Hepatitis B in Poland in 2020.

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

Hepatitis C in Poland in 2020.

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

Hepatitis of unknown aetiology in children - epidemiological overview of cases reported in Europe, 1 January to 16 June 2022.

Following the report of an excess in paediatric cases of severe acute hepatitis of unknown aetiology by the United Kingdom (UK) on 5 April 2022, 427 cases were reported from 20 countries in the World Health Organization European Region to the European Surveillance System TESSy from 1 January 2022 to 16 June 2022. Here, we analysed demographic, epidemiological, clinical and microbiological data available in TESSy. Of the reported cases, 77.3% were 5 years or younger and 53.5% had a positive test for adenovirus, 10.4% had a positive RT-PCR for SARS-CoV-2 and 10.3% were coinfected with both pathogens. Cases with adenovirus infections were significantly more likely to be admitted to intensive care or high-dependency units (OR = 2.11; 95% CI: 1.18-3.74) and transplanted (OR = 3.36; 95% CI: 1.19-9.55) than cases with a negative test result for adenovirus, but this was no longer observed when looking at this association separately between the UK and other countries. Aetiological studies are needed to ascertain if adenovirus plays a role in this possible emergence of hepatitis cases in children and, if confirmed, the mechanisms that could be involved.

Healthcare workers highly affected during the COVID-19 epidemic wave in Poland prior to vaccination availability: seroprevalence study.

BACKGROUND: The aim of the study was to assess seroprevalence of anti-SARS-CoV-2 antibodies among healthcare workers (HCW) before introduction of vaccination, in selected areas in Poland as well as to identify potential risk factors and estimate the cumulative incidence of COVID-19 infections in this population. MATERIAL AND METHODS: The authors conducted a sero-epidemiological, cross-sectional study among HCW of 5 non-COVID-19 hospitals in Poland. The recruitment took place in December 1-23, 2020, all HCW at selected hospitals could volunteer into the study. All persons were screened with rapid SARS-CoV-2 IgM/IgG tests in capillary blood. In case of positive result, 5 ml of venous blood was drawn for confirmatory testing with ELISA assay. The authors estimated prevalence of laboratory confirmed anti-SARS-CoV-2 antibody presence and examined factors associated with positive result. Cumulative incidence was estimated applying 2-source capture-recapture method to serology results and self-report of past infection. RESULTS: Out of 1040 HCW included in the analysis, one-fourth (25.2%) received a positive result for anti-SARS-CoV-2 antibodies by ELISA test, the prevalence among women was 25.3% (95% CI: 22.5-28.4) and 24.6% (95% CI: 19-31.2) among men. The prevalence of anti-SARS-CoV-2 antibodies was the highest among respondents who declared home contact with a confirmed COVID-19 case, 43.9% (95% CI: 32.4-56.1). It was also elevated among those who indicated contact with patients with COVID-19, 32.5% (95% CI: 26.7-38.8) and business contacts, including at the workplace, 28.9% (95% CI: 22.5-36.3). The estimated cumulative incidence of COVID-19 infections in the population, using the capture-recapture method was 41.2% (95% CI: 38.1-44.2). CONCLUSIONS: Healthcare workers remained at increased risk of infection largely due to work-related contacts with infected patients, although home exposure was also common. Estimated cumulative incidence is higher than the antibody prevalence, which indicates the need to monitor HCW for possible immunity waning, also post-immunization immunity. Med Pr. 2022;73(2):109-23.

Data-driven case fatality rate estimation for the primary lineage of SARS-CoV-2 in Poland.

After more than one and a half year since the COVID-19 pandemics outbreak the scientific world is constantly trying to understand its dynamics. In this paper of the case fatality rates (CFR) for COVID-19 we study the historic data regarding mortality in Poland during the first six months of pandemic, when no SARS-CoV-2 variants of concern were present among infected. To this end, we apply competing risk models to perform both uni- and multivariate analyses on specific subpopulations selected by different factors including the key indicators: age, sex, hospitalization. The study explores the case fatality rate to find out its decreasing trend in time. Furthermore, we describe the differences in mortality among hospitalized and other cases indicating a sudden increase of mortality among hospitalized cases at the end of the 2020 spring season. Exploratory and multivariate analysis revealed the real impact of each variable and besides the expected factors indicating increased mortality (age, comorbidities) we track more non-obvious indicators. Recent medical care as well as the identification of the source contact, independently of the comorbidities, significantly impact an individual mortality risk. As a result, the study provides a twofold insight into the COVID-19 mortality in Poland. On one hand we explore mortality in different groups with respect to different variables, on the other we indicate novel factors that may be crucial in reducing mortality. The later can be coped, e.g. by more efficient contact tracing and proper organization and management of the health care system to accompany those who need medical care independently of comorbidities or COVID-19 infection.

COVID-19 module in SRWE system - application and use in epidemiological surveillance and reporting to international institutions.

The new SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) coronavirus causing acute respiratory disease COVID-19 (2019 coronavirus disease) detected in China in 2019 very quickly revealed its epidemic potential and was recognized as a global health problem. The situation caused by the rapidly increasing number of new cases and deaths due to COVID-19 required the rapid development of international recommendations and procedures to limit the spread of infections and ongoing monitoring of the epidemiological situation. In the field of epidemiological surveillance of COVID-19 cases, international organizations - WHO and regionally ECDC, have developed basic requirements for reporting data on newly detected cases of infection. In order to ensure the possibility of reporting new cases and activities undertaken by sanitary-epidemiological services in the country and to fulfill the obligation to report data to the European surveillance network, it was necessary to adapt the electronic system supporting epidemiological surveillance operations, for registration of suspected and confirmed cases of SARS-CoV-2 infections. This work presents the characteristics of the new COVID-19 module created as part of the central Epidemiological Case Reporting System and a preliminary evaluation of its usefulness for the purposes of combating COVID-19. CONCLUSIONS. The Epidemiological Case Reporting System is an efficient and adequate tool that can be adapted to newly emerging threats. In order to use the module to monitor the current epidemiological situation, it is necessary to integrate it with other systems collecting data about COVID-19 patients - ie. EWP and the clinical patient register.