A combined cross-sectional analysis and case-control study evaluating tick-borne encephalitis vaccination coverage, disease and vaccine effectiveness in children and adolescents, Switzerland, 2005 to 2022.

BackgroundTick-borne encephalitis (TBE) is a severe, vaccine-preventable viral infection of the central nervous system. Symptoms are generally milder in children and adolescents than in adults, though severe disease does occur. A better understanding of the disease burden and duration of vaccine-mediated protection is important for vaccination recommendations.AimTo estimate TBE vaccination coverage, disease severity and vaccine effectiveness (VE) among individuals aged 0-17 years in Switzerland.MethodsVaccination coverage between 2005 and 2022 was estimated using the Swiss National Vaccination Coverage Survey (SNVCS), a nationwide, repeated cross-sectional study assessing vaccine uptake. Incidence and severity of TBE between 2005 and 2022 were determined using data from the Swiss disease surveillance system and VE was calculated using a case-control analysis, matching TBE cases with SNVCS controls.ResultsOver the study period, vaccination coverage increased substantially, from 4.8% (95% confidence interval (CI): 4.1-5.5%) to 50.1% (95% CI: 48.3-52.0%). Reported clinical symptoms in TBE cases were similar irrespective of age. Neurological involvement was less likely in incompletely (1-2 doses) and completely (≥ 3 doses) vaccinated cases compared with unvaccinated ones. For incomplete vaccination, VE was 66.2% (95% CI: 42.3-80.2), whereas VE for complete vaccination was 90.8% (95% CI: 87.7-96.4). Vaccine effectiveness remained high, 83.9% (95% CI: 69.0-91.7) up to 10 years since last vaccination.ConclusionsEven children younger than 5 years can experience severe TBE. Incomplete and complete vaccination protect against neurological manifestations of the disease. Complete vaccination offers durable protection up to 10 years against TBE.

Temporal trends in legionellosis national notification data and the effect of COVID-19, Switzerland, 2000-2020.

The notification rate of legionellosis in Switzerland and other European countries has markedly increased over the last 20 years. Here, we investigated the Swiss notification data on legionellosis from 2000 to 2020 in regards of overall time trend, content and data quality. We further explored the impact of the COVID-19 pandemic on the reported case numbers using an interrupted time series approach. Between 2000 and 2020, 5980 cases were included in our analysis. The annual crude notification rate for legionellosis cases increased from 1.1/100,000 population (CI: 0.9-1.4) in 2000 to 5.6/100,000 population (CI: 5.1-6.1) in 2020. In recent years, the summer peaks have been more pronounced and some shifted earlier in the year. The highest notification rate was recorded in 2018 with 6.7/100,000 population (CI: 6.2-7.3). The hospitalisation rate for notified cases remained high across all study years (89.9%), while the case fatality rate slightly decreased (from 7.7% to 3.6%). COVID-19 containment measures, such as travel restrictions and/or related behavioural changes, are associated with a temporary decline in cases of 35%. Overall, the quality of the notification data was good. Clinical data were more susceptible to interferences than data from laboratory reporting, which could be observed most clearly in the decline of clinical reports by 4.3 percentage points in 2020. As the case classification for Legionnaires' disease includes pneumonia symptoms, this decline could lead to an underestimation of Legionnaires' disease cases, yet the continuous reporting though the diagnostic laboratories suggested a robust surveillance system for legionellosis in Switzerland.

Marked increase in measles vaccination coverage among young adults in Switzerland: a campaign or cohort effect?

OBJECTIVES: To evaluate the impact of the Swiss measles elimination strategy-including a mass media campaign-on vaccination coverage and awareness among young adults aged 20-29 years. METHODS: Comparison of the results of two cross-sectional population surveys in 2012 and 2015. RESULTS: Documented vaccination coverage increased from 77 to 88% for two doses of measles vaccine. Major determinants of complete vaccination were survey year, birth cohort, sex and the absence of prior measles disease. If birth cohort and prior history of measles disease are included as factors in a multivariate model, the difference between 2012 and 2015 vanishes. CONCLUSIONS: The marked increase in complete measles vaccination coverage is due to a cohort effect, owing to the introduction of the second dose of vaccine in 1996. Most of the vaccinations were administered before the national strategy was implemented and vaccination catch-ups did not increase during the campaign in young adults. Nevertheless, this study provides evidence of an improvement in the awareness of measles and measles vaccination in young adults, which may result in an impact on measles vaccination coverage in the near future.

Human papillomavirus vaccine uptake in adolescence and adherence to cervical cancer screening in Switzerland: a national cross-sectional survey.

OBJECTIVES: The objectives were to measure uptake of and factors associated with human papillomavirus (HPV) vaccination initiation and to determine whether HPV vaccination reduced the uptake of cervical cancer screening. METHODS: We conducted a cross-sectional survey in a random sample of Swiss women aged 18-49 years in 2014 (N = 3588). RESULTS: Vaccination initiation was 69.3% and full coverage (three doses) 54.1% for 18-20-year olds, respectively, 42.4% and 33.9% for 21-24-year olds. Women with ≥ 10 lifetime sexual partners were less likely to have received any HPV vaccination than women with ≤ 2 partners (18-20 years OR 0.2, 21-24 years OR 0.5). Amongst 1000 unvaccinated women (18-24 years), reasons for not having initiated vaccination were lack of information (22.5%) and fear of vaccine side effects (18.1%). Vaccination status was not associated with adherence to cervical cancer screening recommendations (OR 1.3). 95.4% of all vaccinated participants knew about the continued need for screening. CONCLUSIONS: Our data suggest that HPV vaccination is not associated with reduced uptake of cervical cancer screening. This study provides information that can be used to improve HPV vaccination uptake in Switzerland.

Prospective pertussis surveillance in Switzerland, 1991-2006.

Pertussis has been monitored in Switzerland since 1991 by the nationwide Swiss Sentinel Surveillance Network (SSSN), consisting of approximately 200 general practitioners, internists and pediatricians representing about 3% of the total primary care physicians of these specialities. SSSN members report patients with cough ≥ 14 days plus either an epidemiological link or characteristic symptoms (paroxysms, whoop, post-tussive vomiting) on a weekly basis to the Federal Office of Public Health. Confirmatory PCR from nasopharyngeal specimens is offered for free. A total of 4992 cases have been reported until 2006. Yearly incidence has dropped from 70 cases per 100,000 inhabitants in 1992 to 40 in 2006, with a single epidemic in 1994-1995 with 280-370 cases/100,000. On average 80% of reported cases were tested by PCR, 24% of these were confirmed as Bordetella pertussis infections. For 2.6% of patients complications were reported, most commonly pneumonia, asthma bronchiale, otitis media, bronchitis and rib fractures. On average, 1.5% of patients were hospitalized. Disease in vaccinated patients was mitigated with less frequent complications (unvaccinated: 5.1%; 3 doses: 3.0%; ≥ 4 doses: 1.7%), hospitalizations (unvaccinated: 3.6%; ≥ 1 dose: 1.1%) and various clinical symptoms compared to unvaccinated patients. Comparing the periods 1991-1996, 1997-2001 and 2002-2006, a shift of pertussis from age group 1-9 years to 10-19 and ≥ 40 years was observed among patients cared for by general practitioners and internists. The benefits of further booster doses in adolescents and/or adults need to be considered.

Species diversity and acquisition of gastrointestinal parasites in calves aged 0-13 months in periurban livestock production in Mali.

Post-mortem inspections on 51 calves were conducted to investigate acquisition and spectrum of gastrointestinal parasites in young calves in periurban livestock production in Mali. Generalized linear models with herd as a repeated effect were used to test the influence of management, age and season of birth on parasite numbers and diversity. Parasite number and burden increased with age. In the age class 4-13 months animals carried already up to eight different gastrointestinal parasite species. Parasite spectrum found included 11 nematodes, 3 cestodes and 1 protozoan parasite. The most frequent parasite species found were Haemonchus placei (age class 0-1 month: 7%, 1-4 months: 38%, 4-13 months: 69%), Cooperia pectinata (0%, 33% and 44%) and C. punctata (0%, 33% and 38%). Calves born during the rainy season had higher parasite burden and species diversity than calves born during the dry season. Calves kept under modernised management excreted more Strongyloides papillosus eggs than calves kept under traditional management. Calves acquired most of the parasites occurring in adult bovines in West Africa within their first year of life.