La Direction g\u00e9n\u00e9rale de la sant\u00e9 (DGS) et la Direction g\u00e9n\u00e9rale du travail (DGT) ont saisi conjointement, le 24 avril 2025, le Haut Conseil de la sant\u00e9 publique (HCSP) pour actualiser son avis du 7 septembre 2023 relatif \u00e0 la prise en charge des accidents d\u2019exposition aux prions et aux propagons en laboratoire et lors de proc\u00e9dures m\u00e9dicales invasives. Cette demande d\u2019actualisation est motiv\u00e9e par la complexit\u00e9 pratique de mise en \u0153uvre de l\u2019une des recommandations pr\u00e9c\u00e9dentes.<\/p>\n
Le HCSP r\u00e9affirme plusieurs principes op\u00e9rationnels. En cas d\u2019accident d\u2019exposition \u00e0 des prions, il pr\u00e9conise une intervention imm\u00e9diate visant \u00e0 limiter l\u2019h\u00e9mostase et \u00e0 favoriser le drainage, afin d\u2019\u00e9liminer le plus possible le mat\u00e9riel potentiellement infectieux. Deux grands types d\u2019exposition sont distingu\u00e9s : d\u2019une part, l\u2019exposition par effraction cutan\u00e9e ou contact avec une peau l\u00e9s\u00e9e, pour laquelle l\u2019utilisation d\u2019eau de Javel \u00e0 2,6 % de chlore actif est recommand\u00e9e ; d\u2019autre part, l\u2019exposition par projection sur les muqueuses, pour laquelle un rin\u00e7age abondant au s\u00e9rum physiologique ou \u00e0 l\u2019eau courante est pr\u00e9conis\u00e9.<\/p>\n
En cas d\u2019exposition cutan\u00e9o-muqueuse \u00e0 un pr\u00e9l\u00e8vement susceptible de contenir des propagons, le HCSP pr\u00e9cise que, lorsque le risque est jug\u00e9 \u00e9lev\u00e9 (notamment en cas d\u2019exposition en laboratoire \u00e0 une solution concentr\u00e9e), la conduite recommand\u00e9e pour les ATNC (agents transmissibles non conventionnels) peut \u00eatre appliqu\u00e9e \u00e0 titre de mesure de pr\u00e9caution, m\u00eame si l\u2019eau de Javel n\u2019a pas d\u2019activit\u00e9 neutralisante d\u00e9montr\u00e9e sur ces agents. Cette conduite vise principalement les effets de drainage et d\u2019anti-h\u00e9mostase pour favoriser l\u2019\u00e9limination du contaminant. En l\u2019absence de br\u00e8che cutan\u00e9e, l\u2019usage de d\u00e9tergents valid\u00e9s pour le nettoyage de la peau est recommand\u00e9.<\/p>\n
De mani\u00e8re g\u00e9n\u00e9rale, le HCSP souligne que, compte tenu des incertitudes actuelles sur l\u2019efficacit\u00e9 des protocoles de prise en charge de ces accidents d\u2019exposition, le principe de pr\u00e9caution doit s\u2019appliquer. Il insiste sur la n\u00e9cessit\u00e9 de recherches sp\u00e9cifiques pour lever ces incertitudes et produire les connaissances scientifiques indispensables \u00e0 l\u2019\u00e9laboration d\u2019avis d\u2019expertise robustes, servant de base \u00e0 la d\u00e9cision publique dans les domaines sanitaire et de sant\u00e9 au travail.\u00a0(contenu r\u00e9sum\u00e9 en fran\u00e7ais par l’IA)\u200bLire la Suite<\/a>\u200b<\/p>","protected":false},"excerpt":{"rendered":" La Direction g\u00e9n\u00e9rale de la sant\u00e9 (DGS) et la Direction g\u00e9n\u00e9rale du travail (DGT) ont saisi conjointement, le 24 avril 2025, le Haut Conseil de la sant\u00e9 publique (HCSP) pour 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