Epidemiology of reported cases of leptospirosis in the EU/EEA, 2010 to 2021.

BackgroundLeptospirosis is a zoonotic disease caused by bacteria of the genus Leptospira. Humans are infected by exposure to animal urine or urine-contaminated environments. Although disease incidence is lower in Europe compared with tropical regions, there have been reports of an increase in leptospirosis cases since the 2000s in some European countries.AimWe aimed to describe the epidemiology of reported cases of leptospirosis in the European Union/European Economic Area (EU/EEA) during 2010-2021 and to identify potential changes in epidemiological patterns.MethodsWe ran a descriptive analysis of leptospirosis cases reported by EU/EEA countries to the European Centre for Disease Prevention and Control with disease during 2010-2021. We also analysed trends at EU/EEA and national level.ResultsDuring 2010-2021, 23 countries reported 12,180 confirmed leptospirosis cases corresponding to a mean annual notification rate of 0.24 cases per 100,000 population. Five countries (France, Germany, the Netherlands, Portugal and Romania) accounted for 79% of all reported cases. The highest notification rate was observed in Slovenia with 0.82 cases per 100,000 population. Overall, the notification rate increased by 5.0% per year from 2010 to 2021 (95% CI: 1.2-8.8%), although trends differed across countries.ConclusionThe notification rate of leptospirosis at EU/EEA level increased during 2010-2021 despite including the first 2 years of the COVID-19 pandemic and associated changes in population behaviours. Studies at (sub)national level would help broaden the understanding of differences at country-level and specificities in terms of exposure to Leptospira, as well as biases in diagnosis and reporting.

Willingness to vaccinate among adults, and factors associated with vaccine acceptance of COVID-19 vaccines in a nationwide study in Poland between March 2021 and April 2022.

Introduction: Despite the availability, safety and effectiveness of COVID-19 vaccines, Poland remains one of the six countries of the European Union with the lowest cumulative uptake of the vaccine's primary course in the general population. This study examined willingness to vaccinate and the associated factors in samples of unvaccinated and vaccinated adults between March 2021 and April 2022. Methods: Data were collected using OBSER-CO, a nationwide, repeated cross-sectional study, conducted at four different time points (rounds). Data on willingness to vaccinate among the unvaccinated (at all rounds) and willingness to receive another dose in the vaccinated (at 2 rounds-after booster introduction), reasons for reluctance, sociodemographic, health, and behavioral factors were collected using a uniform questionnaire via computer-assisted telephone interviewing. In each round, more than 20,000 respondents were interviewed. To assess associations between factors and willingness to vaccinate, separate multivariable logistic regression models were fitted for each factor at each round and adjusted for confounders. Results: Between rounds 1 and 4 (March 2021-April 2022), in the unvaccinated, willingness to vaccinate declined from 73 to 12%, whereas in the vaccinated, willingness to receive another dose declined from 90 to 53%. The highest magnitude of decline between subsequent rounds occurred during the Omicron wave. Overall, concerns about side effects, effectiveness, and vaccine adverse effects were common but decreased over time. Age, gender, employment, place of residence, COVID-19 diagnosis or exposure, hospitalization, and participation in social activities were among the factors associated with willingness. However, associations changed over rounds highlighting the influence of different pandemic waves and variants. Conclusion: We observed a declining and multifactorial willingness to vaccinate in Poland, with vaccine attitudes dynamically changing across subsequent rounds. To address vaccine concerns, sustained health communication about COVID-19 vaccines is essential, especially after the emergence of new variants.

Reversed urban-rural gradient in COVID-19 seroprevalence and related factors in a nationally representative survey, Poland, 29 March to 14 May 2021.

BackgroundWe anticipated that people in rural areas and small towns with lower population density, lower connectivity and jobs less dependent on social interaction will be less exposed to COVID-19. Still, other variables correlated with socioeconomic inequalities may have a greater impact on transmission.AimWe investigated how COVID-19 affected rural and urban communities in Poland, focussing on the most exposed groups and disparities in SARS-CoV-2 transmission.MethodsA random digit dial sample of Polish adults stratified by region and age was drawn from 29 March to 14 May 2021. Serum samples were tested for anti-S1 and anti-N IgG antibodies, and positive results in both assays were considered indicative of past infection. Seroprevalence estimates were weighted to account for non-response. Adjusted odds ratios (AORs) were calculated using multivariable logistic regression.ResultsThere was serological evidence of infection in 32.2% (95% CI: 30.2-34.4) of adults in rural areas/small towns (< 50,000 population) and 26.6% (95% CI: 24.9-28.3) in larger cities. Regional SARS-CoV-2 seroprevalence ranged from 23.4% (95% CI: 18.3-29.5) to 41.0% (95% CI: 33.5-49.0) and was moderately positively correlated (R = 0.588; p = 0.017; n = 16) with the proportion of respondents living in rural areas or small cities. Upon multivariable adjustment, both men (AOR = 1.60; 95% CI: 1.09-2.35) and women (AOR = 2.26; 95% CI: 1.58-3.21) from these areas were more likely to be seropositive than residents of larger cities.ConclusionsWe found an inverse urban-rural gradient of SARS-CoV-2 infections during early stages of the COVID-19 pandemic in Poland and suggest that vulnerabilities of populations living in rural areas need to be addressed.

A large multi-country outbreak of monkeypox across 41 countries in the WHO European Region, 7 March to 23 August 2022.

Following the report of a non-travel-associated cluster of monkeypox cases by the United Kingdom in May 2022, 41 countries across the WHO European Region have reported 21,098 cases and two deaths by 23 August 2022. Nowcasting suggests a plateauing in case notifications. Most cases (97%) are MSM, with atypical rash-illness presentation. Spread is mainly through close contact during sexual activities. Few cases are reported among women and children. Targeted interventions of at-risk groups are needed to stop further transmission.

Shigellosis in Poland in 2018-2019.

AIM: The purpose of this study is evaluation of the epidemiological situation of shigellosis in Poland in years 2018-2019, comparing to previous years. MATERIALS AND METHODS: The evaluation of epidemiological situation of shigellosis in Poland was based on analysis of data from epidemiological surveillance collected in questionnaires and sent to the Department of Epidemiology of Infectious Diseases and Surveillance NIPH NIH-NRI by sanitary stations. Once a case was reported on a ZLK-1 and/or ZLB-1 form to the appropriate State Sanitary Inspector, an epidemiological investigation was conducted by collecting additional information from medical records and from the patient interview. Data from the "Infectious Diseases and Poisonings" bulletins years 2012-2019 was also used as well as data from shigellosis outbreaks acquired through ROE system - registry created for outbreak data gathering. RESULTS: In Poland in years 2018-2019 a total of 321 cases of shigellosis was reported. Incidence per 100,000 was 0.74 in 2018, which was considerably more than in previous years, and in 2019 was 0.10 - similarly as two years before. The most cases belonged to the 25-34 and 35-44 age groups, and the least cases to the 0-4 age group. Majority of them were women. Percentage of hospitalizations was 27% in described period. Regarding to previous years, in 2018 decrease of hospitalizations was noted. Imported cases were 54.8% of all with predominance of imports from Albania. Twenty eight percent of infections were caused by S. sonnei species. In discussed years 10 outbreaks were registered with 246 people ill, including two large outbreaks (77 and 150 cases). August was the month with the highest number of cases (217 cases, 67.6% of all), 62.2% of them were imported. CONCLUSIONS: Increase in number of cases and incidence of shigellosis in Poland in 2018 was caused by occurrence of two large epidemic outbreaks. Because of high percentage of imported cases, traveling to shigellosis endemic countries is currently the main risk factor for contracting the disease. This indicates the need for education for those who travel to endemic areas.

Healthcare workers highly affected during the COVID-19 epidemic wave in Poland prior to vaccination availability: seroprevalence study.

BACKGROUND: The aim of the study was to assess seroprevalence of anti-SARS-CoV-2 antibodies among healthcare workers (HCW) before introduction of vaccination, in selected areas in Poland as well as to identify potential risk factors and estimate the cumulative incidence of COVID-19 infections in this population. MATERIAL AND METHODS: The authors conducted a sero-epidemiological, cross-sectional study among HCW of 5 non-COVID-19 hospitals in Poland. The recruitment took place in December 1-23, 2020, all HCW at selected hospitals could volunteer into the study. All persons were screened with rapid SARS-CoV-2 IgM/IgG tests in capillary blood. In case of positive result, 5 ml of venous blood was drawn for confirmatory testing with ELISA assay. The authors estimated prevalence of laboratory confirmed anti-SARS-CoV-2 antibody presence and examined factors associated with positive result. Cumulative incidence was estimated applying 2-source capture-recapture method to serology results and self-report of past infection. RESULTS: Out of 1040 HCW included in the analysis, one-fourth (25.2%) received a positive result for anti-SARS-CoV-2 antibodies by ELISA test, the prevalence among women was 25.3% (95% CI: 22.5-28.4) and 24.6% (95% CI: 19-31.2) among men. The prevalence of anti-SARS-CoV-2 antibodies was the highest among respondents who declared home contact with a confirmed COVID-19 case, 43.9% (95% CI: 32.4-56.1). It was also elevated among those who indicated contact with patients with COVID-19, 32.5% (95% CI: 26.7-38.8) and business contacts, including at the workplace, 28.9% (95% CI: 22.5-36.3). The estimated cumulative incidence of COVID-19 infections in the population, using the capture-recapture method was 41.2% (95% CI: 38.1-44.2). CONCLUSIONS: Healthcare workers remained at increased risk of infection largely due to work-related contacts with infected patients, although home exposure was also common. Estimated cumulative incidence is higher than the antibody prevalence, which indicates the need to monitor HCW for possible immunity waning, also post-immunization immunity. Med Pr. 2022;73(2):109-23.

Data-driven case fatality rate estimation for the primary lineage of SARS-CoV-2 in Poland.

After more than one and a half year since the COVID-19 pandemics outbreak the scientific world is constantly trying to understand its dynamics. In this paper of the case fatality rates (CFR) for COVID-19 we study the historic data regarding mortality in Poland during the first six months of pandemic, when no SARS-CoV-2 variants of concern were present among infected. To this end, we apply competing risk models to perform both uni- and multivariate analyses on specific subpopulations selected by different factors including the key indicators: age, sex, hospitalization. The study explores the case fatality rate to find out its decreasing trend in time. Furthermore, we describe the differences in mortality among hospitalized and other cases indicating a sudden increase of mortality among hospitalized cases at the end of the 2020 spring season. Exploratory and multivariate analysis revealed the real impact of each variable and besides the expected factors indicating increased mortality (age, comorbidities) we track more non-obvious indicators. Recent medical care as well as the identification of the source contact, independently of the comorbidities, significantly impact an individual mortality risk. As a result, the study provides a twofold insight into the COVID-19 mortality in Poland. On one hand we explore mortality in different groups with respect to different variables, on the other we indicate novel factors that may be crucial in reducing mortality. The later can be coped, e.g. by more efficient contact tracing and proper organization and management of the health care system to accompany those who need medical care independently of comorbidities or COVID-19 infection.

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.

Yersiniosis in Poland in 2018-2020.

AIM: The aim of the study was to assess the epidemiological situation of yersiniosis in Poland in 2018-2020 and compare it to previous years. MATERIAL AND METHODS: To assess the epidemiological situation of yersiniosis in Poland, data from individual case reports prepared by Sanitary Epidemiological Stations as part of routine epidemiological surveillance were used. Incidence, number of cases and data on hospitalizations by voivodship included in the bulletins "Infectious Diseases and Poisons in Poland" for 2015-2020 were also used. RESULTS: In 2018-2020, a total number of 542 cases of yersiniosis were registered, including 456 intestinal and 86 extraintestinal forms. The incidence in 2018 was 0.53/100,000 in 2019 0.59/100,000 and in 2020 0.29/100,000. The number of cases in 2020 compared to 2019 decreased by 52%, and compared to 2018 by 45.8%. The percentage of hospitalizations in each year was at a similar level of 65.5% in 2018, 62.4% in 2019, and 60% in 2020. The highest incidence was noted in the 0-4 age group at 44.7% of cases in 2018, 42.9% in 2019 and 55.6% in 2020, respectively (all cases of the intestinal form). The predominant species was Y. enterocolitica in both intestinal and extraintestinal forms. The most common serotype was serotype O:3, which was identified in 34 isolates in 2018, 43 isolates in 2019 and 9 isolates in 2020. SUMMARY AND CONCLUSIONS: Since 2009, Poland has had a decreasing trend in the incidence of yersiniosis. In 2020, both Poland and Europe saw a sharp decline in the number of cases compared to previous years. This is a result of the occurrence of the COVID-19 pandemic in March 2020, during which many measures were introduced to limit the spread of the SARS-CoV-2 virus, which may also have affected the number of other infections. Although the numbers of cases and incidence of yersiniosis among children under the age of 5 are the highest compared to other age groups, the highest number of hospitalizations was reported in the 10-19 age group, which most likely reflects the decreasing number of laboratory tests ordered on an outpatient basis with age and the significant underreporting of cases in this and older age groups.

Giardiasis (lambliasis) in Poland in 2020.

OBJECTIVE: Assessment of the epidemiological situation of giardiasis in Poland in year 2020. MATERIAL AND METHODS: The assessment of the epidemiological situation of giardiasis in Poland in 2020 was performed on the basis of aggregated data from the annual bulletins "Infectious diseases and poisoning in Poland" for the years 2006-2020, data on individual cases collected for the purposes of epidemiological surveillance in the EpiBaza system, and data from food-borne outbreak investigations recorded in the Registry of Epidemic Outbreaks (ROE). RESULTS: The number of new cases of giardiasis reported in Poland in 2020 amounted to 358 cases (incidence rate 0.9 per 100,000 population) and was about 2 times lower than in 2019 (784 cases) and 2.5 times lower than in 2018 (928 cases). In 2020, there was a further decrease in the number of registered cases, but it was much more pronounced than in the preceding years. As in previous years, no deaths from giardiasis were recorded. The downward trend in hospitalizations continued and in 2020 they accounted for approximately 12.6% of all cases, in 2019 the percentage was 15.2% and in 2018 - 19.4%. Most cases met the definition of a confirmed case, with 1 patient meeting the criteria of a probable case. In 2020, 6 outbreaks of giardiasis were reported, which is a decrease compared to 2019 (12 outbreaks) and thus means a reversal of the upward trend occurring at least since 2017. CONCLUSIONS: Data for 2020 should be interpreted taking into account the effect of the COVID-19 pandemic, which could have resulted in changes in long-term trends, but in particular contributed to a strong decrease in the number of cases not only of giardiasis, but also of other infectious diseases. In 2020, almost all EU/EEA countries reported a decrease in the incidence of giardiasis similar to that in Poland. However, as in 2019, in 2020 Poland differed from other EU/EEA countries in terms of incidence by age and sex.

Foodborne infections and intoxications in Poland in the years 2018-2020.

AIM: The purpose of this study is to assess the epidemiological situation of foodborne infections and intoxications in Poland in the years 2018-2020. MATERIALS AND METHODS: The evaluation was based on the analysis of information sent to Department of Epidemiology NIPH NIH - NRI 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 - NRI annual bulletins (Czarkowski MP et al. "Infectious diseases and poisonings in Poland", 2014-2020. Warsaw, NIPH NIH and GIS). RESULTS: In the years 2018-2020 a total number of 2,108 foodborne outbreaks were reported in which 52,175 persons were exposed and 17,023 got sick (in 2016 n=916, in 2019 n=918, in 2020 n=274). In 2020 over 3 fold decrease in the number of outbreaks comparing to 2019 and over 4 fold decrease in the number of cases in those outbreaks was observed. Among outbreaks which took place in 3 most frequent settings (private household, food facility and hospital) the steepest decrease was in 12th week of 2020 (ISO 2020-W12). The most frequent etiological agent of outbreaks in the years 2018-2020 was Salmonella sp. (38.3% of outbreaks in 2018, 32.7% in 2019 and 47.8% in 2020) and specifically serotype Enteritidis (38.3%, 27% and 39.4% accordingly). The most frequent setting of outbreaks was private household (59.7% outbreaks in 2018, 66% in 2019 and 62% in 2020), followed by hospital (17.4%, 18.3% i 19.7% accordingly). Up until 2019 an increasing trend in the number of small outbreaks (up to 4 cases) caused by Salmonella sp. was observed (in 2018 - 605 and in 2019 - 612 were reported). CONCLUSIONS: Decrease in the number of outbreaks in selected settings from 12th ISO week of 2020 might have been due to introduction of restrictions during COVID-19 pandemic and enhancement of personal hygiene practices. An increase in identified and registered small outbreaks caused by Salmonella sp. comparing to the median of the number of those outbreaks from 2014-2016 could partly be a result of routine surveillance enhancement after introducing System for Registry of Epidemiological Interviews (pol. SRWE).

Estimated number of deaths directly averted in people 60 years and older as a result of COVID-19 vaccination in the WHO European Region, December 2020 to November 2021.

Since December 2019, over 1.5 million SARS-CoV-2-related fatalities have been recorded in the World Health Organization European Region - 90.2% in people ≥ 60 years. We calculated lives saved in this age group by COVID-19 vaccination in 33 countries from December 2020 to November 2021, using weekly reported deaths and vaccination coverage. We estimated that vaccination averted 469,186 deaths (51% of 911,302 expected deaths; sensitivity range: 129,851-733,744; 23-62%). Impact by country ranged 6-93%, largest when implementation was early.

Giardiasis (lambliasis) in Poland in 2018 and 2019.

OBJECTIVE: Assessment of the epidemiological situation of giardiasis in Poland in years 2018 and 2019. MATERIAL AND METHOD: The assessment of the epidemiological situation of giardiasis in Poland was performed on the basis of data analysis results of the annual bulletins "Infectious diseases and poisoning in Poland" for the years 2008-2019, information from case report forms provided by employees of Powiat Sanitary-Epidemiological Stations (PSSE) through the Epidemiological Case Reporting System (SRWE), as well as information on outbreaks reported by PSSE employees through the Registry of Epidemic Outbreaks (ROE). RESULTS: The number of new cases of giardiasis recorded in Poland in 2018 was 928 (the incidence rate was 2.4 per 100,000 population), while in 2019 it was 784 (the incidence per 100,000 population was 2.0). Compared to previous years, in 2018-2019 there was a further decrease in the number of registered cases. There have been no reported deaths from giardiasis in 2018-2019. Hospitalizations accounted for approximately 19.4% of all cases in 2018 and 15.2% in 2019. In 2019, there were 3 cases that met the definition of a probable case, the remaining cases, both in 2018 and 2019, were confirmed cases. In 2018, there were 7 outbreaks of giardiasis, which is an increase compared to 2017. In 2019, the number of reported outbreaks increased further and amounted to 11. CONCLUSIONS: The decrease in the number of cases and incidence in Poland over the last few years indicates an improvement in the epidemiological situation. Compared to the EU/EEA average for 2018 and 2019, Poland does not diverge significantly in terms of the number of cases or incidence, however differences occur in the distribution of cases by age and gender, and in the long-term trend.

Campylobacteriosis in Poland in 2018-2019.

INTRODUCTION: Campylobacteriosis is a zoonotic disease caused by bacteria of the genus Campylobacter. This disease usually presents with symptoms of acute gastroenteritis. The majority of Campylobacter infections are usually acquired through consumption of contaminated water or food, less frequently through direct contact with an infected animal or person. In Poland, campylobacteriosis is notifiable disease, according to the EU deffinition implemented in the polish surveillance system. AIM OF THE STUDY: The aim of this study is to assess epidemiological situation of campylobacteriosis in Poland in years 2018-2019 and compare it to previous years. MATERIALS AND METHODS: The study was based on data from the bulletins 'Infectious Diseases and Poisonings in Poland' for 2018-2019 issued by the National Institute of Public Health NIH - National Research Institute and data submitted to the System for Registration of Epidemiological Interwiews (SRWE) by District Sanitary and Epidemiological Stations. RESULTS: In Poland 726 cases of Campylobacterosis were reported in 2018 and 715 in 2019. There was a decrease in the number of reported cases in comparision to 2017 by 17% and 19% in 2018 and 2019 respectively. Cases of campylobacteriosis were reported in all voivodeships, with the highest incidence in both described years in Lubuskie voivodeship. Campylobacteriosis was diagnosed in patients in all age groups but the majority of patients were children under the age of 4. The most frequently identified species was Campylobacter jejuni. SUMMARY AND CONCLUSIONS: Data on the number of campylobacteriosis infections in Poland for 2018 and 2019, demonstrate a stabilized epidemiological situation regarding this disease entity in the country. The high hospitalization rate of patients diagnosed with campylobacteriosis, demonstrates the need to implement microbiological diagnostics in cases of suspected disease. Data show a much lower incidence rate of campylobacteriosis in Poland, compared to other EU countries, which suggests potential underestimation of the actual number of infected case.

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.

COVID-19 module in SRWE system - application and use in epidemiological surveillance and reporting to international institutions.

The new SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) coronavirus causing acute respiratory disease COVID-19 (2019 coronavirus disease) detected in China in 2019 very quickly revealed its epidemic potential and was recognized as a global health problem. The situation caused by the rapidly increasing number of new cases and deaths due to COVID-19 required the rapid development of international recommendations and procedures to limit the spread of infections and ongoing monitoring of the epidemiological situation. In the field of epidemiological surveillance of COVID-19 cases, international organizations - WHO and regionally ECDC, have developed basic requirements for reporting data on newly detected cases of infection. In order to ensure the possibility of reporting new cases and activities undertaken by sanitary-epidemiological services in the country and to fulfill the obligation to report data to the European surveillance network, it was necessary to adapt the electronic system supporting epidemiological surveillance operations, for registration of suspected and confirmed cases of SARS-CoV-2 infections. This work presents the characteristics of the new COVID-19 module created as part of the central Epidemiological Case Reporting System and a preliminary evaluation of its usefulness for the purposes of combating COVID-19. CONCLUSIONS. The Epidemiological Case Reporting System is an efficient and adequate tool that can be adapted to newly emerging threats. In order to use the module to monitor the current epidemiological situation, it is necessary to integrate it with other systems collecting data about COVID-19 patients - ie. EWP and the clinical patient register.

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.

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.