Concern over swine flu in Swiss hospitals

Pregnant women, like the one infected at a Lausanne hospital, are more vulnerable to swine flu Keystone

New cases of swine flu at hospitals in Lausanne and Basel have raised concerns about how well Swiss patients are protected from the virus.

A doctor at Lausanne University Hospital (CHUV) recently infected 12 people with the A/H1N1 virus after returning from a holiday abroad. And in Basel, a young mother who gave birth last month is in a critical condition after catching the flu while in hospital.

The physician, who worked in the CHUV maternity ward, contaminated ten of his colleagues and two pregnant patients when he went back to work on July 31 despite feeling unwell.

The hospital sent the doctor home and contacted everyone he had come into close contact with that day. Those infected were treated with antiviral drugs and his co-workers were also sent home.

“It’s annoying, but it shouldn’t have happened,” CHUV spokesman Darcy Christen told swissinfo.ch.

Meanwhile, a young mother remains hospitalised at Basel University Hospital. She is in a critical condition after catching swine flu from a visitor at Bruderholz Cantonal Hospital in canton Basel-Country, where she gave birth.

The woman has severe pneumonia; she has been in an artificial coma for the past two weeks and is on a respirator. Her child was not infected with the virus.

Pregnant women and people with health problems are vulnerable to more severe effects from the new flu strain.

Question marks

The recent incidents have raised questions about the preventive measures in place at Swiss hospitals.

According to Margrit Kessler, president of the Swiss Patients’ Association, patients are “not properly protected” from swine flu.

“These are serious cases,” she told swissinfo.ch. “The staff is under great pressure to come to work, even when they have a fever, and suddenly it has unbelievable consequences.”

But Jacques de Haller, president of the Swiss Medical Association, told the Tages-Anzeiger newspaper that the Lausanne doctor had not been negligent and the situation should not be overdramatised.

“This is not a disaster,” he said, while admitting that more care should have been taken as the doctor worked in the maternity ward.

He added: “If every doctor who coughs doesn’t work, we all have a problem.”

National coordination

Kessler also criticised the fact that Switzerland has 26 cantonal health systems with slightly different approaches to handling swine flu in hospitals. She felt this should be better coordinated at the national level.

The Federal Health Office says it plans to publish new national recommendations next week aimed at protecting hospital staff and patients. But it won’t deal with the issue of visitors or visiting rights, which is the responsibility of the cantonal hospitals and doctors.

Christen said containment measures had been stepped up at the CHUV since the recent incident.

“We have reminded staff of the strict measures in place: to remain at home and not come to work if they feel ill; to wear a mask for seven days if they have been in contact with someone with the virus; to disinfect hands regularly and cough into tissues,” he said.

There were no plans to reduce hospital visits but specific information on the risks was provided to visitors, the spokesman added.

Different approaches

No additional measures are planned at the Bruderholz Hospital, however.

The hospital continues to focus on informing and educating staff and visitors. Signs have been installed to dissuade people from visiting and all visitors to pregnant patients or the chronically ill are asked to wear masks, but this is not enforceable.

But just 30 kilometres away at the Liestal Cantonal Hospital, also in canton Basel-Country, things are different. All staff and visitors to women who are pregnant or have given birth are obliged to wear a mask and disinfect their hands. The hospital also recommends that they do not receive visits.

In Bern, Basel and Zurich, the main hospitals rely on visitors’ and patients’ personal responsibility. The staff is also kept informed about additional hygiene procedures.

Andreas Bitterlin, a spokesman for Basel University Hospital, said they discussed restricting visiting rights or forcing people to wear a mask.

“But we feared the mask would give a false sense of security and people would neglect other hygiene measures,” he told Der Bund.

“I do not know why this is conceived so differently,” admitted de Haller. “But it is clear; if swine flu is really dangerous they would all quickly agree.”

Simon Bradley, swissinfo.ch

Protection

Avoid close contact with people who appear unwell and who have fever and cough.

Wash your hands with soap and water frequently and thoroughly.

Practise good health habits including adequate sleep, eating nutritious food and keeping physically active.

Swine flu

The Federal Health Office says it will test a vaccine in September. It could be introduced in October.

It will then have to be licensed by the national licensing authority, Swissmed. Switzerland has ordered 13 million doses.

The Federal Vaccine Commission said on Thursday it was not in favour of vaccinating the entire population against swine flu.

Those particularly at risk, up to two million people, should be vaccinated, it said. This remains a voluntary decision, however.

On August 5, pharmaceuticals firm Novartis announced it had begun the first human trials of its A/H1N1 vaccine, testing safety and whether one or two shots are necessary.

Novartis spokesman Eric Althoff said the company expected to start shipping the vaccine in the last quarter of 2009.

As of August 13, there were 726 confirmed and 19 possible cases of swine flu in Switzerland, according to the Federal Health Office. Obwalden is the only canton that has not been affected by the virus.

To date there have been 177,457 cases of swine flu worldwide and 1,462 deaths.

The Swiss Federal Health Office has projected that up to two million Swiss could catch swine flu. Some 400,000 people could consult their doctor over suspected swine flu. Some 1,000 people could be hospitalized and of these 150 people would need intensive care treatment, it said.

Adults and children who are severely ill with H1N1 flu or at high risk of complications should be treated with antivirals like Tamiflu, the World Health Organization (WHO) said on Wednesday. But otherwise healthy people with mild flu-like symptoms need not be given the drugs to combat swine flu, it said.

© wikimedia Commons/Mikael Häggström