Poisonings In Poland Research Articles

Krztusiec w Polsce w 2022 roku

IntroductionThe epidemiological situation of pertussis in Poland in 2022 was influenced by the cancellation of the COVID-19 epidemic and the introduction of an epidemic threat. Decisions related to the gradual easing of restrictions on social contacts and the abolition of the obligation to wear masks caused the number of pertussis cases to slowly start to increase. The most effective strategy for preventing pertussis remains the immunization of children in accordance with the National Immunization Program, and in the case of adults, vaccination repeated systematically every 10 years and immunization of pregnant women in the second/third trimester of each pregnancy. Pertussis remains a public health problem because the immunity obtained through vaccination does not last a lifetime.ObjectivesThe aim of the study was to assess the epidemiological situation of pertussis in Poland in 2022 compared to the situation in previous years, with particular emphasis on assessing the impact of the COVID-19 pandemic and assessing the vaccination status of children against pertussis.Material and MethodsThe assessment of the epidemiological situation of pertussis in Poland was made based on the results of the analysis of individual reports on pertussis cases registered at the NIPH NIH – NRI in the Epibaza system and data from the annual bulletins "Infectious diseases and poisonings in Poland" and the bulletin "Vaccinations in Poland in 2022".ResultsIn 2022, 371 cases of pertussis were recorded. The incidence was 0.98/100 000 and was 104% higher than in 2021. The highest incidence of pertussis occurred in children aged 0-4 years (6.7/100 000), and high in children aged 5-9 years (2.0/100 000). Over 51% of cases concerned people over 15 years of age. A higher incidence was observed in women in general compared to men, and a higher incidence in cities than in rural areas. In 2022, among people with pertussis, 151 (41%) required hospitalization. In 2022, the vaccination rate of children aged 2 years with 4 doses of the pertussis vaccine was 94.3% in total. In 2022, one case of disease resulting in death due to pertussis was reported to the epidemiological surveillance system.ConclusionsIn Poland, in 2022, there was an increase in the number of pertussis cases compared to the previous year, which was undoubtedly influenced by the gradual lifting of restrictions on social contacts and the obligation to wear masks. The increase in the number of people susceptible to pertussis may lead to the occurrence of compensatory epidemics in the future, therefore a high level of vaccination of the population (above 95%) should be maintained to prevent new cases.

Tężec w Polsce w latach 2020-2022

BackgroundTetanus is an infectious disease caused by the bacterium <i>Clostridium tetani,</i> which produces a neurotoxin (tetanospasmin) that causes spastic paralysis. This disease can only be prevented by vaccination. Tetanus is very rare in EU countries, where it mainly affects people over 60 years of age. Tetanus is a serious health problem in countries with low vaccination rates and poor hygiene conditions, and neonatal tetanus is a particularly significant problem in these countries. In Poland, according to the Vaccination Program, mandatory vaccinations against tetanus should be given to children and adolescents up to the age of 19.ObjectiveThe aim of the study was to assess the epidemiological situation of tetanus in Poland in 2020-2022.Material and methodsThe assessment of the epidemiological situation of tetanus in Poland in 2020-2022 was made based on the interpretation of data from the annual bulletins "Infectious diseases and poisonings in Poland" for 2020-2022 and the bulletins "Vaccinations in Poland" for 2020-2022 as well as data from individual epidemiological reports on diseases registered in the "Epibaza" system.ResultsIn 2020, 2 cases of tetanus were registered in Poland, in 2021 – 5 cases, and in 2022 also 5 cases. The total incidence in 2020 was 0.005 per 100 000 people, in 2021 and 2022 – 0.013 per 100 000 and was lower compared to the median for 2015-2019 (0.031). In 2020-2021, all reports concerned hospitalized people, while in 2022 one person was treated as an outpatient. No cases were recorded in people under 30 years of age.ConclusionsIn Poland, a decrease in the number of reported tetanus cases was observed in 2020-2022 compared to previous years. Sporadic tetanus cases in Poland are recorded mainly in older age groups but also occur among adults under 60 years of age. The cases can be associated with the lack of booster vaccinations in adults.

Mumps in Poland in 2021.

Mumps is a contagious viral disease occurring mainly in children, the source of infection being the sick/infected person. Since 2003, vaccination against mumps has been mandatory in Poland, performed according to a two-dose schedule. As part of the Public Health Immunization Program (PSO), the MMR combination vaccine (against measles, mumps and rubella) is used for the entire population of children. The aim of this study was to evaluate epidemiological indicators of mumps in Poland in 2021 compared to previous years, taking into account the impact of the COVID-19 pandemic. The analysis of the epidemiological situation of mumps in Poland in 2021 was based on the interpretation of data from the bulletin , "Infectious diseases and poisonings in Poland in 2021" and , "Immunization in Poland in 2021". 484 cases of mumps were registered in Poland in 2021. The total incidence was 1.3 per 100,000 residents, which was lower than in 2020. The highest incidence of 1.8 per 100,000 residents was registered in Pomorskie Province, and the lowest incidence of 0.7 in Lower Silesia Province. The highest incidence (6.4/100 thousand) was recorded in children aged 0-4 and 5-9. The incidence rate for men (1.4/100,000) was higher than for women (1.1). In 2021, there were 9 patients hospitalized due to mumps, this was more than in 2020. The decrease in the number of cases of mumps in 2021 remained related to the ongoing pandemic - the restrictions introduced during the pandemic period led to a decrease in the number of cases not only of COVID-19, but also of other diseases spread by the droplet route, including mumps. The number of registered cases based on the reports of diagnosing physicians may be underestimating the actual number of cases due to the continued difficult access of patients to primary care physicians.

Mumps in Poland in 2020.

Mumps is an acute, generalized viral disease whose source of infection is the infected person. In 2003, vaccination against mumps became compulsory in Poland, performed according to a twodose scheme. The combined MMR vaccine (against measles, mumps and rubella) was introduced as part of the Protective Vaccination Program (PVP), which influenced the number of cases in Poland. The aim of the study was to evaluate the epidemiological indicators of mumps in Poland in 2020 compared to previous years. The analysis of the epidemiological situation of mumps in Poland in 2020 was based on the interpretation of data from the bulletin "Infectious diseases and poisonings in Poland in 2020" and "Vaccinations in Poland in 2020". In 2020, 582 cases of mumps were registered in Poland. The total incidence was 1.5 per 100,000 inhabitants and was lower compared to 2019. The highest incidence was 2.0 per 100,000 inhabitants were registered in the Świętokrzyskie Voivodeship and the lowest - 0.7 in the Dolnośląskie Voivodeship. The highest incidence (24.6/100,000) was recorded in children aged 5-9 years. The incidence of men (1.8/100,000) was higher than that of women (1.2/100,000). In 2020, 6 patients were hospitalized in Poland due to mumps, which was less than in 2019 (22 patients). The level of vaccination against mumps in children aged 3 was lower by 0.7 percentage points compared to 2019 and amounted to 91.9% across Poland. In 2020, there was a decrease in the number of mumps cases compared to the previous year. The lower incidence may have been the result of a reduction in mumps virus transmission due to a change in population health behavior during the COVID-19 pandemic. Due to the epidemiological threat, the functioning of nurseries, kindergartens and schools was also temporarily suspended, which resulted in a reduction in the incidence of mumps in younger age groups, which are the main group of patients.

Chickenpox in Poland in 2020.

Chickenpox is an infectious disease caused by the varicella zoster virus. The characteristic feature of this virus is very high visibility of 90-95%. The most common connection is direct contact with the disease or via droplets. The United States was the first country to introduce a universal, population-based childhood varicella vaccination program in 1995. In its 25 years of implementation, this program has significantly reduced the burden of chickenpox. There was a more than 97% reduction in varicella incidence and a 90% reduction in varicella-related hospitalizations and deaths, the highest (99%) in those under the age of 20 (born after starting the vaccination programme). Chickenpox is very common in Poland. In recent years, starting from 2002, there has been an upward trend in the incidence of chickenpox, except for 2020. In 2020, a decrease in the number of cases was recorded. The aim of the study was to assess the epidemiological situation of chickenpox in Poland in 2020 and to compare it with the situation in previous years. Evaluation of the epidemiological situation of chickenpox in Poland in 2020 was based on the results of the analysis of aggregate data published in the annual bulletins: "Infectious diseases and poisonings in Poland in 2020." and "Vaccinations in Poland in 2020". In addition, recommendations from the Protective Vaccination Program for 2020 were used. In 2020, 71,567 cases of chickenpox were registered in Poland, i.e. 39.6% less than in the previous year. The incidence of chickenpox in 2020 was 186.6 per 100,000 and was lower than in 2019. The lowest incidence was recorded in the Świętokrzyskie Voivodship - 118.5/100,000, while the highest in the Kujawsko-Pomorskie Voivodeship - 263.5/100,000. Most cases concerned children aged 0-4 years (36,661). The incidence of chickenpox in men was higher than in women, and in rural areas higher than in urban dwellers. Hospitalization due to chickenpox in 2020 covered 1,368 people, which accounted for 0.51% of the total number of registered cases. In 2020, there was a decrease in the number of cases of chickenpox compared to the previous year. The lower incidence may have been the result of reduced transmission of the varicella virus due to changes in the health behavior of the population during the COVID-19 pandemic (isolation measures and the introduction of a lock down throughout Poland limiting the activity of the population).

Measles in Poland in 2020.

Measles is a disease under the elimination program coordinated by the World Health Organization (WHO). The elimination of measles in the country is possible provided that 95% of the population is vaccinated with two doses of the vaccine, the epidemiological situation is monitored, all suspected cases of measles are recorded, and laboratory diagnostics are conducted by the WHO Reference Laboratory. Polish Reference Laboratory is located at the Department of Virology NIPH NIH - NRI. The aim of the article is to analyze the epidemiological situation of measles in Poland in 2020 with presenting the measles vaccination coverage and the progress of the measles elimination programme in Poland. The epidemiological situation of measles in Poland was analyzed on the basis of the case-based questionnaires of cases suspected of measles sent to NIPH NIH - NRI by the Sanitary and Epidemiological Stations, data from the publications: "Infectious diseases and poisonings in Poland in 2020" and "Vaccinations in Poland in 2020". In 2020, 29 cases of measles were notified to the surveillance system in Poland (incidence 0.08 per 100,000 population). The highest incidence was observed in the aged 0-4 was estimated at 0.42 per 100,000 population. Out of all cases, 9 (31%) were hospitalized. No fatal cases due to the measles were reported. The epidemiological situation of measles in 2020 in comparison with the situation in 2019, has improvement. This was a trend in throughout Europe.

Meningitis and encephalitis in Poland in 2020.

Meningitis and/or encephalitis are one of the main infectious diseases of the nervous system. These diseases are most commonly caused by bacterial and viral etiological factors. In this publication, meningitis and/or encephalitis caused by Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae and those with a viral origin - in Poland, most often caused by tick-borne encephalitis virus - are presented in detail. In addition to epidemiological surveillance, immunoprophylaxis in the form of mandatory and recommended vaccinations is used in Poland to prevent these infections. The aim of this study was to to assess the epidemiological situation of meningitis and encephalitis in Poland, in 2020. To analyse the epidemiological situation of neuroinfections in Poland were used data sent to NIPH NIH - NRI by Voivodeship Sanitary and Epidemiological Stations and published in the annual bulletins: "Infectious diseases and poisonings in Poland in 2020" and "Protective vaccination in Poland in 2020" and individual epidemiological interviews registered in the EpiBaza system. In 2020, a total of 831 cases of meningitis and/or encephalitis were registered in Poland. This is a decrease in incidence of up to 62.9% compared to 2019. For infections of bacterial etiology, including cases of neuroborreliosis (incidence of 2.40 per 100,000), the number of cases decreased by 60.4% (from 931 to 369). In the viral infection group, there was a 64.9% decrease (from 1,318 to 462 cases). Of all registered cases, 56% were infections with a viral etiology. Compared to 2019, the number of cases with an S. pneumoniae etiology decreased by 61.3% and for N. meningitidis by 41.1%. It is interesting to note that, in the case of H. influenzae, we can speak of a 20% increase in cases compared to the previous year. In addition, we can see a decrease in the incidence of tick-borne encephalitis - from 265 in 2019 to 158 in 2020 (a decrease of 40.4%). Overall, a downward trend in incidence was shown for both bacterial andviral meningitis and/or encephalitis. The SARS-CoV-2 pandemic and the introduction of restrictions on personto-person contact and various forms of activity, resulting in a reduction in pathogen transmission, were key tothe significant reduction in the number of meningitis and/or encephalitis cases in 2020, but a reduction in theavailability of medical facilities or the completeness of case reports due to the burden of anti-epidemic measureson the Sanitary Inspectorate cannot be excluded either. Only in the case of cases caused by H. influenzae wasa slight increase observed compared to the previous year (12 versus 10 cases). Meningoencephalitis and/orencephalitis, due to its wide etiological range, poses a major challenge to the health care system, particularly interms of correct clinical diagnosis.

Pertussis in Poland in 2020.

The epidemiological situation of infectious diseases in Poland in 2020, including pertussis cases, was significantly influenced by the limitation of interpersonal contacts introduced to reduce the transmission of SARS-CoV-2 virus. There was a reduction by more than half in the number of recorded pertussis cases, from 1,629 in 2019 to 753 in 2020. Pertussis is most dangerous for young children, however, it can get sick at any age, and the disease does not leave permanent immunity. Severe pertussis can also develop in the elderly, which may increase the risk of mortality. Adults usually have pertussis is mildly symptomatic and constitute an important reservoir of B. pertussis. The most effective strategy for the prevention of pertussis is still immunization of children in accordance with the Protective Vaccination Program, and in the case of adults, vaccination with the pertussis component in acellular form, repeated regularly every 10 years. The aim of the study was to assess the epidemiological situation of pertussis in Poland in 2020 compared to the situation in previous years, with particular emphasis on the assessment of the vaccination status of children against pertussis. The assessment of the epidemiological situation of pertussis in Poland was performed on the basis of the results of the analysis of unit reports of pertussis registered in the NIPH NIH - NRI in the EpiBaza system and data from the annual bulletin "Infectious diseases and poisonings in Poland in 2020" and the bulletin "Vaccinations in Poland in 2020". In 2020, 753 cases of pertussis were registered. The incidence was 1.96 per 100,000 population and was lower compared to the incidence in 2019 (4.24). The highest incidence of pertussis occurred in the age group 0-4 years (9.9), and high in children and adolescents aged 5-9 years (5.1) and 10-14 years (6.0 per 100,000 population). About half of the cases concerned people over 15 years of age. In general, a higher incidence of women was observed than that of men, as well as a greater number of cases in cities than in rural areas. In 2020, among people suffering from pertussis, 206 people (i.e. 27%) required hospitalization. In 2020, one fatal case of the disease was reported to the epidemiological surveillance system. In Poland, in 2020, there was a decrease in the number of pertussis casesby more than a half compared to the previous year. Despite the decline in disease rates, pertussis remains a publichealth problem as immunization-induced immunity is not sustained throughout life. Increasing the number ofpeople susceptible to pertussis may lead to compensatory epidemics in the future, therefore the highest possiblelevel of vaccination of the population, >92-94%, should be maintained to prevent new cases of pertussis.

Zatrucia i zakażenia pokarmowe w Polsce w latach 2018-2020

The purpose of this study is to assess the epidemiological situation of foodborne infections and intoxications in Poland in the years 2018-2020. 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). 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). 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).

Hepatitis C in Poland in 2020.

The year 2020 in the extent of HCV infection was set for the first milestones on the road to the eradication of HCV infection in 2030. In addition, in 2020 there was a global public health crisis - the COVID-19 pandemic. The aim of this paper was to assess the epidemiological situation of HCV infection based on epidemiological surveillance data in Poland in 2020. Analysis of: 1) individual data from surveillance in 2020 conducted by EpiBaza system; 2) diagnosis rate from bulletins "Infectious diseases and poisonings in Poland" for the years 2014-2020; and 3) data about deaths due to hepatitis C from the Demographic Surveys and Labour Market Department of Statistics Poland. In 2020, there was a significant decrease in the number of reported cases and thus in the diagnosis rate of HCV infection in Poland - 955 HCV infections were reported (2.49/100,000 - in comparison with 2019, 3.5 times less). The decrease occurred in all voivodeships (ranging from 0.50 to 6.37/100,000), we observe more districts in which HCV infections were not detected (in 2020 - 35.3%; in 2019 - 16.8%). The diagnosis rate of HCV infection in women and men was at a similar level. However, large disproportions are visible if age groups are considered in addition to gender. For years, we have observed a variation of the diagnosis rate of HCV infection depending on the environment of residence - also in 2020, higher values were reported overall in residents of urban than in rural areas (2.90 vs. 1.88/100,000). In 2.9% of newly diagnosed HCV infections, at the same time cirrhosis was already present, 0.4% had liver failure, and 0.1% had hepatocellular carcinoma. Among exposures of HCV infection, those related to nosocomial transmission still dominate (59%), also in acute hepatitis C (60%). One-third of reported infections were diagnosed in primary health care, and one in four were diagnosed during hospitalization. The data presented in this paper show that the COVID-19 pandemic deepened the inequalities observed for years in HCV areas. Establishing a diverse system of testing and linking to care in Poland, reaching those in the greatest risk of ongoing transmission of HCV infection, and providing methodologically correct studies to assess progress in the eradication of HCV infection is becoming increasingly urgent to achieve the planned 2030 WHO targets.

Hepatitis B in Poland in 2020.

Aim of the study was the assessment of hepatitis B epidemiological situation in Poland in 2019 compared to previous years, taking into consideration the impact of the COVID-19 pandemic during that time. Data for 2020 included in individual reports on hepatitis B and HBV infections recorded by sanitary and epidemiological stations at EpiBaza, i.e. in the electronic epidemiological surveillance system on infectious diseases, were analyzed. In the assessment of the epidemiological situation, data published in the annual bulletins: "Infectious diseases and poisonings in Poland in 2020" and "Vaccinations in Poland in 2020" were also used. Data on deaths were obtained from the Statistics Poland (GUS). In 2020, 2,854 cases of hepatitis B were reported, which corresponds to the incidence of 2.59 per 100,000 population, lower by 65.1% than in 2019. 14 cases of acute hepatitis B were reported, constituting 1.4% of all registered cases. The incidence of acute hepatitis B was 0.04 per 100,000 population and was lower by 67% compared to 2019 and lower by 71% compared to the median for the years 2014-2018. There were no cases of acute disease in the age group 0-29 years. A total of 978 chronic and unknown hepatitis B cases (UNK) were registered and the diagnosis rate was 2.56 per 100,000 population, lower by 64.2% than in 2019. Compared to the median diagnosis rate of chronic hepatitis B in 2014-2018, a decrease of 70.4% was observed. In the age group 0-19 years, there was no case reported. In 2020, 24 people died due to hepatitis B, including 22 from chronic hepatitis B. The COVID-19 pandemic resulted in a significant reduction in the number of HBV tests performed and, consequently, a reduction in the number of diagnosed infections. A decrease in the number of detected infections was observed from the second quarter of 2020, i.e. from the beginning of the COVID-19 pandemic, although already in the first quarter of 2020 the number of registered hepatitis B cases was lower than in the same period in 2019. No acute cases were reported among people who were vaccinated against hepatitis B during childhood. Vaccination with three doses of hepatitis B vaccine in children in the second year of life was only slightly lower than in 2019, which proves the stability of the implementation of the preventive vaccination program, despite the limited access to primary health care during the pandemic.

Kampylobakterioza w Polsce w latach 2018-2019

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. The aim of this study is to assess epidemiological situation of campylobacteriosis in Poland in years 2018-2019 and compare it to previous years. 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. 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. 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.

Measles in Poland in 2019.

Since 1998 Poland has endorsed measles elimination programme which is coordinated by the World Health Organization (WHO). To accomplish measles elimination in the country, achievement of vaccination coverage at 95% in the population is needed, as is the monitoring of the epidemiological situation, i.e.: reporting on cases suspected of measles and conducting laboratory diagnostics in WHO Reference Laboratory. Polish Reference Laboratory is located at the Department of Virology NIPH NIH - NRI. The aim of the article is to analyze the epidemiological situation of measles in Poland in 2019 with presenting the measles vaccination coverage and the progress of the measles elimination programme in Poland. The epidemiological situation of measles in Poland was analyzed on the basis of the case-based questionnaires of cases suspected of measles sent to NIPH NIH-NRI by the Sanitary and Epidemiological Stations, data from the publications: "Infectious diseases and poisonings in Poland in 2019" and "Vaccinations in Poland in 2019". In 2019, 1,502 cases of measles were notified to the surveillance system in Poland (incidence 3.91 per 100,000 population, more than four times more than in 2018). The highest incidence was observed in the aged 35-39 was estimated at 11.36 per 100,000 population. Out of all cases, 772 (51.4%) were hospitalized. No fatal cases due to the measles were reported. In 2019 the maintenance of high vaccination coverage among children aged 2 and 12 years old was observed - from 92.6% to 99.5% (primary vaccination, children born in 2009-2017). The epidemiological situation of measles in 2019 in comparison with the situation in 2018, has deteriorated. This was a trend in throughout Europe.

Pertussis in Poland in 2018-2019.

Pertussis is an endemic, highly contagious disease that can be prevented through vaccination. In Poland, since the second half of the nineties, changes in the epidemiology of pertussis have been observed - an increase in the number of cases, despite the high level of vaccination of the population. The highest percentage of registered cases of pertussis concerned people aged 15 and over. The causes of the increased incidence of pertussis are a complex problem. Immunity after pertussis vaccination is unstable, disappears within 4-12 years, and the risk of the disease increases with time after the last dose of the vaccine. Due to the loss of protection against pertussis in adults, it is important to repeat immunization with dTpa every 10 years. The aim of the study was to assess the epidemiological situation of pertussis in Poland in 2018-2019 compared to the situation in previous years, with particular emphasis on the assessment of the vaccination status of children against pertussis. The assessment of the epidemiological situation of pertussis in Poland was performed on the basis of the results of the analysis of unit reports of pertussis registered in the NIPH-NIH through the SRWE system and data from the bulletins "Infectious diseases and poisonings in Poland" for 2018 and 2019 and the bulletins "Vaccinations in Poland" for 2018 and 2019. In 2018, 1 548 were registered, and in 2019 - 1 629 cases of pertussis. The incidence was respectively: 4.0 and 4.2 per 100 000 population and was lower compared to the incidence in 2017 (8.0). The highest incidence of pertussis was in the age group 0-4 years (20.6 and 23.6 respectively), and high in children and adolescents aged 5-9 (10.9 and 11.5 respectively) and 10-14 years (respectively: 12.2 and 11.2 - per 100 000 population). About half of the cases concerned people over 15 years of age. In general, a higher incidence among women was observed than in men, as well as a higher incidence in cities than in rural areas. In 2018, among people with pertussis, 434 people (i.e. 28%) and in 2019 - 482 people (i.e. 29.6%) were hospitalized. In 2019, one fatal case of the disease was reported to the epidemiological surveillance system. In Poland, in the years 2018-2019, there was a decrease in the number of cases of pertussis, the most common were children under the age of four (the highest incidence). A worrying trend is the decreasing number of vaccinations in children aged 2 years against pertussis covered by compulsory primary vaccinations in individual provinces. In the current epidemiological situation, the best way to prevent new cases of pertussis is to use vaccination according to the current regimen and to recommend to adults a single dose of dTpa vaccination, which should be repeated every 10 years.

Salmonellosis in Poland in 2018 and 2019.

The aim of this study is to assess the epidemiological situation of salmonellosis in Poland, in 2018 and 2019 compared with previous years. 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). 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. 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.

Wirusowe zapalenie wątroby typu C w Polsce w 2019 roku

HCV infection continues to be a significant public health problem in Europe. The aim of the study was to assess the epidemiological situation of hepatitis C in Poland in 2019, based on data collected as part of epidemiological surveillance in 2019, comparing them to data from previous years. The following were analyzed: 1) data from epidemiological surveillance in 2019 2) diagnosis rates from "Infectious Diseases and Poisonings in Poland" bulletins for the years 2013-2019 3) data on deaths due to hepatitis C from the Demographic Surveys and Labour Market Department of the Statistics Poland. In 2019, the HCV diagnosis rate was 8.71 per 100 thousand - a total of 3 343 cases of HCV infection were reported. This was a slight decrease compared to 2018. Still we observe the rate differentiation, territorial (differences in the value of the diagnosis rate are noticeable already at the voivodeship and poviat level) and demographic (higher rates in men than in women, higher rates in urban than in rural areas), which is probably related to HCV testing accessibility. Among acute hepatitis C cases according to the EU definition, indicative of current HCV transmission, exposures related to health care (haemodialysis and nosocomial transmission) were identified, followed by non-medical injection (community needle stick injuries, tattoos, piercings) and sexual contact. A low number of diagnoses (5.9%; 196/3343) among people who inject drugs indicate diagnostic difficulties. For years, the overview of hepatitis C in Poland, observed in epidemiological surveillance, has been determined by the availability of HCV testing. Developing the comfortable testing + treatment system in Poland that reaches people exposed to the current transmission of HCV infection (bearing in mind the possibility of re-infection) is the only possibility of eradication of HCV infections.

Hepatitis B in Poland in 2019.

Assessment of hepatitis B epidemiological situation in Poland in 2019 compared to previous years. Data on the incidence of hepatitis B and HBV infections from 2019 registered by sanitary and epidemiological stations in the electronic Epidemiological Interview Registration System in Poland were analyzed. Data from the published annual bulletins: "Infectious diseases and poisonings in Poland" and "Vaccinations in Poland" were also used. Data on deaths were obtained from the Central Statistical Office. In 2019, 2,854 cases of hepatitis B were reported, which corresponds to the incidence of 7.4 per 100,000 population. Acute cases accounted for 1.6% of all registered cases. The incidence of acute hepatitis B was higher by 20% than in 2018 and lower by 20% than the median incidence for 2013-2017. There were no acute cases among children and adolescents aged 0-19 years. In the age group 20-24, 1 case was reported. The incidence of chronic and unknown stage of hepatitis B was lower by 11% than in the previous year, however, compared to the median incidence of chronic hepatitis B in 2013-2017, it was lower by 15%. As in previous years, acute, chronic and unknown infections occurred more often among men than among women, and more often among urban than rural residents. The most common and probable routes of HBV infections were medical procedures, which accounted for 75% of cases with a known route of transmission. In 2019, the HBV vaccination coverage with the third vaccine dose in children born in 2018 was 90.5%, which is less than in previous year. In 2019, 29 people died due to hepatitis B, including one as a result of an acute infection. The incidence of hepatitis B in Poland over the years (2015-2019) has a decreasing tendency. Among people covered by universal HBV vaccinations, born after 1994, no acute cases were reported. However, the decrease in newborns and infants vaccination coverage may cause the increased risk of new HBV infections, even in the people subject to compulsory vaccinations against hepatitis B. Changes introduced in the surveillance system on hepatitis B in 2014 allow for the levelling of territorial discrepancies in the hepatitis B registered cases and allow for the assessment of the actual number of newly detected HBV infections. The persistence of the low incidence of acute hepatitis B indicates the need to maintain the preventive measures applied so far, in particular the universal compulsory vaccinations of newborns and recommending vaccinations to all previously unvaccinated people.

Mumps in Poland in 2019.

Mumps is a highly infectious viral disease, the source of infection is an infected person. In 2003, compulsory vaccination against mumps was introduced in Poland, carried out according to a two-dose schedule. The combined MMR vaccine (against measles, mumps and rubella) is used as part of the Protective Vaccination Program (PVP). Mumps vaccination has led to a significant reduction in the incidence of mumps in Poland. The aim of the study was to evaluate the epidemiological indicators of mumps in Poland in 2019 compared to previous years. The analysis of the epidemiological situation of mumps in Poland in 2019 was based on the interpretation of data from the bulletin "Infectious diseases and poisonings in Poland in 2019" and "Vaccinations in Poland in 2019". In 2019, 1,338 mumps cases were registered in Poland. The total incidence was 3.5 per 100,000 inhabitants and was lower compared to 2018. The highest incidence 4.6 per 100,000 inhabitants were registered in the Opolskie Voivodeship and the lowest - 2.5 in the Podkarpackie Voivodeship. The incidence was the highest among 6-year-olds and amounted to 32.3/100,000. Comparing the differences between the sexes, the incidence of men (4.1/100,000) was higher than that of women (2.9). In 2019, 22 patients were hospitalized due to mumps in Poland, which was less than in 2018 (28). The level of mumps vaccination in children at 3 years of age was lower by 0.3% compared to 2018 and amounted to 92.6% in Poland. Maintaining a high percentage of children vaccinated against mumps will provide sustaining decline in cases of mumps in the coming years.

Hepatitis C in Poland in 2018.

Analysis of data on hepatitis C, collected as part of epidemiological surveillance in 2018, compared to previous years. Analysis of: 1) individual data from surveillance in 2018 2) diagnosis rate from bulletins "Infectious diseases and poisonings in Poland" for the years 2012-2018 and 3) data about deaths due to hepatitis C from the Demographic Surveys and Labour Market Department of the Central Statistical Office. In 2018, there was a decrease in the number of reported hepatitis C cases (3,442 cases) and the diagnosis rate (8.96 per 100,000; taking into account the territorial distribution: from 3.29 per 100,000 in the Podkarpackie voivodeship to 13.69 per 100,00 in the Lubuskie voivodeship). The disproportion of the rates between the sexes returned (in men 9.34 per 100,000 vs. women: 8.61 per 100,000). The disproportion of the diagnosis rate depending on the place of residence was still evident (urban: 10.84 per 100,000 vs. rural: 6.12 per 100,000). There are differences in the values of the diagnosis rates, analyzed in terms of gender, age groups and the place of residence. Based on the EU definition, 14 acute hepatitis C were reported, while according to the PL definition, 88 cases (0.4% and 2.6% of all reported cases, respectively). HCV infections due to medical procedures are still the main route of transmission, also in cases of acute hepatitis C - which indicates the current route of transmission. According to the Demographic Surveys and Labour Market Department of the Central Statistical Office, 119 deaths related to hepatitis C were reported. For years, the general picture of hepatitis C in Poland, observed through epidemiological surveillance, is determined by the availability of testing for HCV infections. The analysis identified subpopulations in which primary prevention activities (e.g. safer medical procedures, intensifying activities in the area of harm reduction for people who inject drugs) as well as secondary prevention (access to testing and quick inclusion in treatment) should be particularly strengthened. According to the micro-elimination strategy, the improvement of testing in particularly affected groups, including marginalized populations, is necessary to achieve the WHO goal of eliminating HCV by 2030.

Hepatitis B in Poland in 2018.

Evaluation of the epidemiological situation of hepatitis B in Poland in 2018 compared to the situation in previous years. 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. In 2018, a total of 3 196 hepatitis B cases were registered, which corresponds to an incidence of 8.3 cases per 100,000 population. Acute hepatitis B cases accounted for about 1.3 % of total. The incidence of acute hepatitis B was lower by 33% than in 2017 and lower by 44% than median of the years 2012-2016. No acute cases were reported among children and adolescents aged 0-19 years and in the age group 20-24. The incidence of chronic and unknown (in terms of the stage) was lower by 4.5% than in the previous year however, in comparison to median incidence of chronic hepatitis B in 2012-2016 an increase of 17% was noted. As in the previous years, acute, chronic and unknown stage (UNK) hepatitis B were more often detected in men and in urban residents. The dominant route of transmission of HBV infections still remains procedures performed in medical settings - 86% of cases with a known transmission route. The coverage with the third HBV vaccine dose in children aged two years was 91 % and remains ( since 2017) below the 95% required in the elimination strategy. In 2018 three people died due to acute hepatitis B and 35 people due to chronic hepatitis B. In 2018 decrease in the incidence of acute and chronic hepatitis B was observed. In group of persons born after 1994 covered by obligatory hepatitis B vaccinations as newborns no acute cases have been reported, however, a progressive decline in children's vaccination coverage poses a risk for new HBV infection also among people subjected to mandatory vaccinations. Maintenance of a low incidence of acute hepatitis B requires improvement in carrying out of mandatory vaccination among newborns and further recommendation of vaccination for all persons previously unvaccinated. A slight decline in the detection of chronic and UNK cases may be related to the number of tests performed in a given year.