Agence Nationale de Sécurité Sanitaire de l'Alimentation, de l'Environnement et du Travail

Introduction: Relative or absolute safety of heated tobacco products (HTP) remains unknown, while independent literature suggests that these products do not favour tobacco control. We conducted a comprehensive systematic review and meta-analysis to evaluate HTP usage patterns and the effect of HTP use on conventional tobacco smoking (use transitions). Methods: We used Pubmed/MEDLINE, Embase and the Cochrane Library to identify all articles published up to February 2022 on HTP use. For the present review, we included all representative cross-sectional studies dealing with HTP use, and all prospective cohort studies or cross-sectional studies on conventional tobacco smoking transitions due to HTP use. From 610 non-duplicate articles, 76 were eligible (71 cross-sectional and 5 prospective cohort studies). Results: Compared with young adults, HTP use was less frequent among middle-aged (pooled odds ratio, OR=0.59; 95% confidence interval, CI: 0.48–0.74; number of studies, n=15) and older adults (OR=0.17; 95%-CI: 0.07–0.38; n=12). HTP use was more frequent among former (OR=2.73; 95%-CI: 1.03–7.25; n=6) and current smokers (OR=14.53; 95%-CI: 6.34–33.31; n=12). Overall, 68.3% of HTP users were dual users (n=26). Eight studies (including 5 cohorts) showed that HTP users were more likely than non-users to start conventional cigarette smoking (OR=6.31; 95%-CI: 4.13–9.65; n=2), whereas current cigarette smokers using HTPs were less likely to quit (OR=0.84; 95%-CI: 0.80–0.89; n=4). Conclusions: We found that HTPs are specifically popular among young generations. More than two out of three HTP users are dual users. Prospective studies consistently show that in real life HTPs are not effective smoking cessation tools.

Background Diet is a primary source of exposure to chemicals in the general population. Dietary contaminants originate from food production (e.g.pesticides) or from environmental contamination by industrial (polychlorinated biphenyls [PCB]) or naturally‐occurring substances (metals). Many are present at non‐negligible levels in human biofluids, and some were found in the human brain. Since many chemicals are lipophilic, the dietary composition, especially the fat content, likely modifies their toxicokinetics. We aimed to explore the link between dietary exposure to multiple chemicals and dementia risk in older persons, considering effect modification by dietary fat content. Method We included 1,288 non‐demented participants from the French Three‐City cohort who completed a food survey (2001‐2002) and were followed for incident dementia. Dietary exposure to 167 chemicals (covering 9 families) was assessed by combining individual food intakes with food chemical content measured in the French second Total Diet Study. We assessed the relation of each individual chemical with dementia risk using Cox proportional hazard models adjusted for age, sex, education, ApoE‐ε4 and Mediterranean diet adherence and exploring effect modification by high‐fat diet content (defined as >35% of energy from fat). We subsequently considered all chemicals simultaneously and performed chemical variable selection using elastic‐net regularization. Result Participants were 76 years‐old on average at baseline; 62% were women; 30% reported a high‐fat diet. Over a median follow‐up of 10 years, 314 individuals developed dementia. No chemical was associated with dementia risk in the whole population. However, having a diet with higher fat content was a strong effect modifier for 82 chemicals (FDR‐corrected p<0.05 for interaction tests). Higher intakes of these chemicals were significantly associated to higher dementia risk among high‐fat diet consumers only. The strongest hazard ratios (HR>1.40 for one SD‐increase in intake) were observed for contaminants provided by seafood and meat, including the brominated flame retardant hexabromocyclododecane‐alpha (HBCDD‐α), perfluorooctane sulfonate (PFOS) and PCB‐77. Among high‐fat diet consumers, the elastic‐net identified 33 chemicals associated with dementia risk, with PFOS and nitrites ranking as primary chemicals. Conclusion In our study, dietary exposure to specific chemicals, was associated with higher dementia risk among older persons consuming >35% of energy from fat in their diet.

Demonstration that a detection method and its critical features is repeatable and reproducible is essential for its adoption as an international standard. An existing RT-qPCR-based method for detection of hepatitis E virus (HEV) in pig liver was modified to incorporate an internal amplification control, enabling a more accurate analysis with less control sample numbers. The method was subjected to interlaboratory trial involving seven laboratories from six European countries. Each laboratory tested eight samples at four artificial contamination levels: 0 genome copies (gc) HEV, 6 × 10⁴ genome copies, 6 × 10³ gc, and 6 × 10² gc per 25 mg liver. Trial sensitivity, or correct identification of positive samples, was 83.3%; the accordance was 82.2%, and the concordance was 69.6%. The positive predictive value was 93.8%. The trial specificity, or correct identification of uncontaminated samples, was 83.3%; the accordance was 66.7%, and the concordance was 70.0%. The negative predictive value was 62.5%. The internal amplification control (IAC) was detected in all samples except one. The results of the study are anticipated to assist in current standardization activities. The methodological advancement should aid in more accurate and reliable analysis, contributing to the broader goal of ensuring safer food supply chains.

Introduction The European Partnership for the Assessment of Risks from Chemicals (PARC) is a 7-year multinational partnership aimed at consolidating and strengthening European Union’s (EU) research and innovation capacity for chemical risk assessment (RA) to protect human health and the environment. It consists of nine work packages (WP) involving more than 200 participating organisations from 29 countries. PARC is currently mapping the most relevant needs in the field of European chemical RA to steer PARC’s future activities in the coming years. The present study aims to gather the perspectives of WP/Task/Project Leaders of PARC to understand their experience during the first prioritisation round of PARC activities and to identify potential points of improvement for future rounds. Methods Three online 90-min focus group discussion (FGD) sessions were conducted between the 3rd and 9th of May 2023. Each session was attended by 4-5 participants with at least one representative from each PARC WPs 4, 5 and 6 (n = 13). The sessions were recorded and transcribed, then analysed in NVivo 12 software using thematic analysis. Results Some important aspects for the prioritisation of activities that were mentioned include: (1) having a transparent prioritisation process even though each WP might need different prioritisation criteria, (2) balancing the fulfilment of short-term regulatory needs and anticipating long-term needs in chemical RA, (3) maintaining alignment and synergy between the WPs and with other relevant EU initiatives to avoid duplication and to ensure continuity of work and (4) making sure that PARC can effectively respond to requests from different PARC stakeholders. Conclusions The next round of PARC research activity steering process will provide an opportunity to implement the various improvements identified. PARC should utilise the advantage of having stakeholders from different backgrounds (e.g., risk assessors, policymakers, regulatory bodies, academia, etc.) within its consortium and its advising bodies to prioritise projects and activities that will support its overall objectives. These recommendations could also be of interest outside PARC in the context of prioritising research and innovation needs related to chemical RA.

West Nile Virus (WNV) and Usutu virus (USUV) circulate through complex cryptic transmission cycles involving mosquitoes as vectors, birds as amplifying hosts and several mammal species as dead-end hosts. Both viruses can be transmitted to humans through mosquito bites, which can lead to neuroinvasive and potentially fatal disease. Notably, WNV can also be transmitted through blood donations and organ transplants. The high proportion of asymptomatic infections caused by these viruses and their cryptic enzootic circulation make their early detection in the environment challenging. Viral surveillance in France still heavily relies on human and animal surveillance, i.e. late indicators of viral circulation. Entomological surveillance is a method of choice for identifying virus circulation ahead of the first human and animal cases and to reveal their genetic identity, but performing molecular screening of vectors is expensive, and time-consuming. Here we show substantial WNV and USUV co-circulation in Atlantic seaboard of France between July and August 2023 using a non-invasive MX (Molecular Xenomonitoring) method that use trapped mosquito excreta. MX offers significant advantages over traditional entomological surveillance: it is cost-effective and efficient, enabling viral RNA screening from a community of trapped mosquitoes via their excreta, which can be transported at room temperature. Additionally, MX extends the longevity of trapped mosquitoes, enhancing virus detection and simplifying logistics, and is easy to implement without requiring specialized skills. At the crossroads between entomological and environmental surveillance, MX can detect the circulation of zoonotic pathogens in the environment before cases are observed in humans and horses, enabling the timely alerts to health policy makers, allowing them to take suitable control measures.

Background While more and more people tend to use herbal products thinking they are safer than conventional western medicine, the reality is other. If natural products are bio-active and possess potential therapeutic activities, then the benefit/risk balance should be considered like any other health product. Some herbs are known to have the potential to interact with patient’s treatment and to cause adverse drug reactions. While these are scarce, they are potentially harmful, and can lead to major sequels and even death in some cases. Despite these known facts, little guidelines about how to evaluate the risk of interaction and to handle them exist in literature. Notably, few scales allowing to assess the risk of a specific combination of herbs and drugs exist. Method We propose a new scoring method BABINE (Boosting Analysis of Bibliography for herb- drug INteraction Evaluation) and discuss a scale to evaluate this risk based on iterative rounds of experts’ discussion. Results After 6 rounds of case reports/clinical studies evaluation, we analyzed and synthesized criteria identified as important by the experts and developed a corresponding evaluation scale. Conclusion Even if our scale greatly simplifies pharmacological events, we believe it provides a robust and transparent way to rapidly assess the risk of adverse event.

The mosquito microbiota, a community of bacteria, fungi, and viruses, interacts with the mosquito’s immune system and influences feeding behavior and physiology, impacting pathogen transmission either positively or negatively. This editorial examines the critical role of the mosquito microbiota in the transmission of vector-borne diseases, drawing on insights from Garrigós et al. [12] who focus on WNV. By exploring the complex relationships between mosquito microbiota and pathogens like Plasmodium and WNV, we can gain a valuable understanding of how these microbial communities shape vector competence—the ability of mosquitoes to acquire, maintain, and transmit pathogens—potentially unlocking innovative approaches to combating diseases that threaten both biodiversity and public health.

Malaria remains a significant global health challenge, with the deadliest infections caused by Plasmodium falciparum. In light of the escalating drug resistance and the limited effectiveness of available vaccines, innovative treatment approaches are urgently needed. This study explores the potential of the probiotic Limosilactobacillus fermentum YZ01, isolated from traditionally fermented kindirmo milk, to modify host responses to Plasmodium berghei ANKA infection. Twenty-five male BALB/c mice were grouped and administered various treatments, including probiotic-enriched yogurt alone or in combination with antibiotics. Parameters assessed included gut lactic acid bacteria (LAB) composition, parasitaemia progression, survival rates, and immune response dynamics over a 21-day postinfection period. The probiotic treatment significantly altered gut microbiota, evidenced by increased LAB counts and modulated immune responses, notably enhancing IgM and IL-4 production while reducing IFN-γ levels. Mice receiving prolonged probiotic treatment exhibited delayed parasitaemia onset, reduced mortality rates, and a more robust immune response compared to control groups. These outcomes suggest that probiotic intervention not only tempers the pathological effects of malaria but also enhances host resilience against infection. This study underscores the role of gut microbiota in infectious disease pathogenesis and supports probiotics as a promising adjunct therapy for malaria management.

The widespread use of pesticides, specifically plant protection products (PPPs), has led to their transformation products (TPs) being increasingly detected in various environmental compartments, notably surface waters. This study integrates field-detected TPs into an environmental risk assessment of lentic small water bodies (LSWBs). For this purpose, measured environmental concentrations (MECs) of PPPs and TPs in 12 LSWBs, influenced by tributaries under varying agricultural pressures, were collected. Ecotoxicological data from multiple sources were compiled to calculate risk quotients (RQs) and identify potentially harmful PPPs and TPs. Among 86 molecules investigated, 17 PPPs and 30 TPs were detected, representing nearly half of those initially targeted. Ponds exhibited diverse PPP and TP compositions and levels with 12 substances posing high pesticide risk, primarily atrazine-2-hydroxy, MCPA, and metolachlor. Various pond conditions indicated moderate to high risk to aquatic organisms at corresponding MECs. Despite diverse agricultural pressures, only one site was deemed low-risk, highlighting widespread contamination risk due to co-occurring molecules. Given the prevalence of TPs in water bodies, urgent efforts are needed to gather ecotoxicological data on these contaminants to enhance environmental risk assessments. This study provides novel insights into pesticide risks in a less-studied yet common European landscape, focusing on TPs.

African trypanosomes are important parasites in sub-Saharan Africa that undergo a quorum-sensing dependent development to morphologically ‘stumpy forms’ in mammalian hosts to favour transmission by tsetse flies. However, some trypanosome clades have simplified their lifecycle by escaping dependence on tsetse allowing an expanded geographic range, with direct transmission between hosts achieved via blood-feeding biting flies and vampire bats (Trypanosoma brucei evansi, causing ‘surra’) or through sexual transmission (Trypanosoma brucei equiperdum, causing ‘dourine’). Concomitantly, stumpy formation is reduced and the isolates are described as monomorphic, with infections spread widely in Africa, Asia, South America and parts of Europe. Here, using genomic analysis of distinct field isolates, we identify molecular changes that accompany the loss of the stumpy formation in monomorphic clades. Using CRISPR-mediated allelic replacement, mutations in two exemplar genes (Tb927.2.4020; Tb927.5.2580) are confirmed to reduce stumpy formation whereas another (Tb927.11.3400) is implicated in altered motility. Using laboratory selection we identify downregulation of RNA regulators as important in the initial development of monomorphism. This identifies a trajectory of events that simplify the life cycle in emergent and established monomorphic trypanosomes, with impact on disease spread, vector control strategies, geographical range and virulence.

Background Within the International Health Regulations framework, the French High Council for Public Health was mandated in 2022 by health authorities to establish a list of priority infectious diseases for public health, surveillance and research in mainland and overseas France. Aim Our objective was to establish this list. Methods A multi-criteria decision analysis was used, as recommended by the European Centre for Disease Prevention and Control. A list of 95 entities (infectious diseases or groups of these, including the World Health Organization (WHO)-labelled ‘Disease X’) was established by 17 infectious disease experts. Ten criteria were defined to score entities: incidence rate, case fatality rate, potential for emergence and spread, impact on the individual, on society, on socially vulnerable groups, on the healthcare system, and need for new preventive tools, new curative therapies, and surveillance. Each criterion was assigned a relative weight by 77 multidisciplinary experts. For each entity, 98 physicians from various specialties rated each criterion against the entity, using a four-class Likert-type scale; the ratings were converted into numeric values with a nonlinear scale and respectively weighted to calculate the entity score. Results Fifteen entities were ranked as high-priorities, including Disease X and 14 known pathologies (e.g. haemorrhagic fevers, various respiratory viral infections, arboviral infections, multidrug-resistant bacterial infections, invasive meningococcal and pneumococcal diseases, prion diseases, rabies, and tuberculosis). Conclusion The priority entities agreed with those of the WHO in 2023; almost all were currently covered by the French surveillance and alert system. Repeating this analysis periodically would keep the list updated.

In amyotrophic lateral sclerosis (ALS), early mitochondrial dysfunction may contribute to progressive motor neuron loss. Remarkably, the ectopic expression of the Orthobornavirus bornaense type 1 (BoDV-1) X protein in mitochondria blocks apoptosis and protects neurons from degeneration. Therefore, this study examines the neuroprotective effects of X protein in an ALS mouse model. We first tested in vitro the effect of the X-derived peptide (PX3) on motoneurons primary cultures of SOD1G93A mice. The total intracellular adenosine triphosphate (ATP) content was measured after incubation of the peptide. We next tested in vivo the intramuscular injection of X protein using a canine viral vector (CAV2-X) and PX3 intranasal administrations in SOD1G93A mice. Disease onset and progression were assessed through rotarod performance, functional motor unit analysis via electrophysiology, and motor neuron survival by immunohistochemistry. The results showed that in vitro PX3 restored the ATP level in SOD1G93A motor neurons. In vivo, treated mice demonstrated better motor performance, preserved motor units, and higher motor neuron survival. Although life expectancy was not extended in this severe mouse model of motor neuron degeneration, the present findings clearly demonstrate the neuroprotective potential of X protein in a model of ALS. We are convinced that further studies may improve the therapeutic impact of X protein with optimized administration methods.

Vector-borne diseases pose significant challenges for both animal and public health worldwide [...]

In the absence of data on the reporting of L. monocytogenes resistance to antibiotics, we sought to determine which clonal complexes (CCs)/sequence types (STs) circulate in the food chain in Kosovo and to determine their antibiogram profiles to a panel of 18 antibiotics. From a total of 114 isolates, 21 different typical STs were identified by multilocus sequence typing (MLST). Each isolate derived from the food categories was subjected to tests to verify its susceptibility to the selected antibiotics according to the designed Sensititre GPN3F panel. Among the different STs that were identified, CC9-ST9 was more abundant in meat products (38.75%) while CC29-ST29 was more abundant (24.0%) in dairy products. Moreover, these isolates showed marked resistance against levofloxacin (22.8%), gentamicin and rifampicin (17.5%), quinupristin/dalfopristin (14.9%), erythromycin (11.4%), penicillin (7.89%), tetracycline (1.75%), and streptomycin (0.88%). A total of 27 multiple antibiotic resistance (MAR) phenotypes were observed amongst the isolates, which ranged from 3 to 12. The ARI of the food category including meat and meat products (MMP, 0.22) and fish meat products (FMP, 0.26) were >0.2, the permissible Krumperman threshold. The number of strains with MAR values >0.2 was 34, (29.8%). The identification of typical multidrug-resistant STs among L. monocytogenes isolates in Kosovo constitutes a potential threat to food safety and public health, which requires a continuous and expanded surveillance system to prevent the further spread of antimicrobial resistant (AMR) isolates.

This study introduces a quantitative risk assessment (QRA) model aimed at evaluating the risk of invasive listeriosis linked to the consumption of ready-to-eat (RTE) smoked and gravad fish. The QRA model, based on published data, simulates the production process from fish harvest through to consumer intake, specifically focusing on smoked brine-injected, smoked dry-salted, and gravad fish. In a reference scenario, model predictions reveal substantial probabilities of lot and pack contamination at the end of processing (38.7% and 8.14% for smoked brined fish, 34.4% and 6.49% for smoked dry-salted fish, and 52.2% and 11.1% for gravad fish), although the concentrations of L. monocytogenes are very low, with virtually no packs exceeding 10 CFU/g at the point of sale. The risk of listeriosis for an elderly consumer per serving is also quantified. The lot-level mean risk of listeriosis per serving in the elderly population was 9.751 × 10−8 for smoked brined fish, 9.634 × 10−8 for smoked dry-salted fish, and 2.086 × 10−7 for gravad fish. Risk reduction strategies were then analyzed, indicating that the application of protective cultures and maintaining lower cold storage temperatures significantly mitigate listeriosis risk compared to reducing incoming fish lot contamination. The model also addresses the effectiveness of control measures during processing, such as minimizing cross-contamination. The comprehensive QRA model has been made available as a fully documented qraLm R package. This facilitates its adaptation for risk assessment of other RTE seafood, making it a valuable tool for public health officials to evaluate and manage food safety risks more effectively.

Carp edema virus disease (CEVD) is a severe viral illness that causes substantial economic losses in wild and farmed common carp and koi. It is caused by carp edema virus (CEV), a member of the Poxviridae family, whose genetic diversity and genome evolution are poorly understood. Based on a genomic fragment of the 4a gene, two genogroups, genogroup I (gI) and geno-group II (gII), have been identified in samples of different origins. By analysing a series of recent samples, we highlight here a new genomic region of interest that varies by substitutions, indels and putative recombinations. In the Japanese reference sequence, this region encodes an ORF, cds46, whose function is unknown despite weak homologies with genes of some members of the Iridoviridae. Surprisingly, AlphaFold protein structure prediction analyses link cds46-encoded ORF with cellular endonucleases, providing insights into its possible origin. The ORF is absent in all gI haplotypes and in some gII haplotypes. Apart from the absence of cds46, gI haplotypes show an insertion of 121 bp with no homology to any viral sequence. When present, cds46 showed two groups of alleles differentiated by substitutions. The analysis of the cds46 locus showed that some samples from fish batches contained mixes of different haplotypes, irrespective of their origin (i.e. France, Japan or Israel). In a 2023 sample, we also found a virus carrying a gII-like atypical 4a allele first identified in France in 2015, indicating the limited but persistent spread of this virus in the country. The cds46 locus is a new target that may be useful for identifying and tracking CEV haplotypes.

Peste des petits ruminants (PPR) is a highly contagious disease affecting mainly sheep and goats. Livestock movements contribute to the spread of the disease by introducing it to naive areas or exposing susceptible animals to it in infected regions. Because of its socio-economic impact, the Food and Agriculture Organisation (FAO) and the World Organization for Animal Health (WOAH) have set the goal to eradicate it by 2030, one of the key steps being the improvement of surveillance networks. The present study aimed to provide tools to identify areas that could serve as sentinel nodes, i.e. areas that may be rapidly infected at the onset of epidemics. Using data from a market survey conducted in Northern Nigeria, we reconstructed the small ruminants mobility network and simulated the diffusion of PPR virus through animal movement. From the analysis of simulation outcomes, we investigated which nodes could act as sentinel nodes under specific conditions for disease transmission. We considered several modified networks to get around the problem of data only being available for part of the overall network structure and to account for potential errors made during the field study. For each configuration, we simulated the spread of PPR using a stochastic Susceptible-Infectious (SI) model based on animal movements to assess the epidemics’ extent and the presence of recurrent patterns to identify potential sentinel nodes. We extracted the backbone of the reference network and checked for the presence of sentinel nodes within it. We investigated how the origin (seed) of the epidemics could affect the propagation pattern by comparing and grouping seeds based on their respective transmission paths. Results showed that the isolated backbone contains 45% of sentinel nodes that remain stable or undergo only minor changes in 9 out of 11 configurations. On top of that, the characteristics of sentinel nodes identified in the backbone are not influenced by the severity of the disease. The H index, in-degree, and eigenvector are the most essential variables. This study provides an overview of the major axes of animal movements in Nigeria and the most vulnerable locations that should be prioritized for monitoring livestock diseases like PPR.

A quantitative risk assessment (QRA) model was developed to evaluate the risk of invasive listeriosis from the consumption of non-ready-to-eat (non-RTE) frozen vegetables. On a lot basis, the QRA model simulates Listeria monocytogenes concentration and prevalence in a “Processing module” that comprises blanching, potential recontamination and packaging, any post-packaging inactivation treatment, and within-lot end-product testing and in a subsequent “Consumer’s handling module” that encompasses portioning of frozen vegetables, defrosting, and cooking. Based on available published data, the model was coded in nine sequential R functions designed to assess the effectiveness of blanching, the improvement in processing environment hygiene, the implementation of sampling schemes at the end of processing, and improved consumer instructions on the product’s package. In a reference scenario, the model estimated that 9.4% of 500 g packages of frozen vegetables would be contaminated, although at mean levels lower than 10 CFU/g, and assuming that 20% of the portions of frozen vegetables would be left to thaw at room temperature for 2 h, the lot-level mean risk of listeriosis in the susceptible population would be 2.935 × 10−14 (median 5.446 × 10−15) for uncooked 50 g servings and 2.765 × 10−17 (median 5.184 × 10−18) for cooked 50 g servings. Analysis of selected scenarios suggested that not cooking the non-RTE product contributes to the risk to a greater extent than the level of contamination in the incoming raw vegetables, the latter in turn being more influential than the level of contamination in the processing environment. The QRA model is freely available as an R package with full documentation and can be used as a tool to inform the consideration of strengthened risk management measures in view of the current changes in consumer behavior and new diet trends.