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PubMed2003

Two-year periodicity of respiratory syncytial virus epidemics in Switzerland.

BACKGROUND: The annual respiratory syncytial virus (RSV) epidemics vary in time and severity. The aims of this study were (1) to describe the time-related pattern of RSV epidemics in Switzerland and (2) to deduce the most effective time period for administration of prophylactic measures to high-risk patients. PATIENTS AND METHODS: Descriptive study of (1) RSV hospitalizations between 1997 and 2001 at a pediatric hospital serving a population of 1 million and (2) of national RSV detection rates reported by diagnostic laboratories between 1988 and 1999. RESULTS: 497 RSV hospitalizations and 8,574 reported RSV detections occurring during four and 12 epidemics, respectively, were analyzed. There was fixed alternation of minor and major epidemics differing in the number of RSV infections (two to fourfold), evolution (median interval from onset to peak 13 weeks, range 4-13 weeks vs 8 weeks, range 7-10 weeks; p = 0.065) and median duration (26 weeks, range 24-29 weeks vs 19.5 weeks, range 18-21 weeks; p = 0.005). For minor epidemics it was estimated that a maximum of 85.6% (range, 79.4-86.6%) of annual RSV infections could be covered by a standard five-dose regimen of the monoclonal anti-RSV antibody palivizumab, if initiated in week 50. During major epidemics the most effective time of initiation would be week 43 (88.7%; range 81.9-94.6%). CONCLUSION: RSV epidemiology in Switzerland is characterized by fixed biannual variation. In the absence of active RSV surveillance, such periodicity is useful for scheduling RSV prophylaxis and for hospital resources management.

Disease Outbreaks↗
PubMed2005

Transregional spread of a single clone of methicillin-resistant Staphylococcus aureus between groups of drug users in Switzerland.

BACKGROUND: An epidemic spread of methicillin-resistant Staphylococcus aureus (MRSA) among intravenous drug users (IDUs) has been observed in Zurich. In the present study we investigated the situation in the Grisons, Switzerland. PATIENTS AND METHODS: We screened IDUs and their caregivers in medical and socio-therapeutical institutions in the Grisons for MRSA. Nose swabs were used for bacterial culture and pulsed-field gel electrophoresis for MRSA genotyping. RESULTS: A total of 191 nose swabs from 111 IDUs and 80 caregivers was analyzed. None of the caregivers was MRSA positive. Six IDUs were asymptomatic MRSA carriers (5.4%). They participated in the official heroin program (MRSA prevalence in this group 16%). The MRSA genotype was identical with the single clone found in IDUs in Zurich, strongly suggesting an epidemic spread. Decolonization was successful in two persons only. Persistence of MRSA in IDUs must therefore be assumed. CONCLUSION: We conclude that a single clone of MRSA, found in IDUs in Zurich, has spread to a distant region of Switzerland. A rigorous infection control program in all institutions with IDUs is necessary to prevent a further spread of MRSA.

Adult↗
PubMed1990

Experimental transmission of Leishmania infantum by the bite of Phlebotomus perniciosus from Switzerland.

The possible role of the sandfly Phlebotomus perniciosus in the transmission of Leishmania infantum in southern Switzerland was investigated. It was found that the Syrian golden hamster (Mesocricetus auratus) could be infected by the bite of experimentally infected P. perniciosus females from canton Ticino, in southern Switzerland. This showed that this sandfly species could indeed be a vector for L. infantum in this area. However, as the population density of P. perniciosus is relatively low in canton Ticino, it is extremely unlikely that leishmaniasis could become endemic there.

Animals↗
PubMed1985

Issues in health education: epidemiology and prevention of hypertension in Switzerland.

Health education issues in high blood pressure concern concepts and actions for prevention, early detection, and long-term control. Data from Switzerland demonstrate both the need and the potential of such programs. The prevalence of hypertension among adults is 11.6%. Roughly only 50% of hypertensives are aware of their condition, and health knowledge is low. However, within an 8-year period, the frequency of blood pressure measurements in the population doubled: 71% of adults in Switzerland had had such an examination within the previous 12 months (1982). In addition, data from a Swiss health survey show avenues for future action. Whereas for the general population health information and easy access to services ("enabling factors") are important, for hypertensive patients, factors such as health knowledge and attitudes and the presence of a supporting partner ("predisposing factors") are of additional significance.

Adult↗
PubMed1983

Waste-related cadmium cycle in Switzerland.

The anthropogenic contribution to the global cadmium flux exceeds natural sources by a factor of three. The most important pathway is the atmosphere; therefore, high cadmium concentrations can be found even in remote areas. On a local level, the increase in cadmium consumption can be observed in increasing concentrations in the soil, plants, and food. The question arises as to what extent the soil-plant-man-waste-soil cycle can be loaded with cadmium in order to function without negative impact on the environment. In Switzerland, 120 tons (t) of cadmium are consumed per year. Of this amount, 25 t end up in municipal solid waste, 3 t in wastewater, and 19 t in precipitation and dry fallout. As a consequence of today's waste management practice (75% incineration, 20% sanitary landfill, 5% composting; 75% of all sewage is purified), the annual input to the soil is 40 t: 18 t concentrated in landfills, 19 t dissipated via the atmosphere, and 3 t directly spread via sewage sludge, compost, and fertilizer on agricultural land. If even distribution were possible, the cadmium content of the soil would theoretically double in 150 years. The accumulation in the soil will increase the cadmium content of plants grown on such a soil. According to a simple model, the level of 3 ppm cadmium in soils should not be surpassed. At such concentrations, plants are likely to contain greater than 0.4 mg Cd/kg, a concentration which can cause toxic effects in long-term experiments. The safe level in food might be even lower. In reality, cadmium is not evenly distributed over Switzerland. According to today's practice, it must be assumed that in only 14 years the use of compost will have enriched soils to such an extent that its cadmium content will prohibit the production of food for human consumption. For sewage sludge, this timespan is 130 years. If heavy metal limits in food are to be observed, the input of such metals to the soil has to be limited. In a steady state, the cadmium input to the soil should be equal to its output via plants, leachate, and erosion. This implies that today's dissipative use of cadmium must be stopped.

Air Pollutants↗
PubMed1988

Study of cost by type of diagnosis in Switzerland.

Lengths of stay, for a given diagnosis, are poorly correlated between Switzerland, the USA., and Australia; and between 5 hospitals within Switzerland. Three different sets of DRG cost weightings (U.S., French A, French B) are also poorly correlated. Hospital operating efficiencies, standardized by DRG, were estimated and compared. The three sets of cost weightings used all yielded very similar estimates of hospital operating efficiency. The use of current existing systems of cost weightings may, therefore, provide a rapid and cheap means of comparing hospital operating efficiency. In the long run, more precise and detailed cost data will enable national cost weightings to be obtained. Associated issues, such as costing methodologies and perspectives on utilization, are also discussed.

Abstracting and Indexing↗
PubMed1994

Estimating the incidence of cancers in Switzerland: 1983-1987.

Estimates have recently been made of the incidence of cancers in the countries of the European Community. Similar estimates are given for Switzerland, based on data from the six Swiss cantonal cancer registries, all of which have been operating for at least 12 years. These registries cover Basel, Geneva, Neuchatel, St Gall and Appenzell, Vaud and Zurich, which account for about 50% of the Swiss population as a whole. Two different methods were used to extrapolate from the incidences observed in the regions covered by cancer registration to the entire country. The first method is based solely on the distribution of populations according to the country's main linguistic groups, whereas the second relies on mortality data. Estimates obtained by the second approach are presented and their reliability is discussed. Comparison of the age incidence curve with that of Denmark tends to confirm the validity of the estimations. Estimated standardised rates (world population) for all sites except nonmelanomatous skin cancer are 294.3 for males and 214.2 for females. Comparisons with other European countries show that in males, lung cancer is relatively less common in Switzerland, whereas in females, breast cancer is relatively more frequent.

Adolescent↗
PubMed1992

Mass miniature X-ray screening for tuberculosis among immigrants entering Switzerland.

Among 50,784 new immigrants entering Vaud Country, Switzerland, between 1988 and 1990, 674 abnormalities were discovered by mass miniature X-ray screening on arrival (424/43,803 foreign workers, 238/4512 refugees and 12/2469 foreign students). 2043 refugees had no radiological examination. After clinical examination, tuberculosis (TB) was considered the likely diagnosis in 256 cases, of which 132 were offered an antituberculous treatment according to the current recommendations of the Swiss Association against TB. 34 of the subjects were smear- or culture-positive (5% of all radiological abnormalities, 0.08% of all immigrants). Only 46 subjects had any clinical complaint. Among foreign workers, 0.18% were carriers of tuberculous lesions needing a treatment; the proportion was 1.22% among refugees. By ethnic origin, the proportion is highest among Africans (1.43%), followed by Turks (1.04%), subjects from the Middle East (0.62%), Yugoslavia (0.55%), Portugal and Spain (0.14%). Mass miniature X-ray screening for TB in immigrants from high prevalence countries entering Switzerland still detects a majority of asymptomatic cases and seems an easy means of preventing the transmission of TB to members of the same community.

Emigration and Immigration↗
PubMed2005

Chronic scrotal pain syndrome: management among urologists in Switzerland.

INTRODUCTION AND OBJECTIVES: Management of patients presenting with chronic or recurrent pain located in the scrotum is often very challenging. Evidence-based literature and clinical practice guidelines for the management of chronic scrotal pain syndrome (CSPS) are not available. We assessed the current perception and management of chronic scrotal pain syndrome by urologists in Switzerland. METHODS: In July 2004, all the members of the Swiss Society of Urology received a questionnaire focusing on diagnostic and treatment practices for the management of chronic scrotal pain syndrome. The questionnaire consisted of 6 topics concerning practice setting, incidence, aetiology, diagnostics, therapy and treatment success rate. RESULTS: 103 questionnaires were completed (63%). All but 2 (2%) responding Swiss urologists see a mean of 6.5 new patients per month (range 1-30). 79% of Swiss urologists consider CSPS to be infectious or post-infectious in nature. Furthermore, a history of vasectomy, psychosomatic disorders, chronic prostatitis, neuromuscular disorders, a history of inguinal surgery, and idiopathic aetiology were mentioned in decreasing order. The most commonly used examinations are urinalysis in 96% and ultrasound in 93%. Additional assessments include blood sampling, duplex ultrasound, assessment for coexisting chronic prostatitis, and referral to an Orthopaedist, Rheumatologist or Psychiatrist. The predominant medication prescribed for CSPS is a non-steroidal anti-inflammatory agent given for a mean of 15.5 days. An antibiotic trial is prescribed by 82% for a mean of 20.5 days. 74% consider epididymectomy the treatment option of choice in recurrence. Inguinal orchiectomy is performed by 7%, microsurgical spermatic cord denervation is performed by 6% of surgeons. Mean estimated recurrence rate after conservative treatment is 48% and thus higher than after epididymectomy with 18%. CONCLUSIONS: Chronic pain located in the scrotum is a common clinical condition in Switzerland. Most urologists consider an infection or post-infectious alterations as the predominant aetiology for CSPS. Consequently, an antibiotic trial in combination with an anti-inflammatory agent is prescribed as first-line therapy. Recurrence rates for conservative treatment are estimated high which is in contradiction to the presumed aetiology. Therefore, further evaluation of this poorly described disease complex is required.

Anti-Inflammatory Agents↗
PubMed2006

Sacral neuromodulation for refractory lower urinary tract dysfunction: results of a nationwide registry in Switzerland.

OBJECTIVE: To assess the efficacy and safety of sacral neuromodulation (SNM) in patients with refractory lower urinary tract dysfunction in Switzerland based on a nationwide registry. PATIENTS AND METHODS: A total of 209 patients (181 females, 28 males) underwent SNM testing between July 2000 and December 2005 in Switzerland. Subjective symptom improvement, bladder/pain diary variables, adverse events, and their management were prospectively registered. RESULTS: SNM testing was successful (defined as improvement of more than 50% in bladder/pain diary variables) in 102 of 209 patients (49%). An implantable pulse generator (IPG) was placed in 91 patients (89% of all successfully tested and 44% of all tested patients). Of the IPG-implanted patients, 71 had urge incontinence, 13 nonobstructive chronic urinary retention, and 7 chronic pelvic pain syndrome. After a median follow-up of 24 mo, SNM was successful in 64 of the 91 IPG-implanted patients (70%) but failed in 27 patients. SNM was continued in 15 of the 27 patients considered failures, because following troubleshooting SNM response improved subjectively and the patients were satisfied. However, improvement in bladder/pain diary variables remained less than 50%. In the other 12 patients both the leads and the IPG were explanted. During the test phase and during/following IPG implantation, 6% (12 of 209) and 11% (10 of 91) adverse event rates and 1% (3 of 209) and 7% (6 of 91) surgical revision rates were reported, respectively. CONCLUSIONS: SNM is an effective and safe treatment for refractory lower urinary tract dysfunction. Adverse events are usually transient and can be treated effectively.

Adult↗
PubMed2004

Diversity within Borrelia burgdorferi sensu lato genospecies in Switzerland by recA gene sequence.

A total of 874 Ixodes ricinus ticks were collected in Switzerland to investigate the genetic diversity of the Borrelia population. We integrated to the RT-PCR method the DNA sequence analysis of a 162-bp fragment of the recA gene. Five genospecies were detected: Borrelia afzelii, Borrelia burgdorferi s.s., Borrelia garinii, Borrelia valaisiana, and Borrelia lusitaniae. A heterogeneous distribution was observed within the B. burgdorferi s.l. genospecies. The most prevalent and diverse genospecies found in Switzerland was Borrelia afzelii, which might suggest a rapid evolution of this genospecies.

Animals↗
PubMed2004

Ocular injuries caused by plastic bullet shotguns in Switzerland.

Five patients with blunt ocular trauma due to hard plastic shotguns used by police forces during riots presented to the Ophthalmology Department of University Hospital in Zurich, Switzerland, between December 2000 and May 2001. All five eyes suffered ocular concussion. Three of five eyes presented with severe damage to the anterior segment of the eye, two of these eyes showed combined involvement of the anterior and posterior segments. Two patients completely recovered their visual acuity in the injured eye, two reached a final visual acuity of 6/12 and in one case the injured eye was legally blinded. Three of the patients claimed to have been uninvolved bystanders at the riots. The theoretical probability of hitting the head/neck area or one of the two eyes for each shot fired at a person from different operational distances is calculated and ophthalmological and technical aspects of this special type of plastic bullet shotgun used in Switzerland are discussed.

Adult↗
PubMed2006

Changes in adolescents' reasons for drinking in Switzerland and associations with alcohol use from 1994 to 2002.

PURPOSE: To determine changes in the prevalence of reasons for drinking and their associations with alcohol use among adolescents in Switzerland from 1994 to 2002. METHOD: Based on national representative samples of 3792 alcohol-using students in 8th and 9th grades in Switzerland (mean age 15.5 years, SD .7), chi-square tests were used to determine changes in reasons for drinking over time. To determine associations between reasons and alcohol use and changes in these associations over time, multiple regression models were estimated separately for the frequency of alcohol consumption and drunkenness. RESULTS: Most adolescents reported drinking to celebrate special occasions, because they wanted to try alcohol, or because they liked the taste of alcoholic drinks. From 1994 to 2002, an increase in all reasons was observed. In multiple regressions, nearly all reasons were significantly related to alcohol consumption and drunkenness. With two exceptions, no interaction with the study year was found. Furthermore, the number of reasons cited by the adolescents surveyed is important: the more reasons they indicated, the more often they drank. The highest alcohol use in 2002 was found among adolescents who indicated all or nearly all reasons, a group that did not exist in 1994. CONCLUSIONS: There appears to be a new group of adolescents who indicated a high number of different reasons for drinking, who often consumed alcohol, and who were frequently drunk. Prevention approaches should be especially targeted at this new risk group.

Adolescent↗
PubMed2004

Age-period-cohort analysis of the Bovine Spongiform Encephalopathy (BSE) epidemic in Switzerland.

Cattle born after animal-feed control measures were implemented in 1990 have become BSE cases in Switzerland, indicating sub-optimal effectiveness of these measures. To evaluate these measures, the incidence of BSE cases in Switzerland recorded through clinical case reporting from January 1991 to June 2000 (categorized into age groups and birth cohorts of 6-month duration) was analyzed by Poisson log-linear regression using an age-period-cohort model. The incidence was maximum in the cattle cohort born from October 1989 to March 1990, and dropped to zero in the cohort born from April to September 1991. A second peak was observed in a cohort born from April to September 1994. The first drop of incidence is interpreted as a result of initial implementation of the feed ban in 1990. The second peak might be related to exposure of cattle to feed intended for pigs and poultry.

Animal Feed↗
PubMed2005

Multiple anthelmintic resistance in Haemonchus contortus isolated from South African Boer goats in Switzerland.

A suspected case of multiple anthelmintic resistance on a farm in the canton of Zurich, Switzerland, into which South African Boer goats had previously been imported, was confirmed in a controlled test. Twenty sheep were allocated into one control group and three treatment groups to determine the efficacy of mebendazole, ivermectin and moxidectin applying the faecal egg count reduction test (FECRT). The sheep were slaughtered 1 week later and post-mortem worm counts were performed. Benzimidazole and ivermectin resistance were found in Haemonchus contortus with an efficacy of 55 and 61%, respectively. Moxidectin appeared to be effective when the data was analysed according to the recommended analytical techniques with an efficacy of 96%. This is the first description of resistance of gastrointestinal nematodes to one of the macrocyclic lactones in small ruminants in Switzerland. The results are discussed in relation to the importance of controlling livestock before importation.

Abomasum↗
PubMed2006

Avermectin-resistance in gastrointestinal nematodes of Boer goats and Dorper sheep in Switzerland.

Anthelmintic resistance in gastrointestinal nematodes among small ruminants is widespread in South Africa and Dorper sheep and Boer goats have been imported into Switzerland from this country on a number of occasions. Therefore, this study aimed to investigate the occurrence of avermectin (AVM) resistant gastrointestinal nematodes (GIN) in these breeds in Switzerland. A total of 24 Boer goat farms and 12 Dorper sheep farms participated in the study. According to the faecal egg count reduction test (FECRT) AVM-resistant GIN populations were confirmed in 7 of the 24 Boer goat farms and suspected in a further 8 farms. Likewise AVM-resistance was confirmed in 2 of 12 Dorper sheep farms and suspected in a further 6 farms. Haemonchus contortus and Trichostrongylus spp. were the dominant resistant species according to larval cultures. In the farms with detected AVM-resistance the animals were additionally treated with levamisole after natural reinfection. With the exception of one farm with a 'close-to cutoff-result' the FECRT gave no indication for resistance against levamisole. The results indicate that AVM-resistance is widespread in Swiss small ruminant farms keeping Boer goats and Dorper sheep. The common tradition of grazing animals from different farms on prealpine and alpine pastures could favour the spread of resistant populations within the country.

Animal Husbandry↗
PubMed1998

Relationship between Borrelia burgdorferi sensu lato species, red squirrels (Sciurus vulgaris) and Ixodes ricinus in enzootic areas in Switzerland.

The infection and reservoir status of red squirrels (Sciurus vulgaris) for Borrelia burgdorferi sensu lato were studied in Switzerland. B. burgdorferi sensu lato was isolated from 15 skin samples from 4/6 dead red squirrels, victims of road traffic. Isolates were identified using restriction fragment length polymorphism (RFLP): B. burgdorferi sensu stricto was present in 14 culture tubes containing skin samples and B. afzelii in two other tubes. A mixed infection was revealed in one case. A total of 227 ticks attached to squirrels were cultivated in BSKII medium and 90 isolates were obtained. Genotypic identification by RFLP showed that B. afzelii (59%) and B. burgdorferi sensu stricto (46%) dominated in ticks feeding on red squirrels. Data collected from one particular animal, highly infested with Ixodes ricinus and harbouring numerous Borrelia-infected Ixodes ricinus ticks, showed that transmission of B. burgdorferi sensu lato occurred from S. vulgaris to feeding ticks. More precisely, B. burgdorferi sensu stricto and B. afzelii were mainly transmitted from S. vulgaris to ticks. The present data emphasized the results obtained previously from small rodents and birds in Japan and in Switzerland, showing the occurrence of specific associations between host species and Borrelia genospecies.

Animals↗
PubMed1998

Molecular and immunodiagnostic investigations on bovine neosporosis in Switzerland.

Neospora caninum has gained considerable attention through its role in the aetiology of bovine abortion. Due to its close phylogenetic relationship with Toxoplasma gondii, respective unequivocal differential diagnosis deserves special consideration. In order to evaluate the diagnostic performance of molecular and immunodiagnostic techniques and to provide insights into the epidemiological significance of bovine neosporosis in Switzerland, we conducted a study on 83 cases of bovine abortion: of these, 24 (29%) foetal brains were positive by Neospora-PCR, six of these foetuses were simultaneously seropositive in Neospora-IFAT and/or somatic antigen-ELISA. Conversely, four (5%) foetal brains were considered positive by Toxoplasma-PCR, two of which were also seropositive in the Toxoplasma-P30-ELISA and/or direct agglutination test. The seroprevalence in 1689 cattle sera obtained from 113 diary farms was 11.5% (95% confidence interval: 9.2-13.8) by Neospora-somatic antigen-ELISA were and 10.7% (95% confidence interval: 8.3-12.6) by Toxoplasma-P30-ELISA. From the same samples, 1.1%, less than statistically expected, were positive in both ELISA. Within selected groups of cow-calf farms, the seroprevalence determined using the Neospora-somatic antigen-ELISA was 14% (95% confidence interval 5.0-23.0) for dams and 15% (95% confidence interval: 3.0-28.0) for offspring calves. Seroprevalences determined by Toxoplasma-P30-ELISA were 8% (95% confidence interval: 4.0-12.0) for dams and 3% (95% confidence interval: 0.3-6.0) for calves. None of the sera gave a positive reaction in both ELISA. Our data indicated that prenatal neosporosis appears as an important cause of bovine abortion in Switzerland.

Abortion, Veterinary↗