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Isolation of swine-like influenza A(H1N1) viruses from man in Switzerland and The Netherlands.

Swine influenza A (H1N1) viruses were isolated from two people in Switzerland and one in the Netherlands in early 1986. In haemagglutination-inhibition and neuraminidase-inhibition assays, the three viruses were closely related to one another and to the A/New Jersey/8/76 strain. The Swiss patients showed only mild symptoms, whereas the Dutch patient suffered from severe pneumonia. Two of the patients had been in close contact with diseased pigs. No such contact could be established for the third patient. None of the three individuals was known to suffer from immunodeficiency. No man-to-man transmission of the virus has been detected.

Animals↗
PubMed2001

Criminal responsibility assessment in Switzerland: changes and continuity.

BACKGROUND: The factors that experts use to assess criminal responsibility are not very well known. Changes in the importance attributed to certain diagnoses are occasionally mentioned in the literature. The aim of this study is to identify the existence and the nature of such modifications. METHOD: We compared the socio-demographic, criminological and psychiatric characteristics of two samples of psychiatric assessments carried out in Geneva, Switzerland in 1973-74 (N = 75) and 1997-98 (N = 94). RESULTS: The two groups of subjects described by the experts' reports appear to be quite different in several characteristics. However, the rate at which experts conclude their reports in favour of diminished responsibility was not found to be significantly different. The logistic regression shows that the diagnosis of personality disorder is the only variable that influenced the experts differently for the 1997-98 period compared to the 1973-74 period. CONCLUSION: In Geneva, psychiatric experts still continue to ascribe diminished responsibility to offenders suffering from psychosis or depression. However, the population that undergoes psychiatric assessments nowadays has changed considerably.

Adolescent↗
PubMed2000

[Adolescents and ambulatory care: results from a national survey of young people 15 to 20 years of age in Switzerland].

UNLABELLED: In industrialized countries, statistics on health services exhibit a low level of health care use by adolescents, despite the fact that their needs have been widely described. OBJECTIVES: To assess ambulatory health care use by 15-20-year-old teenagers in Switzerland. METHOD: Nine thousand, two hundred and sixty-eight adolescents responded to the self-administered questionnaire distributed in secondary schools and vocational classes for the Swiss Adolescent Health Survey. Questions about visits to general practitioners, specialists and gynecologists, reasons for visit, the availability of a regular health care provider and a confidential health care resource were analysed. RESULTS: Within the previous 12 months, 87.6% of the girls and 75.3% of the boys reported having seen a physician. General practitioners were visited more frequently than specialists. The contact with a specialist was the only one to be related to socio-demographic variables: a lower proportion of reported visits to a specialist was related to apprenticeship, low educational status of parents or rural living area. Thirty-nine percent of the girls reported having seen a gynecologist during the previous 12 months. Two adolescents out of three reported having a personal doctor, and one out of two declared being aware of a confidential health care resource. Girls reported a larger number of reasons for visits than boys: chronic conditions, fatigue, headache and depressive symptoms were the most often cited in a list of ten reasons. Among the subjects who declared a health concern (sleep disturbances, eating disorders, depressive symptoms, smoking or alcohol-related problems) and a need for help, less than 10% declared having seen a health care provider for this reason, even if more than 70% reported contact with a physician within the last 12 months. CONCLUSION: These results show that most adolescents, especially girls, reported recent use of medical services, but did not discuss their health concerns with the doctor. Training should be improved to give better knowledge and counseling skills to health professionals, in order to allow them to address adolescents' health needs.

Adolescent↗
PubMed1997

[Suicidal behavior in adolescents in Switzerland: role of physicians].

INTRODUCTION: In most industrialized countries, suicide represents the second leading cause of death among adolescents. Swiss teenagers exhibit one of the highest death rates by suicide in Europe; however, the prevalence of suicidal conducts (suicidal ideas, projects and attempts) in Switzerland is not known. OBJECTIVES: To assess the prevalence of suicidal conducts among Swiss adolescents and to compare these figures with available data from other countries. To establish how suicidal adolescents use health services in comparison with non-suicidal adolescents. METHODS: Bivariate analyses have been performed using data from the "SMASH" study (Swiss Multicenter Adolescent Survey on Health), a national survey on the health and lifestyles of 9,268 15 to 20 years in-school youth (3,993 girls et 5,275 boys). Within a self-administered anonymous questionnaire of 80 items, five specific questions focused on suicidal conducts and lead to the distribution of respondents in four groups: no suicidal concern, suicidal ideas, suicidal plans, suicide attempt. RESULTS: Regarding the last 12 months, 5,144 teenagers (55.5%) report no suicide preoccupation at all; 2,376 (25.6%) report suicide ideas only, 1,366 (14.7%) report suicidal projects and 274 (3%) report suicide attempts. Only 40% of respondents who report a suicide attempt have talked about it to someone in their circle of family or friends. Moreover, less than 20% have spoken of their suicide with a psychologist, and although they see physicians as often as the rest of the sample, only 10% have discussed their attempt with one of them. In comparison with those free of suicidal concerns, suicidal adolescents report significantly more health problems and concerns: they feel more often tired or depressed and use medication more often. They also seem to exhibit more deviant behaviors like alcohol and drug use or runaway. CONCLUSION: Suicidal conducts, especially suicide attempts are much more prevalent among Swiss adolescents, but a small minority is acknowledged and treated by the medical profession. Physicians should be aware of this pathology and better trained both in term of detection and treatment.

Adolescent↗
PubMed1997

Apodemus sp. rodents, reservoir hosts for Borrelia afzelii in an endemic area in Switzerland.

Borrelia burgdorferi is maintained in nature in transmission cycles alternatively involving ticks and reservoir hosts. Small rodents like Apodemus mice and Clethrionomys voles are the primary reservoir of Lyme disease in Europe. In this study, we analyzed by SDS-PAGE and Western blot 20 borrelial isolates from xenodiagnostic ticks fed on four Apodemus sp. mice captured in the Staatswald forest (Switzerland). All isolates but one showed a homogeneous protein pattern expressing an outer surface protein, (Osp) A of 32 kDa and an OspB of 35 kDa and reacted with monoclonal antibody (mAb) I 17.3 specific for B. afzelii. One isolate expressed an OspA of 32.5 kDa and an OspB of 35 kDa and did not react with species-specific mAbs I 17.3, D6 and H3TS, but was shown to belong to B. afzelii by Southern blot analysis. The possibility exists that non-cultivatable borreliae are present in xenodiagnostic ticks. However, our results clearly show that Apodemus sp. are reservoir hosts for B. afzelii, since this genospecies is transmitted from Apodemus sp. to feeding larval ticks.

Animals↗
PubMed1999

A randomized experiment of the effects of including alternative medicine in the mandatory benefit package of health insurance funds in Switzerland.

OBJECTIVES: The present investigation focuses on the following questions: 1. Are complementary medical services paid for by a health insurer used in addition to orthodox medical services, or as substitute for them?; 2. If health insurers include complementary medical services in the basic cover, what will be the effect on costs?; 3. If complementary medical services as included in the basic cover, what will be the effect on the policyholders' subjective state of health? STUDY DESIGN: A randomized experiment was set up in which 7500 members of Switzerland's biggest health insurance fund, Helvetia, were offered free supplementary insurance for alternative medicine for 3 years. This simulated a situation in which the experimental group had access to the full range of complementary medical treatments under their health insurance policies. The remaining members in the scheme (670,000) people) formed the control group. To evaluate the effect on costs, we analysed the health insurer's cost and benefits data. In addition, a survey was carried out among random samples of subjects from the experimental group and from the control group using the 36-Item Short-Form Health Survey (SF-36) to examine the effects of including complementary medicine on subjective state of health. RESULTS: The analysis of the cost data shown that subjects used alternative in addition to orthodox medical services. It is also clear that alternative medical treatments are given in combination with orthodox medicine; less than 1% of the experimental group used exclusively alternative medical services. However, as only a very small percentage of experimental subjects (6.6%) took advantage of complementary medicine, no significant impact on overall health costs can be inferred. On the other hand, multiple regressions show that use of complementary medicine has a greater effect on treatment costs than sex, age or language region. Neither at the beginning nor the end of the experiment were any significant differences noted in the scales of the SF-36 between the experimental and the control group. Nor did multiple regressions reveal any effects on subjects' state of health due to the inclusion of complementary medicine in the basic insurance cover.

Adult↗
PubMed2003

Trends in risk factors for the major "lifestyle-related diseases" in Geneva, Switzerland, 1993-2000.

PURPOSE: Continuous monitoring of health determinants in populations is necessary to predict future disease burdens. The objective of this study was to assess the prevalences of major risk factors for lifestyle diseases for 8 years (1993 to 2000) in representative samples of the general population. METHODS: Independent cross-sectional surveys representative of adults aged 35 to 74 years (4228 men and 4190 women) in Geneva, Switzerland, conducted continuously between 1993 and 2000. RESULTS: Prevalence of hypertension decreased 15% in men and 10% in women (trend p's<.0001), while overweight/obesity prevalences increased 10% in men and 8% in women (trend p's<.05). The prevalences of smoking (men: 29%; women: 24%) and physical inactivity (men: 44%; women: 50%) remained high and unchanged, and the dietary unsaturated/saturated fat ratio did not change (men: 0.40; women: 0.48). CONCLUSIONS: Because of the persistent high prevalence of risk factors, the global burden of chronic diseases is likely to grow in the next decade and beyond. Continuous monitoring provides reliable trends, beyond seasonal and sampling variations.

Adult↗
PubMed2002

Prospective epidemiologic survey of patients with community-acquired pneumonia requiring hospitalization in Switzerland.

BACKGROUND: Community-acquired pneumonia (CAP) is a common problem and the principal infection requiring hospitalization, but its treatment is complicated by the difficulty in microbiological diagnosis and the increasing incidence of antibiotic resistance among respiratory pathogens. The purpose of this paper is to present the main epidemiologic features of patients with CAP requiring hospitalization in our country. METHODS: We enrolled three hundred and eighteen adult patients with CAP requiring hospitalization in seven large medical centers in Switzerland during two winter periods. The patients' mean age was 70.4 years. This study describes the epidemiology of these patients. Clinical, radiologic and microbiological evaluations were performed at study entry during treatment, and at 4 weeks post-therapy. For microbiological diagnostic purposes, sputum culture, throat swab culture, PCR, blood cultures, Legionella urinary antigen and serologic evaluations were also performed. RESULTS: Despite the higher mean age, the overall mortality rate was 8%, lower than in other comparable studies. The most common underlying diseases present at study entry were cardiac failure (23%), chronic obstructive pulmonary disease (20%), renal failure (15%), and diabetes (12%); 40% of the patients were smokers. Although dyspnea, cough and positive pulmonary auscultation findings were present in about 90% of patients, fever >38 degrees C was present in only 64%. The most frequently isolated respiratory pathogens were Streptococcus pneumoniae (12.6%), Haemophilus influenzae (6%), Staphylococcus aureus (1.6%), and Moraxella catarrhalis (1.6%). Atypical pathogens were frequently found, with the following distribution: Mycoplasma pneumoniae, 7.5%; Chlamydia pneumoniae, 5.3%; and Legionella pneumophila, 4.4%. The mean duration between onset of symptoms and hospital admission was 4.8 days, and the mean treatment duration was 12.1 days. Two weeks after the start of therapy, although clinical symptoms were absent, radiologic infiltrates were still present in 24% of patients. CONCLUSIONS: The microbiological diagnosis in CAP can be established in only about 50% of cases with the combination of several diagnostic tools. Epidemiologic surveys of CAP should be performed on a regular basis, regionally, as a way to improve the management of these infections.

Aged↗
PubMed2000

High prevalence of Echinococcus multilocularis in urban red foxes (Vulpes vulpes) and voles (Arvicola terrestris) in the city of Zürich, Switzerland.

Over a period of 26 months from January 1996 to February 1998, 388 foxes from the city of Zürich, Switzerland, were examined for intestinal infections with Echinococcus multilocularis and other helminths. The prevalence of E. multilocularis in foxes sampled during winter increased significantly from 47% in the urban to 67% in the adjacent recreational area, whereas prevalence rates of other helminths were similar in both areas. Seasonal differences in the prevalence of E. multilocularis were only found in urban subadult male foxes which were significantly less frequently infected in summer than in winter. The distribution of the Echinococcus biomass, as expressed by worm numbers per fox was overdispersed in 133 infected foxes randomly sampled in winter. Ten of these foxes (8%) were infected with more than 10,000 specimens and carried 72% of the total biomass of E. multilocularis (398,653 worms). Prevalences did not differ significantly in these foxes in regard to age and sex but worm burdens were significantly higher in subadult foxes as compared with adult foxes. In voles (Arvicola terrestris) trapped in a city park of Zürich, E. multilocularis metacestodes were identified by morphological examination and by PCR. The prevalence was 20% among 60 rodents in 1997 and 9% among 75 rodents in 1998. Protoscoleces occurred in 2 of the cases from 1997. The possible risk for human infection is discussed with respect to the established urban E. multilocularis cycle.

Animals↗
PubMed1992

Genetic relationships among strains of Salmonella enteritidis in a national epidemic in Switzerland.

A collection of Salmonella enteritidis strains isolated in Switzerland (1965-90) was characterized. The phage type and plasmid profile of isolates were compared with the copy number and insertion loci of the DNA insertion element IS200. Three clonal lines of S. enteritidis were identified by IS200 profile; the various phage types were subtypes reproducibly associated with one of these lines. All human and poultry isolates contained a 38 Mda plasmid which hybridized with a mouse virulence-associated gene probe. In S. enteritidis, the IS200 profile is a race-specific molecular marker of the chromosome, and may be particularly applicable for studying the epidemiology of less common serovars.

Bacterial Typing Techniques↗
PubMed1994

Comparison in the immunological properties of Borrelia burgdorferi isolates from Ixodes ricinus derived from three endemic areas in Switzerland.

Borrelia burgdorferi isolates were obtained from Ixodes ricinus from three sites in Switzerland. They were examined by SDS-PAGE and immunoblotting. The phenotypes, in respect of three outer surface proteins (Osp), differed between the sites of collection. In site 1, most isolates had an OspA of 31 kDa and an OspB of 34 kDa; in site 2, isolates presenting an OspA of 33 kDa dominated and in site 3, the isolates with an OspA of 32 kDa and an OspB of 35 kDa were most frequent. This distribution differed significantly. About half of the isolates from sites 1 and 3 reacted with anti-OspA monoclonal antibody H5332 compared to 29% from site 2. Site 1 isolates reacted significantly more frequently (81%) with another anti-OspA monoclonal antibody LA-31 than isolates from site 3 (P < 0.0001). These findings have implications for the epidemiology of Lyme borreliosis, for the further development of serodiagnostic reagents and for the development of a vaccine.

Animals↗
PubMed2005

Outbreaks of gastroenteritis due to infections with Norovirus in Switzerland, 2001-2003.

Viral infections, especially those with noroviruses are the most common cause of acute gastroenteritis in Europe. To obtain information about the epidemic situation of noroviruses in Switzerland, an initial study was launched in the German-speaking part of the country to systematically compile Norovirus outbreak information between 2001 and 2003. In total, 73 outbreaks were registered. Most affected were closed settings, e.g. nursing homes (34%) and hospitals (25%). Transmission pathways were identified in 74% of Norovirus outbreaks. In 81% of these cases person-to-person transmission was the primary route of infection and on seven occasions (13%), a foodborne transmission was the possible cause. Furthermore, Norovirus outbreak characteristics of epidemiological importance are highlighted with a discussion of four selected events.

Caliciviridae Infections↗
PubMed2004

Emissions of the refrigerants HFC-134a, HCFC-22, and CFC-12 from road traffic: results from a tunnel study (Gubrist Tunnel, Switzerland).

This study presents the quantification of the emissions of the refrigerants CFC-12 (CCl2F2), HCFC-22 (CHClF2), and HFC-134a (CF3CH2F) from road traffic in Switzerland. These gases are used as refrigerants in car air conditioning systems (A/C-systems) and in cool aggregates for refrigeration transport. All three substances act as greenhouse gases, and CFC-12 and HCFC-22 are in addition stratospheric ozone depleting chemicals. The measurements have been performed in a highway tunnel in the area of Zürich and cover a large number of individual vehicles, which are thought to be representative of a typical European car fleet. The average emission rates per vehicle were found to be 1.0 +/- 0.2 mg h(-1) for CFC-12, 0.6 +/- 0.4 mg h(-1) for HCFC-22, and 6.2 +/- 0.8 mg h(-1) for HFC-134a. These emission factors have been measured for driving vehicles and represent an average emission rate for all types of vehicles regardless of whether they are equipped with an A/C-unit or not. For an average vehicle equipped with an A/C-unit, these results translate into losses of about 14 mg h(-1) for HFC-134a and 20-30 mg h(-1) for CFC-12, when the estimated distribution of HFC-134a-A/C-units (45%) and CFC-12-A/C-units (3-5%) in the car fleet were taken into account. The emissions of CFC-12 and HFC-134a were mainly attributed to the losses from A/C-systems of passenger cars, whereas the emissions of HCFC-22 originate from losses of refrigeration systems of transport trucks. The observed emissions are discussed in respect to their environmental impact and compared to the overall greenhouse gas emissions of road traffic.

Air Pollutants↗
PubMed2005

Real-world emission factors of fine and ultrafine aerosol particles for different traffic situations in Switzerland.

Extended field measurements of particle number (size distribution of particle diameters, D, in the range between 18 nm and 10 microm), surface area concentrations, and PM1 and PM10 mass concentrations were performed in Switzerland to determine traffic emissions using a comprehensive set of instruments. Measurements took place at roads with representative traffic regimes: at the kerbside of a motorway (120 km h(-1)), a highway (80-100 km h(-1)), and in an urban area with stop-and-go traffic (0-50 km h(-1)) regulated by light signals. Mean diurnal variations showed that the highest pollutant concentrations were during the morning rush hours, especially of the number density in the nanoparticle size range (D <50 nm). From the differences between up- and downwind concentrations (or differences between kerbside and background concentrations for the urban site), "real-life" emission factors were derived using NOx concentrations to calculate dilution factors. Particle number and volume emission factors of different size ranges (18-50 nm, 18-100 nm, and 18-300 nm) were derived for the total vehicle fleet and separated into a light-duty (LDV) and a heavy-duty vehicle (HDV) contribution. The total particle number emissions per vehicle were found to be about 11.7-13.5 x 10(14) particles km(-1) for constant speed (80-120 km h(-1) and 3.9 x 10(14) particles km(-1) for urban driving conditions. LDVs showed higher emission factors at constant high speed than under urban disturbed traffic flow. In contrast, HDVs emitted more air pollutants during deceleration and acceleration processes in stop-and-go traffic than with constant speed of about 80 km h(-1). On average, one HDV emits a 10-30 times higher amount of particulate air pollutants (in terms of both number and volume) than one LDV.

Aerosols↗
PubMed2005

Acidification of soil solution in a chestnut forest stand in southern Switzerland: are there signs of recovery?

In a previous study, a rapid acidification of soil solution was observed between 1987 and 1997 in a cryptopodzolic soil in southern Switzerland despite a reduction in acidic deposition. The molar ratio of base nutrient cations to aluminum (BC/Al) in the soil solution was used to assess acidification. The monitoring of the soil solution chemistry was continued at the same site between 1998 and 2003 to find out how long the delay in reaction to reduced deposition would last and whether the BC/Al ratios would recover. The reevaluation of all data collected during the 16-year observation period showed no clear improvement in the BC/Al ratios, except below the litter layer where the ratios greatly increased after 1998. Initial signs of recovery were also detected in the mineral horizons, the ratios stabilizing in the second part of the observation period. Sulfate concentrations decreased significantly below the litter mat in response to decreased S deposition. BC concentrations markedly declined below the litter layer and in the mineral horizons, which was attributed to the depletion of the BC exchangeable pool as a result of continued acidic deposition.

Acid Rain↗
PubMed2006

Future scenarios for a sustainable water sector: a case study from Switzerland.

Uncertainties about the long-term prospects of urban water management systems have increased substantially over the past decade due to an increasing variety of regulations, technologies, and demand structures. In Switzerland, this uncertainty is mirrored by growing difficulties of utility managers and (waste)water scientists to agree on shared strategies: Water professionals demand support for pressing management problems, while researchers fundamentally question the longer-term sustainability of the established water management system. To reestablish shared orientation, we conducted a foresight study for the Swiss (waste)water sector in 2004. Based on interviews with 29 experts from Swiss water management and research to collect 56 drivers of change, a team of 17 experts developed three scenarios: (A) regional mergers of water utilities leading to enhanced professionalism in the sector, (B) consequent material flows management leading to a radically restructured urban water management system, and (C) generalized financial crisis leading to a breakdown of centralized utility services. These scenarios helped identifying shared research priorities. We conclude that scenario analysis is a powerful tool for framing long-term strategies, defining priorities, and integrating different interests in the multidisciplinary contexts of sustainability science, which are marked by high uncertainties and concern a wide range of stakeholder groups.

Professional Competence↗
PubMed2006

Spatial distribution of natural enrichments of arsenic, selenium, and uranium in a minerotrophic peatland, Gola di Lago, Canton Ticino, Switzerland.

Gola di Lago is a small (ca. 3 ha), minerotrophic peatland in Canton Ticino, southern Switzerland. Chemical analyses of peat show remarkable concentrations of As, Se, and U. Coring at regular intervals (19 sites) revealed several zones of pronounced accumulation, with As concentrations up to 350 mg kg(-1) (2000 mg kg(-1) on a mineral matter basis). Both Fe and S are also enriched at this depth, suggesting that redox-related transformations have affected all three elements. High concentrations of Se (up to 28 mg kg(-1)) and U (up to 470 mg kg(-1)) were also detected, representing on a mineral matter basis 350 and 2900 mg kg(-1), respectively. An intermittent stream entering the peatland contained up to 400 microg of As L(-1), but the permanent stream leaving the mire contains <2 microg L(-1). A three-dimensional map of the spatial distribution of As shows that the main source of As is the intermittent stream and not the basal, mineral sediment underlying the peatland. Arsenic is highly enriched not only in shallow peat layers at the interface between the stream and peatland today but also in deeper peat layers in the center of the mire, at what must have been the stream-peat interface in the past. By sequential extraction of fresh peat samples, 100% of the As could be extracted from a shallow sample but only 19% from a sample taken from the deeper layers. In both cases, most of the As was associated with the organic matter fraction (73% and 57% respectively). Although this peatland is an effective geochemical trap for As in the stream waters, the mechanisms of removal remain unclear.

Arsenic↗