{"id":23,"date":"2020-09-14T20:53:00","date_gmt":"2020-09-14T20:53:00","guid":{"rendered":""},"modified":"2022-10-09T22:52:46","modified_gmt":"2022-10-09T22:52:46","slug":"epidemiologie-et-prophylaxie-des-maladies-infectieuses-transmissibles","status":"publish","type":"post","link":"https:\/\/avo6.com\/?p=23","title":{"rendered":"\u00c9pid\u00e9miologie Et Prophylaxie Des Maladies Infectieuses Transmissibles"},"content":{"rendered":"

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I.\u00a0\u00a0\u00a0<\/span><\/span><\/span><\/b>Introduction\u00a0:<\/span><\/b><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>Il n\u2019est pas possible aujourd\u2019hui de concevoir qu\u2019une maladie infectieuse soit due \u00e0 l\u2019intervention d\u2019un seul facteur ou agent infectieux. On est en mesure d\u2019affirmer que l\u2019infection lui en faut une origine multifactorielle et qui pour la combattre, il faut conna\u00eetre non seulement ces facteurs mais encore les rapports qui existent entre eux.\u00a0<\/span>La surveillance des maladies transmissibles a \u00e9t\u00e9 d\u00e9finie par l\u2019OMS comme l\u2019\u00e9tude \u00e9pid\u00e9miologique d\u2019une maladie consid\u00e9r\u00e9e, un processus dynamique ou une intervention.<\/p>\n

v\u00a0<\/span><\/span><\/span>Dans les pays industrialis\u00e9s\u00a0:<\/span><\/u><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>On assiste actuellement \u00e0\u00a0:<\/span><\/p>\n

\u00d8\u00a0\u00a0\u00a0<\/span><\/span><\/span>Recule remarquable des maladies infectieuses<\/span><\/p>\n

\u00d8\u00a0\u00a0\u00a0<\/span><\/span><\/span>Une attention accrue aux probl\u00e8mes des maladies non infectieuses.<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Maladies chroniques (cancers, mucoviscidose, HTA..)<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Maladies m\u00e9taboliques et d\u00e9g\u00e9n\u00e9ratives.<\/span><\/p>\n

v\u00a0<\/span><\/span><\/span>Dans les pays du tiers monde\u00a0:<\/span><\/u><\/p>\n

\u00d8\u00a0\u00a0\u00a0<\/span><\/span><\/span>Sont au 1er<\/sup>\u00a0rang d\u2019\u00e9pid\u00e9miologie<\/span><\/p>\n

\u00d8\u00a0\u00a0\u00a0<\/span><\/span><\/span>Reste un probl\u00e8me de la sant\u00e9 public majeur<\/span><\/p>\n

\u00d8\u00a0\u00a0\u00a0<\/span><\/span><\/span>Sont d\u2019autant graves qu\u2019elles surviennent sur un terrain de MPC.<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>On r\u00e9alit\u00e9, aujourd\u2019hui le probl\u00e8me n\u2019est pas enti\u00e8rement r\u00e9solu et les maladies transmissibles restent encore un probl\u00e8me de sant\u00e9 public m\u00eame pour les pays d\u00e9velopp\u00e9s et ceci pour plusieurs raisons\u00a0:<\/span><\/p>\n

\u00d8\u00a0\u00a0\u00a0<\/span><\/span><\/span>Toutes les maladies contagieuses ne sont pas bien connues.<\/span><\/p>\n

\u00d8\u00a0\u00a0\u00a0<\/span><\/span><\/span>L\u2019assainissement du milieu se heurte \u00e0 des difficult\u00e9s socio-\u00e9conomiques<\/span><\/p>\n

\u00d8\u00a0\u00a0\u00a0<\/span><\/span><\/span>La protection du sujet sain par des moyens sp\u00e9cifiques et efficaces n\u2019est pas toujours r\u00e9alisable.<\/span><\/p>\n

\u00d8\u00a0\u00a0\u00a0<\/span><\/span><\/span>Les germes les mieux connus se sont transform\u00e9s (r\u00e9sistances aux antibiotiques)<\/span><\/p>\n

\u00d8\u00a0\u00a0\u00a0<\/span><\/span><\/span>Des germes inconnus sont apparus<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>L\u00e9gionella pneumoniae responsable de la l\u00e9gionellose<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>VIH<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Virus de la fi\u00e8vre h\u00e9morragique Africaine\u2026\u2026<\/span><\/p>\n

\u00d8\u00a0\u00a0\u00a0<\/span><\/span><\/span>Des germes classiquement banaux et inoffensifs (commensaux habituels de la peau ou du tube digestif) deviennent pathog\u00e8nes, plac\u00e9s dans des conditions d\u2019environnement particuli\u00e8res (infection hospitali\u00e8re)<\/span><\/p>\n

II.\u00a0\u00a0\u00a0<\/span><\/span><\/span><\/b>Classification des maladies infectieuses\u00a0:<\/span><\/b><\/p>\n

v\u00a0<\/span><\/span><\/span>Solon le type d\u2019agent pathog\u00e8ne\u00a0:<\/span><\/u><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Infection bact\u00e9rienne<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Infection virale<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Infection parasitaire<\/span><\/p>\n

v\u00a0<\/span><\/span><\/span>Selon le mode de transmission\u00a0:<\/span><\/u><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Maladie infectieuse a\u00e9rog\u00e8ne<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Maladie infectieuse ent\u00e9rog\u00e8ne<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Maladie infectieuse cutan\u00e9o-muqueuse<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Maladie infectieuse sexuellement transmissible<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Anthropozoonose<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Infection nosocomiale<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Maladie infectieuse communautaire<\/span><\/p>\n

v\u00a0<\/span><\/span><\/span>Selon la dur\u00e9e d\u2019incubation\u00a0:<\/span><\/u><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Infection rapide<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Infection lente<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>Infection et contagion\u00a0:<\/i><\/b><\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Infection\u00a0:<\/span><\/i>\u00a0p\u00e9n\u00e9tration d\u2019un macro ou micro-organisme capable de s\u2019y multiplier et de se reproduire.<\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Contagion\u00a0:<\/span><\/i>\u00a0transmission d\u2019une<\/ins>maladie d\u2019un sujet \u00e0 l\u2019autre par contact direct ou indirect<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>Par ailleurs une maladie infectieuse est le r\u00e9sultat de l\u2019intervention de plusieurs facteurs et non seulement par la pr\u00e9sence de l\u2019agent pathog\u00e8ne de l\u2019infection.<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>Epid\u00e9miologie analytique\u00a0:<\/span><\/i><\/b><\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Origine de ces infections<\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>M\u00e9canismes de propagation<\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Les r\u00e9servoirs<\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Les h\u00f4tes<\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Les modalit\u00e9s qui leur permettent de persister<\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Leur \u00e9volution au sain de la cha\u00eene de transmission<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>Il est n\u00e9o-moins connu de distinguer entre\u00a0:<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Facteurs statiques\u00a0: \u00e9tude des facteurs qui<\/ins>causent l\u2019infection<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Cha\u00eene \u00e9pid\u00e9miologique\u00a0: \u00e9tude des facteurs conditionnant l\u2019\u00e9volution de la maladie chez le sujet.<\/span><\/p>\n

III.\u00a0\u00a0\u00a0<\/span><\/span><\/span><\/b>Cha\u00eene \u00e9pid\u00e9miologique\u00a0:<\/span><\/b><\/p>\n

A.\u00a0\u00a0<\/span><\/span><\/span>Origine de l\u2019infection\u00a0:<\/span><\/u><\/p>\n

1)\u00a0\u00a0\u00a0<\/span><\/span><\/span><\/i>Agent pathog\u00e8ne\u00a0: agent causal<\/span><\/i><\/p>\n

a)\u00a0\u00a0\u00a0<\/span><\/span><\/span>Germes\u00a0:<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Bact\u00e9ries<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Virus<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>parasites<\/span><\/p>\n

b)\u00a0\u00a0\u00a0<\/span><\/span><\/span>Pouvoir pathog\u00e8ne\u00a0:<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Virulence\u00a0: l\u2019aptitude d\u2019un germe \u00e0 se multiplier dans un milieu (homme ou animal)<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Toxigen\u00e8se\u00a0: capacit\u00e9 de produire une toxine soluble capable de diffuser.<\/span><\/p>\n

2)\u00a0\u00a0\u00a0<\/span><\/span><\/span><\/i>Source d\u2019infection\u00a0: r\u00e9servoir du parasite<\/span><\/i><\/p>\n

a)\u00a0\u00a0\u00a0<\/span><\/span><\/span>Homme\u00a0:<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>i.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Maladie\u00a0:<\/span><\/p>\n

\u00d8\u00a0\u00a0\u00a0<\/span><\/span><\/span>Formes typiques<\/span><\/p>\n

\u00d8\u00a0\u00a0\u00a0<\/span><\/span><\/span>Formes atypiques<\/span><\/p>\n

\u00d8\u00a0\u00a0\u00a0<\/span><\/span><\/span>Formes frustr\u00e9es<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>Le m\u00e9decin peut\u00a0:<\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Poser le diagnostic<\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Conna\u00eetre la nature des produits de virulence (sang, selles\u2026)<\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Conna\u00eetre la contagiosit\u00e9 qui peut s\u2019exercer pendant\u00a0:<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>La phase d\u2019invasion<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>La phase d\u2019\u00e9tat<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>La phase de convalescence<\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Peut diminuer la dur\u00e9e de l\u2019\u00e9valuation.<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>ii.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Les porteurs\u00a0:<\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Sont des bombes \u00e9pid\u00e9miologiques<\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Identification difficile\u00a0:<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Porteurs latents<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Porteurs pr\u00e9coces<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Porteurs convalescents<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Porteurs asymptomatiques ou chroniques<\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Dur\u00e9e de portage.<\/span><\/p>\n

b)\u00a0\u00a0\u00a0<\/span><\/span><\/span>R\u00e9servoir animal\u00a0:<\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Les maladies communes \u00e0 l\u2019homme et \u00e0 l\u2019animal sont des zoonoses qui comportent deux modalit\u00e9s\u00a0:<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Impasse biologique (brucellose, leptospirose)<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Contamination inter humaine (fi\u00e8vre jaune, peste\u2026)<\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Les vecteurs sont souvent des animaux domestiques<\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Les r\u00e9servoirs dangereux pour l\u2019homme constitu\u00e9s essentiellement par les gros mammif\u00e8res et plus rarement des rongeurs et des oiseaux.<\/span><\/p>\n

c)\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>R\u00e9servoir inanim\u00e9\u00a0:<\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Telluriques\u00a0: constitu\u00e9s de germes ana\u00e9robies sporul\u00e9s r\u00e9sistants dans le milieu ext\u00e9rieur (clostridium, botulinum\u2026)<\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Hydrique,<\/ins>alimentaire, a\u00e9rien ou li\u00e9 au mat\u00e9riel m\u00e9dicochirurgical.<\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Inerte tel les piscines pour les dermatoses.<\/i><\/span><\/p>\n

B.\u00a0\u00a0<\/span><\/span><\/span>Transmission de l\u2019infection\u00a0:<\/span><\/u><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>Les modes de transmission sont multiples et sont conditionn\u00e9s par la localisation et la biologie de l\u2019agent pathog\u00e8ne chez le porteur.<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>Le passage de l\u2019agent pathog\u00e8ne du r\u00e9servoir au sujet r\u00e9ceptif implique soit\u00a0:<\/span><\/p>\n

1)\u00a0\u00a0\u00a0<\/span><\/span><\/span>Elimination spontan\u00e9e<\/span><\/i>\u00a0du germe \u00e0 partir de la source d\u2019infection dans le milieu ext\u00e9rieur \u25ba infection ouverte qui peut se faire \u00e0 partir\u00a0:<\/span><\/p>\n

\u00d8\u00a0\u00a0\u00a0<\/span><\/span><\/span>des l\u00e9sions ouvertes (suppurations cutan\u00e9es, muqueuses, ganglionnaires ou \u00e9l\u00e9ments \u00e9ruptifs)<\/span><\/p>\n

\u00d8\u00a0\u00a0\u00a0<\/span><\/span><\/span>des orifices naturels (rhinopharynx, oropharynx, anus, orifices g\u00e9nito-urinaires)<\/span><\/p>\n

2)\u00a0\u00a0\u00a0<\/span><\/span><\/span>Pr\u00e9l\u00e8vement de la source d\u2019infection<\/span><\/i>\u00a0suivie d\u2019une inoculation au r\u00e9cepteur, dans ce cas l\u2019agent pathog\u00e8ne ne peut sortir de l\u2019organisme que par un vecteur \u25ba infection ferm\u00e9e, dans ce cas il s\u2019agit de maladies transmissibles mais non contagieuses.<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>Les modalit\u00e9s de transmission peuvent \u00eatre\u00a0:<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>i.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Transmission directe\u00a0:<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>Dans les infections ouvertes, par contact \u00e9troit\u00a0:<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Voie cutan\u00e9e<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Voie sexuelle<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Voie trans-placentaire (toxoplasmose)<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>ii.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Transmission indirecte\u00a0:<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>N\u00e9cessite un interm\u00e9diaire\u00a0:<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>V\u00e9hicule inerte\u00a0: eau (maladies hydriques), poussi\u00e8res, terres\u2026\u2026<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>V\u00e9hicule anim\u00e9\u00a0: transporteurs de germes (mouches, anoph\u00e8le\u2026)<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>Ces infections dont les vecteurs sont anim\u00e9s d\u00e9pendent des facteurs climatiques et g\u00e9ographiques.<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>iii.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Semi-directe\u00a0: manu-port\u00e9e<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Auto contamination<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Contaminations crois\u00e9es (en milieu hospitalier)<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Maladie des mains sales<\/span><\/p>\n

RQ\u00a0:<\/span><\/i>\u00a0la prophylaxie passe par\u00a0:<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Destruction du vecteur quand celui ci est r\u00e9alisable<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Vaccination<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Elimination prophylactique<\/span><\/p>\n

C.\u00a0\u00a0<\/span><\/span><\/span>H\u00f4te r\u00e9ceptif\u00a0:<\/span><\/u><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>Il faut consid\u00e9rer\u00a0:<\/span><\/p>\n

1)\u00a0\u00a0\u00a0<\/span><\/span><\/span><\/i>La voie de p\u00e9n\u00e9tration ou d\u2019inoculation\u00a0:<\/span><\/i><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Orifice naturel pour les infections ouvertes<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Effraction cutan\u00e9e ou l\u00e9sion pr\u00e9existante pour les infections ferm\u00e9es mais aussi pour les deux.<\/span><\/p>\n

2)\u00a0\u00a0\u00a0<\/span><\/span><\/span><\/i>Etat de r\u00e9ceptivit\u00e9 ou r\u00e9sistance du sujet contamin\u00e9\u00a0:<\/span><\/i><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>Elle est fonction de la d\u00e9fense de l\u2019organisme\u00a0:<\/span><\/p>\n

a)\u00a0\u00a0\u00a0<\/span><\/span><\/span>D\u00e9fense non sp\u00e9cifique\u00a0:<\/span><\/p>\n

\u00a7\u00a0\u00a0\u00a0<\/span><\/span><\/span>M\u00e9canique\u00a0: rev\u00eatement cutan\u00e9<\/span><\/p>\n

\u00a7\u00a0\u00a0\u00a0<\/span><\/span><\/span>Chimique\u00a0: acidit\u00e9 du milieu<\/span><\/p>\n

\u00a7\u00a0\u00a0\u00a0<\/span><\/span><\/span>R\u00e9actions inflammatoires\u00a0: phagocytose<\/span><\/p>\n

b)\u00a0\u00a0\u00a0<\/span><\/span><\/span>D\u00e9fense sp\u00e9cifique\u00a0:<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>L\u2019immunit\u00e9 est la r\u00e9sistance totale ou partielle de l\u2019organisme vis \u00e0 vis de l\u2019agent pathog\u00e8ne. Naturellement l\u2019homme ne poss\u00e8de pas d\u2019immunit\u00e9, lorsqu\u2019il est immunis\u00e9 c\u2019est le r\u00e9sultat d\u2019un processus acquis de fa\u00e7on<\/ins>temporaire ou durable.<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>L\u2019immunit\u00e9 succ\u00e8de g\u00e9n\u00e9ralement \u00e0 l\u2019infection\u00a0:<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>B\u00e9nigne<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Typique<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Atypique<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Rare<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Frustr\u00e9e<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Inapparente<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>L\u2019immunit\u00e9 peut \u00eatre r\u00e9alis\u00e9e artificiellement par la vaccination (effet durable) ou par des immunoglobulines (effet transitoire)<\/span><\/p>\n

3)\u00a0\u00a0\u00a0<\/span><\/span><\/span><\/i>D\u2019autres facteurs peuvent intervenir\u00a0:<\/span><\/i><\/p>\n

a)\u00a0\u00a0\u00a0<\/span><\/span><\/span>Age\u00a0:<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Nourrisson\u00a0: immunit\u00e9 transitoire<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Vieillissement\u00a0: diminution des moyens de d\u00e9fense, apparition de certaines maladies<\/span><\/p>\n

b)\u00a0\u00a0\u00a0<\/span><\/span><\/span>Sexe.<\/span><\/p>\n

c)\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Maladie de vie.<\/span><\/p>\n

d)\u00a0\u00a0\u00a0<\/span><\/span><\/span>Alimentation.<\/span><\/p>\n

e)\u00a0\u00a0\u00a0<\/span><\/span><\/span>Facteurs socioculturels ou professionnels<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>Ces facteurs peuvent intervenir dans des conditions\u00a0:<\/span><\/p>\n

\u00d8\u00a0\u00a0\u00a0<\/span><\/span><\/span>D\u2019exposition<\/span><\/p>\n

\u00d8\u00a0\u00a0\u00a0<\/span><\/span><\/span>De r\u00e9ceptivit\u00e9<\/span><\/p>\n

\u00d8\u00a0\u00a0\u00a0<\/span><\/span><\/span>De r\u00e9sistance<\/u><\/span><\/p>\n

IV.\u00a0\u00a0\u00a0<\/span><\/span><\/span><\/b>Prophylaxie contre la cha\u00eene \u00e9pid\u00e9miologique\u00a0:<\/span><\/b><\/p>\n

A.\u00a0\u00a0<\/span><\/span><\/span>Contre le r\u00e9servoir\u00a0:<\/span><\/u><\/p>\n

1)\u00a0\u00a0\u00a0<\/span><\/span><\/span><\/i>D\u00e9pistage\u00a0:<\/span><\/i><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Clinique et biologique<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Malades<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Porteurs<\/span><\/p>\n

2)\u00a0\u00a0\u00a0<\/span><\/span><\/span><\/i>Isolement du sujet contagieux\u00a0:<\/span><\/i><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Isolement des malades<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Pr\u00e9coce<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Pendant la p\u00e9riode de contagiosit\u00e9<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Si c\u2019est difficile \u00e0 domicile on le fait \u00e0 l\u2019h\u00f4pital<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Eviter les porteurs dans les internats, les \u00e9tablissements scolaires\u2026<\/span><\/p>\n

3)\u00a0\u00a0\u00a0<\/span><\/span><\/span><\/i>D\u00e9claration\u00a0:<\/span><\/i><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Devoir et obligation<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Emp\u00eache l\u2019apparition de nouveaux cas<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Permet d\u2019\u00e9tablir des mesures de luttes et de protection<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Etablir des enqu\u00eates \u00e9pid\u00e9miologiques et de statistiques (mortalit\u00e9, morbidit\u00e9\u2026)<\/span><\/p>\n

4)\u00a0\u00a0\u00a0<\/span><\/span><\/span><\/i>D\u00e9sinfection\u00a0:<\/span><\/i><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>En cours<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Terminale<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Dans le cadre d\u2019hygi\u00e8ne hospitali\u00e8re<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Porte sur les observations\u00a0:<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Des objets du malade<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Le mat\u00e9riel utilis\u00e9 par le malade<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Les d\u00e9jections et les excr\u00e9tas<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Les personnes qui auscultent le malade<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Interdiction d\u2019\u00e9liminer les produits \u00e0 l\u2019\u00e9tat brut dans la nature.<\/i><\/span><\/p>\n

B.\u00a0\u00a0<\/span><\/span><\/span>Lutte contre les moyens de transmission\u00a0:<\/span><\/u><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>Il faut briser la cha\u00eene par\u00a0:<\/span><\/p>\n

1)\u00a0\u00a0\u00a0<\/span><\/span><\/span><\/i>Education sanitaire\u00a0:<\/span><\/i><\/p>\n

a)\u00a0\u00a0\u00a0<\/span><\/span><\/span>Hygi\u00e8ne individuelle\u00a0:<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>i.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Corporelle<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>ii.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Vestimentaire<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>iii.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>En niveau p\u00e9riodique<\/ins><\/span><\/p>\n

b)\u00a0\u00a0\u00a0<\/span><\/span><\/span>Education sanitaire\u00a0: du malade et du porteur<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>i.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Informer du danger du tabac, alcool, mastique\u2026<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>ii.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Assainissement<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>iii.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Changement de comportement<\/span><\/p>\n

2)\u00a0\u00a0\u00a0<\/span><\/span><\/span><\/i>Lutte contre les infections ouvertes\u00a0:<\/span><\/i><\/p>\n

a)\u00a0\u00a0\u00a0<\/span><\/span><\/span>Transmission directe\u00a0:<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Isolement quand c\u2019est r\u00e9alisable<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Hygi\u00e8ne individuelle<\/span><\/p>\n

b)\u00a0\u00a0\u00a0<\/span><\/span><\/span>Transmission indirecte\u00a0:<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>D\u00e9sinfections des locaux ou des objets<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>D\u00e9sinsectisation<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>D\u00e9ratisation<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Epuration de l\u2019eau d\u2019alimentation<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Contr\u00f4le de ma salubrit\u00e9 des aliments.<\/span><\/p>\n

o\u00a0\u00a0\u00a0<\/span><\/span><\/span>Evacuation et traitement des eaux us\u00e9es.<\/span><\/p>\n

3)\u00a0\u00a0\u00a0<\/span><\/span><\/span><\/i>Lutte contre les infections ferm\u00e9es\u00a0:<\/span><\/i><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>D\u00e9sinsectisation<\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Asepsie lors des injections parent\u00e9rales<\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Protection des sujets contact\u00e9s et l\u2019ensemble de la population<\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/span><\/span>Am\u00e9liorer la d\u00e9fense de l\u2019organisme par\u00a0:<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Hygi\u00e8ne individuelle<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Pr\u00e9vention par apport d\u2019Ac pr\u00e9fabriqu\u00e9s\u00a0\u00a0<\/span>(immunit\u00e9 passive \u00e0 dur\u00e9e limit\u00e9e \u00ab\u00a03 semaines\u00a0\u00bb)<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Vaccination<\/span><\/p>\n

q\u00a0\u00a0\u00a0<\/span><\/span><\/span>Surveillance de la vaccination.<\/span><\/p>\n<\/div>\n

.<\/div>\n","protected":false},"excerpt":{"rendered":"

I.\u00a0\u00a0\u00a0Introduction\u00a0: \u00a0\u00a0\u00a0\u00a0\u00a0Il n\u2019est pas possible aujourd\u2019hui de concevoir qu\u2019une maladie infectieuse soit due \u00e0 l\u2019intervention d\u2019un seul facteur ou agent…<\/p>\n","protected":false},"author":2,"featured_media":138,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0},"categories":[11],"tags":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/posts\/23"}],"collection":[{"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/avo6.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=23"}],"version-history":[{"count":3,"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/posts\/23\/revisions"}],"predecessor-version":[{"id":365,"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/posts\/23\/revisions\/365"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/avo6.com\/index.php?rest_route=\/wp\/v2\/media\/138"}],"wp:attachment":[{"href":"https:\/\/avo6.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=23"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/avo6.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=23"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/avo6.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=23"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}