Review of measles-related events recorded by the National IHR Focal Point in Poland in the years 2016-2018

Member States of the World Health Organization (WHO), in accordance with the requirements of the International Health Regulations (2005), were obliged to establish National Focal Points for International Health Regulations (IHR NFP), whose task is, among others, consolidating information on public health events of international importance that occur abroad or in the country. The aim of this article is to review information on measles-related events posted on the Event Information Site for IHR National Focal Points, in the Early Warning and Response System (EWRS), received by email directly from other IHR National Focal Points located in WHO member states, and from all organs of the State Sanitary Inspectorate in Poland in the years 2016-2018. In this time period, the IHR NFP recorded 92 measles-related events of which 38 related to individual cases, 37 to outbreaks of the disease, and 17 involved exposure to a measles case. 36% of reported events were aviationrelated. The number of events in 2018 has tripled compared to 2017 and increased eightfold in comparison to 2016. The current situation indicates the need to take appropriate actions, including implementation of the National Vaccination Program as well as introducing vaccination interventions.

Yersiniosis in Poland in 2017

AIM: The aim of the study is to assess epidemiological situation of yersiniosis in Poland in 2017 in comparison to previous years. MATERIAL AND METHODS: The evaluation is based on analysis of data from the annual bulletins "Infectious diseases and poisoning in Poland", information from individual yersiniosis case reports entered and shared by local sanitary-epidemiological stations through Electronic Registry of Epidemiologic Forms (SRWE), information from individual extraintestinal case reports fulfilled by local sanitary-epidemiological station and sent to the Departments of Epidemiology, National Institute of Public Health - National Institute of Hygiene by regional sanitary-epidemiological stations, information on outbreaks shared through the Electronic Registry of Epidemic Outbreaks (ROE) and data on deaths from the Department of Demographic Studies of the Central Statistical Office. RESULTS: In 2017 255 cases of yersiniosis, including 191 intestinal and 64 extraintestinal were registered. Incidence in 2017 was 0.66/100 000 population. Number of cases registered in 2017 was higher than in 2015 and 2016 (for both years 205 cases with incidence 0.53/100 000 was observed) and similar to the one in 2014 (244 cases, incidence 0.63/100 000). In 2017 all intestinal yersiniosis cases met criteria for confirmed case. Around 35% of cases were registered in mazowieckie voivodship where incidence was similar to the one in European Union. Among Y. enterocolitica isolates, serotype was determined in 62 cases what stands for only 28.7% of all cases. Predominant serotype was 03, it was identified in 81% of serotyped cases. Most of intestinal yersiniosis cases occurred among children under 4 years (54.5% of all registered cases). CONCLUSIONS: In 2017 increase in number of cases was observed. Yersiniosis in Poland is rarely diagnosed, incidence in Poland is more than twice time lower than in European Union.

Campylobacteriosis in Poland in 2017

OBJECTIVE: The aim of this study is to assess the epidemiological situation of campylobacteriosis in Poland in 2017 in comparison to previous years. MATERIAL AND METHODS: The evaluation is based on analysis of data from the annual bulletin "Infectious diseases and poisoning in Poland", information from individual campylobacter case reports sent by local sanitary-epidemiological stations through the Electronic Registry of Epidemiological Forms (System Rejestracji Wywiadów Epidemiologicznych - SRWE), information on outbreaks shared through the Electronic Registry of Epidemic Outbreaks (Rejestr Ognisk Epidemicznych - ROE) and data on deaths from the Department of Demographic Studies of the Central Statistical Office. RESULTS: There were 874 registered cases in Poland in 2017, all of them were confirmed cases. Incidence for Poland was 2.27/100 000 population. The highest incidence was observed in lubuskie voivodeship (7.57/100 000), malopolskie (4.64/100 000), slaskie (4.31/100 000) and warminsko-mazurskie (3.48/100 000). In 2017 increasing trend of proportion of hospitalization was identified again. The rate was on 80% level. Campylobacter species was identified in 89% of all reported cases. Similarly to previous years, vast majority of cases was caused by Campylobacter jejuni - 91%. Among all reported cases, majority of them (72%, 629 cases) was identified in children aged 0-4. In 2017 one campylobacteriosis outbreak was reported. CONCLUSIONS: Campylobacteriosis in Poland is still underreported and rarely diagnosed. Routine Campylobacter diagnosis is performed only by laboratories in small number of poviats which make it way harder to properly assess the campylobacteriosis epidemiological situation in Poland.

Foodborne infections and intoxications in Poland in 2017

AIM: The purpose of this study is to assess the epidemiological situation of food poisonings and infections in Poland in 2017. MATERIALS AND METHODS: The evaluation was based on the analysis of information sent to Department of Epidemiology NIPH-NIH through ROE (pol. Rejestr Ognisk Epidemicznych)- (an electronic system created for uploading, transfer and analysis of data acquired during the outbreak investigations). Additional sources for the analysis were NIPH-NIH annual bulletins (Czarkowski MP et al. "Infectious diseases and poisonings in Poland", 2011-2017. Warsaw, NIPH-NIH and GIS). RESULTS: In 2016 a total number of 926 foodborne infections and intoxications outbreaks were reported in which 27 702 persons were exposed and 7 416. A total number of 2 502 of patients were hospitalized. The most frequent etiological agent of outbreaks was hepatitis A virus (HAV) (27.1%). The most frequent cause of infection for all outbreaks cases was Salmonella sp. ­ 37.2%, especially serotype Enteritidis (32.2%). Among other agents rotaviruses caused 9.3% of outbreaks and noroviruses 14.5%. In 12.2% of outbreaks no etiological agent was found. The most frequent place of an outbreak was private household- 560 outbreaks (60.4%), and after that- hospital- 155 outbreaks (16.7%). In 86.8% of outbreaks no vehicle was found and in remaining the most frequent vehicle were eggs and egg products- 5.6% % of all outbreaks. CONCLUSIONS: Increasing yearly trend of Salmonella Enteritidis outbreaks, and high proportion of eggs and egg products as vehicles in those outbreaks point towards necessity of microbiological surveillance enchantment in relation to abovementioned products. Dynamic increase in HAV outbreaks is a good example of how a pathogen with high epidemic potential could spread in susceptible population.

Yersiniosis in Poland in 2015 and 2016

OBJECTIVE: The aim of this study is to assess the epidemiological situation of yersiniosis in Poland in 2015 and 2016 in comparison to the previous years. MATERIAL AND METHODS: The evaluation is based on analysis of data from the annual bulletins "Infectious diseases and poisoning in Poland" (4,5), information from individual yersiniosis case reports sent to the Department of Epidemiology of Infectious Diseases and Surveillance, NIPH-NIH by regional sanitaryepidemiological stations, information on outbreaks delivered by local sanitary-epidemiological stations through the system "Rejestr Ognisk Epidemicznych" (Electronic Registry of Epidemic Outbreaks) and data on deaths from the Department of Demographic Studies of the Central Statistical Office. RESULTS: The number of registered yersiniosis cases in Poland in 2015 and 2016 was the same ­ 205 cases, corresponding to annual incidence of 0.53/100 000. Among them in 2015 there were 172 intestinal yersiniosis cases and 33 extraintestinal yersiniosis cases and in 2016 ­ 167 intestinal yersiniosis cases and 38 extraintestinal yersiniosis cases. In 2015 and 2016 all intestinal yersiniosis cases met the criteria for confirmed case. In turn, among extraintestinal yersiniosis cases in 2015 26 cases met criteria for probable case and 7 for confirmed case and in 2016 ­ 32 for probable and 6 for confirmed case. Both in 2015 and in 2016 the incidence in mazowieckie voivodeship (1.61/100 000 in 2015 and 1.55/100 000 in 2016) largely exceeded the average incidence in Poland. The overall proportion of hospitalizations, 59.5% in 2015 and 58% in 2016, remained at the level similar to the preceding years. Serotype of the isolated Yersinia enterocolitica in 2015 in Poland was determined in 59 cases (32% of all Y. enterocolitica isolates). In 2016 serotype was determined in 47 cases of Y. enterocolitica infections (27% of all Y. enterocolitica isolates). Predominant serotype was O3. As in the previous years about 1/3 of infections occurred among children aged 0-4 (110 cases, 34.9% in 2015 and 92 cases, 30.9% in 2016). In 2015 there were no yersiniosis outbreaks, in 2016 there was one outbreak caused by Y. enterolitica. CONCLUSION: Yersiniosis in Poland is rarely diagnosed and is likely underreported. The percentage of serotyped isolates continues to be low.

Campylobacteriosis in Poland in 2015 and 2016

OBJECTIVE: The aim of this study is to assess the epidemiological situation of campylobacteriosis in Poland in 2015 and 2016 in comparison to the previous years. MATERIAL AND METHODS: The evaluation is based on analysis of data from the annual bulletins "Infectious diseases and poisoning in Poland", information from individual campylobacter case reports sent to the Department of Epidemiology of Infectious Diseases and Surveillance, NIPH-NIH by regional sanitary-epidemiological stations, information on outbreaks sent by local sanitary-epidemiological stations through the system ROE (Electronic Registry of Epidemic Outbreaks) and data on deaths from the Department of Demographic Studies of the Central Statistical Office. RESULTS: In Poland in 2015 653 cases of campylobacteriosis were registered, in 2016 ­ 787 cases. In comparison to 2014: the number of cases in 2015 number of cases remained at he similar level, in 2016 there was 20% increase in the number of cases. The incidence was 1.7/100 000 population in 2015 and 2.05/100 000 in 2016. All cases registered in 2015 were confirmed cases, among those occurred in 2016 there were 773 confirmed cases and 14 probable cases. In both, 2015 and 2016 incidence significantly higher than the average for Poland was in 3 voivodeships: Lubuskie (5.39/100 000 in 2015 and 5.9/100 000 in 2016), Warminsko-Mazurskie (4.78 and 4.03) and Slaskie (4.43 and 4.47). The overall proportion of hospitalizations was higher than in previous years ­ 75.5% in 2015 and 77.1% in 2016. In both 2015 and 2016 Campylobacter species was determined in more than 80% of cases, among them above 90% of infections were caused by C. jejuni. As in previous years most cases occurred among children aged from 0 to 4. In 2015 there were 4 outbreaks of campylobacteriosis, in 2016 ­ 5 outbreaks. CONCLUSIONS: In Poland there is continuous increase in number of registered campylobacteriosis cases but diagnosis and reporting is overall rare. Routine Campylobacter diagnosis is performed only in some poviats what makes assessment of epidemiological situation in a country not possible to conduct.

Measles elimination ­ review of event notifications sent to National IHR Focal Point between 2010 and 2016

The Member States of the World Health Organization (WHO) in accordance with International Health Regulations (2005) were obliged to appoint National IHR Focal Points (N IHR FP), of which tasks include obtaining information concerning public health emergencies of international concern which occurred abroad or within the country. The aim of this work is the review of WHO, ECDC, National IHR Focal Points from the WHO Member States and The State Sanitary Inspection notifications related to measles received by National IHR Focal Point in Poland in the period from 2010 to 2016. During this period N IHR FP was informed about 79 events related to measles. These events include: 36 related to the outbreaks in different countries, 27 concerning individual cases, 14 related to the exposure in contact with a measles case during air travel and two concerning the implementation of the MMR vaccination programs. Despite the progress in implementing the measures included in the elimination of measles programs in Europe, there was a significant increase in the number of measles cases and outbreaks particularly in years 2010-2011.

Poliomyelitis eradication ­ the review of notifications from the years 2010-2016 sent to National IHR Focal Point

Polio eradication programme was launched after World Health Assembly in 1988. Despite considerable decrease in reported cases it still constitutes a significant public health threat. All WHO member state is bound to appoint National IHR Focal Point, which operates based on International Health Regulations (2005), which were enacted during the World Health Assembly in 2005. In Poland National IHR Focal Point (IHR NFP in Poland) operates since 2007, and is located in the Department of Epidemiology, in National Institute of Public Health - National Institute of Hygiene. Its aim is to acquire, assess and to transfer information on events which may constitute an international threat for the public health. IHR NFP in Poland has an access to WHO's Event Information Site (EIS) as well as Early Warning and Response System (EWRS) with reading-only credentials. Both platforms are of limited access (1). Among recipients of IHR NFP notifications and information are experts from many fields such as epidemiology, virology, bacteriology and others- related to specific type of notification, as well as specific and appointed members of state's administration and authorities in the field of public health. In this paper a review of notifications on the subject of poliomyelitis, sent to IHR NFP in Poland in the years 2010-2016 is presented, as well as references to poliomyelitis epidemiological situation were made based on the date from Global Polio Eradication Initiative.

Emerging infectious diseases not covered by routine vaccination in Europe in 2010-2015--the review of WHO and ECDC notifications for the National IHR Focal Point in Poland.

The National IHR Focal Point is a center set up by each Member State of the World Health Organization (WHO) in accordance with the International Health Regulations (2005). The International Health Regulations (IHR) were adopted on 23 May 2005 at the World Health Assembly and entered into force since 15 June 2007 as the legal instrument designed to help protect all countries from uncontrolled international spread of diseases and other urgent public health threats. According to Article 2 of IHR the purpose and scope of these Regulations are to prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade. Primarily, the scope of IHR is to establish a system of early warning (in accordance with Article 6 and 7) with the functioning in each country National IHR Focal Point which is available at any time to communicate with WHO IHR Contact Points and other entities. The tasks of the National IHR Fo- cal Point in Poland which was appointed by the Minister of Health and runs in the Department of Epidemiology, National Institute of Public Health--National Institute of Hygiene from 1 September 2007 are the notification of events that may constitute a public health emergency of international concern occurring in Poland or abroad and the dissemination of this information to the WHO, other National IHR Focal Points or competent authorities responsible for public health. The task of the National IHR Focal Point in Poland is also the dissemination of WHO and ECDC notifications, including recommendation and risk assessment documents. The aim of this work is the review of WHO and ECDC notifications received by National IHR Focal Point in Poland in the period from 2010 to 2015 which were related to emerging infectious diseases not covered by routine vaccination programs or for which there are no effective vaccines that have occurred in the WHO European Region. The review includes verotoxin-producing Escherichia coli O104: H4 infections, MERS-CoV infections, Ebola virus disease, malaria, dengue fever, West Nile fever, chikungunya and cholera.

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

BACKGROUND: Hepatitis C is registered as a separate entity in the national infectious diseases system in Poland beginning from 1997. All physicians who diagnose the disease are mandated to report it and, additionally, in the years 2006 - 2008, mandatory reporting of positive results of HCV test by laboratories was also implemented. The initial definition adopted at the European Union level was implemented in Poland in 2005 (2005 definition) and it included cases with symptoms or elevated liver function tests, which coincided with the earlier practice. The amended European definition was implemented in 2009 (2009 definition) to require registration of all laboratory confirmed cases. AIM. To assess epidemiological situation of hepatitis C in Poland in 2010 in comparison to the preceding years. MATERIAL AND METHODS: We performed descriptive analysis of data collected through routine mandatory surveillance system. Case classification according to 2005 definition and 2009 definition was verified based on individual case reports. RESULTS: In 2010 in Poland 2021 hepatitis C cases meeting 2005 definition were registered (incidence 5.29 per 100,000), including 38 with mixed HBV-HCV infection. As compared to 2009 (1939 cases, incidence 5.08) the incidence increased by 4%. In consequence the decreasing trend observed since 2006 slowed down. Overall 2212 reported cases (5.79 per 100,000) met the 2009 definition. This number was higher than in 2009, but still several times lower than the number of newly diagnosed HCV cases registered in 2006 - 2008. In total 167 persons died due to hepatitis C (mortality 0.44 per 100,000), including 8 due to acute hepatitis C. This constitutes the highest hepatitis C mortality observed since 1996. CONCLUSIONS: Low number of registered cases meeting the 2009 definition indicates the necessity to improve the completeness of reporting, in ex. through restoring laboratory reporting. It also justifies maintaining the classification according to 2005 definition in order to monitor trends of the disease, even though the number of cases meeting this definition underestimates the real problem. The increase in mortality suggests that further improvements in diagnosis and access to treatment are necessary.