Cohort profile: Actionable Register of Geneva Outpatients and inpatients with SARS-CoV-2 (ARGOS).

PURPOSE: The Actionable Register of Geneva Outpatients and inpatients with SARS-CoV-2 (ARGOS) is an ongoing prospective cohort created by the Geneva Directorate of Health. It consists of an operational database compiling all SARS-CoV-2 test results recorded in the Geneva area since late February 2020. This article aims at presenting this comprehensive cohort, in light of some of the varying public health measures in Geneva, Switzerland, since March 2020. PARTICIPANTS: As of 1 June 2021, the database included 360 525 patients, among which 65 475 had at least one positive test result for SARS-CoV-2. Among all positive patients, 37.6% were contacted only once, 10.6% had one follow-up call, 8.5% had two and 27.7% had three or more follow-up calls. Participation rate among positive patients is 94%. Data collection is ongoing. FINDINGS TO DATE: ARGOS data illustrates the magnitude of COVID-19 pandemic in Geneva, Switzerland, and details a variety of population factors and outcomes. The content of the cohort includes demographic data, comorbidities and risk factors for poor clinical outcome, self-reported COVID-19 symptoms, environmental and socioeconomic factors, prospective and retrospective contact tracing data, travel quarantine data and deaths. The registry has already been used in several publications focusing on symptoms and long COVID-19, infection fatality rate and re-infection. FUTURE PLANS: The data of this large real-world registry provides a valuable resource for various types of research, such as clinical research, epidemiological research or policy assessment as it illustrates the impact of public health policies and overall disease burden of COVID-19.

A community outbreak of Legionnaires' disease in Geneva, Switzerland, June to September 2017.

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.

[Imported malaria in Geneva between 2005 and 2016]. / Paludisme d'importation à Genève entre 2005 et 2016.

As part of the epidemiological surveillance of malaria, cases reported in Geneva during the period 2005­2016 were analyzed and compared to a similar retrospective study covering the period 1998­2004. A total of 600 cases were reported, averaging 50 cases per year. African patients traveling to visit friends and relatives remain at particular risk. The disease was acquired in Africa in 89,6% of cases and Plasmodium falciparum was the predominant species (84,2 %). 41% of patients did not benefit from a pre-travel consultation. The recent rise in imported malaria observed in Geneva since 2014 is a reminder of the need to apply effective prevention measures (chemoprophylaxis) in highly endemic countries, and to train all physicians to screen for malaria all febrile travelers returning from the tropics.

Dans le cadre de la surveillance épidémiologique du paludisme, les cas rapportés à Genève pendant la période 2005­2016 ont été analysés et comparés à une étude rétrospective similaire couvrant la période 1998­2004. Au total, 600 cas ont été rapportés, soit une moyenne de 50 cas par année. Les patients d'origine africaine voyageant pour visiter leur famille ou leurs amis restent la population la plus à risque. La maladie a été acquise dans 89,6 % des cas en Afrique et Plasmodium falciparum est l'espèce prédominante (84,2 %). 41 % des patients n'ont pas bénéficié d'une consultation de médecine des voyages avant leur départ. Une hausse du paludisme d'importation est observée à Genève depuis 2014, rappelant la nécessité d'appliquer des mesures de prévention efficace (chimioprophylaxie) dans les pays fortement endémiques, et d'inciter tout médecin à dépister le paludisme en cas de fièvre de retour de voyage tropical.

Comparative coverage of supplementary and universally recommended immunizations in children at 24 months of age.

BACKGROUND: The introduction of pneumococcal and meningococcal group C conjugate vaccinations as supplementary (a new category in Swiss immunization recommendations) to universally recommended vaccinations in 2006 prompted this study to investigate their acceptance. METHODS: The study was performed in 24-month-old healthy children born in the Geneva or Basel areas in Switzerland between January and April 2007. After informed consent had been obtained from caregivers (for this particular study in Basel and in general for providing immunization data in Geneva on an ongoing basis), all universally recommended and supplementary vaccinations administered by ≤24 months of age were analyzed for completeness and timeliness according to set definitions. Sample size calculations and standard statistical tests were applied for comparative data analyses. RESULTS: Of 592 children at the age of 12 months, 94% and 73% had received complete diphtheria-tetanus-pertussis component combination and pneumococcal conjugate vaccinations, respectively. At the age of 24 months, coverage rates for complete booster doses were 77% and 70%, respectively. Rates for MMR doses 1 and 2 at 24 months were 92% and 72%, respectively, and the rate for meningococcal conjugate vaccine (single dose) was 62%. On an average, coverage rates were similar in the 2 study regions except those for pneumococcal conjugate and second dose of MMR, which were approximately 10% higher in Geneva. CONCLUSIONS: Compliance with supplementary vaccinations was lower than that with universally recommended vaccinations. This can be explained by the recent introduction of supplementary vaccinations or by the public perception that they are less important than universal vaccinations.