Pr Jean François DelfraissyDr Bernadette Murgue

Institut de Microbiologie et Maladies Infectieuses (IMMI)

New Challenges in Infectious Diseases

CEA CHRU

CNRS

CPU INRA

INRIA INSERM

INSTITUT PASTEUR

IRD

2

% of deaths18%

15%

31%

36%PneumoniaDiarrhoeaOther infectionsNon infectious

Infectious diseases account for 26% of all deaths worldwide

Leading cause of mortality in ressources limited countries

Two-thirds of worldwide deaths

in children <5 years old

The Heavy Burden of Infectious Diseases

CEA CHRU

CNRS

CPU INRA

INRIA INSERM

INSTITUT PASTEUR

IRD

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 1999 Nipah virus Nipah virus disease 2003 SARS Coronavirus SARS

2009

A/H1N1v

Influenza pandemic

Avian influenza

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 DiseasesKey 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

French International Research Network