Salmonellosis in Poland in 2021. / Salmonelozy w Polsce w 2021 roku.

AIM: The aim of the article is to present and assess the epidemiological situation of salmonellosis in Poland in 2021, in relation to previous years. MATERIAL AND METHODS: The assessment of the epidemiological situation of salmonellosis in Poland was made on the basis of individual data on salmonellosis cases, entered by sanitary-epidemiological stations into the EpiBaza System, data on outbreaks caused by Salmonella bacilli from the Registry of Epidemic Outbreaks System (ROE), as well as on the basis of aggregated data published in the annual bulletins "Infectious Diseases and Poisoning in Poland" (NIPH NIH - NRI, GIS, Warsaw), including information sent by laboratories of sanitary-epidemiological stations, data from the article on the epidemiological situation of salmonellosis in Poland in 2020 and data from the Demographic Research Department of the Central Statistical Office. RESULTS: In 2021, in Poland sanitary-epidemiological stations registered 8,294 cases of salmonellosis - 8,014 cases of intestinal salmonellosis and 280 extra-intestinal salmonellosis, including 190 cases of salmonellosis septicemia. The incidence rate for total salmonellosis was 21.7/100,000 population, for intestinal salmonellosis 21.0, for salmonellosis septicemia 0.50, and 0.23 per 100,000 population for other extra-intestinal infections of salmonellosis etiology. The reported 7,988 cases were classified as confirmed and 306 as probable. There were 5,127 hospitalizations due to salmonellosis, mainly children and the elderly. The peak of the incidence was registered in July. The highest incidence rate of salmonellosis in 2021 was recorded in the Podkarpackie voivodeship (39.8/100,000 population), the lowest in the Swietokrzyskie voivodeship (10.7/100,000 population). The highest incidence of intestinal salmonellosis was registered in the age group 0-4 years, accounting for 44.2% of the total number of cases. Among extra-intestinal infections, almost 62% of cases occurred in people aged 60+. In 2021, sanitary-epidemiological stations were detected and reported 229 outbreaks of food poisoning caused by Salmonella bacilli, 75% of them was Enteritidis serotype. In 2021, the most frequently isolated serotypes were S. Enteritidis 72%, S. Typhimurium (2%) and S. Infantis (0.5%). The serotype was not determined in 24.3% of cases. There were 24 imported cases of salmonellosis from different regions of the world. Due to Salmonella infection 11 people died in 2021. Laboratories of sanitary-epidemiological stations performed 438,183 tests for the presence of Salmonella and Shigella bacilli among humans, 92% of these tests concerned people working in contact with food. CONCLUSIONS: In 2021, there was an increase in the number of salmonellosis cases in Poland, compared to 2020. It can therefore be concluded that the COVID-19 pandemic did not have a long-term impact on reducing the number of Salmonella infections. At the same time, despite the increase, the situation of salmonellosis in Poland has not fully returned to the state before the COVID-19 pandemic.The area where we observe a significant difference, is the percentage of hospitalizations, which is the lowest in 2021 since 1998. It can be assumed, that one of the reasons for this, could be a stricter qualification of people with milder symptoms for hospital treatment, in favour of outpatient care.

Foodborne botulism in Poland in 2018-2021.

Objectives: The aim of this study is to assess the epidemiological situation of foodborne botulism in Poland in 2018-2021, compared to previous years. Materials and methods: The assessment is based on an analysis of aggregated surveillance data from the annual bulletin "Infectious Diseases and Poisons in Poland" from 2013-2021, as well as botulism case reports collected by sanitary-epidemiological stations and sent to the Department of Epidemiology of Infectious Diseases and Surveillance of the NIPH NIH - NRI or provided by EpiBase. Results: A total of 54 foodborne botulism cases were registered between 2018 and 2021, including 31 (57.4%) cases of laboratory-confirmed botulism intoxication. Most cases (46 cases, 85.2%) were sporadic. The declining trend in the number of notifications continued throughout the time period, and the incidence recorded in 2021 (0.02 per 100,000 population) was the lowest since the introduction of mandatory reporting and registration of botulism in Poland. The highest median annual incidence was recorded in the Warmisko-Mazurskie (0.18), but many voivodeships reported only single notifications or none. The decreasing trend in rural areas relative to the level of incidence in urban areas continued. Men (incidence in men more than twice that of women) and people aged 50-59 predominated. All patients were hospitalized. According to the State Sanitary Inspection, there were 3 deaths (mortality of 5.6%). Conclusions: In 2018-2021, the downward trend in the number of foodborne botulism notifications in Poland continued. At the same time, the considerable proportion of cases reported by physicians without laboratory confirmation and not meeting the definition of botulism adopted in other EU countries is noteworthy. The incidence in rural areas decreases to the level of incidence in urban areas, and the previously observed geographical distribution of cases diminishes.

Infectious diseases in Poland in 2020.

OBJECTIVE OF THE WORK: The article reviews the main problems of the epidemiology of infectious diseases in Poland in 2020. It summarizes relevant findings from the national infectious disease surveillance system. MATERIAL AND METHODS: The data contained in this article come from the reports collected by the State Sanitary Inspection on cases of notifiable infectious diseases notified by clinicians and/or laboratories. These are supplemented by mortality data published by the Statistics Poland. RESULTS AND THEIR DISCUSSION: The epidemiology of infectious diseases was highly impacted by the COVID-19 pandemic. There were 1,306,983 cases notified in 2020 and 41,451 deaths attributed to COVID-19 (according to Statistics Poland). The reported incidence of other infections decreased by 10-98%. We noted especially high decreases in the incidence of viral gastrointestinal infections (by over 70%). The incidence of influenza and influenza-like infections decreased by 34% and tuberculosis by 36% as compared to 2019. However, important decreases were also noted for other diseases under surveillance, which could point to disruption of diagnosis services and reporting due to lockdowns and high workload on the public health services.

Salmonellosis in Poland in 2020.

AIM: The aim of the study is to assess the epidemiological situation of salmonellosis in Poland in 2020 compared with previous years. MATERIAL AND METHODS: The epidemiological situation was assessed on the basis of data provided to the Department of Epidemiology of Infectious Diseases and Surveillance of the NIPH NIH-NRI by sanitary-epidemiological stations through the EpiBaza System and the Registry of Epidemic Outbreaks System (ROE), as well as on the basis of data published in the annual bulletin "Infectious Diseases and Poisoning in Poland in 2020" (NIPH NIH-NRI, GIS, Warsaw, 2021) and from information received from laboratories of sanitary-epidemiological stations and data from the Demographic Research Department of the Statistics Poland. RESULTS: In Poland in 2020, in the sanitary-epidemiological surveillance registered a total of 5,470 cases of salmonellosis, 5,302 cases of intestinal salmonellosis, and the remaining 168 cases of extra-intestinal salmonellosis. The incidence per 100,000 population was 14.3 for total salmonellosis, 13.8 for intestinal salmonellosis and 0.44 for extra-intestinal salmonellosis. Sanitary-epidemiological stations registered 5,349 confirmed cases and 121 probable cases of salmonellosis. Due to intestinal salmonellosis, 63.9% of all patients were hospitalized, while for extra-intestinal salmonellosis 153 patients or 91.1% of cases, were hospitalized. The increase in the number of salmonellosis cases in 2020 started in June, while the peak of the incidence was in August. Among the voivodeships, the highest incidence of salmonellosis was registered in the Podkarpackie voivodeship 33.3/100,000 population, the lowest in Zachodniopomorskie 6.1/100,000 population. Cases in the 0-4 age group accounted for 45.2% of all salmonellosis cases in 2020. Among extra-intestinal salmonellosis, 63.1% were people aged 60+. Sanitary-epidemiological stations registered 131 food poisoning outbreaks caused by Salmonella bacilli in the ROE system, 108 of these outbreaks were caused by the Enteritidis serotype. In 2020, the most common serotypes were S. Enteritidis 70% of all recorded salmonellosis, S. Typhimurium 1.9%, and S. Infantis 0.54%. There were 9 deaths due to Salmonella infection. CONCLUSIONS: The COVID-19 pandemic and the associated restrictions introduced in the country, as well as increased hygiene through more frequent washing and disinfection of hands, could have contributed to a reduction of almost 69% in the number of salmonellosis cases registered in 2020, in Poland, compared to 2019. This is a 82% decrease in relation to 2018. There was also a decrease in the number of food poisoning outbreaks caused by Salmonella bacilli, while at the same time their percentage in the total number of outbreaks increased. On the one hand, the implemented restrictions could have had an impact on the decrease in the number of cases and outbreaks, on the other hand, worse access to medical care and diagnostics, most likely deepened the underestimation of these cases in the country observed for years, and distorted the real picture of the situation.

Infectious diseases in Poland in 2019.

OBJECTIVE OF THE WORK: The article reviews the main problems of the epidemiology of infectious diseases in Poland. It is an introduction to the Epidemiological Chronicle presented annually in the Epidemiological Review. MATERIAL AND METHODS: The data contained in this article come from the reports of the State Sanitary Inspectorate collected as part of routine epidemiological surveillance. Information on deaths comes from the reports from Statics Poland. RESULTS AND THEIR DISCUSSION: Based on the basic materials, this text presents data on infectious diseases of particular importance due to high incidence, such as influenza and other respiratory infections, or due to increasing trends, such as C. difficile infections, and Lyme disease. Particular attention was paid to diseases against which vaccinations are used and to non-endemic diseases imported from abroad. In the epidemiological characteristics of individual diseases, reference was made mainly to the data on the number of cases, incidence and deaths included in Table 1.

Salmonellosis in Poland in 2018 and 2019.

AIM: The aim of this study is to assess the epidemiological situation of salmonellosis in Poland, in 2018 and 2019 compared with previous years. MATERIAL AND METHODS: The assessment of the epidemiological situation was performed on the basis of data provided to the Department of Epidemiology Infectious Diseases and Surveillance of NIPH NIH - NRI by sanitary-epidemiological stations through the Epidemiological Case Reporting System (SRWE) and the Registry of Epidemic Outbreaks (ROE), as well as on the basis of data from the annual bulletins "Infectious Diseases and Poisonings in Poland" 2018 and 2019 (NIPH NIH - NRI, GIS, Warsaw, 2019 and 2020) and from information received from laboratories of sanitary-epidemiological stations and data from the Demographic Research Department of Statistics Poland (GIS). RESULTS: In Poland in 2018 a total of 9,957 cases of salmonellosis were reported in the sanitaryepidemiological surveillance, among these infections 9,651 were cases of intestinal salmonellosis, 306 were cases of extraintestinal salmonellosis. The incidence rate for total salmonellosis was 25.9 per 100,000 population, for parenteral salmonellosis alone was 0.80 per 100,000 population. There were 9,370 cases of confirmed and 587 cases of probable salmonellosis registered. Hospital treatment was given to 65% of patients with intestinal salmonellosis and 88.6% of patients with extraintestinal forms of the disease. The increase in salmonellosis cases in 2018 occurred during the summer months with a peak in cases in August. The highest incidence of salmonellosis nationwide was in the Podkarpackie voivodeship 42.2/100,000, the lowest in the Lubuskie voivodeship 9.4/100,000. More cases were registered in urban areas - 5,866 salmonellosis cases. Cases in the age group 0-4 constituted 37.7% of all cases. Among parenteral salmonellosis 64.7% were people over 60 years of age. In ROE system there were 351 food poisoning outbreaks with Salmonella spp. as the etiological agent, mainly Enteritidis serotype. The most frequently isolated serotypes in Poland in 2018 were S. Enteritidis, S. Typhimurium and S. Infantis, the first of which was responsible for 76.3% of all Salmonella infections. There were 1,719 cases registered in which the serotype was not determined, most of them came from the Pomorskie voivodeship. Sanitary-epidemiological stations performed 547,976 bacteriological tests for Salmonella and Shigella, 0.2% of people working in contact with food had a positive result. There were 43 cases imported from abroad. Due to Salmonella infection 4 people died in 2018. In 2019 a total of 9,234 cases of salmonellosis were registered in Poland, including 8,919 food poisoning and 315 parenteral salmonellosis. The incidence for total salmonellosis in Poland was 24.1 per 100,000 population. There were 8,687 confirmed and 547 probable cases of salmonellosis reported. Due to food poisoning 63.1% of patients were hospitalized, while due to parenteral salmonellosis 87.6% of patients were hospitalized. The peak incidence in 2019 occurred in August. The highest incidence per 100,000 population of total salmonellosis by voivodeship was recorded in the Podkarpackie voivodeship 55.1, the lowest in the Zachodniopomorskie voivodeship 8.8. Almost 40% of all salmonellosis cases in the country were among children aged 0-4; as far as parenteral salmonellosis is concerned, the main group of patients 68.6%, were people over 60 years old. Sanitaryepidemiological stations reported in the ROE system 303 outbreaks of food poisoning of salmonellosis etiology. The most commonly isolated serotype in 2019 in Poland was Salmonella Enteritidis 75.6% of all recorded salmonellosis cases, followed by Salmonella Typhimurium 3% and Salmonella Infantis 1%. The serotype was not determined in 1,692 cases, the highest number in the Pomorskie and Kujawsko-Pomorskie voivodeships - 51% of undetermined isolates each. Laboratories of sanitary-epidemiological stations carried out 610,164 bacteriological tests for Salmonella and Shigella. Among people working in contact with food 0.2% had a positive test result. 71 cases of imported intestinal salmonellosis were registered. Nine deaths due to Salmonella infection were reported. CONCLUSIONS: The salmonellosis situation in Poland in 2018 and 2019 remains at a high but stable level. The significant increase in the number of laboratory tests performed for Salmonella in 2018-2019 and the decrease in the number of people refusing the carrier exclusion test, is an important step in the process of enhancing salmonellosis surveillance.

Infectious diseases in Poland in 2018.

OBJECTIVE OF THE ARTICLE: The introductory text to the Epidemiological Chronicle (EC) of the Epidemiological Review contains data on the incidence of infectious and parasitic diseases in Poland in 2018 compared to 2017 data and medians from 2012-2016. It is a general overview of the epidemiological situation of infectious and parasitic diseases in Poland. With regard to selected diseases, widening and deepening picture is in the content of remaining articles of the epidemiological chronicle. MATERIAL AND METHODS: The source data for this article are mainly individual reports submitted by doctors to the County Sanitary/Epidemiological Stations. The basic material of this study is the data published in the bulletins "Infectious diseases and poisoning in Poland in 2018" and "Immunization in Poland in 2018", as well as data published in the reports "Influenza and suspected influenza in Poland in 2018". Data on deaths due to infectious diseases come from the summaries of the Demographic Research Department of the Central Statistical Office. RESULTS AND THE DISCUSSION: As in previous years, the highest incidence was recorded in the category of upper respiratory tract infections and, but to a much lesser extent, gastrointestinal infections. For at least two decades, there has been a shift in the profile of gastrointestinal infections characterized by an increase in viral infections compared to bacterial infections. Regarding healthcare associated infections, rotavirus infections predominate among children and C. difficile infections among adults. The later creates a serious, growing problem, largely related to the use of antibiotics, but also to fecal-oral transmission. Among infectious diseases, C. difficile caused the highest number of deaths in 2018. Viral infection of the liver continues to be an important problem. Apart from hepatitis B and C, this also applies to hepatitis A, which took the form of an epidemic in 2017. In 2018, the incidence decreased by more than a half, but still the number of cases was about thirty times higher than for the median from 2012-2016. Despite declining tendency for many years, the incidence of tuberculosis still remains above the numbers recorded in the developed countries of Western Europe. In other disease groups, there was no marked increase in risk compared to previous years.

Infectious diseases in Poland in 2017

OBJECTIVE OF THE WORK: The article contains an overview of epidemiological surveillance data on infectious diseases in Poland in 2017 with reference to data from 2016 and median from 2011-2015. This is another introductory article to the systematically conducted Epidemiological Chronicle of Epidemiological Review presenting the current epidemiological situation of selected infectious diseases. In justified cases, eg by cross-border threats, the study includes references to the epidemiological situation in other countries. MATERIAL AND METHODS: The source data for this study are the applications of doctors to the State Sanitary Inspection, which in the form of summary lists or individual notifications are forwarded to the Department of Epidemiology of Infectious Diseases and Surveillance of NIPH-PZH and after being prepared they are included in the bulletins "Infectious diseases and poisoning in Poland in 2017 "and" Protective vaccinations in Poland in 2017". Data on deaths due to infectious diseases come from a list of the Department of Demographic and Labor Market Research of the Central Statistical Office. RESULTS AND THEIR DISCUSSION: Discussion of epidemiological data begins with the most prevalent diseases in Poland, which are upper respiratory tract infections and gastrointestinal infections. In the area of upper respiratory tract infections, attention is drawn to the increase in the number of reported cases in recent years, which may be at least partly related to the development of computerization of reports. The profile of gastrointestinal infections acquired in the non-hospital environment has been changing in recent years towards a clear predominance of infections with viral etiology in relation to bacterial infections. Regarding healthcareassociated infections, rotavirus infections predominate among children, and among adults, C. difficile infections constitute a serious, growing problem, which is largely associated with the use of antibiotics. Viral liver infections are still an important problem. B and C, and in 2017 also hepatitis A, which took the form of an epidemic. In other groups of diseases, there was no clear increase in threats compared to previous years. Despite a steady decline in incidence, tuberculosis has been the disease causing the highest number of deaths among infectious diseases for many years. In 2017, the highest number of deaths was caused by C. difficile infection.

Foodborne botulism in Poland in 2017

OBJECTIVES: The aim of this study is to assess the epidemiological situation of foodborne botulism in Poland in 2017 compared to previous years. MATERIALS AND METHODS: The assessment is based on national surveillance data on foodborne botulism cases available in the annual bulletin "Infectious diseases and poisonings in Poland in 2017" and in previous publications, as well as data from botulism case reports for 2017 submitted by Sanitary-Epidemiological Stations to the Department of Epidemiology of Infectious Diseases and Surveillance NIPH-NIH. RESULTS: In 2017, a total of 24 foodborne botulism cases have been reported including 14 with laboratory confirmation of botulism intoxication. The annual incidence rate (0.06 per 100,000 population) was one the lowest since the introduction of mandatory reporting of the disease in Poland. The highest incidence in the country was noted in Podlaskie (0.34). The incidence rate among rural residents (0.10 per 100,000 population) was more than twice as high as in urban areas (0.04). The incidence in men was 49% higher than in women. The disease was most common in middle-aged and elderly people; the highest incidence was noted in age group of 40-49 years (0.13) and 50-59 years (0.14). The most common sources of the toxin were homemade canned pork products as well as mixed or unknown types of canned meats. All patients were hospitalized. Four deaths related to the disease were reported. CONCLUSIONS: In 2017, the overall number of reported cases continues to decrease. Limited number of laboratories performing laboratory diagnostics of botulism is still an issue. Additionally a priority remains to conduct health education with regard to safe food preservation, storage and consumption.

Salmonellosis in Poland in 2017

AIM: The aim of the study is to assess the epidemiological situation of salmonellosis in 2017 in Poland compared to the previous years. MATERIAL AND METHODS: The assessment of the epidemiological situation was performed on the basis of data submitted to the Department of Epidemiology of Infectious Diseases and Surveillance NIPH-NIH by sanitaryepidemiological stations by means of the Epidemiological Case Reporting System (SRWE) and the Registry of Epidemic Outbreaks (ROE), along with data from the annual bulletin "Infectious diseases and poisonings in Poland in 2017" (NIPH-NIH, CSI, Warsaw 2018), and information from the laboratories of Sanitary epidemiological Stations as well as data from the Department of Demographic Studies of the Central Statistical Office. RESULTS: In 2017, 10 000 cases of Salmonella infection were registered in Poland, 9 710 were cases of intestinal salmonellosis, 290 were forms of extraintestinal salmonellosis. The incidence rate per 100 thousand population was 26.0. The hospitalization rate for all salmonellosis cases was 63.3%. Confirmed cases accounted for 92,1% of all cases, the remaining 7.9% were probable cases. Peak incidence occurred, as in previous years, in the summer months. The voivodships with the largest number of cases caused by Salmonella were the Mazowieckie and Malopolskie voivodeships, the least was recorded in the Lubuskie voivodeship. The age group in which the highest percentage of food poisonings was recorded were children aged 0-4, while extraintestinal forms most often concerned people aged over 60. 278 food poisoning outbreaks were recorded, in which Salmonella Enteritidis was the most frequently isolated serotype. This serotype was most often isolated in foodborne outbreaks and in sporadic cases, it is responsible for 92% of all salmonellosis. Salmonella infection was found in 0.2% of people working with food and in 8.1% of contacts of the cases. According to data from the Central Statistical Office, 10 people died of salmonellosis in 2017. CONCLUSIONS: In 2017, the number of people infected with Salmonella was as high as in 2016, the reason for the persistence of such a high number of cases may be the association of some infections with an international salmonellosis outbreak, the peak of which was in 2016. The high incidence of salmonellosis may also be a consequence of legal changes introduced in 2014 regarding the reporting of positive test results by laboratories for epidemiological surveillance.

Foodborne botulism in Poland in 2016

OBJECTIVES: The main aim of the study is to assess the epidemiological situation of foodborne botulism in Poland in 2016 compared to previous years. MATERIALS AND METHODS: In this assessment we reviewed national surveillance data on foodborne botulism cases published in the annual bulletin "Infectious diseases and poisonings in Poland in 2016" and in previous publications, as well as unpublished data retrieved from botulism case reports for 2016 sent from Sanitary-Epidemiological Stations to the Department of Epidemiology NIPH-NIH. RESULTS: In 2016, a total of 26 foodborne botulism cases (including 18 laboratory confirmed) were reported and the annual incidence rate (0.07 per 100,000 population) was slightly lower than both the previous year and the median incidence from 2010-2014. The highest incidence in the country was noted in Lubelskie (0.33), Warminsko-mazurskie (0.28) and Zachodniopomorskie provinces (0.23). The incidence in rural areas (0.10 per 100,000 population) was twice as high as in urban areas (0.05); incidence among men was 8 times as high as among women; the highest incidence (0.36) was observed in men in the age group of 50-59 years. Most cases were associated with consumption of homemade canned fish or pork products and mixed or unknown types of canned meats. All patients were hospitalized. Three deaths related to the disease were reported. CONCLUSIONS: In 2016, the epidemiological situation of foodborne botulism in Poland has not changed significantly. This study suggests the need for training of health care professionals to improve diagnosis of botulism as well as continuous health education with respect to how to safely preserve, store and consume food at home.

Infectious diseases in Poland in 2016

OBJECTIVE OF THE ARTICLE: This is for the year 2016 subsequent annual analysis of the situation of infectious and parasitic diseases in Poland as part of the Epidemiological Chronicle of the Epidemiological Review. Its purpose is to summarize the collective incidence of infectious diseases and to indicate potential threats to the health of populations from communicable diseases occurring in Poland. MATERIAL AND METHODS: The basic source of epidemiological information for this summary is a summary of data from reports of the State Sanitary Inspection, contained in the annual bulletins "Infectious diseases and poisoning in Poland in 2016" and "Protective Vaccination in Poland in 2016" (1, 2). Supplementary sources are detailed assessments of the epidemiological situation of selected infectious diseases that make up the socalled Epidemiological Chronicle. Data on deaths were obtained from materials of the Department of Demographic and Labor Market Research of the Central Statistical Office regarding deaths from infectious and parasitic diseases registered in Poland in 2015 and in earlier years. RESULTS AND THEIR DISCUSSION: The most numerous group among infectious diseases subject to epidemiological surveillance are upper respiratory tract infections classified as "influenza and influenza - like disease". In 2016, the number this category cases was 4 316 823 (11 233.9 / 100 000). In relation to incidence in 2015, it was an increase of 12.4%, and in relation to the median from 2010-2014 by 196.5%. In 2016, the incidence of intestinal infections of salmonellosis etiology increased compared to the previous year by 16.0%, and in relation to the median from 2010-2014 was higher 19.1%. This is a deviation from the downward trend of these infections observed over last decades. A serious epidemiological problem is the high incidence of infection caused by Clostridium difficile. In 2016, 8 716 (22.7 / 100,000) of these cases were reported, which resulted in 540 deaths. In comparison with the previous year, it was a non-significant decline in incidence by 2.8%, but in comparison with the median from 2010-2014 it was an increase of 56.4%. In 2015, the high incidence of norovirus induced intestinal infection persisted. 3 706 cases were reported (9.64/ 100 000), which is significantly higher than in 2015 (by 2%), but in relation to the median from 2010-2014 it was an increase of 136.6%. Among viral intestinal infections in children, rotavirus infections are still a particularly important problem. Despite the decrease in incidence in comparison with 2015 by 37.3%, the number of cases in 2016 was 21 258 (55.3 / 100,000), which is a serious epidemiological problem. A high percentage of these incidents were infection related to the medical care. In the group of infections and intestinal intoxication, which cause diarrhea in children under 2 years, in 2016 there was a decrease from the previous year of 11.7%, but in relation to the median from 2010-2014 it was an increase of 25.7%. In 2016 number of reported cases of pertussis was 6 828 (17.8 / 100 00), which represented a rise in incidence compared to the previous year by 37.9%, and compared to the median from 2010-2014 by as much as 225%. The year 2016 was another year of decreasing the incidence of rubella. 1105 cases were reported (2.88 / 100 000), what in comparison with the previous year was a decrease of 44.9%, and in relation to the median of 2010-2014 by 81.2%. No congenital rubella was reported. For many years, Poland has been free of native measles. The measles cases are infections imported from abroad and secondary cases of people who have contacted them in the country. In 2016, cases were 133 (0.35 / 100 000). The number of invasive infections caused by Streptococcus pneumoniae in 2016 was 967. In comparison with 2015, it was a non-significant decrease of 1.2%. In 2016, there were 3 806 (9.9 / 100 000) reported cases of hepatitis B, which in relation to the median of 2010- 2014 is an increase of 141.0%. Number of newly diagnosed cases of hepatitis C was 4 261 (11.1 / 100 000), which in relation to the median from 2010-2014 is an increase of 88.2%. This increase in incidence remains in a relationship. with the introduction in 2014 of a new, more sensitive case definition. 21 200 cases of Lyme disease were reported (55.2 / 100 000), which in comparison with the previous year, is an increase of 55.7%. As compared to the median of 2010-2014 it was increase by 132.1%. In 2016, number of cases of newly diagnosed HIV was 1318 (3.43 / 100 000). And number of reported AIDS cases was 102. The increase in the incidence of HIV infection was not significant. The number of cases of AIDS fell by 20.3% as compared to the previous year. Registered cases of malaria refer to people who have been infected abroad in endemic countries. There were 38 such cases in 2016. In 2015, no diphtheria, poliomyelitis, rabies and viral hemorrhagic fevers were found in Poland except for dengue, of which 41 cases of infections acquired in endemic areas were reported for epidemiological surveillance. The number of deaths from infectious and parasitic diseases in 2016 was 2 242 people. The share of deaths from these causes in the total number of deaths in Poland (388 009) was 0.58%. The highest number of deaths was caused by tuberculosis ­ 543 and intestinal infections caused by Clostridium difficile ­ 540.

Salmonellosis in Poland in 2015 and 2016

THE AIM: The aim of the study is to assess the epidemiological situation of salmonellosis in 2015-2016 in Poland, compared to the previous years. MATERIAL AND METHODS: The assessment of the epidemiological situation was performed on the basis of data from bulletins "Infectious diseases and poisonings in Poland", information from the laboratories of Sanitaryepidemiological Stations and data from epidemiological investigations of outbreaks which were provided by Sanitary-epidemiological Stations through the Register of Epidemic Outbreaks (ROE) to the Department of Epidemiology of Infectious Diseases and Surveillance as well as data from the Department of Demographic Studies of the Central Statistical Office. Cases were classified according to the implemented case definitions. RESULTS: In 2015, a total of 8 650 cases salmonellosis were reported. Among them 8 418 were cases of intestinal salmonellosis and 232 of extraintestinal one. Total incidence was 22.5/100 000. 8235 (95,2%) cases met the criteria for confirmed case and 415 cases were classified as probable. In comparison to 2014, the percentage of hospitalized persons increased slightly and remained at a high level of 71.8%. The increase of salmonellosis cases, as in previous years, occurred in the summer months. In 2015 he highest incidence was recorded in the Malopolskie and Mazowieckie voivodeships, and the lowest in the Lubuskie. Children 0-4 were most often affected, especially at the age of 2 and 3 years old. Number of reported foodborne outbreaks caused by Salmonella was 190. Among them 154 were caused by Salmonella Enteritidis. This serotype, as in previous years was the most frequently isolated. Out of the 433 571 tested people who were working with food, 0.2% were infected with Salmonella. In 2016, the total number of reported cases of salmonellosis was 10,027 cases, which was close to 16% increase in cases compared to the previous year and over 19% increase compared to 2014. There were registered 9,701 cases of intestinal and 326 extraintestinal infections. 9,713 cases were classified as confirmed, accounting for 96.9% of all and 314 cases were classified as probable ones. The percentage of hospitalizations in 2016 remained at a similar level as in previous years (71.1%). The peak of incidence as in the previous year was in July. The highest numbers of cases were recorded in the Malopolskie and Mazowieckie voivodeships, which accounted for 23% of all reported cases. As in previous years, most often affected were children at the age 0-4. In 2016 number of reported outbreaks of foodborne infections caused by Salmonella sp. was 240. In 85% of them S. Enteritidis serotype was isolated, which as in previous years was the serotype most frequently isolated in outbreaks and sporadic diseases. Among 443 419 people working with food who were tested for Salmonella 0,2% were positive, as in the previous year. CONCLUSIONS: The increase in the incidence of salmonellosis in 2015-2016 in Poland may be related to the outbreak detected in 2016, covering more than a dozen EU countries, associated with eggs originating in Poland. Observed in the last several years high percentage of hospitalizations due to salmonellosis is a consequence of rare laboratory testing for salmonellosis by GPs of patients with gastroenteritis. It also results in the low sensitivity of salmonella surveillance in Poland.

Hepatitis B in Poland in 2016

OBJECTIVE: Evaluation of the epidemiological situation of hepatitis B in Poland in 2016 compared to the situation in previous years. MATERIAL AND METHODS: The epidemiological situation was assessed based on the results of the analysis of individual data on hepatitis B cases and HBV infections registered by Local Sanitary- Epidemiological Stations in the central database using Epidemiological Interview Registration System (SRWE). Aggregate data published in the annual bulletins "Infectious Diseases and Poisonings in Poland" and "Vaccinations in Poland" were also used. RESULTS: In 2016, a total of 3806 hepatitis B cases were registered, including 21 HBV/HCV co-infections. The number of acute hepatitis B cases was 50 (incidence 0.13 per 100,000 population). In comparison with 2015 there was a slight decrease in both the incidence and contribution of acute cases in the total number of hepatitis B. In people aged 0-20 years, subjected to mandatory vaccinations as neonates, no acute cases have been reported. Most cases of acute hepatitis B occurred probably due to medical procedures (73% of cases with a known transmission route). The incidence of chronic and unknown (in terms of stage) hepatitis B was 9.77 per 100,000 population and it was higher by 8% than in the previous year. The highest incidence was recorded in pomorskie voivodeship (19.42 per 100,000), and the lowest in lubelskie voivodeship (2.81 per 100,000). Chronic and unknown stage (UNK) hepatitis B were more often detected in men (1.3-fold more frequent than in women) and in urban residents (1.5-fold more frequent than in rural). The dominant route of transmission of chronic and UNK infections still remains procedures performed in medical settings (77% of cases with a known transmission route). According to CSO data 4 people died due to acute hepatitis B and 35 people due to chronic hepatitis B in 2016. CONCLUSIONS: In comparison with 2015 the epidemiological situation of hepatitis B did not change significantly - there was a slight increase the incidence of chronic and UNK hepatitis B, may be due to the number of tests performed per year and due to completeness of reporting for surveillance. A high percentage of acute cases related probably to medical procedures points to the need to strengthen compliance with safety rules while performing medical procedures at all levels of care and recommendation of vaccination against hepatitis B for all persons previously unvaccinated.

Foodborne botulism in Poland in 2015

OBJECTIVE: The aim of this article is to assess the epidemiology of foodborne botulism in Poland in 2015 compared to previous years MATERIALS AND METHODS: We reviewed (1) national surveillance data published in the annual bulletin "Infectious diseases and poisonings in Poland in 2015" and in previous publications, and (2) unpublished data retrieved from botulism case reports for 2015 sent from Sanitary-Epidemiological Stations to the Department of Epidemiology NIPH-NIH. RESULTS: In 2015, a total of 30 foodborne botulism cases (including 18 laboratory confirmed) was reported; the annual incidence rate (0.08 per 100,000 population) was remarkably similar to that reported in previous year and to the median incidence for years 2009 to 2013. The highest incidence in the country was reported in Swietokrzyskie (0.24), Lubelskie (0.23) and Zachodniopomorskie province (0.23). Incidence in rural areas (0.13 per 100,000 population) was over 3-times higher than the incidence in urban areas (0.04). Similarly, men had more than 3 times higher incidence than women; As in previous year the highest incidence rate (0.30 per 100,000 population) was observed among men in the age group of 20-24 years. Most cases were associated with consumption of different types of commercially canned meat. Commercially produced canned fishery items were also a common vehicle. All cases except one were hospitalized. No deaths related to the disease were reported. CONCLUSIONS: In 2015, the annual incidence of foodborne botulism in Poland was remarkably similar to that reported in previous years. Since 2008 the number of foodborne botulism is stabilizing with an average of 30 cases per year and corresponding incidence rate of 0.08 per 100,000 population. It is important to conduct thorough epidemiological investigation of each case, in order to identify the most common food vehicles for botulism and other risk factors.

Hepatitis B in Poland in 2015

OBJECTIVE: Assessment of the epidemiological situation of hepatitis B in Poland in 2015 in relation to previous years. MATERIAL AND METHODS: Evaluation of the epidemiological situation carried out based on analysis of data from individual reports on acute hepatitis B cases registered by the sanitary-epidemiological stations, aggregate data published in annual bulletins "Infectious diseases and poisonings in Poland" and data from annual bulletin "Vaccinations in Poland". RESULTS: In total, 3 518 cases of hepatitis B were registered in 2015, including 24 cases of HBV/ HCV co-infections. Acute cases accounted for 1.5% of all recorded cases, with a sustained downward trend in incidence - 0.14 per 100,000. Incidence of acute hepatitis B was lower by 22% compared to the previous year. In group of children up to 14 years old, covered by universal vaccinations of neonates, 1 acute case was reported in a 4-month-old child. Most of acute hepatitis B infections (58%) were probably acquired during medical procedures performed in health care settings. The number of chronic and unknown (in terms of stage) cases registered increased in comparison with the previous year, the incidence was 9.0 per 100,000 population and was higher by 29% than in 2014. Chronic infections and UNK occurred 1.3-fold more frequently in men than in women and 1.5-fold more frequently among urban dwellers than in rural population. In 2015, three people died due to acute hepatitis B, and 57 people due to chronic. CONCLUSIONS: The changes implemented in surveillance in 2014 allow for gradual reducing of territorial disparities and for assessment of the actual number of newly detected infections. Maintenance of a low incidence of acute hepatitis B provides the premise for sustain existing preventive measures, especially universal vaccination of newborns and recommendation to vaccinate of all persons previously unvaccinated.

Infectious diseases in Poland in 2015

PURPOSE OF THE STUDY: This is the next annual analysis of the situation of infectious and parasitic diseases in Poland in 2015 within the framework of the Epidemiological Chronicle of Przeglad Epidemiologiczny - Epidemiological Review. Its purpose is to identify potential threats to the health of populations from infectious diseases occurring in Poland with reference to other parts of the globe. MATERIAL AND METHODS: This paper is an introduction to more detailed studies of the epidemiological situation of selected infectious diseases and summarizes the results of the surveillance of infectious diseases in Poland in 2015. References to epidemiological situation in other countries are limited to situations that may affect current or potential occurrence of the disease in Poland. The main source of epidemiological information for this summary is the data from the reports of the State Sanitary Inspection included in the annual bulletins "Infectious Diseases and Poisonings in Poland in 2015" and "Vaccination in Poland in 2015" (1, 2). The epidemiological situation of particular diseases is further elaborated in the Epidemiological Chronicle of the same issue of the Epidemiological Review. Data on deaths are based on the presentation of the Demographic and Labor Market Department of the Central Statistical Office on deaths from infectious and parasitic diseases registered in Poland in 2015 and earlier. RESULTS: For a long time, the most common diseases among epidemiological surveillance it is upper respiratory tract infections classified as "influenza and suspected influenza". In 2015, the number of cases was 3,843,438 (9 994,7 / 100,000). As to compare with the 2014's incidence, this was an increase of 22.6%. In 2015, incidence of intestinal infections with etiology of salmonella increased by 2.8% compared to the previous year, but compared to the median of 2009-2013 was 2.5% lower. A serious epidemiological problem is a strong upward trend in nosocomial infections including infections caused by Clostridium difficile. In 2015, 8.976 (23.3 / 100,000) of these cases were reported. They caused 491 deaths. Compared to the previous year, the increase in incidence was 39.8%. Compared with the median of 2009-2013 it was an increase of 89.7%. In 2015, there was a continuation of observed for more than a dozen years the unfavorable trend of intestinal infections caused by noroviruses. There were recorded at 3,637 (9.5 / 100,000) of those infections. Among viral intestinal infections, rotavirus infections in children are a particularly important problem. In 2015, as compared with 2014, the increase of incidence in the general population was not high, only 0.5%, but to the median of 2009-2013 it was 44.4%. An important group of intestinal infections, diarrhea in children under 2 years of age, had a slight decrease (by 0.3%) in the category of bacterial infections in 2015, but increased by 26.7% in the category of bacterial poisonings and 5.9% in the category of viral infections. In 2015, there were 4956 cases of pertussis (512.9 / 100,000), which was an increase in the incidence compared with the previous year by 136.2%, and compared with the 2009-2013 median by 127.4%. After the epidemic of rubella outbreaks in 2013, in the year 2014, the incidence dropped by 84.7% and in 2015, the decrease was 65.9%. One case of congenital rubella has been reported. Most measles infections are imported infections or in contact with them in the country. In 2015 the number of cases was 48 (0.12 / 100,000). In 2015, the number of invasive diseases caused by H. influenzae was 62 (0.16 / 100,000). Compared to the previous year, this was an increase of 51.3%. The number of invasive diseases caused by Streptococcus pneumoniae in 2015 was 979 cases. Compared to 2014, this was an increase of 39.0%. When compared with the median of 2009-2013, increase was 128.1%. In 2015, number of reported cases of hepatitis B was 3,518 (9.1 / 100,000), which was 122.7% higher than the median of 2009-2013. Newly diagnosed C-type infections were reported to be 4,285 (11.1 / 100,000), an increase of 91.6% over the median of 2009-2013. Such a large increase in reported cases is related, inter alia to the introduction a new, more sensitive case definition in 2014. The incidence of Lyme disease has been on the rise in the last fifteen years. In 2015, 13,625 cases (35.4 / 100,000) were reported, which, with an insignificant decrease compared to 2014, gives rise to 49.1% over the median of 2009-2013. The downward trend in the incidence of tuberculosis (all forms of tuberculosis) is clearly persistent. In 2015, the incidence of this disease decreased compared to the previous year from 17.4 to 16.7 / 100,000. In 2015 were reported 1,281 cases of newly diagnosed HIV (3,33 / 100,000). It was an increase of 13.0%. The number of AIDS cases decreased by 13.5% compared to the previous year. Reported cases of malaria involve people who have been infected abroad in endemic malaria areas. In 2015 there were reported 29 such cases. None of the cases of diphtheria, chronic childhood paralysis, rabies and viral hemorrhagic fever except for dengue have been reported in 2015. There were reported 12 cases of dengue imported from endemic regions. In Poland in 2015 number of deaths from all infectious and parasitic diseases was 2,199. The share of deaths due to infectious diseases in the total number of deaths was 0.54% and mortality was 5.5 per 100,000 population. The majority of deaths were caused by tuberculosis and its consequences (25.7%) and intestinal infections caused by Clostridium difficile (23.2%).

Influenza in Poland in 2013 and 2013/2014 epidemic season

OBJECTIVE: Analysis of epidemiological situation of influenza in Poland in 2013 and 2013/14 epidemic season in reference to previous years and seasons. MATERIAL AND METHODS: Analysis was based on: 1) data collected within influenza routine surveillance system in Poland, including data published in annual bulletins "Infectious diseases and poisonings in Poland" as well as unpublished data gathered in the Department of Epidemiology of the NIPH-NIH; 2) data collected within influenza system - Sentinel, and beyond this system, concerning results of virological tests carried out in 2013/14 epidemic season in the Department of Influenza Research, National Influenza Center in the NIPHNIH and/or laboratories of provincial sanitary and epidemiological stations which are gathered in the National Influenza Center. RESULTS: Compared to 2012, the number of influenza and influenza-like cases increased more than twofold in 2013 in Poland. A total of 3 164 405 cases were reported. Incidence was 8 218.7 per 100,000 population (33 733.2 in 0-4 age group). As many as 0.45% of patients were referred to hospitals. According to the data of the Central Statistical Office, 115 deaths due to influenza were notified. Based on the data of the sanitary inspection (incomplete data), the percentage of population vaccinated against influenza was 2.4% (7.7% of persons aged more than 64 years). A total of 2 780 945 cases were registered in 2013/14 epidemic season. Its peak was reported in March 2014. Incidence was 7 224.0 per 100,000 population (35 172.8 in 0-4 age group). Compared to 2012/13 epidemic season, it was lower by 8.0%. Incidence rates ranged from 29 339.6 in pomorskie voivodeship to 1 306.5 in lubuskie voivodeship. Nearly a half of all cases (48.7%) were registered in children and adolescents up to 15 years. As many as 0.34% of patients were referred to hospitals (0.87% of persons aged more than 64 years). From the data of the Central Statistical Office transpires that 8 deaths due to influenza were reported in epidemic season. Type A influenza subtype H3N2 predominated in all influenza cases. Human respiratory syncytial virus (RSV) was the dominant agent in other viral infections of respiratory tract. Antigenic analysis of influenza strains showed their affinity with vaccine strains of the vaccine recommended for this epidemic season. CONCLUSIONS: In spite of slow improvements, influenza and influenza-like surveillance system in Poland is still not homogeneous and stable enough. It hinders the assessment of current epidemiological situation. For instance, there are difficulties in determining what is the effect of modifications in the surveillance on the increase in the number of influenza and influenza-like cases observed in Poland in recent years. A low percentage of population vaccinated against influenza (with a decreasing trend beginning from 2005) suggests a necessity of revising the methods of promotion and organization of these vaccines used so far. One of the public health priorities should be to increase the percentage of vaccinated population up to the average level in EU countries.

Salmonellosis in Poland in 2014

OBJECTIVE: The aim of the study is to assess the epidemiological situation of salmonellosis in Poland in 2014 in comparison to the previous years. MATERIAL AND METHODS: The evaluation was based on the data from the bulletin "Infectious diseases and poisoning in Poland 2014", information from the laboratories of sanitary-epidemiological stations and reports from the epidemiological investigations in outbreaks of salmonellosis, sent by the sanitary-epidemiological stations to the Department of Epidemiology, as well as the data from the Department of Demographic Studies of the Central Statistical Office. Cases were classified according to the definitions adopted in the UE. RESULTS: In 2014, a total number of 8 392 cases of salmonellosis derived from animals were reported, including 8 197 cases of intestinal salmonellosis and 195 cases of extraintestinal. The total incidence was 21.8/100 000. Almost 96% of the cases met the criteria for a confirmed case. The number of registered cases was, for the first time since many years, higher than in the previous year, but still lower than the median for 2008-2012. A very high percentage (approximately 70%) of hospitalizations remains among patients diagnosed with salmonellosis. Approximately 33% of all cases in outbreaks of salmonellosis were hospitalized. The highest incidence was among children under the age of 5 years. Salmonellosis was reported as the cause of death for 13 patients. In 2014 there were 171 outbreaks reported with Salmonella as an etiological agent. Majority of them were small outbreaks limited to the family in singular household, and the total number of cases in those outbreaks amounted to 1 229 people. In Poland the most common etiological agent of salmonellosis is (and have been for many years) S. Enteritidis. CONCLUSIONS: In 2014, the first time in many years, an increase was recorded in the annual number of cases of salmonellosis. A very high percentage of hospitalizations for salmonellosis cases indicates a relatively rare practice among GPs in ordering laboratory testing in patients presenting with gastroenteritis. This causes significant underreporting of salmonellosis in throughout the country and indicates the need to introduce mechanisms which would make laboratory testing for salmonellosis as a recommended practice.

Scarlet fever in Poland in 2014

OBJECTIVE: Assessment of the epidemiological situation of scarlet fever in Poland in 2014. MATERIALS AND METHODS: The evaluation was performed by reviewing surveillance data published in the bulletin "Infectious diseases and poisonings in Poland in 2014" as well as in previous bulletins, and unpublished data collected under Statistical survey program of official statistics. These data relate to cases of scarlet fever registered by health sanitary inspection on the basis of statutory notification of scarlet fever reported by physicians. RESULTS: In 2014, annual, incidence rate of scarlet fever in Poland was about 9% lower in comparison to previous year. There were 22 855 cases all over the country and the incidence was 59.5 per 100,000 population; depending on the voivodeship ranged from 19.5 in podkarpackie to 93.2 in pomorskie. The highest incidence was noted among 4-year-old children (981.4) and 5-year-old children (971.0). However the incidence among children and young people up to 15 years accounted for 95.7% of all cases. The incidence among men (67.2) was higher by 28.5% than incidence among women (52.3). Incidence rate in urban areas, in any size town, was higher than in rural areas. Overall incidence in urban areas was 66.4; in rural areas - 49.0. 1,11% of patients were hospitalized. There were no reported deaths related to scarlet fever. SUMMARY: In the surveillance of scarlet fever it is necessary to ensure that the collected data will be valid and reliable. Very low specificity of this surveillance may not only impinge on the assessment of epidemiological situation of this disease in Poland but also overshadow the situation of other diseases, including diseases under elimination program (rubella, measles). This is one of the greatest challenges facing sanitary inspection in the coming years.