Yersiniosis in Poland in 2018-2020.

AIM: The aim of the study was to assess the epidemiological situation of yersiniosis in Poland in 2018-2020 and compare it to previous years. MATERIAL AND METHODS: 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. RESULTS: 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. SUMMARY AND CONCLUSIONS: 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.

[History of reactive arthritis. Historical milestones and future]. / Geschichte der reaktiven Arthritis. Historische Meilensteine und Zukunft.

The introduction of the term reactive arthritis (ReA) for the joint inflammation observed after infection with Yersinia enterocolitica, in which "a causative pathogen cannot be isolated from the synovial fluid", and the association with the HLA-B27 were the historical milestones for a new classification and assignment to the spondylarthritides (SpA). The division into postinfectious and reactive arthritis proposed in 1976 was put into perspective in the 1990s because of investigations with the newly available molecular biological method of the polymerase chain reaction. Microbial products could be identified from joint samples of patients with ReA. Therefore, it was proposed to abandon the distinction between the two groups of diseases and to prefer the term ReA for both. This created a terminological and nosological issue. On the one hand, there are generally accepted classification and diagnostic criteria for the classical HLA-B27-associated ReA that are assigned to SpA. On the other hand, an increasing number of bacterial pathogens, viruses, amoebas, helminths as well as antiviral and antibacterial vaccinations are described as triggers of arthritis, which have been published under the term ReA. Since the beginning of the SARS-CoV­2 pandemic, cases of acute post-COVID-19 arthritis have been described, which were also classified as ReA because of comparable clinical features.