[Globalization, emergence and importation of infectious diseases]

Epidemiology of infectious diseases has considerably changed over the past decades. The current epidemiological risk is global and thus requires a global response. International institutions have developed mechanisms in order to cope with this challenge. France is not only confronted to global risk affecting the world population but also to specific risks in relation to the regional context and the existence of French overseas territories. The unprecedented outbreak of Chikungunya viral infection that affected the French island of La Réunion in 2005-2006 has clearly emphasized the vulnerability of French overseas territories' population to tropical diseases. It also illustrates the risk of importation of such diseases in Metropolitan France (mainland France and Corsica). In disease free areas, the surveillance of potentially imported diseases cannot rely exclusively on data available from endemic countries. Routine surveillance should also include tools tailored to detect potentially emerging pathogens. The role of health professional especially clinicians and biologists in metropolitan France and overseas territories is crucial. For that matter, they are the first line for detection and notification of emerging events.