Infectious diseases in Poland in 1999

Improvement of epidemiological situation of infectious diseases was continued in Poland in 1999. The end of epidemics of measles, pertussis, mumps, scarlatine, chickenpox, and rubella was observed. In comparison with the number of cases of infectious diseases registered in 1998, decrease in the number of notified cases of salmonellosis, dysentery, meningitis, encephalitis, and hepatitis type B and A as well as increase in the number of influenza cases and trichinosis was noticed. In 1999, compared with 1998, among all notified deaths percentage of deaths attributed to infectious diseases (0.80%) and infectious diseases death rate (7.71 per 100,000) were slightly higher as an effect of the influenza deaths increase.     

Infectious diseases in Poland in 2001

In 2001 surveillance system of infectious diseases in Poland remained unchanged. New cases of infectious diseases were recorded in 103 positions including intoxications. Tuberculosis and sexually transmitted infections were registered in separate systems. Influenza was the most frequently reported infectious disease with 576,449 cases, 63.9% less then in the previous year. The next most numerous were foodborne infections, which were reported in 24,393 cases, including 19,788 cases of infections caused by Salmonella sp. An increase in incidence was observed in the following diseases: viral hepatitis type A, rubella, measles and pertussis. Also the number of recorded cases of Lyme boreliosis and tickborne encephalitis were higher then in 2000. Incidence of AIDS remained within the range recorded during the last few years. In 2001 further drop in incidence of viral hepatitis type B was observed reaching the level of 6.2 per 100,000. It was the result of implemented comprehensive program of prophylactic measures, which brought incidence of this disease from the highest in Europe down to the level close to European average. Infectious diseases contributed to 0.75% of deaths. The most frequent cause of death among infectious diseases was tuberculosis and its sequels (1,061 cases). 13 cases of death due to tuberculosis occurred in people below 30 years of age.     

Infectious diseases in Poland in 2002

New regulations concerning infectious diseases effective in Poland since 2002 did not changed surveillance of infectious diseases. The most frequent infectious disease as in the previous years was influenza. 228.055 cases were reported (596.5/100,000). Number of foodborne infections and intoxications remains high--26.734 cases (69.0/100,000). 77% of them were caused by Salmonella. In this high number of foodborne infections in 4,492 (16.8%) etiologic factor was not found. In this number Campylobacter infections, rarely tested in Poland may be found. Especially alarming is number of cases of diarrhea among children 0-2. Age adjusted incidence of 2.464/100,000 is the highest occurrence among infectious diseases in Poland. There was noted decrease of incidence of newly diagnosed cases of viral hepatitis B (5.3/100,000) which dropped to the level of the incidence of viral hepatitis C (5.17/100,000). Hepatitis A remains at the low level (0.9/100,000). Level of newly diagnosed cases of AIDS (113 cases, 0.3/100,000) remains relatively stable for last few years. The major problem is decreasing reporting of possible risk factors. Infectious diseases caused 0.74% of deaths. Mortality from infectious diseases was 6.9/100,000 and was significantly higher among men (8.9) then among women. (5.1). In the age groups 35-64 it was 3-4 times higher. In urban settings mortality from infectious diseases was higher (7.2/100,000) then in the country (6.6). In particular districts (voivodeships) mortality indices remained in the range of 4.3 (opolskie) to 11.4 (?laskie). As in previous years, the highest number of deaths was caused by tuberculosis and its late sequels (35.4%). Attention should be given to the increased number of deaths due to sepsis (33.6%, without neonatal sepsis).     

Infectious diseases in Poland in 2003

The most frequent infectious disease as in the previous years was influenza. 1,216,285 cases were reported (3,184.4/100,000). Number of foodborne infections and intoxications remains high--20,221 cases (52.9/100,000). 81.6% of them were caused by Salmonella. In 15.5% of them etiologic factor was not found. In this number Campylobacter infections, rarely tested in Poland may be hidden. Especially alarming is number of cases of diarrhea among children 0-2. Seasonality of childhood diarrhea indicates domination of viral infections, most probably rotaviral among them. There was noted decrease of incidence of newly diagnosed cases of viral hepatitis B (4.7/100,000) which dropped to the level of the incidence of viral hepatitis C (5.9/100,000). Hepatitis A remains at the low level (0.39/100,000). Level of newly diagnosed cases of AIDS (116 cases, 0.36/100,000) remains relatively stable for last few years. The major problem is decreasing reporting of possible risk factors. Infectious diseases caused 0.75% of deaths. Mortality from infectious diseases was 7.2/100,000 and was significantly higher among men (9.5) then among women (5.0). In urban settings mortality from infectious diseases was higher (7.3/100,000) then in the country (6.9). As in previous years, the highest number of deaths was caused by tuberculosis and its late sequels (34.4%). Attention should be given to the increased number of deaths due to sepsis (32.3%, without neonatal sepsis).     

Surveillance of infectious diseases in the Italian military as pre-requisite for tailored vaccination programme

Surveillance and control of infectious diseases in the Italian military include prompt reporting of all occurring cases and prophylaxis through compulsory vaccination practices. The last mandatory immunisation programme in the Italian military was launched in 1998 (more than 10 years after the previous programme was introduced in 1986-1987) and it was planned according to the epidemiological data herein reported. The incidence rates (number of cases x 100000 subjects) of infectious diseases notified during the period 1976-1980 were compared with the corresponding figures notified 15 years later (1991-1995). An increase of three airborne-transmitted viral diseases--varicella, rubella and measles--counterbalanced by a decrease of other infectious diseases, such as mumps, typhoid fever, tuberculosis, viral hepatitis, scabies, syphilis and gonorrhea, was observed. This may be related to improvements in the general hygienic conditions and more responsible sexual behaviour among Italian military recruits. Moreover, incidence rates of cases notified in the military were compared with those notified in the general population of the same sex- and similar age-range (15-24 years) over a 12-year period (1986-1997), to monitor the epidemiological situation in relation to (a) potential risk factors specifically linked to military life and (b) protective effects induced by specific vaccinations. Airborne-transmitted viral diseases, such as varicella, rubella, measles and mumps--which are usually underreported among civilians--show higher incidence rates in the military. Meningococcal meningitis shows higher incidence rates in the military in 1986 and 1987 (before the introduction of mandatory specific vaccination) as well as in 1995-1997 (main etiologic agent N. meningitidis serogroup B); similar rates were instead observed in the other years. Incidence rates for typhoid fever are generally lower in the military, despite the community life, probably reflecting the protective efficacy of specific vaccine. Hepatitis A and B show similar rates between military and civilian population. Finally, pulmonary tuberculosis generally shows higher rates in the military. These data therefore allow the conclusion that the only infectious diseases, for which possible risk factors in the military life may be hypothesised, seem to be meningococcal meningitis and perhaps pulmonary tuberculosis. Epidemiological surveillance of infectious diseases in the military as a pre-requisite for appropriate public health intervention strategy represents a good model to be followed also in larger contexts.     

AIDS and HIV infection in Poland in 2003

The cumulative number of AIDS cases diagnosed in Poland from 1986 through 2003 reached 1421, and 676 AIDS deaths were registered during this time. Compared to previous years there was a slight increase in number of diagnosed AIDS cases (139 in 2003, incidence 0.36 per 100,000, comparing to 116 in 2002). Moreover the upward trend in AIDS mortality, which began in 2002, continued in 2003, with 61 reported deaths (a 27% increase as compared to 2002 and 45% increase as compared to 2001). Additionally, taking into account the official life statistics data, AIDS deaths might be underreported. In 2003, 610 newly detected HIV infections were reported (incidence 1.5 per 100,000), which is within the range observed in the past years. Injecting drug users constituted the most numerous risk group both among the AIDS cases (59.7%) and the HIV infection cases (35.6%). The proportion of reports of HIV infections with missing information on the risk group, however, remained very high (55% of all reports). In order to monitor the epidemiological situation better quality of data will need to be assured.     

Scarlet fever in Poland in 2000

In 2000, as compared with 1999, a 14% decrease in the number of scarlet fever cases was noted. The incidence was 21.6 per 100,000 population and was one of the lowest since World War II. In particular voivodeships incidence ranged from 9.4 to 34.3 per 100,000 population. In urban areas the incidence was 71.3% higher than in rural ones. Of all registered cases 95.3% were children under 15 years of age. The age distribution of scarlet fever cases in 2000 was similar to the distribution observed in the last decade. The highest incidence was noted among children aged 6 and 5, respectively 257.0 and 224.4 per 100,000. About 2.1% of all cases were hospitalized. No scarlet fever deaths were noted.     

2004-2010凤风山县乙丙类传染病流行状况分析

目的了解广西边远山区凤山县近7年法定传染病的发病态势,分析其流行特征和规律,为制定防治策略和措施提供科学依据。方法收集该县2004—2010年的法定传染病乙类和丙类疫情资料,采用Excel软件进行统计分析。结果全县近7年报告乙类和丙类传染病22种共5303例病例,人群年均报告发病率为382．25／10万,其中乙类传染病15种共3838例病例,人群年均报告发病率为276．65／10万。乙类传染病发病率居前5位的是肺结核、病毒性肝炎、淋病、痢疾和梅毒。值得注意的是淋病病人与梅毒病人之比为4．09：1,淋病病人与AIDS／HIV阳性病人之比为15．66：1,梅毒病人与AIDS／HIV阳性病人之比为3．83：1。传染病死亡人数共29例,人群死亡率为2．09／10万,其中肺结核病例占总死亡人数的37．93％,艾滋病及HIV阳性病例占总死亡人数的31．04％,狂犬病病例占24．14％。结论该县近7年乙丙类传染病报告发病率呈逐年增多趋势,艾滋病及HIV阳性死亡病例呈逐年上升趋势,需进一步加强传染病的监控和预防。     

Rubella in Poland in 2000

In 2000, as compared with 1999, a 49% increase in the number of rubella cases was noted. It corresponded to the development a new compensatory epidemic (the peak of the last epidemic was observed in 1997). A total of 49,181 cases were registered, including 1 case of congenital rubella. Incidence on the country level was 119.5 per 100,000 population. In particular voivodeships it ranged from 24.0 to 314.8. Incidence in urban areas was 35% higher than in rural areas. Incidence among women (109.0) was 16% lower than among men (130.6). One of the probable reasons of this difference was intensive immunization of 13-year old girls, which have been providing for several years. Among all registered rubella cases 94.2% were children under 15 years of age. The highest incidence was noted among 7-year old (1,216.0) and 6-year old (1,148.9) children. About 0.3% of rubella cases were hospitalized. No rubella deaths were noted.     

Rubella in Poland in 2001

In 2001 in Poland we observed a subsequent peak of rubella epidemic (the previous peak was observed in 1997). As compared to 2000, an 82.8% increase in the number of rubella cases was noted. A total of 84,419 cases were registered, including 3 cases of congenital rubella. Incidence on the country level was 218.5 per 100,000 population. In particular voivodeships it ranged from 50.1 to 655.2. For the first time since rubella became reportable, the incidence in rural areas (220.1) was higher than in urban areas (217.4) Incidence among women (193.6) was 21% lower than among men (244.8). This disproportion is gradually increasing. One of the probable reasons of this difference is the intensive immunisation of 13-year old girls, which has been in place for several years now. Among all registered rubella cases 91.7% were children under 15 years of age. The highest incidence was noted among 7-year old (2,235.8), 8-year old (1,964.7) and 6-year old (1,954.5) children. About 0.3% of rubella cases were hospitalised. No rubella deaths were noted if to exclude one death due to congenital rubella.     

Rubella in Poland in 1999

In Poland in 1999 rubella was characterized by an epidemiological stability. A total of 30 958 rubella cases (including one case of Congenital Rubella Syndrome) were registered. The incidence rate was 80.1 per 100,000 and was 28% lower than in 1998. Of all reported cases, children aged 14 and less accounted for 94.6% cases. The highest incidence rate was among children aged 7 years (752.8 per 100,000). Comparing with the eighties, the last decade was characterized by a decline of the mean incidence rate in the population under 30 years of age, which was probably the consequence of mandatory vaccinations of 13 year old schoolgirls. Also, a decline of incidence rate among 2-5-year old children was observed, which was probably due to recommended vaccinations with MMR-II vaccine. The incidence rate among children aged 6-9 years was higher in 1999, as compared with previous years. Of all rubella cases, 0.5% were hospitalized. No deaths from rubella were reported.     

2009-2018年内蒙古阿拉善盟学生及托幼儿童法定传染病流行特征分析

目的 分析内蒙古阿拉善盟学生及托幼儿童法定传染病流行特征,为做好防控工作提供科学依据。方法 从中国疾病预防控制信息系统中获取当地2009-2018年人群分类为学生、托幼儿童全部法定传染病报告病例,采用描述性流行病学方法分析其发病特征,对不同年份、人群类型的发病水平进行比较。结果 2009年1月1日至2018年12月31日期间,阿拉善盟共报告托幼儿童、学生法定传染病共计15种2970例,年平均报告发病率524.24/10万,无死亡病例。未报告甲类传染病,乙类传染病报告10种553例,年平均发病率97.61 /10万;丙类传染病报告5种2417例,年平均发病率426.63/10万。10年间累计报告病例占同期法定传染病报告总数的22.20%。累计报告病例居前5位的病种分别是手足口病、流行性腮腺炎、猩红热、流行性感冒、风疹,占全部报告病例数的93.16%。发病率最高的年龄组为4岁组,男女平均性别比为1.28。呼吸道传染病、消化道传染病、血源及性传播传染病、虫媒及自然疫源性传染病占总报告病例数的42.86%、54.07%、3.0%和0.07%。肠道传染病以3~5岁组发病数最高（1182例,2010.73/10万）,呼吸道传染病以6~12岁组发病数最高（632例,438.84/10万）,血源及性传播疾病以19~24岁组最高（31例,14.37/10万）,虫媒及自然疫源性疾病均分布在13~15岁组。结论 阿拉善盟托幼儿童和学生法定传染病报告占总报告病例数的比率较高,必须落实综合防控措施,有效预防学校托幼机构传染病的发生和流行。     

Rapid assessment of the impact of Haemophilus influenzae vaccine serotype b in Colombia. Public Health Laboratories]

In May 1998 the Ministry of Health of Colombia started a universal vaccination campaign against Haemophilus influenzae type b (Hib) for children under one year of age. The impact of this intervention on the incidence of acute bacterial meningitis was assessed in 1999, using data from the laboratory-based surveillance system coordinated since 1994 by the Microbiology Group of the Colombian National Institute of Health. The analysis compared the annual number of cases of Hib meningitis in children under one year of age diagnosed through the surveillance system before the vaccine was introduced with the number of cases reported during the first year after the vaccine's introduction. The expected number of cases, given the average annual number of cases diagnosed between June 1994 and June 1998, was compared with the number of cases observed after the vaccination program was introduced, from June 1998 through May 1999. To control for the quality of the surveillance system, a similar analysis was done for cases of meningitis due to Streptococcus pneumoniae. The analysis was restricted to those departments of Colombia that had consistently participated in the surveillance system. For the years 1994 through 1998 the numbers of confirmed cases of Hib meningitis were, respectively, 45, 37, 61, 64, and 31. In the period after the vaccine's introduction 31 cases were observed, as compared to the 52 expected (P < 0.001). During the same annual periods there were 32, 26, 43, 48, and 42 confirmed cases of meningitis from S. pneumoniae in children less than 5 years old, showing no significant reduction in the expected number of those cases. The 40% decrease noted in Hib meningitis cases was not attributable to changes in the surveillance system and was due mainly to the effects of the vaccination program.     

Surveillance of notifiable infectious diseases in Bavaria - results in 2002

In 2002 nearly 36 000 cases of notifiable infectious diseases were reported in Bavaria representing a 10 % increase compared to 2001 (33 000 cases). As in 2001, around 75 % of reported cases were gastrointestinal infections. Every third infection was due to salmonella. As compared to last year, the incidence of Norwalk-like virus infections increased fivefold. These infections occurred mostly as outbreaks in nursing homes, hospitals or other institutions, affecting as many as 200 persons. Other frequently reported infections in Bavaria are tuberculosis and hepatitis. The relatively high incidence of measles is mainly due to an outbreak in Coburg. The decline in the incidence of tuberculosis observed over the last years has ceased. Around 70 % of reported hepatitis cases were due to hepatitis C. It should be noted that these cases were a mixture of new infections and ongoing infections diagnosed for the first time. Of great epidemiological importance are diseases caused by meningitis pathogens. The incidence of meningococcal infections was practically unchanged as compared to last year. Around half of them were caused by serotype B, which is currently not preventable by vaccination. Meningitis caused by Haemophilus influenzae B is continually declining due to the high vaccination rate and is very rarely reported. Several cases of FSME were described. According to investigations carried out by health departments these infections were acquired in countries not yet classified as FSME risk areas. Hence, the endemics maps of FSME have to be revised. Two years of reporting according to IfSG (infectious disease control law) yielded very encouraging results, i. e. rapid accessibility of data, flexibility, complete and standardised reporting with high quality of data. We thank all the reporting physicians and laboratories and the staff of the Bavarian health departments for their continuous support.     

2014-2018年天津市滨海新区法定传染病疫情分析

目的 了解天津市滨海新区近五年法定传染病发病情况,掌握流行趋势,为制定区域防治策略提供科学依据。方法 运用描述性流行病学法,对滨海新区2014-2018年法定传染病发病及死亡情况进行统计分析。结果 2014-2018年滨海新区报告法定传染病28种79463例,年均发病率563.72/10万,死亡44例,年均死亡率0.31/10万,病死率0.05%。甲乙类传染病发病前五位的为痢疾（42.50%）、梅毒（15.99%）、肺结核（10.34%）、乙肝（8.83%）和猩红热（8.25%）,发病构成比最高的为肠道传染病（43.26%）。丙类传染病以其他感染性腹泻病（73.44%）和手足口病（18.67%）为主。每年6-8月为发病高峰;全区21个街道均有传染病病例报告;男女性别比为1.29:1,主要集中在0~ 9岁（43.58%）、25~34岁（16.22%）,发病人群以散居儿童（30.37%）、工人（13.80%）、家务及待业（11.32%）为主。结论 2014-2018年滨海新区法定传染病各年度发病趋势相同,整体呈逐年下降趋势,发病高峰明显,实际工作中应结合重点人群和高发传染病有针对性的制定防治策略。     

Estimation of the range of excess death associated with influenza epidemics: application of a model using annual mortality rates and the seasonal index for determining minimum excess mortality estimates

OBJECTIVE: To determine the range of excess death associated with influenza in Japan. METHODS: The monthly rates for mortality from all causes other than accidents (ICD9: E800-E949, ICD-10: V01-X59) were determined from the Japanese national vital statistics for 1987-2003. By employing a model using the annual mortality rates and the seasonal index, the number of expected deaths and the 95% range of mortality in the absence of influenza-associated deaths (normal range) were obtained. Point estimation of excess mortality during an influenza season was performed by calculation of differences between the number of deaths observed and the number of deaths expected. The range of excess death was defined: the lower limit of the excess death was performed by calculation of difference between the number of deaths observed and the upper limit of the normal range. The upper limit of the excess death, on the contrary, was performed by calculation of difference between the number of deaths observed and the lower limit of the normal range. Based on the results of a survey of tendencies in the occurrence of infectious diseases, months showing a high prevalence of influenza and associated deaths were regarded as "months when the rate of death from influenza was 0.9 deaths/100,000 person-years or higher". RESULTS: The excess death determined by point estimation was largest in 1999, followed by 1995, 1993, 1997, 2000, and 2003. The point estimation (range of excess death) in 1999 was approximately 49,000 (approximate range, 37,000-60,000). Correspondingly, the excess death in 1995 was approximately 38,000 (approximate range, 27,000-48,000). While values in 1993, 1997, 2000, and 2003 were in the approximate range of 21,000 to 25,000, the range of excess death of each year showed the differences: approximate range from 15,000 to 36,000 in 1993, from 18,000 to 31,000 in 1997, from 18,000 to 28,000 in 2000, and from 11,000 to 34,000 in 2003, respectively. From comparison of the range of excess deaths by year, that in 1995 appeared to be the largest among the examined years. CONCLUSION: By considering the range of variation in the number of deaths in the years when no influenza epidemics occurred, the increase (the largest number and smallest number of deaths) associated with elevation the prevalence of influenza could be determined. Estimation of the range of excess deaths can be considered a useful method for understanding the influence of influenza on public health.     

Salmonellosis in Poland in 2003

Total number of salmonellosis cases sharply decreased. In 2003, 16 617 cases were reported (20 688 in previous year), incidence rate = 43.5 per 100 000 population. 72.7% of patients were hospitalized, but percentage of hospitalized cases with extraintestinal manifestations was much higher--above 90%. The seasonal peak was observed as in previous years in July and August. The most frequent isolated type remained Salmonella Enteritidis--above 85% of cases. Only three other serotypes (Hadar, Typhimurium and Infantis) were detected in all of 16 voivodeships of Poland. The age, sex, urban/rural distribution of salmonellosis cases remains stable; the highest incidence was registered among children aged 2 (425.5/100 000). Extraintestinal manifestations of salmonellosis (septicemia, meningitis, pneumonia peritonitis and other) were observed in 121 patients (the highest number since 1994).     

Hepatitis C in Poland in 2003

HCV surveillance in Poland is based on registration of newly detected both acute and chronic cases. The data from 1999 - 2003 demonstrate a slight upward trend with an increase in incidence of 0.1 per 100,000 annually. In 2003 there were 2,255 registered cases (incidence 5.9 per 100,000), including 5.2% mixed HCV/HBV infections. The incidence in the urban areas (7.6 per 100,000) was two times higher then the incidence in rural areas (3.1) and the incidence in men (7.0) was 42% higher then in women (4.9). In men the highest incidence was noted in the age group 20 to 24 years (10.8 per 100,000) and in women in the age group 60 - 64 years (9.4). Geographically, the incidence varied from 0.8 per 100,000 in Podlaskie to 16.6 per 100,000 in Swietokrzyskie voyvodship. In total 80.8% of the cases were hospitalised. In several voyvodships the percentage of hospitalised cases was higher, reaching even 100%. This suggests low surveillance sensitivity to less severe cases in these areas. There were 116 deaths from hepatitis C in Poland in 2003. Deaths attributed to HCV infection accounted for 4.2% of all infectious disease deaths in 2003.     

Malaria surveillance in Germany 2000/2001--results and experience with a new reporting system

In Germany, malaria is one of the most frequently imported infectious diseases. In January 2001, the newly implemented Infektionsschutzgesetz (Law for Protection Against Infectious Diseases) brought some important changes in surveillance case notification procedures. After one year, experience shows that the changes did not affect the continuity and representative nature of malaria reporting in Germany. In the years 2000 and 2001, 836 and 1,040 malaria cases, respectively, were reported. In both years, most of the patients were between 30 and 49 years old. 82 % of the infections had been acquired in Africa, and 11 % in Asia. The predominant parasite species was P. falciparum (70 %), followed by P. vivax (12 % in 2000, and 16 % in 2001, respectively). The majority of infections occurred among tourists, fewer in immigrants or business travellers. About two thirds of all patients had not taken any chemoprophylactics. Compared to previous years a decrease in the number of fatal cases was observed (1998: 21, 1999: 18, 2000: 8, 2001: 8). To ameliorate the situation of imported malaria intensified prevention activities are necessary, including efforts to improve choice and compliance of chemoprophylaxis and to facilitate timely diagnosis and treatment.     

Salmonellosis in Poland in 2001

Total number of salmonellosis cases has been gradually falling down since the year 1988. In 2001, 19,881 cases were reported to the sanitary epidemiological stations, incidence rate = 51.5 per 100,000 population (22,799 in the previous year). Over 52% of patients were hospitalized, but percentage of cases with extraintestinal manifestations was higher--over 88%. The seasonal peak was noted in July and August, which was two months later than in 2000. The decreasing trend in confirmation of clinical diagnosis can be observed since 1995 when Salmonella strains were isolated in 91% of patients, but in 2000 only 66% of cases were bacteriologically confirmed. Salmonella Enteritidis was the most frequent type: 88% of cases and 69% of infected healthy persons. Only four other serotypes (Typhimurium, Infantis, Hadar and Virchow) were identified in all of 16 voivodeship of Poland. The age, sex, urban/rural distribution of salmonellosis remain stable. The highest incidence was registered among children one year old (423/100,000). Extraintestinal manifestations of salmonellosis (septicaemia, meningitis, pneumonia, peritonitis, appendicitis and other), were observed in 93 patients with at least one non-fecal specimen culture-positive for non-typhoidal Salmonella. In older patients, other diseases like carcinoma, leukaemia, lupus erythematosus, contributed to Salmonella infection. Twelve of those patients died.