A Retrospective Database Study of Lyme Borreliosis Incidence in Poland from 2015 to 2019: A Public Health Concern.

Background: In Poland, Lyme borreliosis (LB) has been subject to mandatory public health surveillance since 1996 and, in accordance with EU regulations, Lyme neuroborreliosis has been reported to the European Centre for Disease Prevention and Control since 2019. In this study, the incidence, temporal trends, and geographic distribution of LB and its manifestations in Poland are described for the period 2015-2019. Methods: This retrospective incidence study of LB and its manifestations in Poland was based on data sent to the National Institute of Public Health-National Institute of Hygiene-National Research Institute (NIPH-NIH-NRI) by district sanitary epidemiological stations using the electronic Epidemiological Records Registration System and data from the National Database on Hospitalization. Incidence rates were calculated using population data from the Central Statistical Office. Results: During 2015-2019, Poland reported 94,715 cases of LB with an overall average incidence of 49.3 cases per 100,000 population. Cases increased from 2015 (11,945) to 2016 (20,857) and then remained stable through 2019. Hospitalization due to LB also rose during these years. LB was more common among women (55.7%). Erythema migrans and Lyme arthritis were the most common manifestations of LB. The highest incidence rates occurred among >50-year-olds, with a peak in 65-69-year-olds. The highest number of cases was recorded in the third and fourth quarters of the year (July-December). Incidence rates in the eastern and northeastern regions of the country were higher than the national average. Conclusions: LB is endemic in all regions of Poland, and many regions reported high incidence rates. Large variations in spatially granular incidence rates highlight the need for targeted prevention strategies.

Spatiotemporal spread of tick-borne encephalitis in the EU/EEA, 2012 to 2020.

BackgroundTick-borne encephalitis (TBE) is a vaccine-preventable disease involving the central nervous system. TBE became a notifiable disease on the EU/EEA level in 2012.AimWe aimed to provide an updated epidemiological assessment of TBE in the EU/EEA, focusing on spatiotemporal changes.MethodsWe performed a descriptive analysis of case characteristics, time and location using data of human TBE cases reported by EU/EEA countries to the European Centre for Disease Prevention and Control with disease onset in 2012-2020. We analysed data at EU/EEA, national, and subnational levels and calculated notification rates using Eurostat population data. Regression models were used for temporal analysis.ResultsFrom 2012 to 2020, 19 countries reported 29,974 TBE cases, of which 24,629 (98.6%) were autochthonous. Czechia, Germany and Lithuania reported 52.9% of all cases. The highest notification rates were recorded in Lithuania, Latvia, and Estonia (16.2, 9.5 and 7.5 cases/100,000 population, respectively). Fifty regions from 10 countries, had a notification rate ≥ 5/100,000. There was an increasing trend in number of cases during the study period with an estimated 0.053 additional TBE cases every week. In 2020, 11.5% more TBE cases were reported than predicted based on data from 2016 to 2019. A geographical spread of cases was observed, particularly in regions situated north-west of known endemic regions.ConclusionA close monitoring of ongoing changes to the TBE epidemiological situation in Europe can support the timely adaption of vaccination recommendations. Further analyses to identify populations and geographical areas where vaccination programmes can be of benefit are needed.

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.

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.

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).

Lyme disease in Poland in 2019.

INTRODUCTION: Lyme disease is caused by Borrelia spirochetes transmitted by ticks of the genus Ixodes. In Poland, Lyme disease is the most common tick-borne disease. The entire territory of Poland is recognized by ECDC as an endemic area of Lyme disease. Environmental factors and climate change are responsible for the increase in the number of tick habitats, which leads to an increased risk of Lyme disease. AIM OF THE STUDY: The aim of the study is to present the epidemiological situation of Lyme disease in Poland in 2019 compared to the previous year. MATERIAL AND METHODS: The analysis of the epidemiological situation of Lyme disease in Poland was based on data sent to NIPH NIH - NRI by voivodeship sanitary-epidemiological stations and published in the bulletin "Infectious diseases and poisoning in Poland in 2019." RESULTS: In 2019, 20,630 cases of Lyme disease were registered, and 1,701 people were hospitalized. Compared to 2018, there was a shift in the incidence from the first and second quarter to the fourth quarter. The highest incidence of 107.7 / 100,000 population was recorded in the Podlaskie voivodeship, which has belonged to the voivodeships with the highest incidence in the country for many years. Despite an increase in the total number of cases by 2.4% compared to 2018, the percentage of hospitalized cases was lower than in the previous year. SUMMARY AND CONCLUSION: Difficulties in the diagnosis of Lyme disease make it impossible to define an unequivocal trend in the epidemiological situation in Poland. A slight increase in the incidence may result from the growing number of infected ticks and a better understanding of the problem of Lyme diagnosis by doctors.

Meningitis and encephalitis in Poland in 2019.

INTRODUCTION: The most common form of infectious diseases of the nervous system is meningitis and encephalitis. This study discusses in detail bacterial meningitis and/or encephalitis in which the etiological factors are: Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae and viral - in Poland, most often caused by tick-borne encephalitis virus. In addition to routine epidemiological surveillance of diseases caused by these etiological factors, mandatory and recommended vaccinations are carried out in Poland aimed at reducing the number of cases caused by N. meningitidis, S. pneumoniae, H. influenzae and TBEV. AIM OF THE STUDY: The aim of the study is to assess the epidemiological situation of meningitis and encephalitis in Poland in 2019. MATERIAL AND METHODS: The epidemiological situation of meningitis and encephalitis in Poland was assessed on data sent to NIPH NIH - NRI by voivodeship sanitary-epidemiological stations and published in the annual bulletin "Infectious diseases and poisoning in Poland in 2019" and "Vaccinations in Poland in 2019". RESULTS: In 2019, a total of 2,239 cases of meningitis and encephalitis were registered in Poland. This is a decrease by approximately 19,9% compared to 2018. In the case of bacterial infections, including neuroborreliosis, the number of cases decreased by 27%, from 1265 to 921 cases. In the group of viral infections, a decrease by 14% (from 1,533 to 1,318 cases) was recorded. In 31% of all the cases of bacterial etiology, the etiological factor was one of three: Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae. Infections of viral etiology accounted for 58.9% of all registered cases. Compared to 2018, the number of S. pneumoniae cases decreased by 14.6%, and in the case of N. meningitidis by 6.9%. In the case of H. influenzae, there was an increase in the number of cases, compared to the previous year. In addition, there was a slight increase in the number of cases of tick-borne encephalitis - from 197 cases in 2018 to 265 cases in 2019 (an increase of 34.5%). SUMMARY AND CONCLUSION: The analysis showed a generally declining disease trend, both in bacterial and viral meningitis and encephalitis. Only in cases caused by H. influenzae and tick-borne encephalitis virus, an increase was observed compared to the previous year. Meningitis and encephalitis continues to be a challenge for the healthcare system, with particular emphasis on the correct differentiation of the etiology at an early stage of infection detection.

Duration of protection against Bordetella pertussis infection elicited by whole-cell and acellular vaccine priming in Polish children and adolescents.

BACKGROUND: In the context of reported resurgence of pertussis in the last decade, researchers hypothesized that acellular (aP) pertussis vaccines elicit a shorter-lived protection compared to whole-cell (wP) pertussis vaccines. However, in the studies seeking to demonstrate this hypothesis, exposure to each vaccine type was not concurrent, and contradictory epidemiologic modeling questioned its validity. The context of pertussis vaccination history in Poland, with both vaccine types used concurrently in comparable proportions, provided an opportunity to investigate this hypothesis. We sought to compare waning of protection by primary series vaccine type by measuring anti-pertussis toxin antibody concentrations as proxy for recent infection. MATERIALS AND METHODS: Serological samples from 2,745 children and adolescents aged ≥5 years and <16 years and with completed 5-dose pertussis vaccination series were tested by ELISA for pertussis toxin (PT) antibodies. Participants were stratified by type of priming vaccine (wP or aP). Vaccination timeliness and priming-specific trends in anti-PT antibody levels by time since last vaccine dose were analyzed. RESULTS: A total of 1,161 (42.5%) children received wP vaccines, and 1,314 (48.1%) received aP vaccines for their primary series and toddler booster. Overall, 53.57% of the subjects received doses 2-4 in a timely manner, while only 41.52% received all 5 doses at the recommended intervals. Using GMCs or seropositivity measures, both priming groups showed a re-increase in anti-PT antibody levels signing infection in recent years from 8 years after the school-entry booster onward. Comparisons did not show any significant differences between the two groups in the timing or intensity of this re-increase. CONCLUSION: Our results clearly confirm that vaccine-elicited immunity against pertussis wanes among adolescents even after a complete infant, toddler and school-entry vaccination series. The timing and intensity of the waning of protection appear similar with whole-cell as with acellular pertussis vaccines.

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.

Lyme disease in Poland in 2017

INTRODUCTION: Lyme disease is the most common tick-borne disease, caused by spirochetes of the genus Borrelia, transmitted by ticks of the Ixodes genus. Infection caused by Borrelia burgdorferi can occur throughout Poland and therefore, according to ECDC description, the whole country should be considered as an endemic area. AIM OF THE STUDY: The aim of the study is to assess the epidemiological situation of Lyme disease in Poland in 2017 in comparison to the situation in previous years. MATERIAL AND METHODS: The epidemiological situation of Lyme disease in Poland was assessed on data from the annual bulletin "Infectious diseases and poisoning in Poland in 2017". (MP Czarkowski et al., Warsaw 2018, NIZP-PZH, GIS). RESULTS: In 2017 were registered 21,514 Lyme disease cases i.e. 1.48% more than in the previous year and 2,324 people were hospitalized. Epidemiological situation in Western European countries and Poland are similar. SUMMARY AND CONCLUSION: A slightly increase in 2017 and lack of a clear trend in individual voivodeships may indicate, that a very high level of sensitivity of epidemiological surveillance has been achieved.

Meningitis and encephalitis in Poland in 2017

INTRODUCTION: Meningitis are the most common form of the nervous system infectious diseases. There are meningitis and/or encephalitis with bacterial and viral etiology. In epidemiological surveillance are highlighted meningitis and/or encephalitis caused by N. meningitidis, S. pneumoniae, H. influenzae and tick-borne encephalitis virus. Because vaccinations against these agents are common. AIM OF THE STUDY: The aim of the study is to assess the epidemiological situation of meningitis and encephalitis in Poland in 2017. 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 2017" and "Vaccinations in Poland in 2017". (MP Czarkowski et al., Warsaw 2018, NIZP-PZH, GIS). RESULTS: In 2017 were registered 2 095 cases of meningitis and/or encephalitis in Poland. It means a 10.8% decrease in meningitis and/or encephalitis in Poland compared to 2016. With a general decrease in the number of infections of bacterial etiology, the number of cases of meningitis and/or encephalitis of S. pneumoniae, H. influenzae type B cases reported remains at the same level similar to last year. In contrast, the number of cases of etiology of N. meningitidis shows an increase of 25.4% compared to the previous year. Among all cases 57.9% were viral infections. In comparison to 2016 means a decrease in the percentage share of viral infections by 1.2 percentage points for bacterial infections. Among laboratory confirmed cases of neuroinfection with established etiology, the incidence caused by Neisseria miningitidis (122 cases), Streptococcus pneumoniae (171 cases) and tick-borne encephalitis (283 cases) are the most prevalent. SUMMARY AND CONCLUSION: There is a general downward trend in the number of meningitis and/or encephalitis cases, which may be due to introducing mandatory vaccination against S. pneumoniae. It can also mean an improvement in diagnostics given the decrease in unspecified meningitis and/or encephalitis. However meningitis and/or encephalitis remain a challenge for healthcare and epidemiological surveillance institutions.