The surveillance of pneumococcal antibiotic resistance and serotype distribution is hampered by the relatively low numbers of invasive pneumococcal infections. In Switzerland, a nationwide sentinel ...surveillance network was used to assess antibiotic resistance and serotype distribution among 1179 pneumococcal isolates cultured from 2769 nasopharyngeal swabs obtained from outpatients with acute otitis media or pneumonia during 1998 and 1999. The proportion of penicillin-susceptible pneumococcal isolates overall (87%) and among infants <2 years old (81%) was comparable to that of invasive isolates (90% and 81%, respectively). The high number of nasopharyngeal isolates allowed for the detection of a rapid increase in the number of penicillin-nonsusceptible pneumococcal (PNSP) strains in the West region of Switzerland, partly because of an epidemic caused by the 19F clone of Streptococcus pneumoniae. Clustering of risk factors for the carriage of PNSP isolates further explained the geographic variation in resistance rates. The nationwide sentinel surveillance of nasopharyngeal pneumococcus proved to be valuable for the monitoring of antibiotic resistance, risk factors for carriage of PNSP isolates, and serotype distribution and for the detection of the emergence of a new epidemic clone
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In 2002 the first endemic hantavirus infection in Switzerland was detected only by chance following a broad spectrum of diagnostics. This raised the question, whether Hantavirus infection should be ...included in the differential diagnosis of febrile illness of patients in Switzerland. In order to estimate the frequency of hantavirus infections in Switzerland, this survey on hantaviral seroprevalence was conducted in the Canton St. Gallen.
A total of 1693 sera from farmers, forestry workers, and young soldiers as well as blood donors, as a cross-section of the average adult population of the Canton St. Gallen, were screened for hantavirus-specific antibodies by a microsphere-based assay. All volunteers with positive screening results obtained a questionnaire for assessment of details of previous rodent encounter and illnesses compatible with hantavirus infection.
This first survey on hantavirus-specific IgG in populations of eastern Switzerland revealed low seroprevalence-rates not significantly different among populations with higher risk for hantavirus infection (0.0%-1.9%) and the average adult population (0.5%).
As hantavirus infections among different populations are rare, and no evidence for hantaviral nephropathy could be found, serological investigation of suspected endemic hantavirus infection in eastern Switzerland should be confined to patients with acute nephropathy and/or a history of recent rodent encounter.
The national health authorities of Sri Lanka have adopted a combined strategy of rabies vaccination and stray dog removal to control endemic dog rabies. Despite the control efforts, an increase of ...animal and human rabies cases has occurred since 1994. As a consequence, a project to evaluate the national rabies control program has been started and a study focussing on the dog population and rabies control activities in a limited area of Mirigama was conducted. Information on canine abundance and the accessibility of dogs for rabies vaccination was obtained by a household survey, vaccination of dogs against rabies at several vaccination points, collar-marking, and transect line recapture. The number of unvaccinated dogs was estimated by using Bayesian methodology. The estimated number of dogs per square kilometre was 87 (95% credibility interval: 80, 93) for owned dogs and 108 (100, 116) for owned and ownerless dogs. Coverage after the immunisation campaign was 57.6% (53.3, 61.9%) if vaccination at the vaccination points was considered and 66% (60.4, 72.0%) if recently provided vaccination by private veterinarians was also taken into account. The proportion of households with at least one dog vaccinated varied between 59.1 and 94.2% within the catchment area of the different vaccination points. Unvaccinated dogs were puppies (12%), ownerless dogs (57%), and owned dogs, which were not presented for vaccination (31%). In order to improve the rabies immunisation coverage among dogs and to achieve complete elimination of rabies it was recommended that the 95% catchment area of each vaccination point be assessed, the distribution of vaccination points in the vaccination area be redefined if necessary, a system for the vaccination of dogs missing the vaccination campaign for dog owner-specific reasons be established, and an inexpensive marking system be used for vaccinated dogs.
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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.
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.
Background: Public health authorities want to evaluate their sexually transmitted disease (STD) surveillance systems to promote the most effective use of health resources. Goal: The goal of this ...study was to estimate the sensitivity of national laboratory reports of Chlamydia trachomatis in Switzerland (the proportion of cases detected by national laboratory reports). Study Design: A cross sectional prevalence study was conducted by the Swiss Sentinel Surveillance Network of Gynecologists in 1998. Two groups of women aged less than 35 years were included in the study: those having a first consultation for pregnancy and those having a routine check-up. Results: A total of 1589 women were tested for C trachomatis. The prevalence among pregnant women (n = 817) was 1.3%, and that among sexually active women (n = 772) was 2.8%. Using the prevalences observed among check-up women, we estimate that there were at least 24,400 C trachomatis infections in Switzerland among women aged 20 to 34 years in 1998 (95% CI: 14,300-34,300). The number of labo-ratory reports of C trachomatis in this age group was 1150 in 1998. Conclusion: Our study suggests that the sensitivity of national laboratory reports of C trachomatis in 1998 was less than 5% for women aged 20 to 34 years.
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Since April 1993 in Finland and March 1994 in Switzerland, polymerase chain reaction (PCR) has been used routinely nationwide for the diagnosis of pertussis. Nasopharyngeal specimens from 3794 ...patients suspected of having pertussis and 1125controls were tested. Finnish and Swiss assays found 23% and 36% of clinical specimens positive, respectively. PCR showed a higher incidence of pertussis infection among 1- to 6-year-old children in Switzerland than in Finland (P < .001). This difference may be due to the booster dose of vaccine given at 2 years of age in Finland but not in Switzerland. In Finland, PCR-confirmed asymptomatic cases were more common among children <7 years old than in older children (P < .001),whereas older children tended to have symptomatic infection. The use of PCR markedly improves the diagnosis of pertussis and opens new perspectives for epidemiologic and vaccine efficacy studies.
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Quatre types d’appâts ont été testés simultanément sur 200 chiens (50 chiens/type d’appât). L’appât “tête de poulet”-TP a été significativement le meilleur appât, avec un pourcentage d’acceptation de ...96% et un taux de succès vaccinal de 94% ; l’appât industriel à base de “farine de poisson”-FP a occupé la seconde position avec un taux d’acceptation de 80% et un taux de succès vaccinal de 62%.
L’essai de deux vaccins à virus atténués dérivés de la souche SAD, SAD Berne et SAG 1, a par ailleurs confirmé l’immunogénicité par la voie orale de ces souches chez le chien, et encourage donc à envisager ce mode de vaccination chez cette espèce, en complément de la vaccination par voie parentérale.
An economic evaluation of several intervention strategies was conducted to contribute to the setting-up of the national influenza pandemic preparedness planning in Switzerland. A decision analysis ...model was developed to analyze the strategies for different Swiss population subgroups. Local treatment patterns, medical resources use and costs and other necessary data were obtained from national statistics, the literature and expert opinions. Analyses were undertaken from a public health and a societal perspective. The intervention strategies based on availability of vaccine and antiviral medication included the prophylaxis of health care workers (HCW) with antivirals; vaccination of HCW, elderly, high-risk elderly and high-risk adults; post-infection treatment of HCW and adults with antivirals. A worst-case scenario, based on the 1918–1919 influenza pandemic, was chosen as a basis for epidemiological and economic data. To date, in Switzerland, an influenza pandemic could result in 42,000 excess deaths and societal costs of CHF 2.5 billion. The key conclusions of the study were that any prevention strategy must give priority to HCW, essentially to keep the health care system fully functional. Following the availability of a pandemic vaccine, vaccination must be done as soon as possible targeting HCW first; from a public health perspective, vaccination of high-risk groups and elderly was cost-effective; from a societal perspective, vaccination of all adults of working age was cost saving. Post-infection treatment of adults was cost saving from a societal perspective.
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