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Interview. Dr. Didier Musso, who managed the epidemic of 2013-2014 in French Polynesia, makes recommendations in "The Point"

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  • Interview. Dr. Didier Musso, who managed the epidemic of 2013-2014 in French Polynesia, makes recommendations in "The Point"

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    INTERVIEW. Dr. Didier Musso, who managed the epidemic of 2013-2014 in French Polynesia, makes its recommendations in "The Point".

    Published on 02/03/2016 09:12 - Edited on 02/03/2016 at 15:20 | The
    What are your recommendations?

    Authorities recommend monitoring of pregnant women who developed symptoms of Zika during pregnancy. But the recommendation should cover all pregnant women since in 80% of infections, there are no symptoms. Yet the dramatic consequences for the child are the same. Was there any concern of how to implement this monitoring in the Caribbean and in Guyana? If, in metropole France, people consult when they have symptoms, at home or in the Amazon, the population will not consult because of fever or a few bumps.

    We also need to ensure that the affected areas can deal with Guillain-Barr? syndrome, which most often require a care in the ICU. During the epidemic in French Polynesia, our ICUs were at the limit of their capacity; a few more cases , and the situation would have been catastrophic.

    Then, the children born from infected or potentially infected mothers need to be follow because late complications, not necessarily detectable at birth, are possible, as is the case with other infectious agents.

    From 2014, was it foreseeable that the epidemic would spread to the rest of the world?

    We had written it in 2014 in the journal Clinical Microbiology and Infection. I quote: "We believe that the circulation of Zika in other regions of the Pacific and probably beyond is highly likely. The fact that serious complications may arise emphasizes the need to strengthen surveillance of this emergent virus and, in the event of epidemics, to establish strict protocols for monitoring neurological complications (Guillain-Barr? syndrome) or other complications. "

    In 2015, we again wrote in the Lancet that more than half the world's population lived in areas infested by mosquitoes that can transmit Zika and this virus had the potential to become a global public health problem, as well as the dengue virus and chikungunya.

    Today, La Reunion and Mayotte need to prepare for an outbreak of Zika.

    Since 2014, WHO and potentially affected countries they should have taken preventive measures?

    It would be pretentious on our part to say yes. For all diseases transmitted by mosquitoes, the problem is the same: to reduce mosquito populations. That goes for Zika, chikungunya, dengue, malaria, yellow fever ...

    Microcephaly and Guillain-Barre syndrome can they now be totally attributable to Zika? How to protect?

    Recent work in Polynesia show that the connection between Zika and Guillain Barr? is almost certain, more and more data suggest that the link with microcephaly is too. The only way to protect yourself is to avoid mosquito bites not to get infected, mainly for pregnant women living in Zika circulation area.

    Can we envision that other pathologies reveal themselves in shorter or longer term?

    Yes, we cannot know if we shall discover new complications, but this eventuality certainly is not to be ruled out. Personally, I expect it. It is illusory to think that one has already toured the possible complications for a disease that has emerged since only three years. We have already noted ocular and auditory damage. It is therefore necessary to establish a short and medium-term monitoring.

    What are your needs ?

    Strengthen collaboration with the Pacific countries on the one hand, for its population that is isolated and, secondly, because it is a gateway to exotic pathologies for the metropole. We need funds for our work, the experience of Zika showed that this work can be useful to the international medical community.

     INTERVIEW. Le Dr Didier Musso, qui a géré l'épidémie de 2013-2014 en Polynésie française, fait ses recommandations dans "Le Point".
    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela