Hepatitis C in Poland in 2001

Hepatitis C is a notifiable disease in Poland since 1997. The increasing trend in incidence over the last four years may be explained by continuous improvement of diagnosis and notification. In the year 2001, for the first time since 1997, a number of cases and an incidence of hepatitis C was lower than in preceding years. The total number of 1953 acute and chronic hepatitis C cases has been reported in 2001. Incidence per 100,000 inhabitants was 5.05. The differences in hepatitis C incidence in regard to gender, region and age have been observed. The incidence in urban regions was higher than in rural; 6.49/100,000 and 2.74/100,000, respectively. The incidence among men was higher than in women; 5.87/100,000 and 4.28/100,000, respectively. Coinfection with hepatitis B has been observed in 5.84% of hepatitis C cases.     

Hepatitis B in Poland in 2002

Noticeable downward trend of hepatitis B incidence in Poland continued in 2002. In total 2,021 new cases were reported, 84 (4.2%) of which concerned people co-infected with HBV and HCV. The registered incidence, 5.3 per 100,000 population, was 15% lower then in 2001. As in previous years, the incidence in the urban areas (5.7) exceeded the incidence in the rural areas (4.6) and it was higher in men (6.6) then in women (4.0). Comparing the incidence across the regions, the rate ratio between the voivodeship with the highest and the lowest incidence (respectively 13.2 in kujawsko-pomorskie and 2.1 in podkarpackie) was 6.3. In the voivodeships with the highest incidence the age distribution differed significantly from the rest of the country suggesting the necessity of appropriate modifications in the national prevention program. Overall the most affected age groups were the elderly (incidence 8.1 in persons over 74 years of age, 7.9 in 65-74 year olds and 7.3 in 60-64 year olds) and young adults (incidence 6.5 among 20-24 year olds). Approximately 96% of cases were hospitalized. According to preliminary data there were 100 deaths due to acute of chronic hepatitis B in Poland in 2002.     

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.     

Hepatitis C in 1998

In 1998, 1,710 cases of viral hepatitis type C were reported (incidence 4.4 per 100,000). There were 149 (8.7%) mixed infections: HCV + BBV. Both acute cases and newly diagnosed chronic cases were registered. Highest incidence was found in people 55-59 years old (7.49) and 60-64 years old (7.05). Cumulative incidence was higher in men (5.2), than in women (3.7). In particular in age groups of 15-34 incidence in men was even 2-3 times higher that in women. Incidence in cities (5.9) was 3 times higher then in rural areas (2.0). Among reported cases at least 113 (6.6%) employees of health system were found. Data presented above should be taken cautiously because separate registration of hepatitis C was introduced in Poland as late as in 1997.     

Hepatitis B in Poland in 1999

A total of 3,508 of hepatitis B cases (including 152 cases of mixed HBV and HCV infections) were reported in Poland in 1999. For the first time since 1979, when registration has began, the incidence decreased below 10.0 and was 9.1 per 100,000. The program of eradication of hepatitis B in Poland has been introduced in 1993 and since then the fourfold decrease in number of hepatitis B cases has been noticed. During the past 7 years there has been a steady decline in hepatitis B incidence. In 1997 the incidence decreased 23% as compared to 1996, followed by 16.8% decrease in 1998 and 13.9% in 1999; the marked differences in incidence in particular voivodeships have been observed. The overall rate of hospitalized hepatitis B cases in Poland reached 98.1%. A total of 25 cases of hepatitis B (rate 1.2 per 100,000) occurred among children under 4 years of age, who should be vaccinated. Among children aged 5-9 years, of which many could not be vaccinated, the incidence rate was 6 times higher, ranging from 4.9 per 100,000 in girls to 9.8 per 100,000 in boys. The increase of incidence from 5.3 to 9.2 was observed in young people (14-24 years old). Data from the study of serological markers of hepatitis B, conducted among 4,500 health care workers during 1998-2000, have indicated that about 22% of health care workers have been infected with HBV (in 21% of persons anti-HBc and in 1% anti-HBc together with HBsAg were detected).     

Hepatitis B in Poland in 2000

A total of 2,825 (7.3 per 100,000 population) cases of hepatitis B (including 130 co-infections with both HBV and HCV) were reported in 2000 in Poland. Comparing to 1999 the total number of cases decreased by 683 and incidence by 1.8. This decline resulted mainly from vaccination of children and high risk patients though the improvement of sterilization procedures could be also of significance, especially in persons below 60 years of age. The number of hospitalizations in 2000 increased by 15%. Regional differences in both incidence and percentage of hospitalizations were observed. The incidence of hepatitis B per 100,000 was higher in urban (8.3) than in rural (7.4) population. The lowest incidence (0.6) was observed in children aged 0-4 years; in older children (5-9 years of age) the incidence rates were 8.6 in boys and 3.4 in girls. The highest incidence, ranging from 4.5 to 9.1 was found in the age group 14-24 years, especially in boys and young men living in urban areas.     

Hepatitis B in Poland in 2001

2,394 cases of hepatitis B (including 114 infections with both HBV and HCV) were reported in 2001 in Poland; the incidence rate was 6.2 per 100,000 population. The total number of cases decreased by 431 and incidence rate by 1.1 comparing to 2000. From 1993 to 2001 decline in number of cases was 5.5 times. This decline was mainly the result of vaccination of children and high risk patients though the improvement of sterilisation procedures could be of significance, especially in persons below 60 years of age. About 96.3% of all cases were hospitalised. Regional differences in both, the incidence rate and percentage of hospitalizations were observed. The incidence of hepatitis B per 100,000 was higher in urban (7.0) than in rural (4.9) population. The lowest incidence (0.4) was observed in children aged 0-4 years; in older children (5-9 years of age) the incidence rates were 4.5 in boys and 2.2 in girls. The highest ranging incidence, from 5.5 to 8.2 was found in the age group 15-24 years, especially in boys and young men (from 7.4 to 11.6) living in urban areas.     

Hepatitis B epidemiology in Poland, Central and Eastern Europe and the newly independent states

The incidence of hepatitis B virus (HBV) infection varies considerably in countries in Central and Eastern Europe and the Newly Independent States, but data are difficult to compare between countries because of the large differences in levels of diagnosis, particularly serological identification, and levels of notification. Poland has high levels of diagnosis, including laboratory diagnosis. In the past, the incidence of hepatitis B in Poland was approx. 45 reported cases per 100,000 population, but following the introduction of improved sterilization of medical equipment in 1986 and a selective programme of vaccination in 1991, the incidence fell to about 35 per 100,000 by 1993. In 1993, an intensive vaccination campaign was launched, which has reduced the incidence to under 15 per 100,000. The incidence of HBV infection has decreased across all age groups and in both men and women, and in the under 3 years age group only 32 cases in total were reported in 1997. In 1996 and 1997, there was a slight relative increase in the incidence of HBV infection in men aged 20-24 years. This group may be a target for future vaccination programmes and other activities of control for the infection.     

Hepatitis B in 1998

In 1998 in Poland 4074 new cases of viral hepatitis B were noted (including 149 mixed infections with HBV and HCV). Incidence was 10.5 per 100,000 and it was 2.2 lower than year ago. In 1997 the infection with HBV was observed in 4896 persons, including 66 mixed infections (incidence rate 12.7/100,000). Constant decrease in number of new cases and incidence was observed in both sexes gender and all age groups after introduction of the intensive program of prevention and control of hepatitis B in 1993. It lead to almost 4 fold decrease of the number of new cases. There are still significant differences in incidence between particular voivodeships. For example between voivodeships Lodz and Warsaw the difference is twofold (20.6 and 10.2). The incidence of hepatitis B is still higher in cities (11.8) then in rural areas (8.6). It is dependent on gender and age. The lowest incidence is among children 0-4 years old 2.8/100,000 (61 cases). Twofold increase of incidence (from 4.6 to 9.8) is observed between ages 14 and 24; it is mainly due to higher incidence among young men especially those living in cities.     

Influenza in Poland in 2003

Following two years of low influenza incidence in Poland, the activity of this disease markedly increased in 2003. In total 1,216,285 cases of influenza like illness were registered (incidence 3,184.4 per 100,000). Regionally the incidence ranged from 1,195.7 in Zachodniopomorskie to 5,719.7 per 100,000 in Mazowieckie. Children and adolescents under 15 years of age accounted for 41.7% of all cases (507,102 cases, age specific incidence 7,579.0 per 100,000). In this age group the incidence varied regionally from 2,718.1 in Podlaskie to 14,087.6 per 100,000 in Mazowieckie. 3,128 patients (0.26% of all cases) required hospital admission. There were 141 deaths due to influenza (mortality 0.12%) in 2003, in 78.7% these were persons over 70 years of age. Nineteen strains of influenza virus were isolated in 2003 in Poland, including 15 strains of subtype A(H3), 3 strains of subtype A(H1) and one strain of type B. Besides, in other 10 cases influenza A infection was confirmed by direct immunofluorescence test. All isolated influenza strains were antigenically similar to the vaccine strains recommended for the epidemic season 2002/03 and 2003/04.     

Hepatitis C in Poland in 2000

In 2000, a total of 2,086 (5.4 per 100,000 population) acute and chronic hepatitis C cases were noted. The differences in incidence between groups were observed: incidence in urban areas (7.2 per 100,000) was 190% those in rural areas (2.5 per 100,000) and among men (6.4/100,000) was 40% those among women (4.5/100,000). Hepatitis C cases aged 40-49 constituted the most predominant group (475 cases, 22.8%). Because of development of diagnosis and reporting presented data can be a subject to the information bias and thus should be taken cautiously.     

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.     

Hepatitis A in Poland in 2000

A total of 262 cases of hepatitis A were reported in 1999. The incidence was estimated to be 0.7 per 100,000 and represented 74% decrease compared to the preceding year. The incidence rates within rural and urban populations were similar. The highest incidence was reported among persons 20-24 years old. Patients in this age group constituted 20.2% of the total number of cases. The above data shows that since 1997 epidemiological situation of hepatitis A is making for low endemicity pattern.     

Hepatitis A in Poland in 2001

A total of 738 cases of hepatitis A were reported in 2000, which was 3 times higher as compared to 1999. The incidence rate was estimated to be 1.91 per 100,000. The incidence rate in urban areas was 2 times higher than in rural population. The highest incidence rates were reported among persons 10-14 and 20-24 years old. Patients in these age groups constituted 29.4% of the total number of cases. The above data show that, from 1997 epidemiological situation of hepatitis has been approaching low endemicity pattern.     

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.     

1997至2006年卢湾区乙型肝炎流行病学分析

目的分析卢湾区近10年急性乙型肝炎流行特征。方法由本区各社区卫生服务中心防保人员对在1997年至2006年间接报的常住户籍人口急性乙肝病例开展流行因素调查。结果近10年间累计报告急性乙肝病例442例，年均报告发病率12．76／10万，占急肝发病总数的23．62％。1997至2001年间20～29岁年龄组的急性乙肝发病率最高，为30．44／10万，后5年发病高峰退至30～39岁年龄组，平均发病率较前5年下降50．89％。其中，工人乙肝发病数占乙肝发病总数的26．70％。男女发病比为2．65：1。结论在重点人群中开展预防乙肝、提高自身防护意识的健康教育，对重点人群实施免疫接种、提高肝炎病毒分型能力是预防控制乙肝的重要措施。     

Hepatitis C in Poland 1999

In 1999, a total of 1,988 (5.1 per 100,000) acute and chronic hepatitis C cases were noted. HCV and HBV coinfections accounted for 7.6% reported cases. Incidence in urban areas (6.9 per 100,000) was 200% those in rural areas (2.3 per 100,000). Incidence among men (6.0 per 100,000) was 40% those among women (4.3 per 100,000). The most predominant groups were age 40-44 (235 cases, 11.8%) and 65-74 (229 cases, 11.5%). Presented data should be taken cautiously because of development of diagnosis and reporting.     

Measles in Poland in 2002

In Poland 34 measles cases were registered in 2002 (0.09 per 100,000 population)--99 cases less than in the preceding year. Eleven (32%) cases occurred in unvaccinated persons, 9 (27%) in persons who had received only one dose of the vaccine and 14 (41%) in those vaccinated with two doses. The number of cases among the vaccinated population--23, including one case of vaccine associated measles--together with high vaccination coverage after 1975, indicates high effectiveness of measles vaccines used in Poland. Fifteen cases (44%) were confirmed serologically (IgM). Across the voivodeships the number of cases ranged from 0 in four voivodeships to 5 in the ?laskie voivodeship. In none of the voivodeships, however, did the incidence exceed 0.2 per 100,000. The most affected were infants (incidence 0.85 per 100,000), children in their second year of life (incidence 1.09) and children aged 5 and 6 years--incidence of 0.72 and 0.69 respectively. According to the immunization schedule these were children who should receive their first or subsequent dose of vaccine during the year 2002. Cases among children and adolescents below 15 years of age (26 cases) constituted 77% of all reported cases. Out of all reported cases 13 (38%) were hospitalized. There were no deaths due to measles in Poland in 2002.     

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.     

2004-2010年洛阳市乙型病毒性肝炎疫情分析

目的了解我国传染病疫情网络直报以来洛阳市乙型病毒性肝炎的流行特征,为制定控制乙肝疫情策略提供依据。方法根据疫情网络数据和专题调查资料对2004-2010年洛阳市的乙肝疫情资料进行描述性分析。结果 2004-2010年累计报告乙肝病例73 078例,占洛阳市所有报告传染病的36.97%。年平均发病率为195.28/10万,发病年龄集中于15岁～55岁,占发病总数的84.58%;除20~和25~年龄组外,各年龄组发病均为男性高于女性;职业发病分布前3位的是农民(53.87%)、工人(11.65%)、学生(11.59%);高发县区主要为瀍河区(平均发病率415.59/10万)、吉利区(413.15/10万)和伊川县(220.41/10万)。病例分类中,急性乙肝6118例,占7.30%,慢性乙肝31326例,占37.43%,未分类乙肝46239例,占55.25%。结论2004-2010年洛阳市乙肝疫情处于高位波动状态,2004-2007年持续上升,从2007年到2010年逐渐下降,下降幅度低于上升幅度。对乙肝疫情上升贡献最大的是慢性乙肝和未分类乙肝病例,急性乙肝在7年报告中持续在较低报告水平,应提高基层医疗机构对乙肝的诊断分类水平,提高乙肝报告质量。