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PubMed2000

[Epidemiology of Lyme borreliosis in French-speaking Switzerland].

The purpose of this study was to assess the number of cases and the clinical aspects of Lyme borreliosis in French-speaking Switzerland. From July 1996 to December 1997, all laboratories performing serological tests for Lyme borreliosis sent a questionnaire to the treating physicians whenever the tests were positive. In addition, the physicians who diagnosed a case on clinical grounds only were also asked to report these cases. During this period, 1460 positive serological tests were recorded among approximately 10,360 performed (14%). A total of 775 questionnaires were returned (53%). In 3/4 of the cases, the test was ordered because of an acute clinical manifestation or a tick bite. The rest related to chronic symptoms or follow-up. In 504 cases (65%), diagnosis was considered certain or probable. These were erythema migrans in 46%, clinical manifestations of stage II in 33% (26 facial palsy, 20 acute arthritis, 5 benign cutaneous lymphocytoma) and chronic symptoms in 21% (23 acrodermatitis, 26 neuropathies, and 8 arthritis). The adjusted incidence, estimated on the basis of the treating physician's place of residence, ranged from 9/100,000 in Valais to 95/100,000 in Neuchâtel. This study indicates that Lyme borreliosis is a diagnosis frequently looked for and established in French-speaking Switzerland. Although erythema migrans is the main clinical manifestation, symptoms of stage II and III indicate that Lyme borreliosis is also responsible for relatively major systemic morbidity.

Adolescent↗
PubMed2001

[Malignant catarrhal fever in Switzerland. 1.Epidemiology].

Malignant catarrhal fever (MCF) is a usually fatal infectious disease of cattle with global distribution. Based on the recent introduction of a diagnostic PCR assay and a competitive inhibition ELISA (ciELISA) epidemiological data were collected on field cases in Switzerland. Throughout a three-year period, an MCF incidence of 0.6@1000 was observed, with a gradient of cases from Eastern to Western Switzerland. While the cantons Wallis, Vaud and Geneva reported no and the remaining western cantons only reported a few cases, the highest incidence was observed in the cantons Appenzell Innerrhoden, Lucern, Glarus, Grison, St. Gallen, Schwyz, and Thurgau. MCF occurred seasonally and an age-related clustering was also observed. About 50% of all cases and all outbreaks with more than one animal in a single herd occurred between April and June. Animals between six months and two years were strongly over represented. Observations on four surviving cattle showed that the outcome of the disease is not invariably fatal and that these persistently infected cows can produce healthy negative calves. Investigations on the aetiology indicate that the main reservoir for OvHV-2 is in sheep and possibly goats, while cattle do not normally harbor the virus. An OvHV-2 negative sheep herd was raised from lambs, which were reared colostrum-free and in isolation from their mothers. The success rate clearly indicated that vertical intrauterine infection is not the main mode of transmission among sheep. Therefore, horizontal, seasonally occurring transmission of OvHV-2 among sheep has to be assumed.

Age Factors↗
PubMed2001

[Causes of death, zoonoses, and reproduction in the European brown hare in Switzerland].

To elucidate the importance of different causes of mortality which could explain the downward trend of the hare populations in Switzerland and for monitoring selected zoonoses, the health and reproductive status of 167 perished brown hares (Lepus europaeus) was assessed. Concerning causes of mortality, traumas were by far the most frequent diagnosis, 80% of the hares dying because of injuries. Animals killed by road traffic were highly represented. Predators (such as dogs, domestic cats, lynx, martens, buzzards, and golden eagles) killed 16% of the analysed animals. In juveniles, predation was significantly more frequent than in adults. Infectious diseases led to death in 15% of the animals, and cases of pasteurellosis, brucellosis, pseudotuberculosis, tularaemia, listeriosis, and toxoplasmosis were diagnosed. In 5% of the hares, the cause of death pertained to other categories or remained unclear. Reproductive performance was judged to be normal, since mean litter size was 2.5 per female and pregnancy rate in March-June was 74%. We conclude that neither a specific infectious disease, for which adult hares are particularly susceptible, nor an insufficient reproductive performance are responsible for the decline of brown hare populations in Switzerland. This phenomenon is rather a cause of a reduced survival rate in leverets.

Animals↗
PubMedDate not supplied

[Medical manpower in Switzerland: past and future trends].

In 1966, an official report predicted a 3-decades period of shortage of physicians in private practice in Switzerland. However a demographic analysis of the trends of medical students provided a totally different picture, as early as 1971. As a matter of fact, the ratio of doctors in private practice per 100,000 population rose to 195 in 2000 from 88 three decades earlier. In 2020, Switzerland will have a ratio of 240-270, whatever the decisions made today. Will such a tremendous increase introduce a damaging surplus of private practitioners? Medical progress, population aging, increase in the per capita demand for health care and other factors as well give raise to an other conclusion, much more optimistic.

Adult↗
PubMedDate not supplied

Switzerland, the law, and HIV: an overview.

From the first appearance of HIV/AIDS in Switzerland in the mid 1980s, various legal tools have been implemented to combat the disease, most of them based on legislation already in force. To date, there has been no specific AIDS-related legislation, but if the formal legal framework has changed very little, practice has developed and demonstrates the extent to which the law reflects current societal values. At the risk of "giving the game away," it must be said at the outset that there are virtually no major HIV/AIDS-related legal problems in Switzerland.

Civil Rights↗
PubMed2002

[Ambrosia pollen in Switzerland--produced locally or transported?].

The ambrosia (Ambrosia artemisiifolia L.) has been announced in Switzerland for more than 100 years. During the last decade, signs of an increased presence of the ambrosia and its pollen appear in the south-west of Switzerland, in particular in Geneva. Aerobiologic measurements make it possible to highlight the importance of the transport of pollen by the winds since the area of Lyon, where the ambrosia is abundant. It also bring elements making it possible to detect a local production of pollen in the Geneva area, where several invaded fields were discovered with the autumn 2001. A multidisciplinary group was created in Geneva and it attempts to prevent as far as possible probable invasion of the ambrosia.

Asteraceae↗
PubMed2002

[Weil's disease: a case report of acquired leptospirosis in Switzerland].

Leptospirosis is a rare disease in Switzerland. However its incidence is probably underestimated, due to its broad spectrum of presentations, including subclinical benign forms and the ictero-hemorragic form of the Weil's syndrome, whose mortality is high. We describe here a case of Weil's syndrome acquired in Switzerland with a favourable outcome under antibiotherapy. Even in the absence of any travel, the association of an acute renal insufficiency and jaundice with only moderate hepatic cytolysis should lead to the suspicion of leptospirosis. Clinical and epidemiological aspects of the disease are discussed in the article.

Aged↗
PubMed1992

On the epidemiology of sports injuries in Switzerland.

A review of the current literature and of insurance data sources on sports injuries in Switzerland during the latest decade is presented. Epidemiological denominator data to determine the population-at-risk and the exposure time are scarce and it is therefore recommended that both the quantity and the quality of Swiss research in this field will be enhanced. It is also proposed that at least one academic institution in Switzerland would assemble systematically all available data of standard format on sports and recreational injuries to ensure a continuous analysis of these data.

Accident Prevention↗
PubMed1992

[The status of Italian psychiatric reform: the example of Lombardy in comparison with Switzerland].

In Italy, the worldwide reduction in numbers of psychiatric beds since the fifties had led already by 1971 to a much lower per capita rate of beds than in most European countries. In Northern Italy the psychiatric reform of 1979 speeded up the ongoing reduction of beds, ameliorated conditions for hospitalized patients and built up ambulatory care. A comparison with three Swiss cantons shows that, in Lombardy, the largest and economically most developed Italian Region, the rate of patient contacts with outpatient services has probably reached or surpassed the level found in Switzerland. Contacts by home visits are much more frequent than in Switzerland. The number of psychiatric beds per 1,000 inhabitants is 0.7 in Lombardy and thus has been reduced to one third the Swiss bed-ratio. Comparisons of Italian with Dutch and Danish psychiatric register data show that the Italian psychiatric service as a whole reaches a considerably smaller segment of the severely disordered patients. The Region of Lombardy has recently been trying to increase the psychiatric bed-ratio by agreements with private hospitals. The shortage of beds is not compensated by the ambulatory services and is leading to increasing stress for the families of the severely disordered.

Bed Occupancy↗
PubMed1992

[Typing and sensitivity of meningococci isolated in Switzerland 1988-1990].

Since 1906 severe infections due to Neisseria meningitidis have been reported in Switzerland. The clinical application of antimicrobial agents reduced the mortality rate due to meningococcal infections from 82% before 1939 to 22% after 1942. However, the annual incidence remained at about 1.5 cases per 100,000 inhabitants. During the years 1988 to 1990, 177 strains isolated in Switzerland have been typed with a dot ELISA using 15 different monoclonal antibodies. The distribution of serogroups was as follows: A (0.6%), B (70.6%), C (22.6%), and W135 (0.6%), while 5.6% could not be assigned to a serogroup. The most common associations of serogroup, serotype and subtype were: B:15:P1.16 (15.3%), B:4:P1.15 (13.6%), and C:2a:P1.2 (9.0%). The susceptibility of 174 strains was determined by an agar-dilution procedure. All strains were susceptible to cefuroxime, ceftriaxone, ciprofloxacin, minocycline and spiramycin. One strain showed reduced sensitivity to penicillin (MIC = 0.25 mg/l), while another strain was resistant to rifampicin, 3% were resistant of erythromycin and 75% to sulfadiazine.

Drug Resistance, Microbial↗
PubMed1992

[Logistics of antidotes in Switzerland].

Antidotal compounds are principally classified into three groups. The most important compounds are available in all hospitals and pharmacies. They guarantee the basic supply of antidotes in all part of Switzerland. More specific antidotes are constantly available in 24 regional centres, some of which being further specialized in certain areas (e.g. Cantonal Pharmacy of Zurich: anti-venoms and radionucleotide-antidotes). Ongoing routine collaboration between the Swiss Toxicological Information Centre (STIC) and the Swiss Association of Hospital Pharmacists (GSASA) is important for continuous and competent information about the availability of newly developed antidotal drugs in Switzerland.

Antidotes↗
PubMed2004

[Psychosocial and psychosomatic medicine as well as psychotherapy in Switzerland -- developments over the past fifty years].

The development of psychosocial and psychosomatic medicine in Switzerland is as diverse as the country itself with its four official languages and 26 cantons. Psychosomatic medicine of the past and present can be seen in three phases: Psychogenesis of somatic diseases ( phase 1: from about 1930-1960), bio-psycho-social medicine (phase 2: from 1960-1990) and psychobiology in medicine (phase 3: since 1990). In Switzerland the first phase scarcely noticeable, whereas active development in all fields of psychosomatic medicine and psychotherapy has taken place since 1960. The main tendencies of this development are described. The current situation for patients with psychosomatic and somatopsychic disorders is quite good in the outpatient setting. For inpatient treatment there are only about 400 beds in 19 small departments for the whole country. The strengths of the psychosomatic service system are well-established cooperation of doctors and psychotherapists and only few reactions by health insurance companies. Weaknesses are too few inpatient treatment facilities with long waiting times for patients and a lack of specialized treatment for migrants with psychosomatic disorders. Future prospects are not rosy due to the financial situation in the healthcare system, but neither are they bleak, since patients are emphatically asking for more narrative-based medicine and a partnership-based doctor-patient relationship.

Ambulatory Care↗
PubMed1992

[Multiple sclerosis in northwestern Switzerland].

From 1980 to 1987 an epidemiologic survey was conducted in northwestern Switzerland (population 523,000) with the aim of registering as many MS cases as possible. The prevalence for the entire region was 142 per 100,000, with a maximum of 164/100,000 in the city of Basle. Extrapolation suggests there are more than 8000 MS patients living in Switzerland. Other interesting results were: a sex-ratio of 2.2 females:1 male. The mean age at clinical onset was 31.6 years. The mean survival was 30.6 years. Prevalence has grown in recent decades, mainly due to longer survival and to changes in age structure. The incidence presumably remained unchanged.

Adult↗
PubMed2004

Periodontal conditions in Switzerland at the end of the 20th century.

AIM: To epidemiologically assess the periodontal conditions of the adult population in Switzerland. MATERIAL AND METHODS: During a ten-year period, a total of 1318 subjects were randomly selected on the basis of a process involving the community rosters in seven regions (Cantons) of Switzerland: (Canton of Berne; Canton of Zurich; Western cantons (GE,VD,NE); Eastern cantons (SG,AI,AR,TG,SH); Southern cantons (VS,GR,TI); Central cantons (LU,GL,ZG,UR,SZ,OW,NW) and Northern cantons (JU,FR,SO,AG,BL)) and encompassing all adult age groups (20-89 years). The subjects were examined in dental offices randomly distributed throughout the country. The number of teeth present, the mean Plaque and Gingival as well as Retention Indices were assessed. Furthermore, pocket probing depths and loss of periodontal attachment were determined on all teeth. RESULTS: Ninety-four (7.1%) of the subjects were completely edentulous leaving 1224 dentate individuals with an average of 21.65 teeth for analysis. In the youngest cohort (20-29 years) 27.03 teeth were present. During the fourth to the seventh decade of life, tooth loss appeared to follow a linear pattern leaving 17.63 teeth in the age group of 60-69 years. The oldest age group of the 80-89 years old yielded 11.08 teeth. The mean scores of all clinical parameters increased significantly with increasing age. Mean PII in the youngest age group was PII: 0.72 (SD: 0.38) and reached PII: 1.55 (SD: 0.68) in the oldest. The corresponding mean GI were 1.17 (SD: 0.31) and GI: 1.64 (SD: 0.50), respectively. The mean RI increased from 0.24 (SD: 0.29) to RI: 1.34 (SD: 0.70) in the oldest. Mean probing depth increased slightly from 20 to approximately 49 years. Thereafter, mean PPD remained around 3.0 mm. The loss of periodontal attachment increased dramatically after the age of 50. CONCLUSIONS: Periodontitis manifests itself after the age of 50. The pronounced progressive attachment loss in the age cohorts over fifty years explained the marked loss of teeth in some individuals. From a public health point of view, it is indicated to make a major effort for periodontal prevention in the population approaching the second third of life.

Adult↗
PubMed2006

Presence of potentially pathogenic Babesia sp. for human in Ixodes ricinus in Switzerland.

We have designed and performed a new PCR method based on the 18S rRNA in order to individuate the presence and the identity of Babesia parasites. Out of 1159 Ixodes ricinus (Acari: Ixodidae) ticks collected in four areas of Switzerland, nine were found to contain Babesia DNA. Sequencing of the short amplicon obtained (411-452 bp) allowed the identification of three human pathogenic species: Babesia microti, B. divergens, for the first time in Switzerland, Babesia sp. EU1. We also report coinfections with B. sp. EU1-Borrelia burgdorferi sensu stricto and Babesia sp. EU1-B. afzelii.

Animals↗
PubMedDate not supplied

Prevalence and significance of gastrointestinal helminths and protozoa in South American Camelids in Switzerland.

A cross sectional study was conducted to determine the prevalence and significance of endoparasitic infections in South American Camelids (SAC) in Switzerland. Qualitative and quantitative coproscopic examinations were performed in 38 farms during the grazing period. Management practices with possible interference with parasitic infections were analyzed. On the farm level prevalences of endoparasitic infections were: trichostrongyles 87%; Trichuris sp. 74%; Capillaria sp. 68%; Nematodirus battus 63%; Nematodirus sp. 53%; Dicrocoelium dendriticum 34%; Moniezia sp. 8%; Fasciola hepatica 5%; protostrongylids 5%; Eimeria macusaniensis 68%. The level of helminth egg excretion was generally low. The highest values were recorded for trichostrongyles with an average of all investigated farms of 53 eggs per gram of faeces. The mean trichostrongyle egg output was approximately three-fold in SAC on farms that also kept sheep and/or goats, although this difference was not significant (P = 0.11). Clinical trichostrongylidosis was not reported from any of the farms. The low infection level with gastrointestinal nematodes is attributed to the defaecation behaviour of the SAC depositing their faeces focally on small spots on pasture. As a consequence, pasture infectivity is largely restricted to the area adjacent to the dung piles. Dicrocoeliosis is regarded as the most relevant parasitic infection of llamas and alpacas in Switzerland causing severe clinical symptoms and death in untreated animals. Sixteen per cent of the owners regularily treated their herds against dicrocoeliosis using praziquantel at a dose of 50 mg/kg body weight orally.

Animal Husbandry↗
PubMed2006

[Characteristics of patient aggression in a psychiatric hospital in Switzerland].

Characteristics of patient aggression in a psychiatric hospital in Switzerland Patient aggression in psychiatry is a prominent problem for all concerned. In this prospective survey we registered and analysed all violent incidents of patients in a cantonal psychiatric hospital in Switzerland in order to determine the characteristics of aggression. The Staff Observation Aggression Scale Revised (SOAS-R) was utilised. During the study period 815 patients were admitted to the hospital. 71 (63.4%) of the 110 violent incidents were perpetrated by male patients. The majority of aggressive incidents were perpetrated in the vicinity of the rooms of the patients and were triggered mainly by the refusal to adhere to the demands of the patient or by patients' use of toxic substances. The most frequent type of aggression was of a verbally aggressive nature and the principal target was nursing personnel who felt threatened in most of the cases. In order to terminate the aggression the most predominant measure was communication with the patient and coercive measures. This study demonstrates clearly that aggression concerns psychiatric nursing personnel and points to the recommendation to reinforce measures of security and to predictive measures to ameliorate the management of aggression.

Adolescent↗
PubMed2006

Administrative monitoring of tuberculosis treatment in Switzerland.

SETTING: Treatment of tuberculosis (TB) is critically dependent on adherence. Directly observed treatment (DOT) has been shown to be effective. OBJECTIVE: To determine operational treatment outcome using administrative treatment monitoring (ATM) to assess the need for more vigorous promotion of DOT. DESIGN: Cohort study in eastern Switzerland, where ATM was started in 2002. Bi-monthly progress forms and a treatment outcome form (after 6 months) were sent to the treating doctors. Forms not returned within 6 weeks were followed up with phone calls. RESULTS: Between 2002 and 2004, 98 (87.5%) of 112 new TB patients completed a 6-month treatment course. Eight elderly patients died of causes other than TB while on treatment, four travelled out of the region and two were lost to follow-up. Treating doctors opted for DOT in only seven cases. CONCLUSION: Given the high success rate of 87.5% in our cohort, more vigorous promotion of DOT is not a priority for TB case management in eastern Switzerland. In our setting, ATM in collaboration with the family doctors offers a valuable alternative to the more time-consuming universal DOT.

Adult↗