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.

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.

Variables Determining Higher Home Care Effectiveness in Patients with Chronic Cardiovascular Disease.

The aim of this cross-sectional study was to analyze the variables that influence the effectiveness of home care in patients with chronic cardiovascular disease and their informal caregivers. The study was conducted in 193 patients and their 161 informal caregivers. The study used the WHOQOL-BREF Quality of Life Questionnaire, the health behavior inventory questionnaire (HBI), the Camberwell assessment of need short appraisal schedule (CANSAS) and the hospital anxiety and depression scale-modified (HADS-M) version. Spearman's rank correlation coefficient test and logistic regression were used for analyses. Analysis of patients revealed an association between home care effectiveness and the following variables (OR per unit): age (OR = 0.98, 95% CI: 0.95-0.99), educational level (OR = 1.45, 95% CI: 1.05-2.02), financial status (OR = 0.43, 95% CI: 0.21-0.83), medication irregularity (OR = 0.25, 95% CI: 0.07-0.72), presence of comorbidities (OR = 6.18, 95% CI: 1.83-23.78), health care services provided by a nurse (OR = 1.25, 95% CI: 1.03-1.64), and number of visits to a cardiology clinic (OR = 1.25, 95% CI: 1.02-1.59). There was no association between care effectiveness and sex (p = 0.28), place of residence (p = 0.757), duration of cardiovascular disease (p = 0.718), number of home visits (p = 0.154), nursing interventions (p = 0.16), and adherence to lifestyle change recommendations (p = 0.539) or proper dietary habits (p = 0.355). A greater chance of improved health care effectiveness was found in patients whose caregivers reported higher social (OR = 1.24, 95% CI: 1.09-1.44), psychological (OR = 1.68, 95% CI: 1.25-2.37), and physical (OR = 1.24, 95% CI: 1.05-1.49) quality of life. Patients with cardiovascular disease who were characterized by lower educational attainment, poorer financial status, fewer visits to cardiology clinics, lower utilization of medical services, poorer self-perception of mental and physical well-being, recent onset of disease symptoms, and irregular use of medications, were much more likely to have poorer health care effectiveness. Patients with cardiovascular disease and their caregivers can be well supported at home as long as the care model is tailored to the specific needs. This includes family care coordination in the health care team, home care, and general practice support.

The Analysis of the Relationship between the Quality of Life Level and Expectations of Patients with Cardiovascular Diseases under the Home Care of Primary Care Nurses.

The World Health Organization defines quality of life as a person's perception of his or her life situation in relation to the culture and value system in which he or she lives, in relation to and with respect to his or her functioning assumptions, expectations, and standards set by environmental conditions. Meeting the expectations of patients with CVD is one of the factors that positively influences their health status and leads to better diagnostic and treatment outcomes. The aim of this study was to answer three main questions related to patients with chronic cardiovascular disease: (1) What is their quality of life? (2) Are patients' expectations about the quality of care provided by primary health care physicians/nurses met (and at what level)? (3) Is there a correlation between patients' quality of life and their expectations of primary health care physicians/nurses? The study involved 193 Polish CVD patients who were cared for at home by a family nurse practitioner working in primary health care facilities. Data were collected from March 2016 to January 2017. The WHOQOL-BREF Quality of Life Questionnaire and the Author Interview Questionnaire were used for the study. Data analysis was based on the Spearman correlation coefficient test. There was a statistically significant association between patients' expectations of the physician regarding information about the course of the disease and quality of life in the following domains: environmental r = 0.20, p = 0.006, psychological: r = 0.18, p = 0.015, physical: r = 0.18, p = 0.013, and social: r = 0.16, p = 0.025. Patients who did not expect the nurse to be courteous, understanding, or interested were found to have higher quality of life scores in psychological (r = -0.17, p = 0.023) and physical (r = -0.15, p = 0.044) domains. There was a statistically significant relationship between expectations of care from nurses regarding intimacy during care activities and the level of satisfaction with one's own health (r = -0.15, p = 0.038) and quality of life (r = -0.14, p = 0.045), as well as quality of life in the domains of physical (r = 0.21, p = 0.004), social (r = 0.19, p = 0.010), and psychological (r = 0.16, p = 0.024). There is a need to define the expectations of patients with chronic cardiovascular disease in primary care, as lack of expectations of a physician/nurse continues to be associated with lower quality of life in all domains.

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).

Factors Differentiating Rural and Urban Population in Determining Anxiety and Depression in Patients with Chronic Cardiovascular Disease: A Pilot Study.

The aim of this cross-sectional study was to analyze selected variables differentiating rural from urban populations, as well as identify potentially increased levels of depression and anxiety in patients with chronic cardiovascular disease. The study was carried out in 193 patients. The study used the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS), the Health Behavior Inventory Questionnaire (HBI), the WHOQOL-BREF Quality of Life Questionnaire, and the Hospital Anxiety and Depression Scale-Modified Version (HADS-M). Spearman's rank correlation coefficient test and logistic regression were used for analyses. In rural patients, we observed a relationship between anxiety and age (1/OR = 1.04; 95% CI: 0.91-0.99), the assessment of satisfied needs (1/OR = 293.86; 95% CI: 0.00001-0.56), and quality of life (QoL) in physical (OR = 1.56; 95% CI: 1.11-2.33), social (1/OR = 1.53; 95% CI: 0.04-0.94), and environmental domains (OR = 1.67; 95% CI: 1.06-3.00), as well as between depression and QoL in physical (1/OR = 1.39; 95% CI: 0.50-0.97) and psychological (OR = 1.37; 95% CI: 1.01-1.93) domains. In city patients, we observed a relationship between the drug and Qol in the physical (1/OR = 1.25; 95% CI: 0.62-0.98) and psychological (OR = 1.49; 95% CI: 1.13) domains. Younger patients living in a rural area with a lower assessment of met needs, a higher level of QoL in physical and environmental domains, and a lower social domain, as well as patients living in a city with a lower QoL in the physical domain and a higher psychological domain, have a greater chance of developing anxiety and depressive disorders.

Needs, Aggravation, and Degree of Burnout in Informal Caregivers of Patients with Chronic Cardiovascular Disease.

This study aimed to answer three main questions with respect to home caregivers for people with cardiovascular disease: (1) Are the needs of home caregivers being met (and at what level)?; (2) what is the level of emotional exhaustion, depersonalization, and personal accomplishment of home caregivers?; (3) what sociodemographic variables of home caregivers are related to unmet needs and level of emotional exhaustion, depersonalization, and personal accomplishment? The study used the Camberwell Modified Needs Assessment questionnaire and the Maslach Burnout Inventory questionnaire. This study reports on 161 informal home caregivers of patients with cardiovascular disease. We found that younger caregivers were less likely to report unmet needs (p = 0.011), and showed lower rates of burnout on depersonalization and emotional exhaustion. In addition, caregivers who worked more often reported higher levels of met needs (p = 0.022), and showed lower rates of burnout on depersonalization (p = 0.005) and emotional exhaustion (p = 0.018). Subjects residing in urban areas were more likely to report unmet needs (p = 0.007), and showed higher rates of burnout on emotional exhaustion (p = 0.006). Older caregivers who are unemployed and reside in cities should be offered programs to determine their unmet needs and to receive support.

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.

Hepatitis A in Poland in 2017 - epidemic increase cases

AIM: The aim of this article is to describe and assess changes in epidemiological situation of Hepatitis A in Poland in 2017. MATERIALS AND METHODS: The assessment was based on the information from the individual case questionnaires, aggregated data from the bulletins "Infectious diseases and poisonings in Poland in 2017" and reports from epidemiological investigations in outbreaks of hepatitis A, submitted by the sanitary-epidemiological stations to the Department of Epidemiology of Infectious Diseases and Surveillance in NIPH-NIH. RESULTS: In 2017 a large increase of HAV cases and hepatitis A incidence was observed in Poland (3006 cases, incidence 7.8 per 100 000) in comparison to 2016 (35; 0.09). Majority of the cases were registered in large cities, where incidence was 3 times higher than in rural areas. Among reported there were 501 cases (16.6% of all cases) selfdeclaring as man who have sex with man (MSM). In course of the year an increasing trend in the number of cases was observed until September and the increase of male to female ratio (m/f) until May. Moreover 251 HAV outbreaks were reported, number of which increased until October and with the increase of m/f ratio in these outbreaks until April. From July to October there was an increase in the number of small outbreaks with m/f ratio equal 1. There were 178 imported cases reported, most of them from European countries- especially Germany and Spain. SUMMARY AND CONCLUSIONS: In 2017 over 80-fold increase of HAV cases and hepatitis A incidence was observed in comparison to previous years. Available epidemiological data indicate that ongoing HAV outbreak among MSM in Europe reached also Poland, and data from the second part of the year suggest infection spreading in non-MSM part of the population. It is therefore highly indicated that the list of risk groups for which vaccination against hepatitis A is recommended should also be expanded for MSM. To avoid such increase in the number of cases in future it is recommended to introduce vaccinations in risk groups as soon as large international outbreak occurs.

Foodborne infections and intoxications in Poland in 2016

AIM: The purpose of this study is to assess the epidemiological situation of food poisonings and infections in Poland in 2016. 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", 2010-2016. Warsaw, NIPH-NIH and GIS). RESULTS: In 2016 a total number of 680 foodborne infections and intoxications outbreaks were reported in which 22 908 persons were exposed and 7 186 (out of which 38% were children up to 14 years of age) got sick. Hospitalization was required for 1 603 of patients. The most frequent etiological agent was Salmonella sp. ­ 37,6%, 3 and 28,4% of cases). Viruses were responsible for 22,5% of outbreaks and 28,6 % of cases (And among them rotaviruses- 10,8% of outbreaks and 5,2% of cases and noroviruses- 11,1% of outbreaks and 23,3% of cases). In 27,5% of outbreaks no etiological agent was found. Just as in 2015 private household was the most frequent place of an outbreak- 323 outbreaks (47,5%), and after that- hospital- 135 outbreaks (19,9%). In 2016 in more than 81% of outbreaks no vehicle was found and in remaining the most frequent vehicle were eggs and egg products) (25% of outbreaks of known vehicle). CONCLUSIONS: The increase in the both percentage of reported salmonellosis cases among the group of bacterial foodborne infections and the increase of foodborne outbreaks of Salmonella Enteritidis etiology along with the fact of the occurrence of large, multistate outbreak of this etiology with Polish eggs as a vehicle indicates an alarming situation and the necessity of microbiological surveillance enchantment in relation to abovementioned products. Moreover an increase in the percentage of unknown etiology outbreaks, in which clinical symptoms of cases suggest viral etiology indicates the need for more frequent testing oriented for those pathogens during epidemiological investigations.

Hepatitis A in Poland in 2016

AIM: The aim of this article is to assess the epidemiological situation of Hepatitis A in Poland in 2016 with the regard to the recent years. MATERIALS AND METHODS: The assessment was conducted based on the results of the analysis of data from the bulletins "Infectious diseases and poisonings in Poland in 2016" and "Vaccinations in Poland in 2016", as well as information from the individual case- questionnaires and reports from epidemiological investigations in outbreaks of hepatitis A, submitted by the sanitary-epidemiological stations to the Department of Epidemiology of Infectious Diseases and Surveillance in NIPH-NIH. RESULTS: In 2016 in Poland there were 35 cases of hepatitis A registered. Incidence per 100 000 inhabitants in the whole country was 0.09, but in different voivodeships varied from 0.03 (in Wielkopolskie voivodeship) to 0.28 (in podkarpackie voivodeship). The incidence among male was slightly higher than women and was 0.11 and 0.08/100 000 respectively. CONCLUSIONS: In 2016 a decrease in the incidence and percentage of imported cases was observed (comparing it to the previous year). Because of the increasing part of population prone to infection good epidemiological situation concerning HAV in Poland paradoxically increases the risk of an occurrence of HAV epidemic, especially in the scope of ongoing large multistate HAV outbreak among MSM. In relation to this situation the enhancement of surveillance over this disease and undertaking anti-epidemic actions gains particular importance, especially when it comes to promoting vaccinations among members of risk groups.

Hepatitis A in Poland in 2015

AIM: The aim of this article is to assess the epidemiological situation of Hepatitis A in Poland in 2015 with the regard to the recent years. MATERIALS AND METHODS: The assessment was conducted based on the results of the analysis of data from the bulletins "Infectious diseases and poisonings in Poland in 2015" and "Vaccinations in Poland in 2015", as well as information from the individual cases questionnaires and reports of epidemiological investigations in outbreaks of hepatitis A, submitted by the sanitary-epidemiological stations to the Department of Epidemiology in NIPH-NIH. RESULTS: In 2015 in Poland there were 49 cases of hepatitis A registered. Incidence per 100 000 inhabitants was 0,13, and in different voivodeships varied from 0,03 (in Dolnoslaskie, Malopolskie voivodeship) to 0,36 (in Malopolskie voivodeship). The incidence among male and female was similar ­ 0.11 i 0.15/100 000 respectively. CONCLUSIONS: In 2015 despite the decrease in the number of cases (comparing it to the previous year) no significant change in epidemiological situation of hepatitis A was observed. In the course of routine surveillance no information are gathered concerning the risk groups affiliation of persons being vaccinated. This information would facilitate the creation of recommendations for the vaccination against hepatitis A policy. In regard of the increase of population susceptible to infection the maintenance of high level routine surveillance in Poland gains particular importance.

Poliomyelitis eradication ­ the review of notifications from the years 2010-2016 sent to National IHR Focal Point

Polio eradication programme was launched after World Health Assembly in 1988. Despite considerable decrease in reported cases it still constitutes a significant public health threat. All WHO member state is bound to appoint National IHR Focal Point, which operates based on International Health Regulations (2005), which were enacted during the World Health Assembly in 2005. In Poland National IHR Focal Point (IHR NFP in Poland) operates since 2007, and is located in the Department of Epidemiology, in National Institute of Public Health - National Institute of Hygiene. Its aim is to acquire, assess and to transfer information on events which may constitute an international threat for the public health. IHR NFP in Poland has an access to WHO's Event Information Site (EIS) as well as Early Warning and Response System (EWRS) with reading-only credentials. Both platforms are of limited access (1). Among recipients of IHR NFP notifications and information are experts from many fields such as epidemiology, virology, bacteriology and others- related to specific type of notification, as well as specific and appointed members of state's administration and authorities in the field of public health. In this paper a review of notifications on the subject of poliomyelitis, sent to IHR NFP in Poland in the years 2010-2016 is presented, as well as references to poliomyelitis epidemiological situation were made based on the date from Global Polio Eradication Initiative.

Foodborne infections and intoxications in Poland in 2015

AIM: The purpose of the study is to assess the epidemiological situation of food poisonings and infections in Poland in 2015 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 NIZP-PZH annual bulletins (Czarkowski MP et al. "Infectious diseases and poisonings in Poland", 2007-2015. Warsaw, NIPH-NIH and GIS) RESULTS: In 2015 a total number of 560 foodborne infections and intoxications outbreaks were reported in which 21 962 persons were exposed and 7 037 (including 1 896 children up to 14 years of age) got sick. Hospitalization was required for 1 905 of patients. The most frequent etiological agent was Salmonella sp. ­ 34.3%, and 21.4 % of cases). Viruses were responsible for 23.9% of outbreaks and 29.7 % of cases (And among them rotaviruses­ 13% of outbreaks and 7.1% of cases and noroviruses­ 10.5% of outbreaks and 26.9% of cases). In 25.2% of outbreaks no etiological agent was found. Just as in 2014 private household was the most frequent place of an outbreak (235 outbreaks), and after that­ hospital (148 outbreaks). In 2014 the most frequent vehicle were cakes and desserts (25.6% of all outbreaks with known etiological agent). In 2015 the most frequent vehicle of infection were eggs and egg products) (19% of outbreaks of known vehicle). In 57.3% of outbreaks no vehicle was found or proved. Moreover in 2015 a total number of 4 outbreaks in which more than 100 cases were reported CONCLUSIONS: The increase in the number of foodborne outbreaks of Salmonella Enteritidis etiology along with the fact of eggs and egg products being the most frequent vehicle indicates an alarming situation and the necessity of microbiological surveillance enchantment in relation to those products

Foodborne infections and intoxications in Poland in 2014

AIM: The purpose of the study is to assess the epidemiological situation of food poisonings and infections in Poland in 2014. 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 NIZP-PZH annual bulletins (Czarkowski MP et al. "Infectious diseases and poisonings in Poland", 2006-2014. Warsaw, NIPH-NIH and GIS). RESULTS: In 2014 for the first time in many years an increase in the number of infections and intoxications with bacterial etiology was observed. The number of viral foodborne infections was still increasing, which points towards this trend persisting. In 2014 a total number of 533 foodborne infections and intoxications outbreaks were reported in which 10 754 persons were exposed and 5 494 (including 1 891 children up to 14 years of age) got sick. Hospitalization was required for 1 687 patients. The most frequent etiological agent in those outbreaks were those of viral origin (among which rotavirus was the most frequent agent - 25%, 3 of outbreaks and 15.7% of cases). Salmonella spp. was responsible for 32.8 % of outbreaks and 22.6 % of cases, and in 20.1% of outbreaks no etiological agent was found. Just as in 2013 private household was the most frequent place of an outbreak (249 outbreaks), and after that- hospital (130 outbreaks). In 2014 the most frequent vehicle were cakes and desserts (25.6% of all outbreaks with known etiological agent). In 84.4% no vehicle was found. Moreover in 2014 a total number of 3 outbreaks in which more than 100 cases were reported. CONCLUSIONS: The increase in the number of foodborne outbreaks of viral etiology shows the need of adjustment some aspects of epidemiological investigations especially such features as: laboratory conformation of etiological agent of ill persons as well as persons involved in the food processing and meals preparing and the aspect of food samples testing.

Hepatitis A in Poland in 2014

AIM: The aim of this article is to assess the epidemiological situation of hepatitis A in Poland in 2014 with the regard to the recent years. MATERIALS AND METHODS: The assessment was conducted based on the results of the analysis of data from the bulletins "Infectious diseases and poisonings in Poland in 2014" and "Vaccinations in Poland in 2014", as well as information from the individual cases questionnaires and reports of epidemiological investigations in outbreaks of hepatitis A, submitted by the sanitary-epidemiological stations to the Department of Epidemiology in NIPH-NIH. RESULTS: In 2014 in Poland there were 76 cases of hepatitis A registered. Incidence per 100 000 inhabitants was 0.20, and in different voivodeships varied from 0.07 (in Dolnoslaskie voivodeship) to 0.30 (in Malopolskie voivodeship). The incidence among male and female did not differ (and was 0.20/ 100 000). CONCLUSIONS: In 2014 despite the increase in the number of cases (comparing it to the previous year) no significant change in epidemiological situation of hepatitis A was observed. Poland is still regarded as a country of low endemicity of hepatitis A. In routine surveillance system there is no information concerning the professional affiliation of persons being vaccinated, whereas the vaccinations themselves are recommended in the Polish vaccination schedule. Particular attention should be directed towards the vaccinations of persons who take part in berries primal production, product of which Poland is a major exporter of in the EU. In the light of increasing number of international hepatitis A outbreaks (which could be characterized by the prolonged duration, as well as the high possibility of secondary cases appearing- especially in countries of low endemicity) the maintenance of high level routine surveillance in Poland gains importance. The latter could also contribute to the efficiency of epidemiological investigations in multistate outbreaks.

Emerging infectious diseases not covered by routine vaccination in Europe in 2010-2015--the review of WHO and ECDC notifications for the National IHR Focal Point in Poland.

The National IHR Focal Point is a center set up by each Member State of the World Health Organization (WHO) in accordance with the International Health Regulations (2005). The International Health Regulations (IHR) were adopted on 23 May 2005 at the World Health Assembly and entered into force since 15 June 2007 as the legal instrument designed to help protect all countries from uncontrolled international spread of diseases and other urgent public health threats. According to Article 2 of IHR the purpose and scope of these Regulations are to prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade. Primarily, the scope of IHR is to establish a system of early warning (in accordance with Article 6 and 7) with the functioning in each country National IHR Focal Point which is available at any time to communicate with WHO IHR Contact Points and other entities. The tasks of the National IHR Fo- cal Point in Poland which was appointed by the Minister of Health and runs in the Department of Epidemiology, National Institute of Public Health--National Institute of Hygiene from 1 September 2007 are the notification of events that may constitute a public health emergency of international concern occurring in Poland or abroad and the dissemination of this information to the WHO, other National IHR Focal Points or competent authorities responsible for public health. The task of the National IHR Focal Point in Poland is also the dissemination of WHO and ECDC notifications, including recommendation and risk assessment documents. The aim of this work is the review of WHO and ECDC notifications received by National IHR Focal Point in Poland in the period from 2010 to 2015 which were related to emerging infectious diseases not covered by routine vaccination programs or for which there are no effective vaccines that have occurred in the WHO European Region. The review includes verotoxin-producing Escherichia coli O104: H4 infections, MERS-CoV infections, Ebola virus disease, malaria, dengue fever, West Nile fever, chikungunya and cholera.

Foodborne infections and intoxications in Poland in 2013.

AIM: The purpose of the study is to assess the epidemiological situation of food poisonings and infections in Poland in 2013. MATERIALS AND METHODS: The evaluation was based on the analysis of information from reports of epidemiological investigations in outbreaks of food poisonings and infections, submitted by the sanitary-epidemiological stations to the Department of Epidemiology, NIZP-PZH annual bulletins (Czarkowski MP et al. "Infectious diseases and poisonings in Poland", 2006-2013. Warsaw, NIPH-NIH and GIS). RESULTS: In 2013 a further decrease in the number of infections and intoxications with bacterial etiology and an increase in the infections of viral etiology was observed. Furthermore 2013 is another year with low number of cases of trichinellosis (9 cases in total). In 2013 a total number of 491 foodborne infections and intoxications outbreaks were reported in which there were 29,179 persons exposed and 5,664 (including 2 193 children up to 14 years of age) persons ill. Hospitalization was required for 1,445 persons. The most frequent etiological agent in those outbreaks was Salmonella spp.--which was responsible for 36,3% of outbreaks and 21,5% of cases. Viruses were responsible for 29,7 of outbreaks and 45,7 cases, in 19,3% of outbreaks no etiological agent was established. Like in 2012 the most frequent vehicle were dishes made from eggs and milk combined with eggs (9,4% of outbreaks). In 65% of outbreaks reported no vehicle could be found. Moreover in 2013 a total number of 3 outbreaks in which more than 100 cases were reported. CONCLUSIONS: The increase in the number of foodborne outbreaks of viral etiology shows the need of adjustment some aspects of epidemiological investigations especially such features as: laboratory conformation of etiological agent of ill persons as well as persons involved in the food processing and meals preparing and the aspect of food samples testing.