[Rotaviruses in human and veterinary medicine]. / Les rotavirus en médecine humaine et vétérinaire.

Rotaviruses are the commonest cause of diarrhea and are responsible for more than 25% of all deaths from diarrhea worldwide. Children become infected early in life and most infections in infants older than 3 months are symptomatic. These viruses account for 18 million cases of moderate or severe disease and 900,000 deaths each year. The incidence of rotaviral disease is similar in developed and developing countries but the number of deaths is higher in developing countries. Infections occur throughout the year in developing countries but are seasonal in developed countries, occurring mainly between October and March. The mean age at first infection is 6 to 9 months in developing countries and 9 to 15 months in developed countries. The greater severity of infections in developing countries is associated with malnutrition, lower hygiene standards and the lactose malabsorption and deficiencies of zinc and vitamin A that accompany diarrhea. Many mixed infections also increase the severity of the rotavirus infection. The clinical symptoms of the disease in hospitalized patients are diarrhea, vomiting and dehydration. There is more vomiting than with bacterial infections. The severity of the clinical symptoms depends on the virulence of different strains. The disease is more severe and persistent in patients with reduced immunity. Age also has an effect. All children may have rotavirus in their feces but the percentage of children developing diarrhea is highest at an age of 3 to 6 months and decreases steadily thereafter. Rotaviruses can survive in air and may remain on surfaces for several hours. They are thus often responsible for nosocomial infections. Rotavirus was first identified in cattle in 1969. The virulence of the strain and the age of the calf at infection are important in the pathogenesis of rotaviral infection in cattle. Replacement of villous enterocytes is slow in newborn calves. This means that newborn calves are susceptible to disease caused by strains that are only moderately virulent. They are, however, protected during the first days of life by antibodies transmitted via the colostrum. There is competition between the rate of replication of rotavirus and replacement of enterocytes in older animals so only more virulent strains cause diarrhea in six-week-old calves. Adult animals become resistant to disease, but not to infection. The rotavirus genome consists of 11 segments of double-stranded RNA. Genetic recombination between these segments occurs naturally and can be reproduced in vitro. Recombinants between human and bovine strains have been identified but the epidemiological importance of this is unknown. The genomic segments encode 6 structural proteins (VP) and 5 non-structural proteins (NSP). VP6, the major capsid antigen, present can be used to identify groups of rotaviruses. The presence of VP7 indicates that the virus belongs to the G (glycoprotein) group of serotypes. There are 14 G serotypes, 10 of which can infect humans. The four main G serotypes are G1 to G4, with G1 accounting for 60% of human serotypes. The presence of VP4 identifies the P (protease-sensitive) serotype. The serotypes have different geographic distributions with G1P8 responsible for more than 50% of epidemics worldwide. The WHO project for the control of rotaviral infections focuses on avoiding fecal contamination. This is achieved by ensuring high standards of food hygiene, sewage treatment and chlorinated running water and by introducing vaccination when vaccines become available. Recombinant animal (bovine or simian) and human rotaviruses are currently being tested in phase III studies. Attenuated live human viruses, including cold-adapted strains are being tested in phase I trials. The quadrivalent recombinant rhesuslhuman vaccine had only mild side-effects in children and was effective, giving 82-92% protection against severe diarrhea over two years and 50% protection on average. (ABSTRACT TRUNCATED)

[Identification of human carcinogenic risks in IARC monographs]. / Identification des facteurs cancérogènes pour l'homme dans les Monographies du CIRC.

For more than twenty years, the IARC has been evaluating the carcinogenic risk to humans of chemicals, groups of chemicals, complex mixtures, occupational exposures, behavioral and life-style exposures, biological agents, such as bacteria and viruses, and physical agents, such as radiation, on the basis of published studies of carcinogenicity in humans and laboratory animals. This paper includes the list established by IARC of substances carcinogenic to humans.

Individual susceptibility and prevention of occupational diseases: scientific and ethical issues.

Genetic testing of employees is controversial; objections have been raised with regard to privacy, right to work, and the relevance of the tests. A study is being conducted on "the ethical, social, and scientific problems related to the application of genetic screening and genetic monitoring for employees in the context of a European approach to health and safety at work." A conceptual model is proposed of the complex interactions between exposure, acquired and inherited susceptibility, and risk for disease. The validity of tests for determining genotype and phenotype and their relevance for disease must be evaluated critically to provide an objective basis for ethical discussions. The acceptability of such tests is related to a number of issues, which are identified and discussed.

Response of experimental animals to human carcinogens: an analysis based upon the IARC Monographs programme.

Only the results of epidemiological studies can be used to establish a causal relationship between an exposure to an agent and human cancer; however, such studies often cannot be carried out due to limitations of population or latent period or to the presence of mixed exposures. It is essential, therefore, that the validity be established of extrapolating to humans the results obtained from long-term carcinogenicity tests in animals. The responses of experimental animals to known and suspected human carcinogens, as evaluated in the IARC Monographs series, were analysed as an indication of the sensitivity of animal tests for predicting human carcinogens. Although the response was high - 84% - it would have been even higher had all the compounds been adequately tested experimentally. An additional finding was that for many exposures causally related to human cancer, there is a target organ in common between humans and at least one animal species, despite many inherent physiological differences. These findings show clearly the importance of experimental carcinogenicity studies in the primary prevention of cancer.

Target organs for carcinogenicity of chemicals and industrial exposures in humans: a review of results in the IARC monographs on the evaluation of the carcinogenic risk of chemicals to humans.

Epidemiological observations indicate that cancers affecting different organs and systems in humans have different causes. At the descriptive level, cancer incidence and mortality rates exhibit patterns of geographic and temporal variation which are distinct and separate for each cancer site and even, at a given site, for different histological types (for instance, increasing squamous cell carcinoma of the lung and decreasing stomach cancer in most developed countries in recent decades). The existence of these distinct patterns in itself indicates that different causes are at the origin of cancers at different sites. Hence, it is of scientific and practical importance not only to identify agents that are carcinogenic to humans but also to specify as definitely as possible the target organ(s) of their action. This is done in the present review of results in the International Agency for Research on Cancer Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Humans.