Sleep disturbances in the vicinity of the short-wave broadcast transmitter schwarzenburg

Summary: Objectives: The studies reported here investigated the association between health complaints and the vicinity to the short wave transmitter Schwarzenburg, and looked for evidence for a relationship between magnetic field exposure and sleep disturbances. Subjects and Methods: Between 1992 and 1998 two cross-sectional and two panel studies were performed in the area of Schwarzenburg. In each cross-sectional survey about 400 adults living in differently exposed areas were asked about somatic and psycho-vegetative symptoms including sleep disturbances as well as possible confounding factors. Exposure was estimated based on 2621 measurements of magnetic field strength made in 56 locations. In the panel studies, sleep quality and melatonin excretion was studied when the transmission was interrupted or definitively shut down, respectively. Results: In both surveys, prevalence of difficulties of falling asleep and in particular, maintaining sleep, increased with increasing radio frequency electromagnetic field exposure (RF-EMF). Sleep quality improved after interruption of exposure. A chronic change of melatonin excretion following RF-EMF exposure could not be shown, but a parallel study of salivary samples in cows showed a temporary increase after a short latency period following interruption of exposure. Conclusions: The series of studies gives strong evidence of a causal relationship between operation of a short-wave radio transmitter and sleep disturbances in the surrounding population, but there is insufficient evidence to distinguish clearly between a biological and a psychological effec

The Denominator problem: estimating the size of local populations of men-who-have-sex-with-men and rates of HIV and other STIs in Switzerland.

OBJECTIVES: There is no estimate of the current number of men who have sex with men (MSM) in Switzerland, or of their geographical distribution. We aimed to (1) estimate MSM concentration factors and population sizes for 83 Swiss postal code areas (PCA), including the nine largest Swiss cities, and (2) calculate MSM-specific local HIV prevalence and yearly rates of diagnosed HIV, hepatitis C virus (HCV), syphilis and gonorrhoea. METHODS: We triangulated data from general population estimates, MSM online surveys, published data on HIV prevalence and Swiss notification data for HIV and STDs. We compared two different formulae for the estimation of local MSM populations and calculated Bayesian 95%-credible-intervals (CrI) for each PCA. RESULTS: Across Switzerland, we estimate the MSM population aged 15-64 at roughly 80 000 men (95% CrI 64 000-96 000). (1) MSM in Switzerland were most concentrated in the five largest cities of Zurich, Geneva, Lausanne, Bern and Basel. (2) We estimate that in 2012, 6300 MSM, or 8.0%, were living with HIV, both diagnosed and undiagnosed and 1700 MSM, or 2.2%, had non-suppressed HIV infection. Between 2010 and 2013, average yearly rates of diagnosed HIV, HCV, syphilis and gonorrhoea were 0.3%, 0.02%, 0.4 % and 0.4 %, respectively. CONCLUSIONS: Combining general population data, MSM online surveys and notification data allows the calculation of realistic estimates of local MSM populations and thus proportions of MSM with diagnosed HIV and other STIs, with implications for prevention planning, commissioning of health services and counselling MSM on HIV/STI risk. Our methodology for Switzerland is transferable to other countries with similar data sources

Surveillance of tuberculosis in Switzerland and the Principality of Liechtenstein, 2009 to 2019.

OBJECTIVE: To describe the epidemiology of tuberculosis in Switzerland from 2009 to 2019.METHODS: Analysis of Swiss notification data. RESULTS: Tuberculosis cases declined from 553 (7.1/100,000) in 2009 to 437 (5.1/100,000) in 2019. The male-to-female ratio was 3:2. Although the number of tuberculosis cases of Swiss origin has steadily declined, the number of tuberculosis cases of foreign origin was rather stable but peaked in 2016. Overall, three quarters of tuberculosis cases were among people of foreign origin; of these, around half were from East Africa, Southern East Europe, and Southern Asia. Forty-nine percent had extrapulmonary manifestations. Every year, with little variation, 7-16 cases with rifampicin resistance were reported (2.9% overall). Independent risk factors for rifampicin resistance were prior anti-tuberculosis treatment, with an adjusted odds ratio (aOR) of 5.5 and a 95% confidence interval (CI) from 3.7 to 8.1, and foreign origin (aOR 3.6, 95% CI 2.0-7.0), particularly Georgia (aOR 10.0, 95% CI 4.0-23.1), Ethiopia (aOR 9.4, 95% CI 3.5-24.2), Tibet (aOR 6.9; 95% CI 2.9-16.6) and Somalia (aOR 8.1, 95% CI 4.0-17.2), together with Eritrea (aOR 2.6, 95% CI 1.1-5.9), accounting for more than half of all 134 cases . From 2016 to 2018, applying the World Health Organization definitions, overall treatment success in culture-confirmed pulmonary cases was 78%, and thus below the target of 85%. Since most cases with unsuccessful outcome are due to missing information, the proportion of unsuccessful outcome are overestimated. CONCLUSION: Autochthonous tuberculosis has become rare in Switzerland and the new diagnoses are increasingly attributable to immigration. Rifampicin resistance remains rare. Switzerland currently fails to achieve international targets for treatment success

Epidemiology of childhood tuberculosis in Switzerland between 1996 and 2011

Approximately 9 million cases of tuberculosis (TB) are reported annually and half a million occur in children <15years of age. Globally, TB notifications in children have been neglected for decades although childhood TB may represent a sentinel for ongoing transmission. Data included in this study were collected from the TB database of the Swiss Federal Office of Public Health, which includes culture-confirmed TB and/or cases treated with ≥3 anti-mycobacterial drugs. Data from all children <15years of age reported between 1996 and 2011 were analyzed. A total of 320 cases of TB (166 cultures confirmed, 5 confirmed by nucleic acid amplification, 149 other than definite cases) were reported with an overall incidence rate of 1.6 per 100,000 children (range 1.2-2.2). A total of 154 (48%) children were younger than 5years of age and 141 (44%) were born in Switzerland. Children below 5years of age were more likely to be Swiss-born compared to children aged 10 to 14years (74% versus 26%). When analyzing the country of origin, only 55 children (17%) were of Swiss origin. Of all children with foreign origin, 117 (47%) were from a country within the WHO European Region. In 288 (90%) of all notified cases, the site of disease was the lung. Mycobacterial culture was positive in 166 cases (51.9%) with 1.8% multi-drug-resistance. The overall incidence of childhood TB disease reported in Switzerland remained stable over a 16-year period with a remarkable high rate of very young patients of foreign origin. Only half of the reported cases were culture confirmed, highlighting the need for better diagnostic tests in childhood TB

Retrospective, matched case-control analysis of tickborne encephalitis vaccine effectiveness by booster interval, Switzerland 2006-2020

Objective: To estimate effectiveness of tickborne encephalitis (TBE) vaccination by time interval (<5, 5-10 and 10+years) postvaccination. Design: A retrospective, matched case-control study PARTICIPANTS: Cases-all adult (age 18-79) TBE cases in Switzerland reported via the national mandatory disease reporting surveillance system from 2006 to 2020 (final n=1868). Controls-community controls from a database of randomly selected adults (age 18-79) participating in a 2018 cross-sectional study of TBE vaccination in Switzerland (final n=4625). Primary outcome measures: For cases and controls, the number of TBE vaccine doses received and the time since last vaccination were determined. Individuals were classified as being 'unvaccinated' (0 doses), 'incomplete' (1-2 doses) or 'complete' (3+ doses). Individuals with 'complete' vaccination were further classified by time since the last dose was received (<5 years, 5-10 years or 10+ years). A conditional logistic regression model was used to calculate vaccine effectiveness (VE: 100 × [1-OR]) for each vaccination status category. Results: VE for incomplete vaccination was 76.8% (95% CI 69.0% to 82.6%). For complete vaccination, overall VE was 95.0% (95% CI 93.5% to 96.1%). When the most recent dose was received <5 years prior VE was 91.6% (95% CI 88.4% to 94.0%), 95.2% (95% CI 92.4% to 97.0%) when the most recent dose was received 5-10 years prior, and 98.5% (95% CI 96.8% to 99.2%) when the most recent dose was received 10+ years prior. Conclusions: That VE does not decrease among completely vaccinated individuals over 10+ years since last vaccination supports the longevity of the protective response following complete TBE vaccination. Our findings support the effectiveness of 10-year TBE booster intervals currently used in Switzerland. Keywords: Breakthrough Infection; Duration; Prevention; Protection; TBE

Phylogeography of Francisella tularensis subspecies holarctica and epidemiology of tularemia in Switzerland.

Tularemia, an endemic disease that mainly affects wild animals and humans, is caused by Francisella tularensis subsp. holarctica (Fth) in Switzerland. The Swiss Fth population consist of multiple different subclades which are distributed throughout the country. The aim of this study is to characterize the genetic diversity of Fth in Switzerland and to describe the phylogeographic relationship of isolates by single nucleotide polymorphism (SNP) analysis. This analysis is combined with human surveillance data from reported cases over the last 10 years and in vitro and in silico antibiotic resistance tests to provide insight into the epidemiology of tularemia in Switzerland. We sequenced the whole genomes of 52 Fth strains of human or tick origin collected in Switzerland between 2009 and 2022 and analyzed together with all publicly available sequencing data of Swiss and European Fth. Next, we performed a preliminary classification with the established canonical single nucleotide polymorphism nomenclature. Furthermore, we tested 20 isolates from all main Swiss clades for antimicrobial susceptibility against a panel of antimicrobial agents. All 52 sequenced isolates from Switzerland belong to major clade B.6, specifically subclades B.45 and B.46, previously described in Western Europe. We were able to accurately reconstruct the population structure according to the global phylogenetic framework. No resistance to clinically recommended antibiotics could be identified in vitro or in silico in the western B.6 strains