Listeriosis in Poland in 2012-2021. / Listerioza w Polsce w latach 2012-2021.

AIM: The aim of the study is to present and evaluate the epidemiological situation of listeriosis in Poland in the years 2012-2021. MATERIAL AND METHODS: The analysis material consisted of data from individual epidemiological case reports on listeriosis submitted to the Department of Epidemiology of Infectious Diseases and Surveillance of the NIPH NIH - NRI by state sanitaryepidemiological stations in the form of paper questionnaires (2012-2019) and in the electronic form through the EpiBaza system (2020 and 2021), as well as aggregated data from the bulletin "Infectious Diseases and Poisoning in Poland". RESULTS: Between 2012 and 2021, a total of 896 cases of listeriosis were registred in Poland. The median incidence was 0.23 per 100,000 population, which was an increase by 52.2% compared to the previous 5-year period (2007-2011). Every year, more than 90% of cases were hospitalized. The highest percentage of patients were in the age group >60 years old (65.5%). From 2012 to 2019 (in the years when information on cases was collected on a paper form), a total of 275 deaths of patients from listeriosis were recorded (38.4% of all reported cases). According to data from the EpiBaza system, in 2020 and 2021 there were 5 (8.33%) and 25 (20.83%) deaths due to listeriosis. A total of 92.1% of patients with listeriosis had significant predisposing factors for the occurrence of this disease, most of which were associated with neoplasia and heart disease and were present in half of all cases. As part of routine surveillance, no epidemic outbreak associated with Listeria monocytogenes infection was reported in Poland in the years 2012-2021.A total number of 49 pregnant women with listeriosis were reported during described period. Between 2012 and 2021, 37 cases of congenital listeriosis were reported. The median of incidence was 1.07/100 thousand live births, a decrease of 26% compared to the previous 5-year period (2007-2011). Of all congenital infections in newborns, 12 deaths (32.43%) were reported. CONCLUSIONS: The epidemiology of listeriosis is changing both in the EU/EEA countries and in Poland: the incidence is increasing and the distribution of cases in different age groups is changing, affecting primarily the elderly, especially those with predisposing diseases. Although 2020 tere was a decrease in the number of cases at EU level, possibly related to the COVID-19 pandemic, the overall trend of listeriosis cases isincreasing. The clinical condition has a significant impact on the course of L. monocytogenes infection: in healthy people, infection is usually asymptomatic. The disease primarily affects immunocompromised people. In contrast, infection of pregnant women can lead to premature birth, miscarriage, meningitis and neonatal sepsis with mortality rate of 20-30%. The growing trend in listeriosis is alarming and requires greater attention in terms of prevention and control of the disease.

Legionellosis in Poland in 2018-2021.

Objectives: The aim of this study is to compare the epidemiological situation of legionellosis in Poland in 2018-2021 to prior years, taking into account the impact of the COVID-19 pandemic in 2020-2021. Material and methods: The assessment is based on national surveillance data published in the annual bulletin "Infectious Diseases and Poisons in Poland" from 2013 to 2021, as well as data from Legionnaires' disease case reports collected and sent to the Department of Epidemiology of Infectious Diseases and Surveillance NIPH NIH - NRI by sanitary and epidemiological stations or submitted to EpiBase. Results: In Poland, both Legionnaires' disease (an acute infection that progresses to pneumonia) and Pontiac fever (a mild, flu-like sickness) are reported. In 2018-2021, a total of 255 cases of legionellosis were registered, including 236 cases of Legionnaires' disease and 19 cases of Pontiac fever. Each year, there was an increase in the number of notifications compared to the annual median number of cases from 2013-2017. The annual incidence rate in 2019 (0.23 per 100,000 population) was the highest since the start of legionellosis case registration in Poland. It declined again during the years of the COVID-19 pandemic. The notifications occurred throughout the country, but the highest notification rate was observed in the western belt of voivodeships. Pomorskie reported the highest incidence, accounting for more than 20% of all registered cases. The median incidence of Legionnaires' disease in men (0.23 per 100,000) was more than twice that of women (0.10), with the highest incidence (0.58) recorded in men 65 years of age or older. All indigenous cases of Legionnaires' disease were sporadic; all but three patients were hospitalized. State Sanitary Inspection reported 26 fatal cases of Legionnaires' disease (mortality = 11%). Twenty-four cases were linked to contaminated water systems in health-care settings, and 21 cases were likely associated with travel abroad. Summary and conclusions: Although the number of notifications has increased in recent years, Legionnaires' disease is still an infrequently diagnosed respiratory infection in Poland, and the reported incidence remains one of the lowest in the entire EU. The most affected demographic group is men aged 65 and older. Improving the early diagnosis of Legionnaires' disease in healthcare settings remains a priority.

Shigellosis in Poland in 2018-2019.

AIM: The purpose of this study is evaluation of the epidemiological situation of shigellosis in Poland in years 2018-2019, comparing to previous years. MATERIALS AND METHODS: The evaluation of epidemiological situation of shigellosis in Poland was based on analysis of data from epidemiological surveillance collected in questionnaires and sent to the Department of Epidemiology of Infectious Diseases and Surveillance NIPH NIH-NRI by sanitary stations. Once a case was reported on a ZLK-1 and/or ZLB-1 form to the appropriate State Sanitary Inspector, an epidemiological investigation was conducted by collecting additional information from medical records and from the patient interview. Data from the "Infectious Diseases and Poisonings" bulletins years 2012-2019 was also used as well as data from shigellosis outbreaks acquired through ROE system - registry created for outbreak data gathering. RESULTS: In Poland in years 2018-2019 a total of 321 cases of shigellosis was reported. Incidence per 100,000 was 0.74 in 2018, which was considerably more than in previous years, and in 2019 was 0.10 - similarly as two years before. The most cases belonged to the 25-34 and 35-44 age groups, and the least cases to the 0-4 age group. Majority of them were women. Percentage of hospitalizations was 27% in described period. Regarding to previous years, in 2018 decrease of hospitalizations was noted. Imported cases were 54.8% of all with predominance of imports from Albania. Twenty eight percent of infections were caused by S. sonnei species. In discussed years 10 outbreaks were registered with 246 people ill, including two large outbreaks (77 and 150 cases). August was the month with the highest number of cases (217 cases, 67.6% of all), 62.2% of them were imported. CONCLUSIONS: Increase in number of cases and incidence of shigellosis in Poland in 2018 was caused by occurrence of two large epidemic outbreaks. Because of high percentage of imported cases, traveling to shigellosis endemic countries is currently the main risk factor for contracting the disease. This indicates the need for education for those who travel to endemic areas.

Foodborne infections and intoxications in Poland in the years 2018-2020.

AIM: The purpose of this study is to assess the epidemiological situation of foodborne infections and intoxications in Poland in the years 2018-2020. MATERIALS AND METHODS: The evaluation was based on the analysis of information sent to Department of Epidemiology NIPH NIH - NRI through ROE (pol. Rejestr Ognisk Epidemicznych) - an electronic system created for uploading, transfer and analysis of data acquired during the outbreak investigations. Additional sources for the analysis were NIPH NIH - NRI annual bulletins (Czarkowski MP et al. "Infectious diseases and poisonings in Poland", 2014-2020. Warsaw, NIPH NIH and GIS). RESULTS: In the years 2018-2020 a total number of 2,108 foodborne outbreaks were reported in which 52,175 persons were exposed and 17,023 got sick (in 2016 n=916, in 2019 n=918, in 2020 n=274). In 2020 over 3 fold decrease in the number of outbreaks comparing to 2019 and over 4 fold decrease in the number of cases in those outbreaks was observed. Among outbreaks which took place in 3 most frequent settings (private household, food facility and hospital) the steepest decrease was in 12th week of 2020 (ISO 2020-W12). The most frequent etiological agent of outbreaks in the years 2018-2020 was Salmonella sp. (38.3% of outbreaks in 2018, 32.7% in 2019 and 47.8% in 2020) and specifically serotype Enteritidis (38.3%, 27% and 39.4% accordingly). The most frequent setting of outbreaks was private household (59.7% outbreaks in 2018, 66% in 2019 and 62% in 2020), followed by hospital (17.4%, 18.3% i 19.7% accordingly). Up until 2019 an increasing trend in the number of small outbreaks (up to 4 cases) caused by Salmonella sp. was observed (in 2018 - 605 and in 2019 - 612 were reported). CONCLUSIONS: Decrease in the number of outbreaks in selected settings from 12th ISO week of 2020 might have been due to introduction of restrictions during COVID-19 pandemic and enhancement of personal hygiene practices. An increase in identified and registered small outbreaks caused by Salmonella sp. comparing to the median of the number of those outbreaks from 2014-2016 could partly be a result of routine surveillance enhancement after introducing System for Registry of Epidemiological Interviews (pol. SRWE).

Foodborne infections and intoxications in Poland in 2017

AIM: The purpose of this study is to assess the epidemiological situation of food poisonings and infections in Poland in 2017. MATERIALS AND METHODS: The evaluation was based on the analysis of information sent to Department of Epidemiology NIPH-NIH through ROE (pol. Rejestr Ognisk Epidemicznych)- (an electronic system created for uploading, transfer and analysis of data acquired during the outbreak investigations). Additional sources for the analysis were NIPH-NIH annual bulletins (Czarkowski MP et al. "Infectious diseases and poisonings in Poland", 2011-2017. Warsaw, NIPH-NIH and GIS). RESULTS: In 2016 a total number of 926 foodborne infections and intoxications outbreaks were reported in which 27 702 persons were exposed and 7 416. A total number of 2 502 of patients were hospitalized. The most frequent etiological agent of outbreaks was hepatitis A virus (HAV) (27.1%). The most frequent cause of infection for all outbreaks cases was Salmonella sp. ­ 37.2%, especially serotype Enteritidis (32.2%). Among other agents rotaviruses caused 9.3% of outbreaks and noroviruses 14.5%. In 12.2% of outbreaks no etiological agent was found. The most frequent place of an outbreak was private household- 560 outbreaks (60.4%), and after that- hospital- 155 outbreaks (16.7%). In 86.8% of outbreaks no vehicle was found and in remaining the most frequent vehicle were eggs and egg products- 5.6% % of all outbreaks. CONCLUSIONS: Increasing yearly trend of Salmonella Enteritidis outbreaks, and high proportion of eggs and egg products as vehicles in those outbreaks point towards necessity of microbiological surveillance enchantment in relation to abovementioned products. Dynamic increase in HAV outbreaks is a good example of how a pathogen with high epidemic potential could spread in susceptible population.

Shigellosis in Poland in 2013-2017

AIM: The purpose of this study evaluation of the epidemiological situation of shigellosis in Poland in years 2013-2017. MATERIALS AND METHODS: The evaluation was based on analysis of : data gathered and sent to Department of Epidemiology of Infectious Diseases and Surveillance in NIPH-NIH by local and voivodeship sanitary stations in the form of epidemiological questionnaires. It was also based on aggregated data from annual bulletins "Infectious diseases and poisonings in Poland" as well as data from shigellosis outbreaks acquired through ROE system (an electronic system created for uploading, transfer and analysis of data from the outbreak investigations). All cases were reported according to the Decision 2008/426/WE. RESULTS: In the years 2013-2017 in Poland 140 shigellosis cases were reported. Mean incidence per 100 000 was 0.05. A decrease of incidence median for years 2013-2017 was observed comparing to preceding, 5- year period by 0,03. Slightly over half of cases (51%) belonged to the age group 20-44. Majority of cases were males (57.1%). In each year from described period percentage of hospitalizations was over 70%. Imported cases amounted for 28% of all cases reported in that period- most of them being imported from countries from outside UE/ EFTA. In years 2013-2017 there were 10 outbreaks of shigellosis registered, in which 47 persons got ill. CONCLUSIONS: In years 2013-2017 no clear increasing or decreasing trend in shigellosis cases was observed, however in years when epidemic outbreaks occurred there was a significant increase in the number of cases reported yearly. Because of low number of cases being reported every year, an occurrence of large outbreak may result in seasonal peak of cases shifting, which was the situation in 2017 when most cases onset was in October, while in other years it was in September. High percentage of hospitalizations in cases could mean that severe cases are more readily reported, and in the same time that other cases are underreported. Because the date on shigellosis cases are acquired through general, not shigella-specific questionnaire it may result in incomplete or missing data on exposure (e.g. information on risk group affiliation), and therefore impairs the epidemiological situation assessment. It points the need of introduction Shigella- specific questionnaire.