Hepatitis A in Poland in 2017 - epidemic increase cases

AIM: The aim of this article is to describe and assess changes in epidemiological situation of Hepatitis A in Poland in 2017. MATERIALS AND METHODS: The assessment was based on the information from the individual case questionnaires, aggregated data from the bulletins "Infectious diseases and poisonings in Poland in 2017" and reports from epidemiological investigations in outbreaks of hepatitis A, submitted by the sanitary-epidemiological stations to the Department of Epidemiology of Infectious Diseases and Surveillance in NIPH-NIH. RESULTS: In 2017 a large increase of HAV cases and hepatitis A incidence was observed in Poland (3006 cases, incidence 7.8 per 100 000) in comparison to 2016 (35; 0.09). Majority of the cases were registered in large cities, where incidence was 3 times higher than in rural areas. Among reported there were 501 cases (16.6% of all cases) selfdeclaring as man who have sex with man (MSM). In course of the year an increasing trend in the number of cases was observed until September and the increase of male to female ratio (m/f) until May. Moreover 251 HAV outbreaks were reported, number of which increased until October and with the increase of m/f ratio in these outbreaks until April. From July to October there was an increase in the number of small outbreaks with m/f ratio equal 1. There were 178 imported cases reported, most of them from European countries- especially Germany and Spain. SUMMARY AND CONCLUSIONS: In 2017 over 80-fold increase of HAV cases and hepatitis A incidence was observed in comparison to previous years. Available epidemiological data indicate that ongoing HAV outbreak among MSM in Europe reached also Poland, and data from the second part of the year suggest infection spreading in non-MSM part of the population. It is therefore highly indicated that the list of risk groups for which vaccination against hepatitis A is recommended should also be expanded for MSM. To avoid such increase in the number of cases in future it is recommended to introduce vaccinations in risk groups as soon as large international outbreak occurs.

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.