Renaud Piarroux | |
---|---|
Born | September 27, 1960 |
Nationality | French |
Education | Pediatric Residency, 1990
PhD Microbiology & Cellular Biology, University of Aix-Marseille, 1995 [1] |
Renaud Piarroux (born 27 September 1960) is a French pediatrician specializing in infectious diseases and tropical medicine. From 2008 to 2017, he has been a full professor of parasitology and mycology at the University of Aix-Marseille in Marseille, France, and head of parasitology and mycology at Assistance Publique-Hôpitaux de Marseille. [2] Since 2017, he has been a full professor of parasitology and mycology at the Sorbonne University in Paris, [3] France, and Head of Parasitology and Mycology at Assistance Publique – Hôpitaux de Paris. [4] Over the years, Piarroux has taken part in several missions and research projects in Africa, including the study of the dynamics of cholera epidemics in Comoros, Democratic Republic of Congo [5] [6] [7] [8] [9] [10] and Guinea, [11] prevention and management of parasitic diseases in Morocco, and a program to fight against waterborne diseases in Ivory Coast. [12] [13]
Piarroux has been the Regional Representative of the Franche-Comté region of France and responsible for various missions with Médecins du Monde (MDM) (Doctors of the World) in Grand Comoros [14] and the Democratic Republic of Congo. He also worked on the analysis of risks of epidemics and assessing health priorities after natural disasters and conflicts including:
In these risk analyses he studied how cholera spreads through regions and communities.
In November 2010 he was called in by the Haitian government and French Embassy to investigate the origin and course of the world's largest cholera epidemic of recent times, [16] [17] [18] [19] [20] [21] and to assist authorities in creating an effective control program. These activities were highlighted in the book Deadly River(Cornell University Press, 2016), authored by Ralph R. Frerichs. [22] Piarroux related the end of the story and related scientific controversies in the book Choléra. Haïti 2010-2018 : histoire d’un désastre [Cholera. Haiti 2010-2018, a disasters' story]. (CNRS editions, 2019). [23] [24]
Piarroux is an ongoing member of the travel-related and imported diseases committee of the French Ministry of Health. [25] He is a founding member of the Global Alliance Against Cholera (GAAC), started in the eastern part of DR Congo, that has since expanded to other cholera-affected countries. [26] He has been awarded the French Legion of Honour in 2017. [27]
Renaud Piarroux was born in Cherbourg, France, the son of painter Jean Piarroux and medical pathologist Marie-Claude Deleval.
Following graduation, he became assistant professor of parasitology at Besançon University Hospital, where he created the parasitology-mycology department and became a full professor in 2001. He was director of Santé et Environnement Rural Franche-Comté, and the EA2276 research team at Franche-Comté University from 2004 to 2007. [28] [29] [30]
In Besançon, his academic publication subjects included: Farmer's lung, the relationship between mold and asthma, unhealthy dwellings, cholera, echinococcosis (a local parasitic disease). [31] Following a move in 2008 to Marseille, his work focused on three subjects: [32]
His interest in cholera epidemics started in 1994 while working as a volunteer pediatrician in Goma, Zaire during an extensive cholera outbreak following the Rwandan genocide. [33] He next encountered cholera while working with MDM in Grand Comorro in 1998. [34] There, he created a surveillance system that with rapid follow-up and simple interventions eventually brought the outbreak under control.
Piarroux next helped in defining cholera control priorities in eastern Democratic Republic of Congo, with the help of a local epidemiologist, who became his student, Dr. Didier Bompangue. [35] They observed that cholera regularly came back from the lake area in eastern Democratic Republic of Congo. [36] Enlarging his study in time and space, and using genetic analysis he concluded that only a few towns play the role of amplifier, [37] and that cholera was linked to human mobility. [38]
In 2010 Piarroux was asked by the French government to investigate the Haiti cholera epidemic; questions arose in the scientific community as Haiti had never been hit by cholera before. [39] His investigation led to the controversial conclusion [40] that the epidemic was imported by United Nations soldiers in a Nepalese UN peacekeeping camp near Mirebalais in the center of Haiti. [41] His findings ran counter to the more popular Haitian environmental cholera paradigm. Pr Rita Colwell, the main proponent of the environmental theory, postulated it was a "perfect storm" of three converging factors, an earthquake followed by a hot summer and then a Hurricane that triggered the explosive epidemic. [42] Piarroux agreed that some vibrios are living in coastal waters, but argued that in Haiti (as in Democratic Republic of Congo), cholera didn't come ex nihilo from coastal water, [43] [44] [45] [46] and further that the storm came after the epidemics had started. [47] Other scientists demonstrated that the cholera in Haiti originated from Nepal. [48] [49] Human mobility was thus key to disease transmission in Haiti. This was important information for formulating an effective elimination strategy. [50] [51] Details of the political and scientific controversies are presented in Deadly River by Ralph R. Frerichs (Cornell University Press, 2016). Following the publication of a long time United Nations Special Rapporteur, Philip Alston, [52] [53] the Secretary-General of the United Nations Ban Ki-moon acknowledged the role of United Nations soldiers in the beginning of the Haitian cholera epidemics. [54] [55] He presently defends a new approach based on an "intense effort to treat and prevent the disease, as well as a concerted effort to deliver material assistance to those most directly affected." [56]
In 2020, he was actively working for the APHP CPVID response team, especially in developing COVISAN, a project aiming at helping COVID positive person to better isolate themselves. [57] He describe this fight in La Vague, l'épidémie vue du terrain(CNRS Editions, 2020). [58]
Piarroux has three adult children. He resides in Paris.
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Cholera is an infection of the small intestine by some strains of the bacterium Vibrio cholerae. Symptoms may range from none, to mild, to severe. The classic symptom is large amounts of watery diarrhea lasting a few days. Vomiting and muscle cramps may also occur. Diarrhea can be so severe that it leads within hours to severe dehydration and electrolyte imbalance. This may result in sunken eyes, cold skin, decreased skin elasticity, and wrinkling of the hands and feet. Dehydration can cause the skin to turn bluish. Symptoms start two hours to five days after exposure.
Lassa fever, also known as Lassa hemorrhagic fever, is a type of viral hemorrhagic fever caused by the Lassa virus. Many of those infected by the virus do not develop symptoms. When symptoms occur they typically include fever, weakness, headaches, vomiting, and muscle pains. Less commonly there may be bleeding from the mouth or gastrointestinal tract. The risk of death once infected is about one percent and frequently occurs within two weeks of the onset of symptoms. Of those who survive, about a quarter have hearing loss, which improves within three months in about half of these cases.
Yellow fever is a viral disease of typically short duration. In most cases, symptoms include fever, chills, loss of appetite, nausea, muscle pains – particularly in the back – and headaches. Symptoms typically improve within five days. In about 15% of people, within a day of improving the fever comes back, abdominal pain occurs, and liver damage begins causing yellow skin. If this occurs, the risk of bleeding and kidney problems is increased.
An epidemic is the rapid spread of disease to a large number of hosts in a given population within a short period of time. For example, in meningococcal infections, an attack rate in excess of 15 cases per 100,000 people for two consecutive weeks is considered an epidemic.
Chikungunya is an infection caused by the Chikungunya virus (CHIKV). The disease was first identified in 1952 in Tanzania and named based on the Kimakonde words for "to become contorted". Symptoms include fever and joint pain. These typically occur two to twelve days after exposure. Other symptoms may include headache, muscle pain, joint swelling, and a rash. Symptoms usually improve within a week; however, occasionally the joint pain may last for months or years. The risk of death is around 1 in 1,000. The very young, old, and those with other health problems are at risk of more severe disease.
Viral hemorrhagic fevers (VHFs) are a diverse group of animal and human illnesses. VHFs may be caused by five distinct families of RNA viruses: the families Filoviridae, Flaviviridae, Rhabdoviridae, and several member families of the Bunyavirales order such as Arenaviridae, and Hantaviridae. All types of VHF are characterized by fever and bleeding disorders and all can progress to high fever, shock and death in many cases. Some of the VHF agents cause relatively mild illnesses, such as the Scandinavian nephropathia epidemica, while others, such as Ebola virus, can cause severe, life-threatening disease.
Alkhurma virus (ALKV) is a zoonotic virus of the Flaviviridae virus family. ALKV causes Alkhurma hemorrhagic fever (AHF), or alternatively termed as Alkhurma hemorrhagic fever virus, and is mainly based in Saudi Arabia.
A rickettsiosis is a disease caused by intracellular bacteria.
The seventh cholera pandemic is the seventh major outbreak of cholera and occurred principally from the years 1961 to 1975, but the strain involved persists to the present. WHO and some other authorities believe this should be considered as an ongoing pandemic. As stated in its cholera factsheet dated 30 March 2022, the World Health Organization (WHO) continues to define this outbreak as a current pandemic, and with cholera having become endemic in many countries. In 2017, WHO announced a global strategy aiming to end this pandemic by 2030.
Health problems have been a long-standing issue limiting development in the Democratic Republic of the Congo.
Lujo is a bisegmented RNA virus—a member of the family Arenaviridae—and a known cause of viral hemorrhagic fever (VHF) in humans. Its name was suggested by the Special Pathogens Unit of the National Institute for Communicable Diseases of the National Health Laboratory Service (NICD-NHLS) by using the first two letters of the names of the cities involved in the 2008 outbreak of the disease, Lusaka (Zambia) and Johannesburg. It is the second pathogenic Arenavirus to be described from the African continent—the first being Lassa virus—and since 2012 has been classed as a "Select Agent" under U.S. law.
Zika virus is a member of the virus family Flaviviridae. It is spread by daytime-active Aedes mosquitoes, such as A. aegypti and A. albopictus. Its name comes from the Ziika Forest of Uganda, where the virus was first isolated in 1947. Zika virus shares a genus with the dengue, yellow fever, Japanese encephalitis, and West Nile viruses. Since the 1950s, it has been known to occur within a narrow equatorial belt from Africa to Asia. From 2007 to 2016, the virus spread eastward, across the Pacific Ocean to the Americas, leading to the 2015–2016 Zika virus epidemic.
Armillifer armillatus is a species of tongue worm in the subclass Pentastomida occurring in tropical Africa. Its typical definitive hosts are pythons, such as the African rock python, while rodents are presumed to act as intermediate hosts. Humans may become accidentally infected by the eggs particularly if consuming infected snakes. Ingested eggs develop into nymphs that invade different visceral organs causing a disease called porocephalosis. Humans have been infected by eating undercooked snake meat or through direct contact. Most human infections are asymptomatic, some are debilitating, or rarely even lethal. Diagnoses of infection has usually been done by accident, and almost all patients did not require treatment.
The 2010s Haiti cholera outbreak was the first modern large-scale outbreak of cholera—a disease once considered beaten back largely due to the invention of modern sanitation. The disease was reintroduced to Haiti in October 2010, not long after the disastrous earthquake earlier that year, and since then cholera has spread across the country and become endemic, causing high levels of both morbidity and mortality. Nearly 800,000 Haitians have been infected by cholera, and more than 9,000 have died, according to the United Nations (UN). Cholera transmission in Haiti today is largely a function of eradication efforts including WASH, education, oral vaccination, and climate variability. Early efforts were made to cover up the source of the epidemic, but thanks largely to the investigations of journalist Jonathan M. Katz and epidemiologist Renaud Piarroux, it is widely believed to be the result of contamination by infected United Nations peacekeepers deployed from Nepal. In terms of total infections, the outbreak has since been surpassed by the war-fueled 2016–2021 Yemen cholera outbreak, although the Haiti outbreak is still one of the most deadly modern outbreaks. After a three-year hiatus, new cholera cases reappeared in October 2022.
Ebola, also known as Ebola virus disease (EVD) and Ebola hemorrhagic fever (EHF), is a viral hemorrhagic fever in humans and other primates, caused by ebolaviruses. Symptoms typically start anywhere between two days and three weeks after infection. The first symptoms are usually fever, sore throat, muscle pain, and headaches. These are usually followed by vomiting, diarrhoea, rash and decreased liver and kidney function, at which point some people begin to bleed both internally and externally. It kills between 25% and 90% of those infected – about 50% on average. Death is often due to shock from fluid loss, and typically occurs between six and 16 days after the first symptoms appear. Early treatment of symptoms increases the survival rate considerably compared to late start. An Ebola vaccine was approved by the US FDA in December 2019.
Ralph R. Frerichs is professor emeritus of epidemiology at UCLA where he was active as a full-time faculty member in the School of Public Health for 31 years and as the Epidemiology department chair for 13 years, before retiring in late 2008. Both at UCLA and in international workshops he taught epidemiologic methods, the use of rapid community-based surveys, epidemiologic simulation models for focused research, and screening and surveillance methods for HIV/AIDS and other diseases.
Bacterial phylodynamics is the study of immunology, epidemiology, and phylogenetics of bacterial pathogens to better understand the evolutionary role of these pathogens. Phylodynamic analysis includes analyzing genetic diversity, natural selection, and population dynamics of infectious disease pathogen phylogenies during pandemics and studying intra-host evolution of viruses. Phylodynamics combines the study of phylogenetic analysis, ecological, and evolutionary processes to better understand of the mechanisms that drive spatiotemporal incidence and phylogenetic patterns of bacterial pathogens. Bacterial phylodynamics uses genome-wide single-nucleotide polymorphisms (SNP) in order to better understand the evolutionary mechanism of bacterial pathogens. Many phylodynamic studies have been performed on viruses, specifically RNA viruses which have high mutation rates. The field of bacterial phylodynamics has increased substantially due to the advancement of next-generation sequencing and the amount of data available.
Neglected tropical diseases in India are a group of bacterial, parasitic, viral, and fungal infections that are common in low income countries but receive little funding to address them. Neglected tropical diseases are common in India.
The outbreak of Marburg virus disease in Gueckedou district, Guinea started in July 2021, and ended in September. A single individual got sick and died of the virus, with no other known cases.
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