Sanitary-epidemiological Stations Research Articles

Problems in Medicine and Health Care in Karakalpakstan During the World War II

The article discusses the widespread prevalence of infectious intestinal diseases and parasitic typhus among the urban and rural population of Karakalpakstan during the years of World War II. It also highlights the frequent occurrence of urban doctors recording deaths from acute respiratory diseases (such as influenza and measles), as well as tuberculosis and gastrointestinal diseases (such as dysentery and hemocolitis). Regarding the heads of the sanitary-epidemiological stations (in Nukus, Chimbay, Tortkol, Muynak, and others), it is emphasized that they worked not out of fear, but conscientiously, without regard for time and effort, as expected during the wartime period. During the war years, the attitude of urban populations toward modern medicine improved significantly. It highlights that doctors such as U. Khalmuradov, V. V. Voskoboynikov, V. P. Khaneeva, A. V. Poltoratsky, I. G. Lepeshkin, E. G. Ridaeva, S. Alimov, and others gained great respect and worked diligently among the population.

Salmonellosis in Poland in 2021.

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

Listeriosis in Poland in 2012-2021.

The aim of the study is to present and evaluate the epidemiological situation of listeriosis in Poland in the years 2012-2021. The analysis material consisted of data from individual epidemiological case reports on listeriosis submitted to the Department of Epidemiology of Infectious Diseases and Surveillance of the NIPH NIH - NRI by state sanitaryepidemiological stations in the form of paper questionnaires (2012-2019) and in the electronic form through the EpiBaza system (2020 and 2021), as well as aggregated data from the bulletin "Infectious Diseases and Poisoning in Poland". Between 2012 and 2021, a total of 896 cases of listeriosis were registred in Poland. The median incidence was 0.23 per 100,000 population, which was an increase by 52.2% compared to the previous 5-year period (2007-2011). Every year, more than 90% of cases were hospitalized. The highest percentage of patients were in the age group >60 years old (65.5%). From 2012 to 2019 (in the years when information on cases was collected on a paper form), a total of 275 deaths of patients from listeriosis were recorded (38.4% of all reported cases). According to data from the EpiBaza system, in 2020 and 2021 there were 5 (8.33%) and 25 (20.83%) deaths due to listeriosis. A total of 92.1% of patients with listeriosis had significant predisposing factors for the occurrence of this disease, most of which were associated with neoplasia and heart disease and were present in half of all cases. As part of routine surveillance, no epidemic outbreak associated with Listeria monocytogenes infection was reported in Poland in the years 2012-2021.A total number of 49 pregnant women with listeriosis were reported during described period. Between 2012 and 2021, 37 cases of congenital listeriosis were reported. The median of incidence was 1.07/100 thousand live births, a decrease of 26% compared to the previous 5-year period (2007-2011). Of all congenital infections in newborns, 12 deaths (32.43%) were reported. The epidemiology of listeriosis is changing both in the EU/EEA countries and in Poland: the incidence is increasing and the distribution of cases in different age groups is changing, affecting primarily the elderly, especially those with predisposing diseases. Although 2020 tere was a decrease in the number of cases at EU level, possibly related to the COVID-19 pandemic, the overall trend of listeriosis cases isincreasing. The clinical condition has a significant impact on the course of L. monocytogenes infection: in healthy people, infection is usually asymptomatic. The disease primarily affects immunocompromised people. In contrast, infection of pregnant women can lead to premature birth, miscarriage, meningitis and neonatal sepsis with mortality rate of 20-30%. The growing trend in listeriosis is alarming and requires greater attention in terms of prevention and control of the disease.

Foodborne botulism in Poland in 2018-2021.

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

Salmonellosis in Poland in 2020.

The aim of the study is to assess the epidemiological situation of salmonellosis in Poland in 2020 compared with previous years. 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. 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. 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.

The aim of the study was to assess the epidemiological situation of yersiniosis in Poland in 2018-2020 and compare it to previous years. 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. 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. 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.

Exposure to PM2.5 and PM10 pollution and the risk of respiratory diseases in upper Silesia inhabitants

Background: Multiple studies confirm that PM2.5 and PM10 can affect lung growth and development in children and adolescents, the number of medical visits, and hospital emergency admissions due to asthma, respiratory symptoms, and upper and lower respiratory tract disorders. Objective: The objective of this study was the measurement-based assessment for determining whether the concentrations of PM10 and PM2.5 are within admissible limits or exceeded in the Upper Silesia urban area (Silesia province) and to examine the relationship between PM concentrations and the number of admissions in Primary Health Care due to respiratory diseases like asthma and chronic bronchitis for children, adolescents and adults. Material and methods: The data provided by the Voivodship Inspectorate for Environmental Protection in Katowice, National Health Fund - Silesian Department, and the District Sanitary-Epidemiological Station in Katowice for the period 2012-2017 was used in the statistical analysis. Results: The increase in the number of excessive levels of average daily PM10 concentration was observed in almost all measurement stations, both for the acceptable level, information, and alarm level. The increase in average annual PM2.5 concentrations was also observed. The results showed an increased prevalence of respiratory diseases (ICD-Diagnosis Code 10-CM: J017, J030, J034, J038, J040) during the study period in 14 of 20 cities of Silesia province, consistently higher for children than adults. Conclusions: In Silesia province, the air quality is poor and has deteriorated over the last few years. Exposure to ambient PM2.5 and PM10 was significantly associated with the development of respiratory tract diseases in children and adults.

1351. A Retrospective Database Study of Lyme Borreliosis Incidence and Distribution in Poland from 2015 to 2019

Abstract Background Lyme borreliosis (LB), a tick-borne disease caused by Borrelia burgdorferi sensu lato, has been subject to mandatory public health surveillance since 1996 in Poland. Here, the incidence, temporal trends, and geographical distribution of LB and its manifestations in Poland are described for the period 2015-2019. Methods This retrospective incidence study of LB and its manifestations in Poland was based on the data sent to the National Institute of Public Health (NIPH-NIH–NRI) by district sanitary-epidemiological stations using the electronic Epidemiological Records Registration System and data from the National Database on Hospitalization. LB and its manifestations were reported in two categories- probable and confirmed (through laboratory tests). Incidence rates were calculated using the population data from the Central Statistical Office of Poland. Results In Poland, a total of 94,715 cases of LB with an overall mean incidence of 49.3 cases per 100,000 population were reported between 2015-2019. Cases increased from 2015 (11,945) to 2016 (20,857), and then remained stable through 2019. LB was more common among women (55.7%). The highest incidence rates occurred among >50-year-olds, with a peak in 65-69-year-olds. 48,717 persons with LB were hospitalized in the 5-year period, with higher number of hospitalizations in age groups 55-69 years old. Erythema migrans and Lyme arthritis were the most common manifestations of LB with incidence rates of 36.2 and 15.8 per 100,000 population, respectively. EM accounted for approximately 74% of all manifestations of LB. The highest number of cases were recorded in the 3rd and 4th quarters of the year (July – December). Incidence rates in the East and Northeastern regions (Podlaskie, Lubelskie, and Warmińsko-Mazurskie voivodeships) of the country were higher than the national average. These regions correspond to greater forest cover and/or agricultural areas. Time trend of LB cases and incidence in Poland, 2015-2019. Conclusion LB is endemic in all regions of Poland, and many regions reported high incidence rates. LB is reported year-round in Poland. Thus, large variations in temporal and spatially granular incidence rates highlight the need for targeted prevention strategies, such as vaccines. Disclosures Jozica Skufca, Epidemiologist, p95: Paid by Pfizer to perform the study Archana Nagarajan, Ph.D., P95: Paid by Pfizer to perform the study Andreas Pilz, PhD, Pfizer: Employee|Pfizer: Stocks/Bonds|Pfizer: Stocks/Bonds Andrew Vyse, Ph.D., Pfizer: Stocks/Bonds Elizabeth Begier, M.D., M.P.H., Pfizer: Employee|Pfizer: Stocks/Bonds Mendwas Dzingina, Ph.D., Pfizer: Stocks/Bonds Maxim Blum, Ph.D., P95: Paid by Pfizer to perform the study Margarita Riera, MD, MPH, P95: Paid by Pfizer to perform the study Bradford Gessner, MD, MPH, Pfizer: Stocks/Bonds James Stark, Ph.D., Pfizer: Stocks/Bonds.

Lyme disease in Poland in 2020.

Lyme borreliosis, also known as Lyme disease, is a zoonotic disease transmitted by ticks. The infection occurs through a bite by a common tick (Ixodes ricinus). Due to the annual cycle of tick activity, mainly dependent on temperature, Lyme disease is seasonal. In certain cases, post-exposure prophylaxis may be indicated, while the vaccine is in phase III clinical trials. The aim of the study is to assess the epidemiological situation of Lyme disease in Poland in 2020 compared to the situation in previous years. The epidemiological situation of Lyme disease in Poland was assessed on the basis of the data sent to NIPH NIH - NRI by voivodeship sanitary-epidemiological stations and published in the bulletin "Infectious diseases and poisoning in Poland in 2020". In 2020, 12,934 Lyme borreliosis cases and 459 hospitalizations were registered which, compared to 2019, means a 37.3% decrease in morbidity and a 73% decrease in hospitalization. It may be related to the outbreak of the SARS-CoV-2 virus at the end of 2019, which reached Poland at the beginning of March 2020. It can be seen that in Q2, due to the lower activity of people due to the epidemic, the number of cases of Lyme disease was less than in Q1 (2,064 in Q2 compared to 2,253 in Q1). The decrease compared to 2019 also continued in the third and fourth quarter, by 28% and 49%, respectively. The impact of the SARS-CoV-2 outbreak on the distribution of Lymedisease incidence is noticeable, in particular on the decrease in the overall number of cases during the year,as well as on hospitalization due to Lyme disease with the previously observed stabilization of the incidence. The pandemic could have influenced this state of affairs on various levels. The main reason was, of course, theintroduction of the epidemic and the related restrictions (including reduced mobility), but it cannot be ruledout that the cause was not an excessive burden on the health care system and sanitary inspection (delay inregistration of reports).

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.

Giardiasis (lambliasis) in Poland in 2018 and 2019.

Assessment of the epidemiological situation of giardiasis in Poland in years 2018 and 2019. 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). 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. 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.

Stages of formation and development of sanitary and epidemiological stations in Russia. (to the anniversary of the State Sanitary and Epidemiological Service of Russia)

The concept and purpose of sanitary stations organized in the XIX century in Western Europe, as well as the first sanitary stations of pre-revolutionary Russia in the cities of Perm, Odessa, Moscow and St. Petersburg are revealed. The historical roots of the emergence of the first district sanitary stations on the territory of the USSR are presented. The information about the creation in the Ryazan region in 1928 of the first complex specialized sanitary and epidemiological institution — the provincial central sanitary and bacteriological station named after the 10th anniversary of Soviet medicine. The main stages of formation and development of sanitary-epidemiological stations in the USSR are shown.

Lyme disease in Poland in 2019.

Lyme disease is caused by Borrelia spirochetes transmitted by ticks of the genus Ixodes. In Poland, Lyme disease is the most common tick-borne disease. The entire territory of Poland is recognized by ECDC as an endemic area of Lyme disease. Environmental factors and climate change are responsible for the increase in the number of tick habitats, which leads to an increased risk of Lyme disease. The aim of the study is to present the epidemiological situation of Lyme disease in Poland in 2019 compared to the previous year. The analysis of the epidemiological situation of Lyme disease in Poland was based on data sent to NIPH NIH - NRI by voivodeship sanitary-epidemiological stations and published in the bulletin "Infectious diseases and poisoning in Poland in 2019." In 2019, 20,630 cases of Lyme disease were registered, and 1,701 people were hospitalized. Compared to 2018, there was a shift in the incidence from the first and second quarter to the fourth quarter. The highest incidence of 107.7 / 100,000 population was recorded in the Podlaskie voivodeship, which has belonged to the voivodeships with the highest incidence in the country for many years. Despite an increase in the total number of cases by 2.4% compared to 2018, the percentage of hospitalized cases was lower than in the previous year. Difficulties in the diagnosis of Lyme disease make it impossible to define an unequivocal trend in the epidemiological situation in Poland. A slight increase in the incidence may result from the growing number of infected ticks and a better understanding of the problem of Lyme diagnosis by doctors.

Meningitis and encephalitis in Poland in 2019.

The most common form of infectious diseases of the nervous system is meningitis and encephalitis. This study discusses in detail bacterial meningitis and/or encephalitis in which the etiological factors are: Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae and viral - in Poland, most often caused by tick-borne encephalitis virus. In addition to routine epidemiological surveillance of diseases caused by these etiological factors, mandatory and recommended vaccinations are carried out in Poland aimed at reducing the number of cases caused by N. meningitidis, S. pneumoniae, H. influenzae and TBEV. The aim of the study is to assess the epidemiological situation of meningitis and encephalitis in Poland in 2019. The epidemiological situation of meningitis and encephalitis in Poland was assessed on data sent to NIPH NIH - NRI by voivodeship sanitary-epidemiological stations and published in the annual bulletin "Infectious diseases and poisoning in Poland in 2019" and "Vaccinations in Poland in 2019". In 2019, a total of 2,239 cases of meningitis and encephalitis were registered in Poland. This is a decrease by approximately 19,9% compared to 2018. In the case of bacterial infections, including neuroborreliosis, the number of cases decreased by 27%, from 1265 to 921 cases. In the group of viral infections, a decrease by 14% (from 1,533 to 1,318 cases) was recorded. In 31% of all the cases of bacterial etiology, the etiological factor was one of three: Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae. Infections of viral etiology accounted for 58.9% of all registered cases. Compared to 2018, the number of S. pneumoniae cases decreased by 14.6%, and in the case of N. meningitidis by 6.9%. In the case of H. influenzae, there was an increase in the number of cases, compared to the previous year. In addition, there was a slight increase in the number of cases of tick-borne encephalitis - from 197 cases in 2018 to 265 cases in 2019 (an increase of 34.5%). The analysis showed a generally declining disease trend, both in bacterial and viral meningitis and encephalitis. Only in cases caused by H. influenzae and tick-borne encephalitis virus, an increase was observed compared to the previous year. Meningitis and encephalitis continues to be a challenge for the healthcare system, with particular emphasis on the correct differentiation of the etiology at an early stage of infection detection.

Lyme disease in Poland in 2018.

Lyme disease is the most common tick-borne disease, caused by spirochetes of the genus Borrelia, transmitted by ticks of the Ixodes genus. According to ECDC, Poland should be considered as an endemic area. The risk of Lyme disease incidence in-creases with tick habitats increase, which is a response to environmental factors and climate change. The aim of the study is to assess the epidemiological situation of Lyme disease in Poland in 2018 compared to the situation in previous years. The epidemiological situation of Lyme disease in Poland was assessed on the basis of the data sent to NIPH-NIH by voivodeship sanitary-epidemiological stations and published in the bulletin 'Infectious diseases and poisoning in Poland in 2018' . In 2018; 20,150 Lyme disease cases was registered, 2,124 people were hospitalized. You can also see an increase in cases in the second and third quarter in favor of the fourth quarter. The epidemiological situation in Western European countries is similar to the situation in Poland. The inability to determine the clear trend of the epidemiological situation in Poland indicates the sensitivity of the surveillance system, but also the difficulty in new cases diagnosis. You can also see a decrease in the number of cases, which may be a sign of having the right tools or experience in the Lyme disease diagnosis.

Legionella spp. in Polish hospitals in 2009–2013 and 2014–2016: An epidemiological analysis

Summary Introduction Bacteria of the genus Legionella cause Legionnaires’ disease (atypical pneumonia, often with a severe clinical course) and Pontiac fever (self-limiting infection with flu-like symptoms). Legionella spp. are commonly found in natural aquatic environments and artificial water distribution systems. Material & Methods An epidemiological analysis of Legionella spp. in hospital water supply systems was based on the results obtained from Sanitary-Epidemiological Stations of Poland. The materials for this study were hot water samples collected from 346 hospitals in 2009–2013 and from 221 hospitals in 2014–2016. Results Between 2014 and 2016, there was a decrease in the percentage of the number of water samples in Group A (<100 CFU/100 ml). In other groups: B (>100 CFU/100 ml), C (>1000 CFU/100 ml), D (>10 000 CFU/100 ml) was observed an increase in the percentage of the number of water samples, which was a negative phenomenon. The mean number of L. pneumophila colonies in analyzed periods 2009–2013 and 2014–2016 were different. In 2009–2013, the most virulent L. pneumophila serogroup 1 (SG 1) was detected in 3 hospitals (0.9%), and L. pneumophila SG 2-14 were isolated in 20 (5.5%). Between 2014 and 2016, L. pneumophila SG 1 and L. pneumophila SG 2-14 were found in 5 hospitals (2.2%) and 18 hospitals (8.1%), respectively. Disscusion In this study a comparative epidemiological analysis was performed on the prevalence of L. pneumophila in hospital water supply systems in Poland in the following two periods: 2009 –2013 and 2014–2016. The study demonstrated that the water supply systems of Polish hospitals were colonized by L. pneumophila at different levels. However, between 2014 and 2016 an upward trend was observed in comparison with 2009–2013.

Activities of the district sanitary and epidemiological service of Moscow during the Great Patriotic War (1941-1945)

The analysis of data and publications concerning the activities of the sanitary and epidemiological service (SES) during The World War II has been made in the memory of the 75th anniversary of the historical Victory of the Soviet people in the Great Patriotic War. An expert and analytical study was performed. There was a report of the work of the state sanitary Inspection and Sanitary-epidemiological station of the Kirovsky district of Moscow in 1944. The effort of the sanitary service of the Kirovsky district in 1944 allowed performing the supervision on controlled objects by 162.3% and restored the house water pipes and sewers which were destroyed in the past winter; to improve the housing stock of the district; to renovate and provide equipment of the hostel, to improve the content of dormitories and eliminate lice, to open 4 new kindergartens and nursery toddlers ‘ groups and to improve the sanitary condition and maintenance of children’s institutions, to organize the summer improving children’s company, to repair schools, to improve nutrition in child care, to improve health of workers and the maintenance of industrial and municipal enterprises, to reduce the incidence of injuries at the leading industrial enterprises, to improve the working conditions of Junior enterprises, to reduce the number of occupational diseases and occupational injuries; to reduce the incidence of influenza, dysentery, diphtheria and malaria, to exceed the preventive vaccination plan ahead of time, to achieve almost complete (98.3%) hospitalization of epidemic patients, to organize connections with public health instructors, to exceed the work plans of all SES laboratories, to perform scientific and practical work. Conclusion. The work of the state sanitary Inspection and sanitary inspection Service of the Kirovsky district of Moscow in 1944 provided an appropriate level of sanitary conditions at enterprises, institutions and the territory of the district. Military difficulties and limited human resources did not affect on the use of the main forms of work of the service: preventive and routine sanitary supervision, laboratory and instrumental research methods, vaccination, public health education, and administrative measures.

Activities of the district sanitary and epidemiological service of Moscow during the Great Patriotic War (1941-1945)

The analysis of data and publications concerning the activities of the sanitary and epidemiological service (SES) during The World War II has been made in the memory of the 75th anniversary of the historical Victory of the Soviet people in the Great Patriotic War. An expert and analytical study was performed. There was a report of the work of the state sanitary Inspection and Sanitary-epidemiological station of the Kirovsky district of Moscow in 1944. The effort of the sanitary service of the Kirovsky district in 1944 allowed performing the supervision on controlled objects by 162.3% and restored the house water pipes and sewers which were destroyed in the past winter; to improve the housing stock of the district; to renovate and provide equipment of the hostel, to improve the content of dormitories and eliminate lice, to open 4 new kindergartens and nursery toddlers ‘ groups and to improve the sanitary condition and maintenance of children’s institutions, to organize the summer improving children’s company, to repair schools, to improve nutrition in child care, to improve health of workers and the maintenance of industrial and municipal enterprises, to reduce the incidence of injuries at the leading industrial enterprises, to improve the working conditions of Junior enterprises, to reduce the number of occupational diseases and occupational injuries; to reduce the incidence of influenza, dysentery, diphtheria and malaria, to exceed the preventive vaccination plan ahead of time, to achieve almost complete (98.3%) hospitalization of epidemic patients, to organize connections with public health instructors, to exceed the work plans of all SES laboratories, to perform scientific and practical work. Conclusion. The work of the state sanitary Inspection and sanitary inspection Service of the Kirovsky district of Moscow in 1944 provided an appropriate level of sanitary conditions at enterprises, institutions and the territory of the district. Military difficulties and limited human resources did not affect on the use of the main forms of work of the service: preventive and routine sanitary supervision, laboratory and instrumental research methods, vaccination, public health education, and administrative measures.

Refleksija Štamparove javno-zdravstvene djelatnosti na području Slavonskoga Broda

Aktivnost javnozdravstvene službe u Slavonskom Brodu započinje već u vrijeme Vojne granice, kada je organiziran sanitarni kordon i karantena da bi se spriječilo prenošenje opasnih zaraznih bolesti preko Save. Ipak, razvijenija preventivna djelatnost slijedila je u vrijeme djelovanja Andrije Štampara, jer se osniva Školska poliklinika, održavaju javnozdravstvena predavanja, započinje rad Antituberkuloznoga dispanzera, Ambulante protiv veneričnih bolesti te Stanice protiv bjesnoće. Velik je napredak učinjen 1946. godine osnivanjem Sanitarno-epidemiološke stanice kao zasebne institucije. Pokazala se vrlo uspješnom u suzbijanju poslijeratne epidemije trbušnoga tifusa, eradikaciji malarije i uvođenju masovnoga cijepljenja protiv dječjih zaraznih bolesti. Kroz četrdesetgodišnje razdoblje, u okviru Medicinskoga centra slijedila je izvjesna stagnacija, napose u usporedbi s velikim progresom kliničkih i dijagnostičkih grana medicine. Osnivanjem Županijskog zavoda za javno zdravstvo 1994. godine preventivna djelatnost doživljava znatni razvitak. To se posebno odnosi na praćenje i suzbijanje kroničnih degenerativnih bolesti, malignih tumora, zaštitu školske djece i mladeži, kao i na osvješćivanje sve češće prisutne bolesti ovisnosti u mladoj populaciji.

Borreliosis in the inhabitants of Bielsko-Biała and the surrounding area in the period 2008-2017

Introduction: Lyme disease is a multiorgan tick-borne disease which endemically occurs primarily in countries in the Northern Hemisphere. It is caused by the bacteria Borrelia burgdorferi, and the vector of infection are ticks from the Ixodes family. In recent years it has been noted that there is an increase in the number of Lyme disease cases in the world. Due to the varied clinical picture of disease and the possibility of complications, Lyme disease should be diagnosed early and properly treated. The objective of the research was an analysis of the occurrence of Lyme disease among inhabitants of “bielski” district and the city of Bielsko-Biala in years 2008-2017. Methods: The analysis of the occurrence of Lyme disease was based on data collected from the Sanitary Epidemiological Station in Bielsko-Biala. Results: In the analysed period there were 1450 cases of Lyme disease diagnosed, mostly among people living in the city which has a population of more than 10000 inhabitants. The disease most frequently afflicted women 51 to 60 and 61 to 70 years of age. Tick bites occurred most frequently during summer months. The most common symptom of infection was malaise, fever and erythema at the site of the tick bite. Conclusions: In the analysed period covering the years 2008-2017, the number of cases of Lyme disease among people living in Bielsko-Biala and the surrounding area remains on the similar level with a noticeable significant increase in 2009 and a decrease in 2014-2015. Women were suffering from Lyme disease more often than men. Lyme disease affected people of all ages. However, the group at risk consisted of people in their fifties and sixties. Tick bites, which resulted in bacterium Borrelia burgdorferi infection, occurred between July and November with the intensity in the summer months.