Burden of chickenpox complications in Poland, 2006 to 2021: A comprehensive registry-based study.

BackgroundChickenpox, a vaccine-preventable disease caused by the varicella zoster virus, generally presents with mild symptoms but can cause complications necessitating hospitalisation. In Poland, since 2009, vaccination has been obligatory for children up to 12 years of age who are particularly vulnerable to infection and for children in their vicinity.AimTo examine the burden of chickenpox complications and the trends of hospitalisation arising from these complications over time in the Polish population.MethodsData spanning 2006-21 were sourced from the Polish Infectious Diseases Surveillance System, the Nationwide General Hospital Morbidity Study and the Statistics Poland death registry. Standardised and age-specific incidence rates, hospital discharge rates and number of deaths because of chickenpox were calculated. Moreover, the joinpoint regression model was used to analyse trends of annual hospital discharge rates.ResultsOver the analysed timeframe, 25,804 hospitalisations and 52 deaths attributable to chickenpox complications were documented, and 1.0% of chickenpox cases required hospitalisation because of chickenpox. Age-standardised hospitalisation rates varied between 2.3 and 9.6 per 100,000 population. The analysis revealed no statistically significant trend in overall hospital discharge rates from chickenpox complications. However, a notable increase in hospitalisation rates was observed in children aged 0-4 and among inhabitants of rural areas, with annual percentage changes of 4.9% and 3.4% respectively.ConclusionsOur findings suggest that the implementation of a universal chickenpox immunisation programme, supported by health education, should be considered to reduce the number of hospitalisations and nearly eliminate deaths because of chickenpox.

Mumps in Poland in 2021. / Swinka w Polsce w 2021 roku.

INTRODUCTION: Mumps is a contagious viral disease occurring mainly in children, the source of infection being the sick/infected person. Since 2003, vaccination against mumps has been mandatory in Poland, performed according to a two-dose schedule. As part of the Public Health Immunization Program (PSO), the MMR combination vaccine (against measles, mumps and rubella) is used for the entire population of children. OBJECTIVES: The aim of this study was to evaluate epidemiological indicators of mumps in Poland in 2021 compared to previous years, taking into account the impact of the COVID-19 pandemic. MATERIAL AND METHODS: The analysis of the epidemiological situation of mumps in Poland in 2021 was based on the interpretation of data from the bulletin , "Infectious diseases and poisonings in Poland in 2021" and , "Immunization in Poland in 2021". RESULTS: 484 cases of mumps were registered in Poland in 2021. The total incidence was 1.3 per 100,000 residents, which was lower than in 2020. The highest incidence of 1.8 per 100,000 residents was registered in Pomorskie Province, and the lowest incidence of 0.7 in Lower Silesia Province. The highest incidence (6.4/100 thousand) was recorded in children aged 0-4 and 5-9. The incidence rate for men (1.4/100,000) was higher than for women (1.1). In 2021, there were 9 patients hospitalized due to mumps, this was more than in 2020. CONCLUSIONS: The decrease in the number of cases of mumps in 2021 remained related to the ongoing pandemic - the restrictions introduced during the pandemic period led to a decrease in the number of cases not only of COVID-19, but also of other diseases spread by the droplet route, including mumps. The number of registered cases based on the reports of diagnosing physicians may be underestimating the actual number of cases due to the continued difficult access of patients to primary care physicians.

Rubella in Poland in 2021. / Rózyczka w Polsce w 2021 roku.

INTRODUCTION: Rubella is a viral infectious disease, and humans are the only reservoir of the virus. In 2020, all WHO member countries conducted epidemiological surveillance for rubella, and almost all (99%) had access to rubella testing at laboratories operating under the WHO Global Measles and Rubella Laboratory Network. OBJECTIVES: The aim of this study was to evaluate epidemiological indicators of rubella in Poland in 2021 compared to previous years, taking into account the impact of the COVID-19 pandemic. MATERIAL AND METHODS: The assessment of the epidemiological situation was based on a review of data from the bulletin , "Infectious Diseases and Poisons in Poland in 2021" (5), and the assessment of the immunization status of the population was based on data from the bulletin , "Immunization in Poland in 2021" (6). Classification of cases was made based on the definition used in the 2021 surveillance (7). Data from the epidemiological surveillance system "EpiBase" were also used. RESULTS: In 2021, 50 cases of rubella were registered, 48 fewer than in 2020 (98 cases). There was also a decrease in incidence to 0.13 per 100,000, compared to 0.26 per 100,000 in 2020. The highest incidence, regardless of gender and residential environment, was recorded in the 0-4 age group (1.23 per 100 thousand). No cases of congenital rubella syndrome were reported in 2021. CONCLUSIONS: In 2021, there was a decrease in the number of rubella cases in Poland, which could be a result of the COVID-19 pandemic and the introduced restrictions. In addition, rubella was registered 99% on the basis of clinical diagnoses, without the required laboratory confirmation, which means that other rash diseases could be registered as rubella.

Measles in Poland in 2021. / Odra w Polsce w 2021 roku.

INTRODUCTION: Measles is one of the most contagious childhood diseases, and the behavior also occurs in adults. This is a multi-year vaccination covered by an elimination program coordinated by the World Health Organization (WHO). Elimination of measles in the country is conditional on a 95% incidence of infection with two victims, monitoring the epidemiological situation, registering all suspected cases of measles, and monitoring by the WHO Reference Laboratory. In our country, the Department of Virology of the NIZP PZH-PIB in Warsaw serves as the head of the Department of Virology. OBJECTIVES: The aim of this study was to evaluate epidemiological indicators of measles in Poland in 2021 compared to previous years, taking into account the impact of the COVID-19 pandemic. MATERIAL AND METHODS: The assessment of the epidemiological situation was based on a review of data from the bulletin, "Infectious Diseases and Poisons in Poland in 2021" (5), and the assessment of the immunization status of the population was based on data from the bulletin, "Immunization in Poland in 2021" (6). Classification of cases was made based on the definition used in the 2021 surveillance (7). Data from the epidemiological surveillance system "EpiBase" were also used. RESULTS: In 2021, 13 measles cases were registered in Poland (incidence 0.03 per 100,000), 44.8% less than in 2020 and 80% less than the median in 2014-2018. In 2021, the highest incidence was recorded at 0.32 per 100,000 children aged 0-4 years. 6 patients (46.2%) were hospitalized; no deaths due to measles were reported. 32 suspected measles cases were recorded, with over a hundred cases expected. Vaccination status of children aged 3 with the first dose was 90.8%, and the second dose was given to children at the age of 9. - 84.6%. CONCLUSIONS: Epidemiological indicators of measles in 2021 in Poland compared to 2020 have decreased. A similar trend observed throughout Europe. This is related to the extinguishment of outbreaks that occurred before the pandemic, mainly in 2019.

Chickenpox in Poland in 2021. / Ospa wietrzna w Polsce w 2021 roku.

INTRODUCTION: Chickenpox is a highly contagious disease, but one that can be effectively prevented by vaccination. In Poland, vaccination against the disease is recommended, paid for, and chickenpox remains very common. In recent years, starting in 2002, the upward trend in the incidence of chickenpox has continued, except in 2020. In 2020, there was a decrease in incidence. OBJECTIVES: The aim of this study was to evaluate epidemiological indicators of chickenpox in Poland in 2021 compared to previous years, taking into account the impact of the COVID-19 pandemic. MATERIAL AND METHODS: The evaluation of the epidemiological situation of chickenpox in Poland in 2021 was carried out based on the results of the analysis of aggregate data published in the annual bulletins: "Infectious Diseases and Poisons in Poland in 2021" and "Immunization in Poland in 2021". In addition, recommendations from the 2021 Immunization Program are described. RESULTS: 57,669 cases of chickenpox were registered in Poland in 2021, 42% less than in the previous year. The incidence of chickenpox in 2021 was 151.1 per 100,000, which was lower than in 2020, as well as in 2019, when it was 470.6/100,000. The lowest incidence was registered in Lower Silesia Province - 99.2/100,000, while the highest in Silesia Province - 215.8/100,000. The highest incidence was in children aged 0-4 years (18,028). The incidence of chickenpox in males was higher than in females (159.5 vs. 143.3/100 thousand), and urban residents were higher than rural residents (152.1 vs. 149.6/100 thousand). Hospitalization due to chickenpox in 2021 included 210 people, which accounted for 0.36% of the total number of registered cases. CONCLUSIONS: In 2021, there was a decrease in the number of chickenpox cases compared to the previous year. The lower incidence may have been the result of a decrease in the transmission of the chickenpox virus, the decrease in the number of cases has to do with, among other things, the restrictions put in place in connection with the COVID-19 pandemic, which result in, among other things, reduced human contact, the wearing of masks and increased social distance.

Tick-borne encephalitis epidemiology and surveillance in Poland, and comparison with selected European countries before and during the COVID-19 pandemic, 2008 to 2020.

BackgroundTick-borne encephalitis (TBE) is the most common viral central nervous system (CNS) infection in Poland. Previous research suggests that its incidence was underestimated in the pre-pandemic period. The COVID-19 pandemic caused a considerable burden on surveillance systems, which could further impact reporting.AimWe aimed to assess the completeness of reporting of TBE in the years 2008 to 2020 and explore the potential impact of the COVID-19 pandemic on reporting to the epidemiological surveillance system, compared with hospitalisations for TBEV and other viral neuro-infections.MethodsWe compared the Polish epidemiology of TBE and other viral infections of the CNS from national surveillance reports with data on hospitalisations from 2008 to 2020 and data from selected European countries.ResultsBetween 2008 and 2020, 3,016 TBE cases were reported to surveillance compared with 3,620 hospitalisations. There was an increasing trend in hospitalisations, while surveillance data demonstrated the opposite, with the largest discrepancy observed in the first pandemic year (354 hospitalisations vs 159 cases reported to surveillance). Serological testing for TBE was used more in the known endemic region of north-eastern Poland and less in non-endemic areas. Other European countries reported higher TBE case numbers and an increase during the COVID-19 pandemic, whereas Poland observed an opposite trend.ConclusionThe sensitivity of TBE surveillance in Poland requires improvement. There are considerable regional differences. Regions that test for TBE intensively report most cases. Policymakers should be made aware of the value of quality epidemiological data for planning prophylactic measures in risk areas.

Lyme disease in Poland in 2021.

Introduction: Lyme disease, a zoonosis transmitted by vector (by ticks), may manifest itself in several different forms, such as: erythema migrans, osteoarticular or neuroborreliosis. Infection occurs when an infected common tick (Ixodes ricinus) feeds. Lyme disease is seasonal due to the cycle of tick activity throughout the year. Aim of the study: The aim of the study was to assess the epidemiological situation of Lyme disease in Poland in 2021 compared to the situation in previous years. Material and methods: To assess the epidemiological situation of Lyme disease in Poland, data sent to NIPH NIH - NRI by the Voivodeship Sanitary-Epidemiological Stations and published in the annual bulletin: "Infectious diseases and poisonings in Poland in 2021" were used. Results: In 2021, 12,500 cases of Lyme disease and 411 hospitalizations were registered, which means a decrease in the number of cases by 3.4% and a decrease in hospitalizations by 10.5%. The number of cases was similar to 2020, and Lyme disease cases did not return to the pre-COVID-19 pandemic level (approx. 20,000 cases per year). The quarterly distribution of cases remained unchanged, with cases occurring most frequently in Q3 and least frequently in Q1. Summary and conclusions: The impact of the COVID-19 pandemic on the number of reported Lyme disease cases was still noticeable, the number of recorded cases was lower than in the first pandemic year. The distribution of cases in quarters retained the seasonality characteristic of Lyme disease.

Meningitis and encephalitis in Poland in 2021.

Introduction: Meningitis meningitis and/or encephalitis regardless of etiology are subject to monitoring in Poland as part of routine epidemiological surveillance. In this paper, meningitis and/or encephalitis in 2021 caused by Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae and tick-borne encephalitis virus are discussed in detail. In Poland, immunoprophylaxis in the form of mandatory or recommended vaccinations is used to prevent diseases caused by the aforementioned etiological agents. Aim of the study: The aim of this study was to assess the epidemiological incidence of meningoencephalitis and encephalitis in Poland, in 2021 including analysis of the impact of the COVID-19 pandemic. Material and methods: To analyse the epidemiological situation of neuroinfections in Poland, we used data sent to NIPH NIH - NRI by Voivodeship Sanitary and Epidemiological Stations and published in the annual bulletin: "Infectious diseases and poisonings in Poland in 2021" and "Protective vaccination in Poland in 2021" as well as individual epidemiological interviews recorded in the EpiBase system. Results: In 2021, a total of 973 cases of meningitis and/or encephalitis were registered in Poland. This is a 16.1% increase in the number of cases compared to 2020, but still a 57% decrease in the number of cases compared to 2019 when 2,249 cases were recorded. For infections of bacterial etiology, including cases of neuroborreliosis, the number of cases increased by 38.3% (from 376 to 520, incidence from 0.96 to 1.76 per 100,000). Compared to 2020 and 2019, the incidence of meningitis and/or encephalitis of N. meningitidis decreased by 10.7% (from 0.13 to 0.15) and 47.4% (from 0.25 to 0.13), respectively, and for H. influenzae by 75% (from 0.01 to 0.03) and 70% (from 0.01 to 0.03). For S. pneumoniae, we can speak of an increase in incidence against 2020 of 57.1% (121 vs 77 cases, incidence 0.32 vs 0.20) and a decrease against 2019. (121 vs 190, incidence 0.32 vs 0.47). Infections of viral etiology accounted for 47% of all registered cases. There was a slight decrease in their number, by 2% (from 462 to 453 cases). In addition, there was an increase in cases of tick-borne encephalitis, from 158 in 2020 to 210 in 2021 (an increase of 32.9%), and a decrease in cases from 265 in 2019 (a decrease of 20.8%). Summary and conclusions: 2021 showed an overall upward trend in the number of recorded cases of bacterial meningitis and/or encephalitis, and a slight decrease in the number of viral meningitis and/or encephalitis cases compared to 2020. Still, the observed number of meningitis and/or encephalitis cases in 2021, both bacterial and viral incidences, remains below the levels observed in the pre-pandemic COVID-19 period (2019). As a result of the SARS-CoV-2 outbreak, the introduction of measures to limit the transmission of the SARS-CoV-2 virus has been observed to reduce the spread of other droplet- and airborne pathogens, thus also pathogens such as S. pneumoniae, H.influenzae and N. menningitidis.

Pertussis in Poland in 2020.

INTRODUCTION: The epidemiological situation of infectious diseases in Poland in 2020, including pertussis cases, was significantly influenced by the limitation of interpersonal contacts introduced to reduce the transmission of SARS-CoV-2 virus. There was a reduction by more than half in the number of recorded pertussis cases, from 1,629 in 2019 to 753 in 2020. Pertussis is most dangerous for young children, however, it can get sick at any age, and the disease does not leave permanent immunity. Severe pertussis can also develop in the elderly, which may increase the risk of mortality. Adults usually have pertussis is mildly symptomatic and constitute an important reservoir of B. pertussis. The most effective strategy for the prevention of pertussis is still immunization of children in accordance with the Protective Vaccination Program, and in the case of adults, vaccination with the pertussis component in acellular form, repeated regularly every 10 years. OBJECTIVES: The aim of the study was to assess the epidemiological situation of pertussis in Poland in 2020 compared to the situation in previous years, with particular emphasis on the assessment of the vaccination status of children against pertussis. MATERIAL AND METHODS: The assessment of the epidemiological situation of pertussis in Poland was performed on the basis of the results of the analysis of unit reports of pertussis registered in the NIPH NIH - NRI in the EpiBaza system and data from the annual bulletin "Infectious diseases and poisonings in Poland in 2020" and the bulletin "Vaccinations in Poland in 2020". RESULTS: In 2020, 753 cases of pertussis were registered. The incidence was 1.96 per 100,000 population and was lower compared to the incidence in 2019 (4.24). The highest incidence of pertussis occurred in the age group 0-4 years (9.9), and high in children and adolescents aged 5-9 years (5.1) and 10-14 years (6.0 per 100,000 population). About half of the cases concerned people over 15 years of age. In general, a higher incidence of women was observed than that of men, as well as a greater number of cases in cities than in rural areas. In 2020, among people suffering from pertussis, 206 people (i.e. 27%) required hospitalization. In 2020, one fatal case of the disease was reported to the epidemiological surveillance system. SUMMARY AND CONCLUSIONS: In Poland, in 2020, there was a decrease in the number of pertussis cases by more than a half compared to the previous year. Despite the decline in disease rates, pertussis remains a public health problem as immunization-induced immunity is not sustained throughout life. Increasing the number of people susceptible to pertussis may lead to compensatory epidemics in the future, therefore the highest possible level of vaccination of the population, >92-94%, should be maintained to prevent new cases of pertussis.

Lyme disease in Poland in 2020.

INTRODUCTION: Lyme borreliosis, also known as Lyme disease, is a zoonotic disease transmitted by ticks. The infection occurs through a bite by a common tick (Ixodes ricinus). Due to the annual cycle of tick activity, mainly dependent on temperature, Lyme disease is seasonal. In certain cases, post-exposure prophylaxis may be indicated, while the vaccine is in phase III clinical trials. AIM OF THE STUDY: The aim of the study is to assess the epidemiological situation of Lyme disease in Poland in 2020 compared to the situation in previous years. MATERIAL AND METHODS: The epidemiological situation of Lyme disease in Poland was assessed on the basis of the data sent to NIPH NIH - NRI by voivodeship sanitary-epidemiological stations and published in the bulletin "Infectious diseases and poisoning in Poland in 2020". RESULTS: In 2020, 12,934 Lyme borreliosis cases and 459 hospitalizations were registered which, compared to 2019, means a 37.3% decrease in morbidity and a 73% decrease in hospitalization. It may be related to the outbreak of the SARS-CoV-2 virus at the end of 2019, which reached Poland at the beginning of March 2020. It can be seen that in Q2, due to the lower activity of people due to the epidemic, the number of cases of Lyme disease was less than in Q1 (2,064 in Q2 compared to 2,253 in Q1). The decrease compared to 2019 also continued in the third and fourth quarter, by 28% and 49%, respectively. SUMMARY AND CONCLUSION: The impact of the SARS-CoV-2 outbreak on the distribution of Lyme disease incidence is noticeable, in particular on the decrease in the overall number of cases during the year, as well as on hospitalization due to Lyme disease with the previously observed stabilization of the incidence. The pandemic could have influenced this state of affairs on various levels. The main reason was, of course, the introduction of the epidemic and the related restrictions (including reduced mobility), but it cannot be ruled out that the cause was not an excessive burden on the health care system and sanitary inspection (delay in registration of reports).

Mumps in Poland in 2020.

INTRODUCTION: Mumps is an acute, generalized viral disease whose source of infection is the infected person. In 2003, vaccination against mumps became compulsory in Poland, performed according to a twodose scheme. The combined MMR vaccine (against measles, mumps and rubella) was introduced as part of the Protective Vaccination Program (PVP), which influenced the number of cases in Poland. AIM: The aim of the study was to evaluate the epidemiological indicators of mumps in Poland in 2020 compared to previous years. METHODS: The analysis of the epidemiological situation of mumps in Poland in 2020 was based on the interpretation of data from the bulletin "Infectious diseases and poisonings in Poland in 2020" and "Vaccinations in Poland in 2020". RESULTS: In 2020, 582 cases of mumps were registered in Poland. The total incidence was 1.5 per 100,000 inhabitants and was lower compared to 2019. The highest incidence was 2.0 per 100,000 inhabitants were registered in the Swietokrzyskie Voivodeship and the lowest - 0.7 in the Dolnoslaskie Voivodeship. The highest incidence (24.6/100,000) was recorded in children aged 5-9 years. The incidence of men (1.8/100,000) was higher than that of women (1.2/100,000). In 2020, 6 patients were hospitalized in Poland due to mumps, which was less than in 2019 (22 patients). The level of vaccination against mumps in children aged 3 was lower by 0.7 percentage points compared to 2019 and amounted to 91.9% across Poland. CONCLUSIONS: In 2020, there was a decrease in the number of mumps cases compared to the previous year. The lower incidence may have been the result of a reduction in mumps virus transmission due to a change in population health behavior during the COVID-19 pandemic. Due to the epidemiological threat, the functioning of nurseries, kindergartens and schools was also temporarily suspended, which resulted in a reduction in the incidence of mumps in younger age groups, which are the main group of patients.

Chickenpox in Poland in 2020.

INTRODUCTION: Chickenpox is an infectious disease caused by the varicella zoster virus. The characteristic feature of this virus is very high visibility of 90-95%. The most common connection is direct contact with the disease or via droplets. The United States was the first country to introduce a universal, population-based childhood varicella vaccination program in 1995. In its 25 years of implementation, this program has significantly reduced the burden of chickenpox. There was a more than 97% reduction in varicella incidence and a 90% reduction in varicella-related hospitalizations and deaths, the highest (99%) in those under the age of 20 (born after starting the vaccination programme). Chickenpox is very common in Poland. In recent years, starting from 2002, there has been an upward trend in the incidence of chickenpox, except for 2020. In 2020, a decrease in the number of cases was recorded. OBJECTIVES: The aim of the study was to assess the epidemiological situation of chickenpox in Poland in 2020 and to compare it with the situation in previous years. MATERIAL AND METHODS: Evaluation of the epidemiological situation of chickenpox in Poland in 2020 was based on the results of the analysis of aggregate data published in the annual bulletins: "Infectious diseases and poisonings in Poland in 2020." and "Vaccinations in Poland in 2020". In addition, recommendations from the Protective Vaccination Program for 2020 were used. RESULTS: In 2020, 71,567 cases of chickenpox were registered in Poland, i.e. 39.6% less than in the previous year. The incidence of chickenpox in 2020 was 186.6 per 100,000 and was lower than in 2019. The lowest incidence was recorded in the Swietokrzyskie Voivodship - 118.5/100,000, while the highest in the Kujawsko-Pomorskie Voivodeship - 263.5/100,000. Most cases concerned children aged 0-4 years (36,661). The incidence of chickenpox in men was higher than in women, and in rural areas higher than in urban dwellers. Hospitalization due to chickenpox in 2020 covered 1,368 people, which accounted for 0.51% of the total number of registered cases. CONCLUSIONS: In 2020, there was a decrease in the number of cases of chickenpox compared to the previous year. The lower incidence may have been the result of reduced transmission of the varicella virus due to changes in the health behavior of the population during the COVID-19 pandemic (isolation measures and the introduction of a lock down throughout Poland limiting the activity of the population).

Intrest in influenza and influenza like illnesses in Poland 2016-2021 based on Google Trend's data analysis.

INTRODUCTION: Influenza and Influenza Like Illness (ILI) are viral diseases that show seasonality in incidence. Influenza can be effectively prevented with immunization. Vaccination is recommended for risk groups, especially for the elderly, immunocompromised population, with chronic diseases and pregnant women. AIM OF THE STUDY: The purpose of the study was to assess interest in influenza and influenza vaccine in Poland by users of the Google search engine over the last five years using the Google Trends (GT) tool. MATERIAL AND METHODS: Data collected from Google Trends (GT) over a five-year period beginning on 11/9/2016 was analyzed. The time trend analysis focused at four phrases in Polish "grypa", "grypa objawy", "szczepionka przeciw grypie" and "szczepionka na grype", which can be translated into English, as; "flu", "flu symptoms", "flu vaccine", and a colloquial phrase meaning "against the flu vaccine". RESULTS: Before the outbreak of the COVID-19 pandemic, a seasonal increase in inquiries is evident, mimicking the increase in influenza and ILI cases or an increase in interest in the topic during the season in which prophylaxis is carried out using available vaccines. During the COVID-19 pandemic, the seasonal interest in the above topic was disrupted. CONCLUSIONS: During the COVID-19 pandemic, there were changes in the search terms in Polish. This included the timing and amount of queries related to influenza-themed expressions. During the COVID-19 pandemic, there was an increase in influenza and ILI queries during the period of increased incidence of COVID-19.

Meningitis and encephalitis in Poland in 2020.

INTRODUCTION: Meningitis and/or encephalitis are one of the main infectious diseases of the nervous system. These diseases are most commonly caused by bacterial and viral etiological factors. In this publication, meningitis and/or encephalitis caused by Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae and those with a viral origin - in Poland, most often caused by tick-borne encephalitis virus - are presented in detail. In addition to epidemiological surveillance, immunoprophylaxis in the form of mandatory and recommended vaccinations is used in Poland to prevent these infections. AIM OF THE STUDY: The aim of this study was to to assess the epidemiological situation of meningitis and encephalitis in Poland, in 2020. MATERIAL AND METHODS: To analyse the epidemiological situation of neuroinfections in Poland were used data sent to NIPH NIH - NRI by Voivodeship Sanitary and Epidemiological Stations and published in the annual bulletins: "Infectious diseases and poisonings in Poland in 2020" and "Protective vaccination in Poland in 2020" and individual epidemiological interviews registered in the EpiBaza system. RESULTS: In 2020, a total of 831 cases of meningitis and/or encephalitis were registered in Poland. This is a decrease in incidence of up to 62.9% compared to 2019. For infections of bacterial etiology, including cases of neuroborreliosis (incidence of 2.40 per 100,000), the number of cases decreased by 60.4% (from 931 to 369). In the viral infection group, there was a 64.9% decrease (from 1,318 to 462 cases). Of all registered cases, 56% were infections with a viral etiology. Compared to 2019, the number of cases with an S. pneumoniae etiology decreased by 61.3% and for N. meningitidis by 41.1%. It is interesting to note that, in the case of H. influenzae, we can speak of a 20% increase in cases compared to the previous year. In addition, we can see a decrease in the incidence of tick-borne encephalitis - from 265 in 2019 to 158 in 2020 (a decrease of 40.4%). SUMMARY AND CONCLUSIONS: Overall, a downward trend in incidence was shown for both bacterial and viral meningitis and/or encephalitis. The SARS-CoV-2 pandemic and the introduction of restrictions on personto-person contact and various forms of activity, resulting in a reduction in pathogen transmission, were key to the significant reduction in the number of meningitis and/or encephalitis cases in 2020, but a reduction in the availability of medical facilities or the completeness of case reports due to the burden of anti-epidemic measures on the Sanitary Inspectorate cannot be excluded either. Only in the case of cases caused by H. influenzae was a slight increase observed compared to the previous year (12 versus 10 cases). Meningoencephalitis and/or encephalitis, due to its wide etiological range, poses a major challenge to the health care system, particularly in terms of correct clinical diagnosis.

Measles in Poland in 2020.

INTRODUCTION: Measles is a disease under the elimination program coordinated by the World Health Organization (WHO). The elimination of measles in the country is possible provided that 95% of the population is vaccinated with two doses of the vaccine, the epidemiological situation is monitored, all suspected cases of measles are recorded, and laboratory diagnostics are conducted by the WHO Reference Laboratory. Polish Reference Laboratory is located at the Department of Virology NIPH NIH - NRI. OBJECTIVE: The aim of the article is to analyze the epidemiological situation of measles in Poland in 2020 with presenting the measles vaccination coverage and the progress of the measles elimination programme in Poland. MATERIAL AND METHODS: The epidemiological situation of measles in Poland was analyzed on the basis of the case-based questionnaires of cases suspected of measles sent to NIPH NIH - NRI by the Sanitary and Epidemiological Stations, data from the publications: "Infectious diseases and poisonings in Poland in 2020" and "Vaccinations in Poland in 2020". RESULTS: In 2020, 29 cases of measles were notified to the surveillance system in Poland (incidence 0.08 per 100,000 population). The highest incidence was observed in the aged 0-4 was estimated at 0.42 per 100,000 population. Out of all cases, 9 (31%) were hospitalized. No fatal cases due to the measles were reported. CONCLUSIONS: The epidemiological situation of measles in 2020 in comparison with the situation in 2019, has improvement. This was a trend in throughout Europe.

Rubella in Poland in 2020.

INTRODUCTION: Since 2005, rubella has been included in the eradication program coordinated by the World Health Organization (WHO). The elimination of rubella in the country is possible provided that it is achieved by min. 95% immunization status and monitoring of the epidemiological situation, including the recording all suspicions of rubella and conducting laboratory diagnostics in the WHO Reference Laboratory. AIM OF THE STUDY: The aim of the study is to assess the epidemiological situation of rubella in Poland in 2020, taking into account the assessment of rubella vaccination status and the degree of implementation of the WHO rubella elimination program in Poland. MATERIAL AND METHODS: Assessment of the epidemiological situation of rubella in Poland based on aggregated reports of suspected rubella cases sent to the National Institute of Public Health NIH - National Research Institute by the Voivodeship Sanitary and Epidemiological Stations, data from the bulletin "Infectious diseases and poisoning in Poland in 2020" and data from the Epibaza system and the bulletin "Preventive vaccination in Poland in 2020". RESULTS: In 2020, 98 cases of rubella were registered, 187 cases less than in 2019 (285 cases). There was also a decrease in the incidence to 0.26 per 100,000, compared to 0.74 per 100,000 in 2019. The highest incidence, iregardless of gender and place of residence, was recorded in the 0-4 age group (2.98 per 100,000). In 2020, no cases of congenital rubella syndrome were reported. In 2020, only one case (1.02%) was classified as a case confirmed in a laboratory test. The remaining 98.98% (97 cases) were diagnosed on the basis of clinical symptoms. SUMMARY AND CONCLUSIONS: In 2020, in Poland, a decrease in the number of rubella was observed. Rubella was registered in 99% on the basis of a general diagnosis, without the required laboratory confirmation, which means that other rash diseases can be registered as rubella.

Lyme disease in Poland in 2018.

INTRODUCTION: Lyme disease is the most common tick-borne disease, caused by spirochetes of the genus Borrelia, transmitted by ticks of the Ixodes genus. According to ECDC, Poland should be considered as an endemic area. The risk of Lyme disease incidence in-creases with tick habitats increase, which is a response to environmental factors and climate change. AIM OF THE STUDY: The aim of the study is to assess the epidemiological situation of Lyme disease in Poland in 2018 compared to the situation in previous years. MATERIAL AND METHODS: The epidemiological situation of Lyme disease in Poland was assessed on the basis of the data sent to NIPH-NIH by voivodeship sanitary-epidemiological stations and published in the bulletin 'Infectious diseases and poisoning in Poland in 2018' . RESULTS: In 2018; 20,150 Lyme disease cases was registered, 2,124 people were hospitalized. You can also see an increase in cases in the second and third quarter in favor of the fourth quarter. The epidemiological situation in Western European countries is similar to the situation in Poland. SUMMARY AND CONCLUSION: The inability to determine the clear trend of the epidemiological situation in Poland indicates the sensitivity of the surveillance system, but also the difficulty in new cases diagnosis. You can also see a decrease in the number of cases, which may be a sign of having the right tools or experience in the Lyme disease diagnosis.

Meningitis and encephalitis in Poland in 2018.

INTRODUCTION: Infectious diseases of the nervous system are most often manifested in the form of meningitis. We distinguish meningitis and/or encephalitis according to their etiology, i.e. bacterial and viral. The study discusses meningitis and encephalitis caused by: N. meningitidis, S. pneumoniae, H. influenzae and tick-borne encephalitis virus. This is due to the epidemiological surveillance of these diseases and the available prevention in the form of vaccinations against these diseases. AIM OF THE STUDY: The aim of the study is to assess the epidemiological situation of meningitis and encephalitis in Poland in 2018. MATERIAL AND METHODS: The epidemiological situation of meningitis and encephalitis in Poland was assessed on data from the annual bulletin "Infectious diseases and poisoning in Poland in 2018" and "Vaccinations in Poland in 2018". RESULTS: In 2018, a total of 2406 cases of meningitis and/or encephalitis were registered in Poland. It is a 14.7% increase in incidence compared to 2017. An increase was recorded in the viral infections from 1212 to 1533 cases. In contrast, the number of infections with bacterial etiology decreased from 886 to 873 cases. Meningitis and/or encephalitis caused by pathogens specified in epidemiological surveillance have noticed a decreased incidence. The only exception is the increase in cases caused by S. pneumoniae, compared to 2017, from 177 to 212. This is an increase of 19.8% compared to the previous year. However, the number of cases of N. meningitidis showed a decrease of 16.4% during this period. Viral infections constituted 63.7% of all cases. Compared to 2017, it means an increase in the percentage of viral infections by 5.9 percentage points. Among laboratory confirmed cases of meningitis and/or encephalitis of known etiology, cases caused by Neisseria meningitidis (102 cases), Streptococcus pneumoniae (212 cases) and tick-borne encephalitis (197 cases) were predominant. SUMMARY AND CONCLUSION: There is a general increasing trend in the number of cases of viral meningitis and/or encephalitis. On the other hand, thanks to vaccinations, no significant increase was noted in H. influenzae, meningococcal and TBE infections. There is a chance to minimize the incidence of bacterial meningitis and/or encephalitis as in the H. influenzae infections. On the other hand, it should be seen that the problem of diagnosing cases of viral etiology should be considered. This is more related to the determination of the etiological factor than the diagnosis of viral meningitis and/or encephalitis. Difficulties in determining the etiological factor indicate that, meningitis and/or encephalitis remain a challenge for healthcare and epidemiological surveillance institutions.

Rubella in Poland in 2019.

INTRODUCTION: Rubella has been included in the elimination program coordinated by the World Health Organization (WHO) since 2005. Elimination of rubella in the country is possible provided that min. 95% of the vaccination status of the population and monitoring the epidemiological situation, including recording all suspected rubella and conducting laboratory diagnostics at the WHO Reference Laboratory. AIM: The aims of the present article are to analyze the epidemiological situation of rubella in Poland in 2019 and to discuss the rubella vaccination coverage. MATERIAL AND METHODS: The assessment of the epidemiological situation of rubella in Poland was conducted on the basis of aggregated reports of suspected rubella cases sent to the National Institute of Public Health - National Institute of Hygiene by Voivodeship Sanitary and Epidemiological Stations, and data from the bulletin "Infectious diseases and poisoning in Poland in 2019" and "Vaccinations in Poland in 2019 ". RESULTS: In 2019, there was a decrease in the number of rubella cases with registered 285 cases (in 2018 - 37 cases), and a decline in incidence (from 1.1 per 100,000 to 0.74). The highest incidence rate, regardless of gender and the environment, was observed among children agded 0-4 years (6.4 per 100,000). In 2019, no cases of congenital rubella syndrome were registered. In 2019, only 3 (1.05%) cases were classified as laboratoryconfirmed cases. The remaining 98.9% (282 cases) were diagnosed on the basis of clinical symptoms. CONCLUSIONS: In 2019, there was a decrease in the number of rubella cases. In Poland rubella in reported exclusively on the basis of the clinical picture. The proportion of laboratory tests confirming/excluding rubella infection is still very low in Poland.

Pertussis in Poland in 2018-2019.

INTRODUCTION: Pertussis is an endemic, highly contagious disease that can be prevented through vaccination. In Poland, since the second half of the nineties, changes in the epidemiology of pertussis have been observed - an increase in the number of cases, despite the high level of vaccination of the population. The highest percentage of registered cases of pertussis concerned people aged 15 and over. The causes of the increased incidence of pertussis are a complex problem. Immunity after pertussis vaccination is unstable, disappears within 4-12 years, and the risk of the disease increases with time after the last dose of the vaccine. Due to the loss of protection against pertussis in adults, it is important to repeat immunization with dTpa every 10 years. OBJECTIVE: The aim of the study was to assess the epidemiological situation of pertussis in Poland in 2018-2019 compared to the situation in previous years, with particular emphasis on the assessment of the vaccination status of children against pertussis. MATERIAL AND METHODS: The assessment of the epidemiological situation of pertussis in Poland was performed on the basis of the results of the analysis of unit reports of pertussis registered in the NIPH-NIH through the SRWE system and data from the bulletins "Infectious diseases and poisonings in Poland" for 2018 and 2019 and the bulletins "Vaccinations in Poland" for 2018 and 2019. RESULTS: In 2018, 1 548 were registered, and in 2019 - 1 629 cases of pertussis. The incidence was respectively: 4.0 and 4.2 per 100 000 population and was lower compared to the incidence in 2017 (8.0). The highest incidence of pertussis was in the age group 0-4 years (20.6 and 23.6 respectively), and high in children and adolescents aged 5-9 (10.9 and 11.5 respectively) and 10-14 years (respectively: 12.2 and 11.2 - per 100 000 population). About half of the cases concerned people over 15 years of age. In general, a higher incidence among women was observed than in men, as well as a higher incidence in cities than in rural areas. In 2018, among people with pertussis, 434 people (i.e. 28%) and in 2019 - 482 people (i.e. 29.6%) were hospitalized. In 2019, one fatal case of the disease was reported to the epidemiological surveillance system. SUMMARY AND CONCLUSIONS: In Poland, in the years 2018-2019, there was a decrease in the number of cases of pertussis, the most common were children under the age of four (the highest incidence). A worrying trend is the decreasing number of vaccinations in children aged 2 years against pertussis covered by compulsory primary vaccinations in individual provinces. In the current epidemiological situation, the best way to prevent new cases of pertussis is to use vaccination according to the current regimen and to recommend to adults a single dose of dTpa vaccination, which should be repeated every 10 years.