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PubMed2002

New peat bog record of atmospheric lead pollution in Switzerland: Pb concentrations, enrichment factors, isotopic composition, and organolead species.

A peat core collected at Etang de la Gruère, an ombrotrophic bog in the Jura Mountains of Switzerland, was analyzed for organolead species (DEL, TEL, DML, and TML) using GC-MIP AES, Pb isotopes using TIMS, and total Pb using XRF and age-dated using 210Pb. The earliest occurrence of quantifiable alkyllead is found at a depth of 24 cm, which is dated at AD 1946 +/- 3; this finding is consistent with the introduction of leaded gasoline in Switzerland in 1947. The maximum concentration of alkyllead (2.89 ng/g) is found at 5 cm, which is dated at AD 1988 +/- 2. This same sample yielded 206Pb/207Pb = 1.1254, which is the least radiogenic value in the entire 2K core and comparable to the isotopic composition of Pb in leaded gasoline. The highest concentrations of DML (906 ng/g) and DEL (1906 ng/g) also were found in this sample. Total alkyllead never accounts for more than 0.02% of total Pb in any given sample. The spatial and temporal variations in organolead species is matched by the changes in the isotopic composition of Pb over the same interval. Despite this, the decline in anthropogenic Pb pre-dates the maximum in total alkyllead and minimum 206Pb/207Pb, indicating that atmospheric Pb emissions had already begun their decline prior to the introduction of unleaded gasoline. In fact the decline in anthropogenic Pb was probably in response to the introduction of legislation, first in Germany and later in the European Union, establishing a maximum allowable concentration of Pb in gasoline.

Air Pollutants↗
PubMed2002

Environmental exposure and risk assessment of fluoroquinolone antibacterial agents in wastewater and river water of the Glatt Valley Watershed, Switzerland.

The mass flows of fluoroquinolone antibacterial agents (FQs) were investigated in the aqueous compartments of the Glatt Valley Watershed, a densely populated region in Switzerland. The major human-use FQs consumed in Switzerland, ciprofloxacin (CIP) and norfloxacin (NOR), were determined in municipal wastewater effluents and in the receiving surface water, the Glatt River. Individual concentrations in raw sewage and in final wastewater effluents ranged from 255 to 568 ng/L and from 36 to 106 ng/L, respectively. In the Glatt River, the FQs were present at concentrations below 19 ng/L. The removal of FQs from the water stream during wastewater treatment was between 79 and 87%. During the studied summer period, FQs in the dissolved fraction were significantly reduced downstream in the Glatt River (15-20 h residence time) (66% for CIP and 48% for NOR). Thus, after wastewater treatment, transport in rivers causes an additional decrease of residual levels of FQs in the aquatic environment. Refined predicted environmental concentrations for the study area compare favorably with the measured environmental concentrations (MEC) obtained in the monitoring study. Total measured FQ concentrations occurring in the examined aquatic compartments of the Glatt Valley Watershed were related to acute ecotoxicity data from the literature. The risk quotients obtained (MEC/PNEC < 1) following the recommendations of the European guidelines or draft documents suggest a low probability for adverse effects of the occurring FQs, either on microbial activity in WWTPs or on algae, daphnia, and fish in surface waters.

Anti-Infective Agents↗
PubMed2003

Occurrence and fate of macrolide antibiotics in wastewater treatment plants and in the Glatt Valley watershed, Switzerland.

An analytical method was developed for determining macrolide antibiotics in treated wastewater effluents and in ambient water based on solid-phase extraction and LC/MS analysis as well as on LC/MS/MS for structural confirmation. In wastewater treatment plants (WWTPs) macrolides are only partly eliminated and can therefore reach the aquatic environment. In treated effluents from three WWTPs in Switzerland, clarithromycin, roxithromycin, and erythromycin-H2O, the main degradation product of erythromycin, were found. The most abundant, clarithromycin, reflects the consumption pattern of macrolide antibiotics. Summer concentrations of clarithromycin varied between 57 and 330 ng/L in treated WWTP effluents. In the WWTP Kloten-Opfikon seasonal differences revealed a load two times higher in winter than in summer. The higher abundance of erythromycin-H2O in the effluent of WWTP Kloten-Opfikon can be explained by distinct consumption patterns due to the main international airport of Switzerland in the catchment area. In the Glatt River clarithromycin reached concentrations of up to 75 ng/L. Mass flux determinations in treated effluents and in river water in the Glatt Valley watershed showed that elimination of clarithromycin along the river stretch of 36 km is insignificant (<20%). Investigations in the Glatt River before and after the diversion of the largest WWTP revealed an observable decrease in clarithromycin loads.

Anti-Bacterial Agents↗
PubMed1998

The epidemiology of bite and scratch injuries by vertebrate animals in Switzerland.

Pet and wildlife populations are a potential source of various public health problems, and injuries and complications due to animal bites and scratches are the most obvious. As no population based data on the frequency of animal bites were available at a national level in Switzerland, a study was conducted by the Swiss Sentinel Surveillance Network. The objectives of this study were to estimate the incidence of medical consultations due to bite and scratch injuries in humans caused by vertebrate animals, to identify possible risk factors, and to assess bite management habits in primary health care. An annual bite and scratch incidence rate of 325 per 100,000 population was estimated. Consultations peaked during the summer months and geographical differences in the reported incidence were observed. Dogs accounted for more than 60% and cats for about 25% of all cases reported. Animal bites and scratches were frequent in persons under 20 years of age. In most ages, the incidence was higher among women than among men, but not in children under the age of ten years. The incidence of cat bites was especially high in adult women. Bites to the head and neck were most frequent in infants and young children and accounted for approximately one third of the reported cases in this age group. Patients sought medical care principally for primary wound care (52.0%) and for vaccination advice (29.6%). Rabies postexposure prophylaxis was initiated in 1.1% of patients. Wound infection was reported in 10.9% of cases, with cat bites/scratches being more often infected than injuries due to dogs. Hospitalization was reported in 0.3 % of patients. Data from the emergency department of two district hospitals showed that head and neck injuries were more frequent in out-patients and a higher proportion of persons presented with wound infections (14.1%). The hospitalization rate for emergency department visits was 4.7%. Animal bites and scratches are common events in Switzerland. They represent a public health issue of growing importance due to the steadily increasing pet population. A practice based sentinel surveillance system may be an appropriate tool to monitor national trends in animal bites and scratches.

Adolescent↗
PubMed2003

Comparison of the effectiveness of two mumps vaccines during an outbreak in Switzerland in 1999 and 2000: a case-cohort study.

In two recent nation-wide outbreaks of mumps in Switzerland two-thirds of young children with clinical mumps had a history of primary vaccination. On average, measles-mumps-rubella (MMR) vaccination coverage is 80%. Two types of vaccine are commonly used: Jeryl-Lynn and Rubini. The effectiveness of the latter has been questioned in several publications. The authors therefore compared Rubini to Jeryl-Lynn in a case-cohort study. The study included 111 young children with clinical mumps who had been reported to the Swiss Federal Office of Public Health (SFOPH) by primary care physicians of the Swiss Sentinel Surveillance Network (SSSN) between January 1999 and May 2000. Sentinel physicians also sampled 661 children from the same birth cohort as the cases. While we found no evidence for the effectiveness of the Rubini strain, vaccination with the Jeryl-Lynn strain was 70% effective against clinical mumps. Furthermore, children vaccinated with the Rubini strain attended primary health care more frequently with clinical mumps than those who had received Jeryl-Lynn (odds ratio: 2.4; 95% confidence interval (CI): 1.3, 4.7). Restricting the analysis to laboratory confirmed cases increased the odds ratio to 18.4 (95% CI: 2.5, 811.2). Our study confirms the low effectiveness of the Rubini strain vaccine in the field. This vaccine should therefore be considered inappropriate for the control and elimination of mumps and its use should be discontinued. As other vaccines with comparable quality and safety standards and a substantially higher effectiveness are available the MMR vaccination program in Switzerland will not be compromised if the use of Rubini is no longer recommended.

Cohort Studies↗
PubMed2003

Distribution and prevalence of Borrelia burgdorferi sensu lato in Ixodes ricinus ticks of canton Ticino (Switzerland).

Free-living Ixodes ricinus ticks were collected from 12 different sites of canton Ticino, south of the Alps (Switzerland). Each tick was examined for the presence of Borrelia burgdorferi sensu lato (sl), the etiologic agent of Lyme borreliosis using direct fluorescent antibody assay, and isolation of the bacteria. Borreliae were characterized by PCR followed by RFLP. The abundance and infection rates of I. ricinus ticks varied greatly between the areas. Two localities were found free of Borrelia. The prevalence of infected ticks ranged from 5 to 19%. Most ticks (96%) were found infected by < 50 spirochetes. Three B. burgdorferi sl species were successfully isolated: B. garinii dominated, followed by B. lusitaniae and B. valaisiana. Additionally, a mixed infection with B. garinii and B. valaisiana was observed. The distribution of the various Borrelia species in the different areas was heterogeneous. This is the first report of the presence of B. lusitaniae in I. ricinus in Switzerland.

Altitude↗
PubMed2004

Trends in violent deaths among young people 10-24 years old, in Switzerland, 1969-1997.

PURPOSE: To assess violent death rates and trends between 1969 and 1997 among young people aged 10-24 years old in Switzerland. METHODS: Total causes of death, all external causes of injuries, traffic injuries, suicides and overdoses were retrieved from the databank of the Swiss Federal Statistical Office (SFSO), using the eighth and tenth revisions of the International Classification of Diseases (ICD). Mortality rates per 100,000 individuals were computed by gender and by age (10-14, 15-19, 20-24) using census records as denominators. RESULTS: In 1995-1997, violent deaths represented the primary cause of fatalities among young people. Rates of violent death were much higher among males than among females, with a ratio of 3.5:1 in 1995-1997 and also became increasingly elevated from the age range of 10-14 to 20-24 years (1.9:1-4.4:1). In 1995-1997, violent deaths accounted for 66% (n = 1221) of all fatalities among young people. Among violent deaths, 36% were due to traffic injuries, 13% to other types of injuries, 32% to suicide, 15% to overdoses, 3% to homicides and 1% to undetermined intent. Between 1969 and 1997, rates of traffic injuries decreased in both genders and in the three age groups considered, while rates of suicide remained stable and rates of overdoses stabilised during the nineties after a sharp increase during the eighties. CONCLUSION: Although violent deaths in Switzerland have become significantly less frequent over the last 30 years, they still represent the single greatest cause of fatalities among young people and, as such, constitute a major public health challenge.

Accidents, Traffic↗
PubMed2002

[Ovine enzootic abortion: seroprevalence in Switzerland using a competitive enzyme-linked immunosorbent assay (cELISA)].

The present study gives an overview over the seroprevalence of ovine enzootic abortion in Switzerland. 639 sheep flocks out of eight cantons in Switzerland were examined by a competitive enzyme linked immunosorbent assay (cELISA) for antibodies against Chlamydophila abortus (Chlamydia psittaci serotype 1), the agent causing ovine enzootic abortion. The eight cantons included Aargau, Bern, Zürich, Appenzell-Ausserrhoden, Appenzell-Innerrhoden and Fribourg, the Vallais and the Graubünden. They were representative for 57% of the Swiss sheep flocks and for 60% of Swiss sheep population. In total, almost 19% (118) of the examined flocks were seropositive. Seroprevalence was the highest in Graubünden with 41%; this requires further examination and the evaluation of the need for a monitoring and controlling program. The examination of pooled sera made it possible to test a large number of samples with a reasonable amount of work. Higher sensitivity (92.9%) and specificity (97.6%) than the complement fixation test (CFT) in combination with testing of pooled sera makes the cELISA to be an usuable tool for serological screening on flock level.

Abortion, Veterinary↗
PubMed2003

Vector-borne diseases in humans and animals: activities of the Swiss Tropical Institute and risks for Switzerland.

The recent outbreak of anaplasmosis in a Swiss cattle herd triggered a discussion of the risk of vector-borne diseases in animals and humans in relation to climate changes and other factors. This overview presents the Swiss Tropical Institute's (STI) activities on vector-borne diseases (malaria, trypanosomosis, and leishmaniosis in humans and tick-borne diseases in livestock), describes the possible risks for humans and animals in Switzerland, and discusses options for action in the domains of public health, livestock production and companion animals. Switzerland is increasingly confronted with vector-borne diseases in humans and animals, but this is mainly due to an increase in imported cases. The emergence of a disease in one sector (human or veterinary medicine) may predict future trends in the other. A stronger intersectoral collaboration between public health and veterinary institutions at the federal and cantonal level is needed.

Animal Husbandry↗
PubMed2003

[Current data on antibiotic resistance of the most important bovine mastitis pathogens in Switzerland].

100 strains of Staphylococcus aureus (S. aureus), 100 strains of coagulase-negative staphylococci (CNS), 100 strains of Streptococcus spp. and 100 strains of Escherichia coli (E. coli), isolated from bovine mastitis milk samples between November 2002 and April 2003, were tested for their sensitivity to various antibiotics by means of the agar diffusion method. The antibiotics were chosen on the basis of their licenses for intramammary application in Switzerland (www.vetpharm.unizh.ch). 91% of the S. aureus strains were sensitive to all the antibiotics tested. Only 9% of the strains were resistant to Penicillin G and 7% to Ampicillin. 53% of the CNS strains were sensitive to all the antibiotics tested. 31% exhibited resistance to Penicillin G, 26% to Ampicillin, 16% to Cloxacillin and 14% to Lincomycin. 30% of the Streptococcus spp. strains were sensitive to all the antibiotics tested. 4% were resistant to Penicillin G, 4% to Amoxicillin/clavulanic acid, 1% to Cefoperazone, 2% to Cefquinome, 35% to Neomycin, 22% to Gentamicin, 61% to Kanamy-cin and 11% to Lincomycin. 43% of the strains showed multiple resistance. 79% of the E. coli strains were sensitive to all the antibiotics tested. 20% exhibited resistance to Ampicillin, 9% to Neomycin and 10% to Kanamycin. A comparison of the own results with data of other authors in Switzerland shows no important changes in the resistance situation during the last 20 years. With the exception of two strains (Streptococcus spp.), all tested isolates were sensible against Cefquinome.

Animals↗
PubMed2004

[Pharmacovigilance for veterinary drugs in Switzerland].

Pharmacovigilance is a system concerned with the acquisition, evaluation and classification of informations about suspected adverse drug reactions (SADR). Such a system was developed in Switzerland under the supervision of Swissmedic after the introduction of the federal law on therapeutic products on January 1st 2002. By sending declarations about SADRs, veterinary practitioners play a central role in this scheme. The reports are processed according to international standards (ABON) and provide useful hints to enhance the safety of drug usage by both patients and owners. The system acquired 58 reports in its first complete year of operation (2003). Analysis of these reveals that trends observed in foreign countries are also applicable to Switzerland: most of the reports concerned the use of antiparasitic or antibiotic drugs in small animals. The first year also revealed a high percentage of declarations coming from the pharmaceutical companies and the authors would therefore like to encourage practitioners to take a more active part in this scheme.

Adverse Drug Reaction Reporting Systems↗
PubMed2004

[Demographic characteristics of dog population in Switzerland].

Dog Registration data from three Cantons, patient data of 13 veterinary practices and registrations in the Swiss Dog Pedigree Book were collected, analysed and compared to results of a commercial household survey, to assess demographic characteristics of dog population in Switzerland. The proportion of "pure-bred" dogs was different depending on how the term was used, varying from 24% regarding registrations in the Swiss Dog Pedigree Book, to 75% regarding dogs with only one breed recorded in Veterinarian's patient-history-management systems. Most popular breeds were dogs called "German Shepherd/Shepherd", followed by the Labrador and Golden Retriever. Comparison of different data sources suggested regional differences in popularity of breeds. The average life expectancy was estimated on 10.5 and 11 years. Sex distribution was equal. One third of all male dogs and half of the female dogs were neutered. Regardless sex, neutering was more common in cross-bred dogs than in "pure-bred" dogs (OR = 1.9). Some bias in all sources had to be considered and there was a major concern regarding definition of breeds. However, the study was able to add different parameters out of different sources to a homogenous picture of demographic data of dog population in Switzerland.

Animals↗
PubMed2005

[South American camelids in Switzerland. I. Population, management and health problems].

At the beginning of 2000, a population of 1622 South American camelids in 257 herds was living in Switzerland. The origin of the animals, their age, the management systems, their feeding habits, their use as well as the observed medical conditions and the indications for treatment were assessed with a questionnaire. Results of this study show that 60% of the South American camelid population in Switzerland consisted of llamas (999 animals) and 40% of alpacas (623), and that females younger than 4 years of age made up the majority of the animals. South American camelids were predominantly kept for hobby, breeding or trekking. The most frequent health problems were related to the digestive tract, the skin, the eyes and the metabolism. Veterinarians were consulted for deworming, vaccinations, castrations or obstetric interventions. The parasitological examination of 204 fecal samples showed that llamas and alpacas were infested with the same endoparasites as ruminants (i.e. nematodes, trematodes and protozoas).

Age Distribution↗
PubMed2006

[Cerebrospinal nematodosis in sheep in Switzerland].

In December 2005 three sheep, originating from Canton Tessin, were presented with cerebrospinal nematodosis. The animals had a history of progressive pelvic limb ataxia and recumbency. The most important clinical findings were an abnormal gait (wide stance, pelvic limb paresis) and decreased sensitivity of the pelvic limbs. The general condition was slightly or moderately disturbed, appetite was normal. Examination of the cerebrospinal fluid revealed mononuclear cells and eosinophils, suggesting a helminthic infection of the central nervous system. Postmortem findings confirmed the clinical diagnosis in one animal as parts of a nematode were found in the thoracic spinal cord. Even though the nematode could not be identified, infection with Elaphostrongylus cervi seems very likely, as the sheep are in close contact with deer on the pastures and the parasite is known to infect goats in Switzerland. This is the first description of cerebrospinal nematodosis in sheep in Switzerland.

Animals↗
PubMed2001

[Promotion of exercise among the physically inactive: a challenge also in Switzerland].

The scientific evidence for the importance of regular physical activity for health is beyond any doubt. This association is widely known and physical activity promotion activities are generally appreciated by the general population. Nevertheless the prevalence of physical inactivity in Switzerland is still rising. A growing number of large scale physical activity promotion projects like << Allez Hop! >>, Vita Parcours and the 'Feel Your Power' campaign of the Swiss Foundation for Health Promotion have begun to target physically inactive individuals. Intervention studies have given first indications of both the possibilities and the limitations of behavioural change. The 'Office in Motion' study used the ecological or settings approach in a white collar worksite intervention and has shown encouraging changes in previously inactive individuals. A number of ongoing studies based on the transtheoretical model in the primary care setting ('Active upon Advice'), in a military context ('Fitcheckplus') and on the Internet ('Active online') have shown positive preliminary results. A tourist region pilot study ('Heidiland aktiv') is used to illustrate the potential limitations of intervention projects: though a promising counselling system was developed and put in place it was not possible to develop an effective approach to the tourists and to generate sufficient interest in the issue to justify a full scale outcome study. These experiences from Switzerland show that behavioural change in previously inactive individuals is possible and that the general practitioner in particular can play an important role in this process. Expectations concerning the size of the intervention effect have to be realistic. Promotion of health enhancing physical activity remains a challenge.

Exercise↗
PubMed2005

[Epidemiology of tick-borne encephalitis (TBE) in Switzerland 1984 to 2004].

From 1984 to 2004 a total of 1370 TBE cases have been reported to the Federal Office of Public Health through the notification system. A significant increase of cases was observed in the nineties. Since 1999 the yearly average of reported cases was 101, corresponding to a yearly incidence of 1.4/10(5) inhabitants for all of Switzerland or to an incidence of approximately 6/10(5) if only the population living in endemic regions is taken into account. Male cases were twice as frequent as female ones. The age distribution showed two peaks in the age ranges of 6 to 14 and 60 to 69 years. Cases in children under 6 years of age were very rare with a yearly average of two hospitalised children. The severity of the disease increased with age. In 86% of the patients CNS involvement was present while 14% showed only flu-like symptoms. Ninety percent of patient with CNS involvement were hospitalised, 1,3% died (on average one death per year since 1999). Cases in fully vaccinated persons were very rare. The majority of patients had most probably been infected at their place of residence or in the nearer surroundings. The incidence in the large cities was low (< or = 1/10(5)/year). In smaller towns located directly in an endemic region, the incidence rose to as much as 18/10(5)/year. During the 21 years of observation, the endemic regions in four cantons known in the early eighties had clearly expanded and new infected regions appeared in seven other cantons. A frequent recreational or occupational exposure in wooded areas was mentioned by 85% of the patients. Although 80% of these concerned leisure time activities (mainly walking), the incidence is most probably still higher in occupationally exposed persons. This indicates that not only persons with leisure time exposure but also occupationally exposed persons are still insufficiently vaccinated to achieve an optimal control of this disease in Switzerland.

Adolescent↗
PubMed2005

[Experiences with "incident reporting" at the East Switzerland Childrens Hospital].

Our healthcare system has become a "high-tech" industry and, as a consequence, incidents are almost "normal" events. It is one of the most important obligations in the quality management to get control of these very dangerous and therefore extremely important problems. The Children's Hospital in St. Gallen (Switzerland) introduced in 1998 a reporting system in order to monitor incidents and mistakes and to be able to introduce preventive action. For this we have been using the so called "system approach", i.e. we are not trying to find a guilty person or a single source for a mistake, but we analyze the complete working system involved in the action. According to our experience, such reporting systems have to respect a number of specific rules and prerequisites in order to be successful. The most crucial one is a "change of culture", which means, that we are not looking for a guilty person, but for the weak elements which are responsible for the mistakes in our working systems. In Switzerland a National Foundation for Patient Safety has been created for supporting all the acting professionals in the healthcare system in their challenging task.

Adolescent↗
PubMed2005

[Organ donation in Switzerland].

Since 1985 Swisstransplant coordinates all allocations for organ transplantations in Switzerland. During these 20 years the number of deceased donors decreased, while the number of living donors increased. In the same period the number of patients on a waiting list for organ transplantation increased significantly, up to more than 1000 at the end of2004. During the year 2004 412 patients were transplanted, 43 (4%) died while waiting on the list. In comparison to other European countries the frequency of organ donation from deceased donors is relatively low in Switzerland, only 13 per million inhabitants. In order to treat the high number of patients needing organ transplantation, additional efforts have to be undertaken in future. The measures include the development of alternative therapies preventing or treating organ failure, the amelioration of legal conditions of organ transplantation with the new law, an increase of resources and knowledge to improve donor evaluation and donor pools in the donor hospitals, a further improvement of the allocation process, the enhancement of information and motivation of the population by the patient organisations, the medical staff, Swisstransplant and eventually public means.

Organ Transplantation↗