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D Desgrandchamps

Publications and source records attributed to D Desgrandchamps.

At least 19 recordsLinked to original sources
PubMed2001

How to improve communication on vaccine issues at the national level? INFOVAC-PED: an example from Switzerland.

For physicians in private practice, rapid access to relevant and up-to-date objective information is required to better meet their clients' concerns on vaccine-related issues. To meet this need, INFOVAC-PED, an academic network of on call pediatric infectious diseases experts who can be reached free of charge at a central e-mail address, now answers Swiss physicians' questions within 24-48h. INFOVAC-PED also distributes monthly bulletins including news from the Federal Office of Public Health, vaccine producers, literature survey, and answers to most frequently asked questions. The rapid success of this novel initiative underlines the need to better support front line physicians.

Communication↗
PubMed2001

Seroprevalence of varicella-zoster virus immunoglobulin G antibodies in Swiss adolescents and risk factor analysis for seronegativity.

BACKGROUND: Little is known about the seroprevalence of anti-varicella-zoster virus (VZV) serum antibodies in adolescents in Switzerland as in most other European countries. METHODS: Serum specimens from 13- to 15-year-old students from eight urban and rural areas in Switzerland, obtained as part of an allergy risk assessment study project (SCARPOL), were available for analysis of IgG antibodies against VZV by enzyme-linked immunosorbent assay (ELISA) and confirmation by fluorescent antibody staining of membrane antigen in a subcohort. Serum specimens and comprehensive sociodemographic data had been collected during two study periods between 1992 and 1995. RESULTS: Data and serum specimens were available from 1709 and 1788 subjects, respectively. Seroprevalence of anti-VZV antibodies as measured by ELISA was 95.5% (95% confidence interval, 94.5 to 96.4). When serum specimens that were indeterminate by ELISA were tested by FAMA, seroprevalence was 96.5% (95% confidence interval, 95.7 to 97.4). After logistic regression analysis, the number of siblings was the only factor that significantly influenced the presence of VZV antibodies (90.1% in those with no siblings, >96% with 1 or more siblings), whereas residence (urban vs. rural), parental education, nationality and gender did not. CONCLUSIONS: Seroprevalence of anti-VZV serum antibodies is comparatively high among Swiss adolescents. Individuals who grow up without siblings have a significant risk of evading natural VZV infection in childhood, and they therefore form a potential target group for varicella immunization in Switzerland.

Adolescent↗
PubMed2000

[Seroprevalence of IgG antibodies against measles, mumps and rubella in Swiss children during the first 16 months of life].

OBJECTIVE: To study the question of how long maternal IgG antibodies against measles, mumps and rubella persist in infants. METHODS: Sera of children aged 0-16 months who had been hospitalised in our institution between 1994 and 1999 were identified from our routine serum collection. Exclusion criteria were: preterm delivery; suspected measles, mumps or rubella illness or exanthema of unknown aetiology; transfusion of blood products in the 6 months preceding serum collection; foreign-born mother; previous MMR immunisation. IgG antibodies were measured by use of commercially available ELISA kits. RESULTS: 254 serum specimens were analysed. Age distribution of patients was as follows: 0-3 months n = 58; > 3-6 months n = 48; > 6-9 months n = 52; > 9-12 months n = 42; > 12-16 months n = 54. The following seroprevalence rates for IgG antibodies were found (measles/mumps/rubella): 0-3 months 97%/62%/91%; > 3-6 months 40%/2%/42%; > 6-9 months 4%/2%/10%; > 9-12 months 2%/0%/12%; > 12-16 months 0%/7%/7%. CONCLUSIONS: Our results demonstrate high levels of passive immunity against measles and rubella in Swiss infants during the first months of life, whereas immunity against mumps appears to be considerably less reliable. Beyond the first 3 months of life, IgG antibodies against all 3 illnesses are lacking in the majority of patients; beyond 12 months of age they are only rarely detectable. These results raise the question whether the first MMR immunisation, currently recommended at the age of 15 months in Switzerland, should be brought forward.

Aging↗
PubMed2000

[Herpes simplex virus type 1 and 2 in Switzerland].

A worldwide increase in the incidence of genital herpes infections has been described in recent years. Transmission of the herpes simplex virus type 2 (HSV-2) by asymptomatic seropositive subjects is considered to be a relevant mode of infection. The seroprevalence of HSV-2 varies considerably between different populations. In Europe, data are scarce and the epidemiological situation in Switzerland is unknown. In 1997 we performed serological examinations in 151 adult volunteers (87% between 20 and 49 years of age) of a low-risk population from the region of Basel with no history of genital herpes or any other sexually transmitted disease. The overall seroprevalence of HSV-1 was 77% and an annual seroconversion rate of 4.6% (95% CI: 3.8-5.6) was estimated for both sexes. Of the 51 subjects with no symptoms of orolabial herpes, 25 (49%) proved to be HSV-1 seropositive. In contrast, of 91 patients with symptoms of orolabial herpes, 90 (97%) had serum antibodies against HSV-1. The seroprevalence of HSV-2 was 14.6% for women (n = 89) and 8.1% for men (n = 62). The annual seroconversion rate was estimated to be 0.61% (95% CI: 0.14-1.4) for women and 0.49% (95% CI: 0.09-1.4) for men for the period after 1985 (when "safer sex" and the use of condoms were promoted). Our results indicate the significance of herpes simplex virus type 2 infections in Switzerland. More detailed studies are needed to describe the epidemiology of HSV-2 infections more reliably, especially in view of progress in the development of vaccines against HSV infections.

Adult↗
PubMed1998

[Routine preventive vaccinations].

In 1996, a second measles, mumps and rubella (MMR) vaccination at the time of school entry was included in the Swiss Childhood Immunization schedule, and universal hepatitis B immunization will likely be added in 1998. An additional innovation is the possibility to use acellular pertussis vaccines which have a lower rate of side effects. Each physician who is involved in immunizations should be familiar with the arguments that support the official immunization recommendations in order to be able to provide competent advice to patients or their parents.

Adolescent↗
PubMed1998

[Vaccination against hepatitis B].

Three comparable vaccines against hepatitis B, consisting of recombinant HBsAg, are registered in Switzerland. After intramuscular administration (deltoid, thigh), they induce seroconversion in 95% of subjects following a 0, 1, 6 or 0, 1, 2 and 12 months schedule. The determination of antibody titers is thus not required in healthy subjects in absence of an increased risk of exposure (healthcare workers). Vaccine induced protection is extended beyond the disappearance of specific antibodies, through the persistence of immunological memory, which reactivates immune defense mechanisms upon viral exposure. A booster immunization is thus not necessary after a full immunization course, even if given in the first year of life or in newborns of HBsAg positive mothers. The excellent safety profile of these vaccines (local pain 3-29%, fever 1-6%) allows their universal administration. Two combined vaccines are already available, and new vaccines may yet facilitate prevention of hepatitis B in the future by allowing a reduction in the number of doses required for protection.

Adult↗
PubMed1998

[Hepatitis B vaccination: knowledge and acceptance by Swiss physicians].

Difficulties with the acceptance of immunization recommendations by physicians have been documented. A recommendation for universal hepatitis B vaccination was published in 1998 for Switzerland. We conducted a qualitative study of pediatricians and family physicians in the fall of 1996 with eight focus groups stratified by region of the country and medical specialty. Sixty-two physicians participated. Most participants felt that universal hepatitis B immunization would be useful. Pediatricians in the French-speaking part of the country were more willing to implement such a recommendation, while family physicians in the German-speaking regions were least willing. Before supporting universal hepatitis B immunization, physicians stated that they need more information about the epidemiology of the infection, the effectiveness and safety of the vaccine, and the perceived high cost of an immunization program. Participants felt that two injections per visit was the maximum tolerable for infants and young children. Many preferred to immunize older children or adolescents against hepatitis B, both because fewer injections are currently recommended at that age and because adolescence is a developmentally appropriate age to address sexuality and drug abuse. Physicians expected the population to be reluctant to accept universal hepatitis B vaccination, partly because of a lack of understanding of the disease and partly because of a feeling that children already receive more than enough immunizations. While the general sentiment for a universal hepatitis B immunization recommendation in Switzerland seems to be positive among physicians, concerns regarding its implementation linger. It remains to be seen how hepatitis B will be perceived in the population, and how willing parents and adolescents will be to get their children and themselves vaccinated. Helping physicians to understand the importance of this measure, in addition to convincing them to immunize their patients, will be an important first step towards achieving sufficient hepatitis B immunization coverage.

Adolescent↗
PubMed1998

[Routine vaccination in childhood].

Some major modifications of the recommended Swiss vaccination schedule have been introduced in spring 1996: 1. The vaccination against pertussis using the new acellular vaccines, which cause fewer side-effects. This allows the administration of a fourth and a fifth dose at the age of 2 and 4-7 years, respectively. 2. The consideration of combination vaccines, which contain the vaccinations against diphtheria, tetanus and pertussis as well as the vaccine against invasive diseases caused by Haemophilus influenzae type b. 3. In order to increase the individual vaccination protection, a second dose of MMR vaccine is recommended, preferably at the age of 4-7 years. A general recommendation for hepatitis B vaccination during adolescence may be expected in 1998.

Adolescent↗
PubMed1998

[Vaccine complications].

Explore the source record for details and available documents.

Adverse Drug Reaction Reporting Systems↗
PubMed1995

[Tuberculosis in Switzerland].

In Switzerland, in 1992, 957 persons suffered from tuberculosis; 52.3% were Swiss, 47.7% foreigners. Most of the swiss TB patients were more than 65 years old, whereas the foreigners generally were young patients originating from countries with high TB-infection rates. Asylum seekers had much higher TB-case rates (131 cases per 100,000) than other foreigners (27 cases per 100,000) or Swiss (9 cases per 100,000). Special refuge reception centers have been set up in Switzerland, in charge of tuberculosis screening procedures in this high-risk group on arrival to this country. Although HIV and AIDS patients bear a much higher risk of developing tuberculosis once infected, the HIV epidemic did not lead to an increase of tuberculosis in Switzerland so far, since young Swiss are rarely infected with tuberculosis. HIV-infected, drug addicts, homeless persons and alcoholics run a higher risk of contracting tuberculosis only when congregating with a person suffering from active tuberculosis not yet diagnosed or improperly treated. In order to maintain low levels of tuberculosis in Switzerland DOT (directly observed therapy) must be implemented in all patients with uncertain compliance, especially as cultural and social backgrounds become increasingly complex.

Adolescent↗
PubMed1995

[Computer-supported patient history: a workplace analysis].

Since 1991, an extensive computer network has been developed and implemented at the Cantonal Hospital of Lucerne. The medical applications include computer aided management of patient charts, medical correspondence, and compilation of diagnosis statistics according to the ICD-9 code. In 1992, the system was introduced as a pilot project in the departments of pediatrics and pediatric surgery of the Lucerne Children's Hospital. This new system has been prospectively evaluated using a workplace analysis. The time taken to complete patient charts and surgical reports was recorded for 14 days before and after the introduction of the computerized system. This analysis was performed for both physicians and secretarial staff. The time delay between the discharge of the patient and the mailing of the discharge letter to the family doctor was also recorded. By conventional means, the average time for the physician to generate a patient chart (26 minutes, n = 119) was slightly lower than the time needed with the computer system (28 minutes, n = 177). However, for a discharge letter, the time needed by the physician was reduced by one third with the computer system and by more than one half for the secretarial staff (32 and 66 minutes conventionally; 22 and 24 minutes respectively with the computer system; p < 0.0001). The time required for the generation of surgical reports was reduced from 17 to 13 minutes per patient and the processing time by secretaries from 37 to 14 minutes. The time delay between the discharge of the patient and the mailing of the discharge letter was reduced by 50% from 7.6 to 3.9 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluation Studies as Topic↗
PubMed1994

[Effect of conjugated PRP vaccines on the incidence of invasive diseases caused by Haemophilus influenzae Type B in childhood].

Prior to the introduction of conjugate vaccines, Haemophilus influenzae type b (Hib) was the leading cause of severe invasive infections in young children, in Switzerland as in other countries. From 1976 to 1990, 150 children were treated for Hib meningitis at the Children's Hospital of Lucerne, corresponding to an annual incidence of 9.2 cases per 100,000 children aged under 15 years. In the same time period, the case fatality rate for meningitis was 4%. 87.3% of the meningitis cases occurred among children aged under 5 years. For this age group an annual incidence of 26.4 cases per 100,000 children was calculated. From 1979 to 1990, 141 children were hospitalized for epiglottitis, corresponding to an annual incidence of 10.9 cases per 100,000 children aged under 15. The introduction of conjugated vaccines resulted in a significant reduction in the frequency of invasive Hib disease. From 1991 to 1992, 9 cases each of meningitis and epiglottitis were observed. In 1993, only one case of meningitis and 2 cases of epiglottitis were seen. For children under 15 years these 21 cases represent annual incidences of 3.2 cases of meningitis and 3.6 cases of epiglottitis per 100,000 children. 2 of 10 meningitis cases occurred in twice vaccinated children under 2 years of age with no signs of immunodeficiency, and another case was seen in a 5-month-old infant vaccinated with only one dose. Assuming a vaccination coverage of 70% among children under 5 during the years 1991 and 1992, the calculated efficacy is 80 to 85% for the vaccine PRP-D in this predominantly affected age group during the period when only this vaccine was available.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

[Antibiotics 1992: mechanism of resistance and its clinical relevance].

In recent years, many new substances have been synthesized in the domain of beta-lactam antibiotics (penicillins, cephalosporins, monobactams, carbapenems), macrolide antibiotics, and quinolones. Their purpose was to counter the development of resistance to older antibiotics, or to achieve pharmacokinetic ameliorations. However, resistance of clinical relevance has also been observed with these new antibiotics: the effect of all third generation cephalosporins is neutralized by the overproduction of chromosomally encoded cephalosporinases (induction or stable derepression), or by the occurrence of extended-spectrum beta-lactamases. They should be used only with caution against bacteria with possible inducibility. In macrolide antibiotics, poor bioavailability after oral administration can lead to therapeutic failure. The improved pharmacokinetic properties of the new macrolide antibiotics can correct this disadvantage. The generally highly active quinolone antibiotics show diminished activity against grampositive bacteria and Pseudomonas aeruginosa. Careful surveillance of resistance and critical use of the quinolones are essential for the prevention and control of resistance.

4-Quinolones↗
PubMed1990

[Salmonella gastroenteritis: causes, sequelae, therapeutic perspectives].

Enteric salmonella are the most frequently isolated pathogens of bacterial diarrhea in Switzerland. Since 1987, increasing numbers have been reported to the Federal Health Office. The causes of this rise in salmonellosis prevalence, which has been observed in a number of countries, are the high rates of contamination in different foods, mainly in poultry and eggs. It has been shown that the usual kinds of egg preparation are not suitable for the elimination of salmonella, which may also be found inside the egg-shells. The solution to this problem involves measures of veterinary epidemiology and food hygiene. The epidemiologic significance of the asymptomatic carrier is considered to be rather slight. However, prolonged excretion of salmonella repeatedly results in social and economic problems, because the carrier food handlers are excluded from work when and for as long as they are excreting salmonella. Current possibilities in antibiotic treatment for these and other salmonellosis patients are discussed.

Carrier State↗
PubMed1989

[Infectious gastroenteritis in the immunocompetent child. Significance of Cryptosporidium spp. and Aeromonas ssp].

Over a one-year period we have examined 390 stool specimens from 210 children hospitalized for infectious gastroenteritis or in whom infectious gastroenteritis occurred during hospitalization. The most prevalent pathogens were rotaviruses (22.4%), followed by enteric salmonella (8.1%), Campylobacter jejuni/coli (2.4%), Cryptosporidium spp. (2.4%) and Aeromonas spp. (1.9%). Both Cryptosporidium spp. and Aeromonas spp. are important pathogens of infectious gastroenteritis in immunocompetent children in Switzerland. For both pathogens the most frequently observed clinical sign was self-limited, watery diarrhea with vomiting and fever often requiring parenteral rehydration. The laboratory findings in our patients revealed a left shift with a rise in total leukocyte count in Aeromonas infections only. Electrolytic disorders were frequently found in infections associated with either pathogen, while marked compensated metabolic acidosis was found with cryptosporidiosis only. This points toward a secretory component as part of the still unclear pathogenetic mechanism. Possible modes of infection in cryptosporidiosis are transmission by infected livestock (calves) and person-to-person communication, and in Aeromonas infections transmission by contaminated food or water. We recommend screening for both pathogens in infectious gastroenteritis of immunocompetent children.

Adolescent↗