Search

Abstract: Private practice physicians play a central role in the detection and control of outbreaks. In Geneva, a local alert and response network completes the federal surveillance system, based on the mandatory reporting of infectious diseases. The common objective of these two mechanisms is to help health authorities in detecting, assessing, and controlling infectious diseases treats. Private practice physicians are one of the most effective and timely sources of information. As network members, they receive brief reports and information and are involved in the implementation of control and prevention measures. Their key-role was confirmed during a measles epidemic which occurred in Geneva in the spring of 2003. [Copyright &y& Elsevier]

Purpose: Eight confirmed cases of Legionnaires’ disease were identified at the Geneva University Hospitals between 28 July 2017 and 02 August 2017, leading to a detailed outbreak investigation., Methods: Legionnaires’ disease cases were defined according to Swiss and European (ELDSNet) consensus guidelines. An outbreak investigation task force was put in place. Patients were interviewed, when feasible, with a standard questionnaire. A Legionella pneumophila urinary antigen test was performed in all cases. Lower respiratory tract (LRT) specimens were collected for culture, polymerase chain-reaction (PCR) assay, monoclonal antibody subtyping and sequenced-based typing (SBT). Multiple environmental samples were collected. Case geographical mapping was performed and local meteorological data were obtained., Results: Thirty-four confirmed cases of Legionnaires’ disease were identified between 20 June 2017 and 16 September 2017, including 28 patients living in the Canton of Geneva and 6 cases in neighbouring cantons and France. The case fatality rate was 8.8%. The urinary antigen test was positive in 32/34 (94.1%) cases. Among the 17/34 (50%) cases with available LRT specimens, 8 (47.1%) were culture/PCR positive, 5 (29.4%) were PCR positive only, and 4 (23.5%) were culture/PCR negative. Monoclonal antibody subtyping and SBT on 12 samples allowed subtype identification of 8 samples, with a predominance of L. pneumophila serogroup-1 subtype-France/Allentown ST23 among clinical isolates. A specific city area was identified as a possible outbreak epicentre in 25/34 (73.5%) cases, although molecular analysis of clinical and environmental specimens revealed heterogeneous subtypes of L. pneumophila., Conclusions: In this largest documented outbreak of Legionnaires’ disease in Switzerland, we report prompt outbreak identification, leading to timely initiation of a detailed, well-orchestrated clinical and epidemiological investigation.

Between January and August 2011, the canton of Geneva, Switzerland, experienced a large measles outbreak with 219 cases (47 cases per 100,000 inhabitants) in the context of an extensive epidemic in a neighbouring region of France. Most cases were young adults (median age: 18 years), often unaware of their vaccination status. The vast majority of cases were either not (81%) or incompletely vaccinated (8%). Thirty clusters with a total of 119 cases and a median cluster size of three (range: 2–15 cases) were identified. Overall, 44 cases were imported or linked to imported cases. Of 73 contacts of cases who were quarantined, 50 developed measles and caused six secondary cases. This compares to 81 secondary cases among 173 non-quarantined cases (relative risk: 0.26; 95% confidence interval: 0.06–0.65), demonstrating the effectiveness of well targeted quarantine measures in reducing transmission.

An outbreak of measles is ongoing in Geneva, Switzerland, since January 2011, in the context of a measles epidemic in neighbouring Rhône-Alpes, France. A total of 41 confirmed cases have been reported, the majority among young adults, many unaware of their non-immune status. There is no large clustering of cases and 14 cases were imported or linked to imported cases. Catch-up vaccination, especially among young adults, may be necessary to prevent further extension of this outbreak.

Private practice physicians play a central role in the detection and control of outbreaks. In Geneva, a local alert and response network completes the federal surveillance system, based on the mandatory reporting of infectious diseases. The common objective of these two mechanisms is to help health authorities in detecting, assessing, and controlling infectious diseases treats. Private practice physicians are one of the most effective and timely sources of information. As network members, they receive brief reports and information and are involved in the implementation of control and prevention measures. Their key-role was confirmed during a measles epidemic which occurred in Geneva in the spring of 2003.

Background: A measles outbreak occurred in Geneva between March and July 2003. An investigation was conducted to determine its magnitude, identify predominant modes of transmission, and assess disease outcome., Methods: In Switzerland, measles notification has been mandatory for physicians since 1999 and laboratories since 1988. All cases were investigated and followed up by interviewing physicians using a standardized questionnaire. Viral genotype was determined for 4 cases using a saliva specimen processed at the Robert Koch Institute, Berlin. Geographic distribution of cases and vaccination coverage were compared., Results: Overall, 54 cases were notified. Fifty-three cases were between 10 and 19 years of age. Ninety-four percent (n = 46) of 49 cases with known vaccination status were not vaccinated and none were fully immunized (2 doses). Measles complications occurred among 19% (n = 7) of the 36 patients with follow up information: pneumonia (n = 4, combined with pericarditis and hepatitis in one case) and bronchitis (n = 3). Three persons were hospitalized. No complication was reported among 3 persons partially vaccinated (1 dose). The virus belonged to genotypes D8 and D5. Five separate clusters of related cases included 74% of all cases. Transmission mainly occurred within families (43% of all cases) and school (28%). Two of the most affected areas had measles vaccination coverage well below the cantonal average., Conclusion: Low vaccination coverage combined with clusters of unvaccinated household contributed to continued virus circulation and represents a threat to the canton of Geneva as new outbreaks of measles may reoccur.