A cross-sectional study among Polish hunters: seroprevalence of hepatitis E and the analysis of factors contributing to HEV infections.

Hepatitis E virus (HEV) is known as zoonotic agent. The main reservoirs of HEV in Europe are pigs, wild boars, and deer. Hunting activity is considered to be a risk factor for HEV infection. We conducted a cross-sectional study among 1021 Polish hunters. To understand socio-demographic characteristics of this population and to gather information on potential exposures, all participants completed a questionnaire. Commercial immunoassays were employed to estimate seroprevalence anti-HEV. Samples with confirmed positive result of anti-HEV IgM were examined for HEV RNA. Anti-HEV IgG were identified in 227 people, 22.2% of the studied group. Seroprevalence among the studied hunters was associated with age ≥65 [adjusted prevalence ratio (aPR) 1.6, p = 0.037), living in a house (aPR 1.54, p = 0.013), professional contact with farm animals (aPR 1.09, p = 0.01), and consumption of stewed offal (aPR 1.61, p = 0.00). Washing hands after disembowelment was linked to lower seroprevalence (aPR 0.53; p = 0.00). Lower prevalence of anti-HEV IgG among hunters living in cities was associated with age: 35-49 (aPR 0.52, p = 0.011) and 50-64 (aPR 0.93, p = 0.58), living in a house (aPR 1.58, p = 0.002) and owning a cat (aPR 0.58, p = 0.042). Among hunters living in rural areas, seropositivity was associated with contact with farm animals (aPR 1.66, p = 0.013) and consumption of stewed offal (aPR 1.81; p = 0.001). Contrary to initial assumptions, it was concluded that hunting was of significantly lesser importance than other factors. Due to the high level of HEV seroprevalence identified, we recommend conducting a large-scale study in the general population of Poland.

Hepatitis A in Poland in 2013.

OBJECTIVE: The aim of the study is to assess the epidemiological situation of hepatitis A in Poland in 2013 compared to previous years. MATERIAL AND METHODS: The evaluation was carried out on the basis of the results of the analysis of data from the annual bulletin "Infectious diseases and poisonings in Poland in 2013" and "Vaccinations in Poland in 2013", the information from individual diseases forms and epidemiological investigations forms for hepatitis A outbreaks, sent by sanitary-epidemiological stations to the Department of Epidemiology of NIZP-PZH. RESULTS: In 2013, 48 cases of hepatitis A were registered in Poland. The incidence per 100,000 inhabitants was 0.12, and in particular provinces it ranged from 0.05 in the Kujawsko-Pomorskie province to 0.26 in the Wielkopolska province. The incidence of hepatitis A for men and women was at a similar level and amounted to 0.13 and 0.12/100,000. In 2013 imported cases accounted for 45.8% of the total number of hepatitis A cases. There were three outbreaks, where the total of 13 people fell ill. SUMMARY AND CONCLUSIONS: 2013 saw a slight decrease in the number of cases compared to the previous year. Besides, there were no significant changes in the hepatitis A epidemiological situation. In Poland, there is still very low endemicity. Since several years, there has been a decline in the number of people vaccinated against hepatitis A. All of this affects the accumulation of a fairly large population of people susceptible to the infection, which may increase incidence. Although the current hepatitis A epidemiological situation in Poland is good, it still requires monitoring, analysis and constant observation within the structured epidemiological surveillance.

Occurrence and maintenance of hantavirus infections among rodent populations in their natural habitat--results of a field study from Podkarpackie province, Poland 2010-2012.

UNLABELLED: Human cases of hantavirus infection have been reported annually in Poland's Podkarpackie province, since 2007. In 2014 the number of cases reported significantly increased prompting a rise in studies focusing on the infection. OBJECTIVE: The purpose of this study was to evaluate the prevalence, maintenance and the dynamics of hantavirus infection among rodent species, including the bank vole (Myodes glareolus) and yellow-necked mouse (Apodemus flavicollis) which act as reservoirs of hantavirus in the environment. MATERIAL AND METHODS: Rodent capture was carried out on seven research grids in the Podkarpackie province, from summer 2010 to spring 2012. They were caught in live-capture traps used in accordance with the protocol CMR (Catch-Mark-Release). The population was estimated as MNA (Minimum Number Alive). Blood samples were collected for serological testing on live animals by puncture of saphenous vein. In order to determine the hantavirus infection we used ReaScan Ab-Dect Puumala IgG--Reagena® for bank voles, and for mice ELISA--Mouse Hanta Virus Test ELISA Kit (Version with Control Antigen Wells)--BioCat GmbH®. The relationship between age, gender, seasons, population size and prevalence of hantavirus infection was tested by Pearson's chi-squared test or Fisher's exact test and by calculating the Pearson's correlation coefficient. RESULTS: A total of 854 rodents were captured: 222 bank voles, 592 yellow-necked mice, 4 common voles and 36 striped field mice. Of these, 564 were tested. The presence of specific anti-hantavirus was found in 9.7% of bank voles and 9.5% of yellow-necked mice. There was a statistically significant difference in the frequency of infection between the groups of male and female yellow-necked mice as well as in the groups of adult group in both species. The dynamics of spread of hantavirus infection was clearly evident in the studied area of Sanok. The correlation coefficient between the number of individuals caught and the prevalence of hantavirus infection in yellow-necked mice was -0,87 but for the bank vole it was 0,76. SUMMARY AND CONCLUSIONS: The results of the study indicate that hantavirus infection among yellow-necked mice and bank voles are unevenly distributed in certain hot spots, vary over time, and are most in the spring season. In addition, differences observed in the dynamics of infection depended on the species of animal hosts. It would be advisable to conduct long-term study, which would allow for a risk assessment of the possibility of turning the spot located outbreaks into endemic area of hantavirus occurrence.

Occurrence and prevalence of selected zoonotic agents: Echinococcus multilocularis, Trichinella spiralis and hepatitis E virus (HEV) in the population of Polish hunters--results of the study conducted in 2010-2012.

UNLABELLED: In Poland the development of the knowledge concerning zoonotic pathogens, of which free-living animals are the reservoir of is gaining in importance both in epidemiological aspect as well as in the context of prevention for improving public health. Dietary habits such as the consumption of forest undergrowth products and wild game meat, and the way of those products being prepared (in the process of barbequing) pose a risk factors of infection with the foodborne pathogens such as Echinococcus multilocularis, Trichinella spp., and HEV. AIM: The aim of this study is to estimate the prevalence of infections caused by Trichinella spp., Echinococcus multilocularis, and HEV in the population of Polish hunters, describing their geographical distribution in Poland, and to try to define basic factors, which may contribute to their occurrence. MATERIAL AND METHODS: In 2010-2012 a cross-sectional study was carried out among Polish hunters. A blood samples were collected as well as a survey of 1027 participants recruited in the 16 provinces was also carried out. Serological tests were performed for the presence of specific antibodies against Echinococcus multilocularis, Trichinella spp. and HEV using commercial or "in home" ELISA tests. In case of positive result for Echinococcus, an Em2plus ELISA or/and western blot test were carried out, and for positive results for IgM for HEV a recomLine HEV IgM test was carried out. RESULTS: In the studied population a total number of 2 cases of Echinococcus multilocularis infection were found. Moreover in 47 (4,6%) participants presence of antibodies against Trichinella spp. were found, including 17 positive and 30 borderline results. In 206 persons (25%) IgG anti-HEV antibodies were found (by ELISA test). Geographical diversity in prevalence of both, the Trichinella spp. and HEV cases was observed. SUMMARY AND CONCLUSIONS: The study confirmed presence of zoonotic infections such as Echinococcus multilocularis, Trichinella spp., and hepatitis E (HEV) among Polish hunters. In the case of Echinococcus multilocularis, and Trichinella spp., it appears that these infections are more common in the studied sample than in the general population. Additionally results on the prevalence of HEV infections indicate a need for further research on the occurrence of the virus in the country.

Shigellosis in Poland in 2012.

BACKGROUND: Shigellosis according to European Centre for Disease Control (ECDC) Report is registered in all countries of the European Union (EU) and of the European Free Trade Association (EFTA) with exception of Italy and Luxemburg. The incidence rate in Poland below 0.1/100 000 of population is the lowest among the EU/EFTA countries. AIM: To assess epidemiological situation of shigellosis in Poland in 2012 in comparison to preceding years. MATERIALS AND METHODS: An assessment of the epidemiological situation of shigellosis was based on the results from an analysis of the yearly annual bulletins: "Infectious diseases and poisonings in Poland in 2012", reports from bacteriological laboratories and reports from individual cases and epidemiological investigations of outbreaks linked to shigellosis, sent by Sanitary-Epidemiological Stations to the Department of Epidemiology at NIZP-PZH. RESULTS: In 2012 the tendency that the number of registered cases of shigellosis was lower than in the former years continued - only 13 confirmed cases of shigellosis were registered (incidence rate 0.03 per 100 000 inhabitantsbut in the previous year the 18 cases ( incidence rate 0.05). Cases were registered only by 6 provinces, most of the cases by the Lodz province - 4. All together 5 persons nearly 40% were infected in travel to the foreign countries. According to data from laboratories of Sanitary-Epidemiological Stations, Shigella was detected only 4 convalescents and 2 carriers. All cases of shigellosis registered in 2012, were confirmed by a hospital laboratory or a private laboratory. CONCLUSIONS: In our opinion the above mentioned data concerning the cases of shigellosis in Poland in 2012 are not reflecting the true epidemiological situation of shigellosis in Poland. The sanitary situation was changing nearly every year for better than in former years but the surveillance of dysentery require more active epidemiological measures.

Foodborne infections and intoxications in Poland in 2012.

AIM: The purpose of the study is to assess the epidemiological situation of foodborne infections and intoxications in Poland in 2012. MATERIALS AND METHODS: The evaluation was based on analysis of information from reports of epidemiological investigations in foodborne outbreaks, submitted by the sanitary-epidemiological stations to the Department of Epidemiology, NIZP-PZH annual bulletins (Czarkowski MP et al. "Infectious diseases and poisonings in Poland", 2006-2012. Warsaw, NIPH-NIH and CSI). RESULTS: In Poland in 2012 there was observed decrease in the number of infections intoxications both of bacterial and viral origin. It was recorded only one case of trichinellosis. There were reported 491 outbreaks of foodborne poisonings or infections included 5 774 people, among them 718 children 1-14 years old. Out of them 1 364 people were hospitalized. Unlike last year, the predominant etiological agent in those outbreaks were zoonotic Salmonella serotypes which caused 38.1% outbreaks and 26.7% outbreak cases. The viruses have caused 27.1% of outbreaks and 36.2% of cases. In 23.8% of outbreaks etiological agent has not been established. Most often the settings of an outbreak was a private household - 236 outbreaks and a hospital (84 outbreaks). As in previous years, the most common vehicle of infection were foods prepared with milk and eggs -11.8% of outbreaks and egg dishes - 9.0%. In 57.6% of oubreaks vehicle of infection has not been established. Among outbreaks reported in 2012, there were 4 which involved more than 100 people. In 163 outbreaks of food items had been tested and in 33% of them the results were positive. CONCLUSIONS: The increasing negative results of bacteriological examinations of food items, suggested necessity to start testing food contamination with viruses.

Hepatitis A in Poland in 2012.

AIM: The aim of the article is evaluation of the epidemiological situation of hepatitis A in Poland in 2012. MATERIALS AND METHODS: Assessment of epidemiological situation of hepatitis A was based on results from analysis of the annual bulletins: "Infectious diseases and poisonings in Poland in 2012", "Vaccinations in Poland in 2012", reports from individual cases and epidemiological investigations of outbreaks linked to hepatitis A, sent by Epidemiological Departments in Sanitary Epidemiological Stations to the Department of Epidemiology at NIPH-NIH. RESULTS: In Poland, 71 cases of hepatitis A were registered in 2012. The incidence of 0.17/ per 100 000 inhabitants was slightly higher than previous year. The incidence of hepatitis A ranged from 0.08/100 000 in Lódzkie and Podlaskie to 0.35/100 000 in Slaskie. The incidence of hepatitis A in men and women was at an approximate level and amounted to 0.19 and 0.18/100 000 respectively. The peak of incidence was recorded during the summer and autumn-winter months. In 2012 imported cases constituted 52.1% of all cases of hepatitis A. There were five outbreaks involving of 11 registered cases in 2012. CONCLUSIONS: In 2012, there was a slight increase in the incidence of hepatitis A in compared with the previous year. However, apart from that there were no significant changes in the epidemiological situation of hepatitis A. In Poland there is still very low endemicity for hepatitis A. Decreased incidence and the small number of people vaccinated against hepatitis A facilitates the accumulation of a fairly numerous population of persons susceptible to infection which is connected with the possibility to increase the number of cases of hepatitis A. Despite the fact that the current epidemiological situation of hepatitis A in Poland is good, the disease still requires monitoring and analysis within the framework of epidemiological surveillance system.

Foodborne infections and intoxications in Poland in 2011.

THE PURPOSE OF THE STUDY: To assess the epidemiological situation of food poisoning and infections in Poland in 2011. MATERIALS AND METHODS: The assessment was based on information from the forms of the epidemiological investigations in outbreaks of foodborne poisoning and infections, sent by the sanitary-epidemiological stations to the Department of Epidemiology, NIPH-NIH (NIZP-PZH) and the results of the analysis of annual bulletins (Czarkowski MP et al. "Infectious diseases and poisonings in Poland"- 2005 - 2011. Warsaw, NIZP-PZH and GIS). RESULTS: In 2011 it was observed decrease in the number of infections and food poisoning of bacterial etiology and steady marked increase in the incidence of those of viral etiology, classified as "viral and other intestinal infections." In 2011 there were registered 490 outbreaks of poisoning / infection of food, which had affected 6 386 people, including 1,718 children under 14. Among them 1364 people required hospitalization. The predominant etiologic factor in outbreaks were viruses - 36.5% of outbreaks and 40.6% of cases then zoonotic Salmonella types - 35.5% of outbreaks and 27.8% of cases. In 22.2% of outbreaks etiological factor was not established. Most of the outbreaks occurred in households - 235 and in hospital - 118. As in previous years, the most common carrier of infection was food prepared from milk and eggs -11.4% of outbreaks and egg only dishes - 9.8%. In more than 61% of outbreaks etiologic factor has not been established. In 2011, there were five outbreaks, in which got ill 100 people or more. CONCLUSION: Since the seasonality of outbreaks of unknown etiologic factor is similar to outbreaks of viral etiology; they occur in the autumn and winter, one should pay special attention to the testing samples taken for viral agents.

Shigellosis in Poland in 2011.

BACKGROUND: Shigellosis, also known as bacillary dysentery, is a contagious and infectious disease. In the European Union, on the basis of the Commission Decision of 2 April 2009 and the Commission Decision of 28 April 2008, a unified system for collecting epidemiological data on infectious diseases was introduced, including shigellosis. This makes it possible to compare data collected at different times and in different countries. AIM: The aim of the article is to evaluate the epidemiological situation of shigellosis in Poland in 2011. MATERIALS AND METHODS: An assessment of the epidemiological situation of shigellosis was based on the results from an analysis of the yearly annual bulletins: "Infectious diseases and poisonings in Poland in 2011", reports from bacteriological laboratories and reports from individual cases and epidemiological investigations of outbreaks linked to shigellosis, sent by Sanitary Epidemiological Stations to the Department of Epidemiology at NIZP-PZH. RESULTS: In Poland, 17 confirmed cases of shigellosis were registered in 2011. The incidence of 0.04 per 100,000 inhabitants was lower when compared to the previous year. The number of cases is lower by 48% when compared with the median of years 2005-2009--35 cases (incidence 0.09/100,000). Most of the cases were registered in the Silesian province--7 (incidence 0.15 /100,000). According to data from 16 laboratories of Sanitary Epidemiological Stations, Shigella was not detected among the subjects. All cases of shigellosis registered in 2011, were confirmed by a hospital laboratory at or a private laboratory. CONCLUSIONS: In Poland, we have observed a decline in the number of cases of shigellosis and the incidence remains at a relatively steady level and constitutes less than 0.1/100,000 inhabitants. Compared to the rest of the countries belonging to the EU/EFTA, the current epidemiological situation of shigellosis in Poland is good. Poland is a country with the lowest incidence. In spite of this, the surveillance of shigellosis required more active epidemiological measures. Special attention should be paid to the bacteriological testing of people living in rural areas, children and young people.

Hepatitis A in Poland in 2011.

AIM: The aim of the article is evaluation of the epidemiological situation of hepatitis A in Poland in 2011. MATERIALS AND METHODS: Assessment of epidemiological situation of hepatitis A was based on results from analysis of the annual bulletins: "Infectious diseases and poisonings in Poland in 2011", "Vaccinations in Poland in 2011", reports from individual cases and epidemiological investigations of outbreaks linked to hepatitis A, sent by Epidemiological Departments in Sanitary Epidemiological Stations to the Department of Epidemiology at NIZP-PZH. RESULTS: In Poland, 65 cases of hepatitis A were registered in 2011. The incidence of 0.17/100,000 was lower them in the previous year. The incidence of hepatitis A ranged from 0.07/100,000 in Dolnoslaskie province to 0.52/100,000 in Slaskie province. The incidence of hepatitis A in men (0.19) was higher than in woman (0.15). Imported cases constituted 49.2% (32 cases) of the overall number of cases of hepatitis A. There were two outbreaks of hepatitis A involving 7 cases registered in 2011. CONCLUSIONS: In the year 2011, a decrease in the number of cases was noted in comparison with the median of years 2008 - 2010. Despite the fact that the current epidemiological situation of hepatitis A in Poland is good, the disease still requires monitoring and analysis within the framework of epidemiological surveillance system.

[Dysentery and amoebiasis in Poland in 2010]. / Czerwonka bakteryjna i pelzakowa w Polsce w 2010 roku.

INTRODUCTION: Dysentery as infective and contagious disease is registered by all EU and EFTA countries only as shigellosis according to etiological classification of the infectious diseases. The cases are also registered by ECDC. According to ECDC Report for 2006-2008 the incidence rate in Poland < 0.01/100 000 was the lowest from all EU/EFTA countries that have send the data to ECDC as the cumulative for EU countries was 1.78/100 000. MATERIAL AND METHODS: Epidemiological data were collected by Regional Epidemiological Sanitary Stations, send to the National Register of Infectious Diseases, evaluated, calculated and published by Department of Epidemiology National Institute of Public Health (NIZP-PZH) in Annual Bulletin "Infections and Intoxications in Poland in 2010", Warsaw NIZP-PZH and GIS (Chief Sanitary Inspectorate ) 2010. Laboratory data were collected as reports from all Regional Sanitary Laboratories send to NIZP-PZH Department of Bacteriology, data from epidemiological investigation of outbreaks including data from identification of Shigella strains obtained from the Reference Laboratory for Gram-negative Bacilli of NIZP-PZH Bacteriology Department. RESULTS: In 2010 thirty cases of shigellosis were registered (incidence was 0.08/100 000 inhabitants) the same number of cases and incidence was observed in 2009, nearly the same in 2008 - 33 cases (incidence 0.09). The numbers were lower than the median in 2004-2008 (64 cases, incidence 0.17/100 000). According to laboratory reports in all 16 Regional Sanitary Stations only 14 persons were Shigella positive, in spite that more than 600 000 were examined: 10 persons were infected by S. sonnei, 4 by S. flexneri. Only one strain of S. sonnei was isolated from a patient with diarrhea. It was in the Regional Sanitary Station laboratory of the malopolskie voievodeshaft. No one strain of S. boydii or S. dysenteriae was isolated. DISCUSSION AND CONCLUSION: Most of the dysentery cases were examined by other laboratories than laboratories of sanitary epidemiological service. The obligation of private payment for bacteriological examination of suspected cases is one of reason that patient is treated with antibacterial drugs without determination of etiological agent of the infection. It concern the population of small and medium towns as well as population of farmers living in the country, children and youth. The registration of shigellosis in Poland is not valuable. In 2010 no case of amoebiasis was registered as in 2008 the disease no more should be obligatory registered.

[Foodborne infections and intoxications in Poland in 2010]. / Zatrucia i zakazenia pokarmowe w Polsce w 2010 roku.

AIM: The purpose of this paper was to describe the epidemiology of foodborne outbreaks in Poland in 2010. MATERIAL AND METHODS: The evaluation of the epidemiological situation was based on data from outbreak investigation forms, reported by Sanitary and Epidemiological Stations to the Department of Epidemiology, NIPH-NIH. RESULTS: In 2010 a notable increase in the number of cases reported with a bacterial infection was observed. This increase however did not exceeded the median number of cases reported in 2004-2008. In 2010 392 foodborne infections and food poisoning involving 6994 cases (outbreaks involving 4 person or more) and 145 foodborne outbreaks (where 2-3 persons became ill were reported. S. Enteritidis was the most frequently etiological agent in outbreaks associated with bacterial infection (32.9% of outbreaks 22.4% cases). Viruses caused 26% of outbreaks affected 30% of cases. In 38.3% outbreaks the etiological agent could not be established. The main vehicle of foodborne outbreaks were meals prepared from (> 3) raw meats (4.6% of outbreaks, 10.9% cases) and meals prepared using milk and eggs (9.9% of outbreaks 5.7% cases). The most frequent places of contamination included farms who produced goods for human consumption (11.5% of outbreaks, 5.0% of cases). Private residences (113 outbreaks with 745 cases) and hospitals were the most common place where food poisoning outbreaks occurred. In 2010 there were 6 outbreaks where more than 100 people were affected in these settings. CONCLUSIONS: Like in previous years, in 2010 the etiological agents, vehicle and sources of infection were not identified in most foodborne outbreaks. In order to decrease the number of outbreaks with undetermined etiological agent, the spectrum of routine laboratory tests of samples taken in outbreaks should be broaden.

[Hepatitis A in Poland in 2010]. / Wirusowe zapalenie watroby typu a w Polsce w 2010 roku.

OBJECTIVES: The purpose of this paper was to describe the epidemiology of hepatitis A in Poland in 2010. MATERIALS AND METHODS: The evaluation of the epidemiological situation was based on data published in the annual bulletins (Czarkowski MP et al. Infectious diseases and poisonings in Poland in 2010 Warsaw, NIPH - NIH and CHI, Vaccinations in Poland in 2010, NIPH - NIH and CHI). RESULTS: In Poland in 2010 were reported 155 cases of hepatitis A. The incidence rate in 2010 were 0.41 per 100 000 population. Most cases were registered in mazowieckie voivodeship (37 cases), slaskie voivodeship and wielkopolskie voivodeship (35 cases). The highest incidence were observed in wielkopolskie voivodeship 1,03 per 100 000 inhabitants. Incidence was higher among men than among women--0.53 and 0.29 per 100 000 population, respectively. In 2010 were notify of 5 foodborne outbreaks involving 10 cases. There were no death cases resulting from the infections hepatitis A. CONCLUSION: In 2010, compared with 2008 - 2009 (0.55 and 1.71 per 100 000 respectively), incidence was lower. However, it is possible to increase the number of cases and a local outbreak of hepatitis A due to a large group susceptible to infection.

[Dysentery and amoebiasis in Poland in 2009]. / Czerwonka bakteryjna i pelzakowa w Polsce w 2009 roku.

Only 30 cases were notified (incidence rate 0.08/100 000 population) in the year 2009, while the 33 cases were notified in 2008 (incidence rate 0.09/100 000), and median in the 2003-2007 years was 74 cases, incidence rate 0.19/100 000 population. Since 2000 no one-death case was notified. In the period of low frequency of Shigella infections, the external quality assessment control of the quality of bacteriological media, laboratory and prae-laboratory procedures for detection of different Shigella groups and types should be executed. In 2009 no one amoebiasis case was notified.

[Foodborne infections and intoxications in Poland in 2009]. / Zatrucia i zakazenia pokarmowe w polsce w 2009 roku.

In 2009 were notified of 451 foodborne infections and intoxications involving 5118 cases (only outbreaks involving 4 person or more) and 140 foodborne (involving 2-3 persons). S. Enteritidis were the most frequency etiological agent in outbreaks (32.2% of outbreaks 30.0% cases in outbreaks). The main vehicle of foodborne outbreaks in 2009 were meals prepared from various (> 3) raw materials of animal sources (32% of outbreaks, 18.9% cases). Of the places of food contamination, the most prevalent were private homes (10.9% of outbreaks, 5.2% of cases) and food producing farms (11.3% of outbreaks,7.6% of cases).

[Hepatitis A in Poland in 2009]. / Wirusowe zapalenie watroby typu a w Polsce w 2009 roku.

The 2009 was another year when the hepatitis A incidence in Poland increased. In total there were 562 cases registered and the incidence was 1.71 per 100 000 population and were 3 times higher than in 2008. The highest and the lowest incidence were observed in mazowieckie voivodeship and podkarpackie voivodeship respectively (5.16, 0.29). The most affected age groups among men were 25-29 years (6.96) and 20-24 years (6.71). The highest incidence in women was observed among 20-24 years (2,09). In 2009 8.6% cases were imported from intermediate and high-endemic countries. No hepatitis A deaths were registered.

[Hepatitis E as zoonosis]. / Wirusowe zapalenie watroby typu E jako zoonoza.

The hepatitis E virus (HEV) the causative agent of hepatitis E, is a non-enveloped RNA virus. HEV is transmitted through oral consumption of contaminated food and water According to the currently knowledge now be considered as zoonosis. The main reservoir of HEV are pigs, boars and deer. For the first time HEV was isolated from animals (pigs) in 1997 in the U.S. Genetic analysis of strains isolated from pigs showed high similarity to strains HEV isolated from humans. This was the first evidence showing that HEV is a zoonosis. Further studies have shown that occupational groups e.g. veterinarians, swine breeders with close contact to pigs have an increased risk for HEV infections. The additional evidence supported the zoonotic potential of HEV were reports of acute hepatitis E after the consumption of undercooked meat from deer and wild boar. Infection of HEV in the domestic pig and wild boar population in Europe is widespread.