérites sévères. Les calicivirus, et plus spécifiquement les norovirus sont des agents majeurs de gastro-entérites communautaires de sévérité modérée et d'épidémies d'origine hydriques ou alimentaires. Les astrovirus et les adénovirus restent minoritaires, en dehors d'une immunodépression sous-jacente. Les co-infections par plusieurs virus sont fréquentes (5 à 15 % des cas). Les caractéristiques épidémiologiques de ces virus sont très différentes et, à ce jour, la surveillance épidémiologique mise en place après les premiers essais de vaccination contre les rotavirus n'a pas montré d'augmentation des infections à calicivirus ou à adénovirus. Les améliorations diagnostiques apportées par les techniques de typage moléculaire ont montré la très grande diversité génétique au sein des différents genres viraux, et la possibilité de recombinaison ou d'échange génétiques entre souches circulantes et entre souches humaines et animales, avec émergence de souches nouvelles ou « variants » capable de se propager dans des populations géographiquement éloignées. Cette dynamique doit faire l'objet d'une surveillance continue, dans le cadre de la mise en place des nouveaux vaccins rotavirus.

Mots clés: Gastroentérites, Diarrhées

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