La source traite de la r\u00e9\u00e9mergence de la maladie \u00e0 virus Marburg, une fi\u00e8vre h\u00e9morragique s\u00e9v\u00e8re dont la l\u00e9talit\u00e9 varie de 24 % \u00e0 90 %, le plus souvent au-dessus de 50 %. Identifi\u00e9e en 1967 dans des laboratoires en Allemagne et en ex-Yougoslavie \u00e0 partir de singes verts import\u00e9s d\u2019Ouganda, cette maladie \u00e9tait jusque r\u00e9cemment consid\u00e9r\u00e9e comme limit\u00e9e \u00e0 l\u2019Afrique centrale et orientale. Depuis 2021, des cas ont cependant \u00e9t\u00e9 signal\u00e9s en Guin\u00e9e, au Ghana, en Guin\u00e9e \u00e9quatoriale, en Tanzanie, au Rwanda et en \u00c9thiopie, ce qui remet en cause cette perception g\u00e9ographique.<\/p>\n
Face \u00e0 cette r\u00e9\u00e9mergence, Markos Tibbo (Organisation des Nations unies pour l\u2019alimentation et l\u2019agriculture \u2013 FAO), Robert Barigye et Gobena Ameni (universit\u00e9 des \u00c9mirats arabes unis) ont conduit une synth\u00e8se narrative de la litt\u00e9rature disponible. Leur travail repose sur l\u2019analyse de rapports d\u2019\u00e9pid\u00e9mies, de mod\u00e9lisations \u00e9cologiques, d\u2019enqu\u00eates s\u00e9rologiques, d\u2019analyses g\u00e9nomiques et d\u2019\u00e9valuations des dispositifs de surveillance. Les donn\u00e9es \u00e9tant jug\u00e9es trop h\u00e9t\u00e9rog\u00e8nes pour une m\u00e9ta-analyse, les auteurs ont structur\u00e9 l\u2019information autour de m\u00e9canismes r\u00e9currents observ\u00e9s d\u2019une \u00e9pid\u00e9mie \u00e0 l\u2019autre, en les comparant lorsque possible entre plusieurs pays (Angola, Ouganda, R\u00e9publique d\u00e9mocratique du Congo, Guin\u00e9e \u00e9quatoriale, Tanzanie, Rwanda, \u00c9thiopie). Ils pr\u00e9cisent que leur travail propose un cadre d\u2019analyse et non un mod\u00e8le pr\u00e9dictif.<\/p>\n
Les analyses g\u00e9nomiques indiquent que de nombreuses \u00e9pid\u00e9mies r\u00e9centes r\u00e9sulteraient de passages ind\u00e9pendants du virus de l\u2019animal \u00e0 l\u2019homme (\u00ab spillover \u00bb), plut\u00f4t que de cha\u00eenes de transmission interhumaine se prolongeant d\u2019un pays \u00e0 l\u2019autre. Cette hypoth\u00e8se est coh\u00e9rente avec la large distribution du principal r\u00e9servoir identifi\u00e9, la roussette d\u2019\u00c9gypte (Rousettus aegyptiacus), une chauve-souris frugivore vivant dans les grottes, mines et tunnels dans une grande partie de l\u2019Afrique subsaharienne. Les auteurs restent toutefois prudents et soulignent que la d\u00e9tection d\u2019\u00e9pid\u00e9mies dans de nouveaux pays ne suffit pas, \u00e0 elle seule, \u00e0 d\u00e9montrer un sch\u00e9ma de transmission pr\u00e9cis.<\/p>\n
Chez la roussette, l\u2019infection par le virus Marburg est le plus souvent asymptomatique. Le virus est excr\u00e9t\u00e9 dans la salive et circule par pics saisonniers, en particulier chez les jeunes individus apr\u00e8s les mises bas, ce qui entra\u00eene une variation temporelle du risque de transmission \u00e0 l\u2019homme. L\u2019exposition humaine intervient via les excr\u00e9tions des chauves-souris, la fr\u00e9quentation de g\u00eetes contamin\u00e9s ou la consommation de fruits partiellement entam\u00e9s par ces animaux.<\/p>\n
Le risque de contact entre l\u2019homme et le r\u00e9servoir animal augmente lorsque les activit\u00e9s humaines empi\u00e8tent sur l\u2019habitat des chauves-souris. Sont notamment mentionn\u00e9s l\u2019essor de l\u2019exploitation mini\u00e8re, la fr\u00e9quentation accrue des grottes, la d\u00e9forestation, l\u2019expansion agricole et l\u2019urbanisation. Les auteurs d\u00e9crivent une \u00ab convergence \u00e9cologique \u00bb o\u00f9 ces pressions s\u2019additionnent plut\u00f4t qu\u2019elles ne se manifestent isol\u00e9ment. Ils \u00e9voquent \u00e9galement un r\u00f4le possible du climat, sans pouvoir le documenter davantage \u00e0 ce stade. Ces \u00e9l\u00e9ments rel\u00e8vent d\u2019enjeux de sant\u00e9 publique et d\u2019am\u00e9nagement du territoire, avec des implications potentielles pour les politiques de surveillance \u00e9pid\u00e9miologique, de gestion des activit\u00e9s extractives, agricoles et urbaines, et de pr\u00e9vention des zoonoses dans les pays concern\u00e9s et, par extension, pour les administrations int\u00e9ress\u00e9es par la pr\u00e9paration et la veille internationale en mati\u00e8re de maladies \u00e9mergentes.\u00a0(contenu r\u00e9sum\u00e9 par l’IA)Lire la Suite<\/a>\u200b<\/p>","protected":false},"excerpt":{"rendered":" La source traite de la r\u00e9\u00e9mergence de la maladie \u00e0 virus Marburg, une fi\u00e8vre h\u00e9morragique s\u00e9v\u00e8re dont la l\u00e9talit\u00e9 varie de 24 % \u00e0 90 %, le plus souvent au-dessus […]<\/p>\n","protected":false},"author":1,"featured_media":4499,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center 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