Influenza in Poland in 2002

In 2002 the number of cases of influenza and influenza-like illness (ILI) registered in Poland amounted to 228,055. This is 39.5% of the number of cases recorded in 2001. The highest influenza incidence was found in Mazowieckie voivodship (2297.5 per 100,000), while the lowest incidence was registered in Swietokrzyskie voivodship (104.1) and Lubelskie voivodship (117.6). In children aged 0 to 14 years the number of influenza and ILI cases amounted to 104,552 (incidence of 1511.9 per 100,000) and this is 46% of the total number of cases recorded in 2002. The number of patients referred to hospitals amounted to 223, including 92 children aged 0-14 years. There were isolated 10 influenza strains, including 7 strains of subtype A (H3N2) and 3 strains of subtype A (H1N1). Immunofluorescence test carried out in 57 specimens did not confirm infection with influenza virus. Sero-surveys showed the lowest antihemagglutinin antibody levels in the age groups 0-3 and 4-7 years, while the highest in people aged 8-14 and 15-25 years.     

Influenza in Poland in 2000

In 2000 the number of cases of influenza and influenza-like illness (ILI) registered in Poland amounted to 1,596,920 (68.1% of 1999 cases). The highest influenza incidence was reported in ?ódzkie voivodship (9,388.8 cases per 100,000). Among children aged 0 to 14 years the number of influenza and ILI cases amounted to 408,495 (incidence 5,518.8 cases per 100,000) and was 25.5% of the total number of cases recorded in 2000. The number of patients referred to hospital was 7,028 and 358 persons died due to influenza and its complications. No influenza strains were isolated in 2000. Immunofluorescence test confirmed infection with influenza type A in 39 patients, while with type B--in 2 patients. Sero-surveys carried out in the epidemic season 2000/2001 showed that the highest antihemagglutinin antibody levels were produced for influenza strain A(H3N2) and B. The highest antibody titers were recorded in the age group 15-25, while the lowest levels--in the age group 0-3 years.     

Influenza in Poland in 2001

In 2001 the number of cases of influenza and influenza-like illness (ILI) registered in Poland amounted to 576,449. This is 36.1% of the number of cases recorded in 2000. The highest influenza incidence was found in Dolno?laskie voivodship (3013.4 per 100,000), Mazowieckie voivodship (2688.5 per 100,000) and Zachodniopomorskie voivodship (2132.2 per 100,000). In children aged 0 to 14 years the number of influenza and ILI cases amounted to 275,358 (incidence was 3851.4 per 100,000) and this is 47.8% of the total number of cases recorded in 2001. The number of patients referred to hospitals amounted to 678 and 26 persons died. One influenza strain A(H1N1) was isolated from the patient aged 10. Immunofluorescence tests carried out in over 900 specimens did not confirm infection with influenza virus. Sero-surveys performed in the epidemic season 2001/2002 showed that the levels of antihemagglutinin antibodies were comparable for three antigens: A(H1N1), A(H3N2) and B. The highest antibody titers were recorded in the age group 15-25. Since May 2001 Poland is a member of the European Influenza Surveillance Scheme.     

Influenza in Poland in 1999

A total of 2,344,773 cases of influenza were reported in Poland in 1999, corresponding to 6066.1 cases per 100,000 population and was 2.8 times higher as compared with 1998. The highest influenza incidence rate (10,770.9 per 100,000) was reported in Ma?opolskie voivodeship. Children up to 14 years old accounted for 34.9% (818,629; incidence 10,616.2 per 100,000) of all reported influenza cases. A total of 3,925 persons required hospitalization, eight times more as compared with 1998. The number of deaths due to influenza amounted to 402. Compared with 1998, in 1999 reported influenza deaths increased 6.4 times. During the second two weeks of January 1999 four influenza strains of type B were isolated from patients aged 13, 16, 31, and 38. During the first part of February 1999 another two strains of influenza virus type B were obtained from persons aged 35 and 45. All six isolates were related antigenically to the vaccine strain B/Beijing/184/93 and were confirmed by the WHO Collaborating Center for Influenza Reference and Research, London.     

Rabies in Poland in 2003

In Poland 399 cases of animal rabies were reported in 2003. Mass oral vaccination of wild animals against rabies, which was introduced in 1993, seems to show a positive impact on the epizootic situation of rabies in Poland. In 2003 we observed about three-fold decrease in number of animal rabies cases. The outbreak of animal rabies, which started in 2001 in Wielkopolskie voivodeship, was still present. About 42% of rabies cases were reported from this province. Moreover sources of wild and domestic animal rabies are present in the north-east, east, and south-east of the country. Out of 7 155 persons vaccinated in Poland against rabies, 519 (7%) were bitten by or had contact with a rabid animal. Main reason for vaccination against rabies was exposure to an animal category C--rabies not excluded (5 790 cases, 81%) or category D--animals healthy at the moment of an exposition (846 cases, 12%).     

Mumps in Poland in 2003

In 2003, 87,336 cases of mumps were reported in Poland. The incidence (228,7 per 100,000) was higher then in 2002(104.6), which corresponds to a periodical increase of mumps incidence. According to the natural periodicity the peak incidence would be expected to take place in 2002. The increase of mumps incidence in 2003, still lower however then the previous peaks, can be attributed to the prolongation of the epidemics cycle usually occurring with growing vaccine coverage. Even though the mumps vaccine was not included into the national immunization program, the coverage in 3-year old children in 2003 reached 39.6%. Approximately 4.6% of cases were hospitalized (4,056) and no mumps deaths were reported. Children 5-9 year old constituted the most affected age group (incidence 2,133.1 per 100,000). In Poland the MMR vaccine was recommended on voluntary basis in place of measles vaccine for children in their 2nd and 7th year of age. Immunization of 2-years old children is mandatory beginning in 2004.     

Botulism in Poland in 2003

A total number of 78 foodborne botulism cases were registered in Poland in 2003, (incidence rate 0.20 per 100 000 population), in rural areas--46 cases (incidence 0.31) and in urban areas--32 cases (incidence 0.14). There were noted 48 sporadic cases, 8 outbreaks of two persons and 1 outbreak of three, four and five people. Meat dishes were the main vehicle of botulinum toxin, especially home made bottling jars prepared from pork meat (24.4% of cases). Two deaths from foodborne botulism were registered.     

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).     

Rubella in Poland in 2003

In Poland, 10,588 cases of rubella were registered in 2003 (incidence 27.7 per 100,000 population). No cases of congenital rubella syndrome were reported. A 74% decrease in incidence was noted, compared to 2002. Across voivodeships, the incidence ranged from 113.1 per 100,000 in warmińsko-mazurskie to 6.2 per 100,000 in lódzkie. As in 2002 rubella incidence among residents of urban areas was lower, compared to residents of rural areas (26.4 and 29.8, respectively). The incidence in men (32.3) was 38% higher than in women (23.4) and this difference appears to systematically increase with routine vaccination of 13-year old girls. The highest incidence was observed in children aged 7 (242.0 per 100,000) and 8 years (209.3). Approximately 0.5% of cases required hospital admission. No rubella deaths were registered.     

Tuberculosis in Poland in 2003

In 2003 year decrease of tuberculosis notification rates in Poland has continued. In this year 10 125 tuberculosis cases (TB) were notified in Poland--incidence rate--26.5 per 100 000 population, with the large differences in notification rates between voivodeships (from 16.9 to 39.8/100 000). Between 1994-2003 notification rates decreased by 3.9% yearly overall. 87.8% of the TB cases notified were new cases. Pulmonary cases represented 90.9% of TB cases. Male to female sex ratio--2.1. Age specific rates were much lower in children--1.5/100 000 (100 cases)--1% of all TB cases and highest in person over 65 years--57.6/100 000 (27.9% all TB cases). Sixty percent of all pulmonary cases were confirmed by culture and 38% were sputum smear positive. Among all the pulmonary TB cases treated there were 292 cases with resistance to at least one drug. They represented 3.4% of bacteriologically positive pulmonary cases treated and from many years remains relatively low. There 892 death due tuberculosis reported in 2002 y.i.e. 2.3/100 000. Mortality among males--3.7 and 1.1/100 000 among females. Since many years the TB mortality is of the order 0.2% of total mortality and almost 40% mortality from infectious diseases. In 2003 year--93.5% new born babies were vaccinated BCG; 82% of all TB pulmonary cases were detect by symptoms and 4% by contact examination. Success rates (cured or completed) of treatment were reported in 83.3%; failed 1.0%; deaths during treatment were reported in 6.2% (2.4% from TB) treatment default in 7.8% treated cases.     

Tetanus in Poland in 2003

In last decade gradual decrease in numbers of reported cases of tetanus was observed. In 2003, 30 cases of tetanus (14 women and 16 men) were reported in Poland. All those cases were among people of age 20 or more. In 2003 relatively high number of 14 deaths were recorded. All cases were unvaccinated or vaccination status was unknown. The data show effectiveness of vaccination program in younger age groups, but they also show need for promotion of post exposure prophylaxis, especially among older people both in rural and in urban areas. No case of neonatal tetanus was noted in Poland since 1984.     

Dysentery in Poland in 2003

The notified number of dysentery cases is the lowest in this century and even every year decreasing. Only 75 cases were notified in the year 2003 (incidence rate 0.20/100 000 population) while 220 cases were registered in 2002 (incidence 0.58/100 000 population). No one death case was notified. The last three death cases were notified in 1999. Only one outbreak of dysentery (due to S. flexneri 2a) was registered involving 23 patients/111 residents of Social Home for Mentally Disabled Men. Source of infection was probably one of residents who were infected during an outbreak of dysentery in the same institution four years earlier in 1999. The outbreak changed the overall etiology of dysentery cases in 2003: 52% was due to S. sonnei, but 46% was due to S. flexneri and 2% to S. dysenteriae 2, S. boydii were not found among persons examined bacteriologically by laboratory service of Epidemiological and Sanitary Service. The external quality control of procedures for selective investigation of Shigella infections in stool probe was done in 37 laboratories of Sanitary Epidemiological Stations with the use of control strain S. boydii 6. It was shown that in nearly all laboratories the strain was unable to grow on media SS and Hektoen after enrichment in the phosphate selenine--medium (SF) used by them. In the period of low frequency of Shigella infections the external control of the quality of bacteriological media and laboratory procedures is needed and should be done regularly.     

Malaria in Poland in 2003

Seventeen cases of malaria were reported in Poland in 2003. All of them were imported: 13 from Africa, 2 from Asia and 1 from Indonesia. In 8 cases P. falciparum etiology was confirmed. Among the cases 14 were men and 3 were women. The youngest patient was 10 and the oldest 63, 11 of the patients were in the age group 21 to 40 years. Most commonly the reasons for travel were tourism or family visits (6 cases), professional (4 cases) and missionary (4 cases) travel. One death from falciparum malaria was reported in Poland in 2003. In 4 cases some kind of chemoprophylaxis was documented. In other prophylaxis was not used or not documented.     

Measles in Poland in 2003

In Poland 48 measles cases were registered in 2003 (0.13 per 100,000 population)--of which 65% were cases imported from Chechnya and Afghanistan. Measles outbreaks occurred in 3 centers for immigrants. In total, 31 cases were reported, of which 96.8% were unvaccinated, and 93.5% were under 15 years of age. Of 17 local cases, 5 (29.4%) cases occurred in unvaccinated persons, 3 (17.6%) in persons vaccinated with one dose and 7 (41.2%) in those vaccinated with two doses of measles vaccine (administered at the age of 13-15 months and 7 years). Among 12 vaccinated cases only one 2-year old child was recently vaccinated. The remaining cases were in the 3-7 and 10-24 age ranges. The most affected were infants (incidence 0.57 per 100,000), 1-year old (0.28) and 2-year old children (incidence 0.27). Cases among adolescents and adults over 15 years of age increased from 23.5% in 2002 to 47.1% in 2003. The increasing age of locally-acquired cases, together with constantly high immunization coverage indicates high effectiveness of vaccinations in Poland. Out of all reported cases 13 (38%) were hospitalized. There were no deaths due to measles in Poland in 2003. Poland participates in the WHO Measles Elimination Strategy. Presently, the most important is the maintenance of a sensitive and timely surveillance of measles and measles-compatible cases, with serologic confirmation of one rash-like illness per 100 000 population. The performance of the surveillance system is insufficient with only 55 measles-compatible cases reported in 2003 (15% of expected reports). Serologic confirmation of cases was also insufficient, with 22 cases (40.0%) confirmed by IgM ELISA test. These results indicate the need to maintain the high immunisation coverage and improve measles surveillance system.     

Pertussis in Poland in 2003

Since reemergence of pertussis in Poland since 1997/1998 shift of incidence toward older groups of age was observed. Possible explanations include decreased effectiveness of used whole cell pertussis vaccine and lack of booster vaccinations in the age older than two. At least this last possibility was eliminated by introduction of additional dose of DTaP at the age of 6. Though effects of this change may be observed within several oncoming years. 2034 cases were reported in 2003, a slight increase from the previous year (1788 in 2002) More cases occurred among females (1159 cases, 5.9/100,000) than among males (875 cases, 4.7/100,000) and in urban areas (6.8/100,000) than in the rural ones (2.9/100,000). Big differences in numbers of cases reported between different districts and between urban and rural areas bring strong possibility of insufficient sensitivity of the surveillance in many regions of Poland.     

Hepatitis A in Poland in 2003

Epidemiological situation of hepatitis A in Poland since 1997 was evaluated as low endemicity and since 2002 as very low endemicity. High percentage of cases were noted among adult persons, especially in the age 25-29 years. The course of disease was more serious, than before 1997. In 2004 only 95 cases of hepatitis A were noted in Poland (Incidence rate 0.25/100 000). The number and percentage of unimmunized persons, especially among children, adolescents and young adults increases very rapidly. In such situation vaccination against hepatitis A of persons from risk groups is necessary.     

Cestode infections in Poland in 2003

In 2003, 218 intestinal cestode infections were registered in Poland. Among them 157 were caused by Taenia saginata, 4 by T. solium, 32 by Taenia sp., 1 by Diphyllobothrium latum,. Moreover, 34 cases of cystic echinococcosis were also registered. The obtained results confirmed decreasing frequency of intestinal cestodes in Poland.     

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.     

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).     

Hepatitis B in Poland in 2003

In 2003 1,812 cases of hepatitis B were registered in Poland, including 118 (6.5%) caused by mixed infections with HBV and HCV. The incidence was 4.7 per 100,000. Compared to the preceding year, the number of cases decreased by 209 cases and the incidence decreased by 0.6 per 100,000. The decreasing trend of HBV continued during the recent years. During the consecutive years of hepatitis B control programme implementation the incidence decreased below 5.0 per 100,000 becoming comparable to the European level.