Rapidly assessing the risks of infectious diseases to wildlife species.

Predicting the likelihood of rare events is increasingly demanded by risk managers. A key challenge is dealing with different types of uncertainty, including epistemic uncertainties (lack of knowledge), stochasticity (inherent randomness) and natural variation. One potentially catastrophic event which is impacted by high levels of all three of these uncertainty types is the transmission of livestock pathogens to wildlife, particularly for endangered species. There is often a lack of basic information, e.g. about a given pathogen's presence in local livestock populations or the susceptibility of a given wildlife species to infection by the pathogen. We adapted the OIE (World Organisation for Animal Health) risk assessment framework to rapidly assess and prioritize the risks of livestock pathogens for wildlife, taking account of epistemic uncertainties, stochasticity, seasonal movement of animals and interaction between different species at different spatial and temporal scales. We demonstrate the approach using the endangered saiga antelope (Saiga tatarica tatarica) as a case study. We conclude that, in general, transmission events are likely to be rare and limited to small geographical areas; however, their impact could be high. Brucella spp. and foot-and-mouth disease virus are among those most likely to be transmitted from livestock to the Betpak-Dala saiga population.

Evolution of the hygiene hypothesis into biota alteration theory: what are the paradigms and where are the clinical applications?

For thousands of years, changes in human cultures have altered the biota associated with the human body, and those alterations have strongly influenced human health. The hygiene hypothesis has evolved over the past 30 years into a nuanced biota alteration theory, but modern medical priorities and regulatory policies have resulted in tragic underutilization of the acquired knowledge.

The predictive value of a maculopapular rash in children hospitalized for dengue fever in Cayenne, French Guiana.

In order to determine the predictive value of a rash during dengue fever, a cohort study was conducted in children hospitalized for dengue during an epidemic in French Guiana. A rash was predictive of uncomplicated dengue: the HR of developing a severe form of disease was 0.43 (95% CI 0.21-0.88; p-value=0.021) for patients with rash.