Legionellosis in Poland in 2017

OBJECTIVE: The aim of this study is to assess the epidemiological situation of legionellosis in Poland in 2017 in comparison with previous years. MATERIAL AND METHODS: The analysis is based on national surveillance data published in the annual bulletin: "Infectious diseases and poisonings in Poland in 2017" and bulletins from previous years along with data from legionellosis case reports collected and sent to the Department of Epidemiology of Infectious Diseases and Surveillance NIPH ­ NIH by Sanitary and Epidemiological Stations. RESULTS: In Poland, both cases of Legionnaires' disease (an acute form of infection with pneumonia) and Pontiac fever (a mild, influenza-like form of infection) are routinely reported to the surveillance system. In 2017, a total of 39 cases of legionellosis were registered, including 38 cases of Legionnaires' disease and 1 case of Pontiac fever; the annual incidence rate 0.102 (per 100,000 population) has increased by almost 50 percent since previous year (0.070) and is almost three times higher than the median incidence (0.036) for 2011-2015. The infections were reported in fourteen voivodeships; only one voivodeship (Swietokrzyskie) did not register any case in last years. The incidence in men (0.129 per 100,000) was higher compared to women (0.076); the highest incidence (0.323) was noted in men aged 50-59. All reported cases were sporadic and were hospitalised. The Sanitary Inspection reported nine fatal cases ­ 6 women and 3 men. Thirty three cases were autochthonous including four cases linked with contaminated water systems in health-care settings. Six cases were associated with travels abroad (to Egypt, Albania, Italy and Crete). SUMMARY AND CONCLUSIONS: Although in recent years number of reported cases continues to rise, the incidence of legionellosis in Poland remains one of the lowest in the entire EU. Also draws attention variation of incidence between provinces and a high mortality among reported cases. Our data suggest significant under-diagnosis of legionellosis. A priority remains to improve early diagnosis of Legionnaires' disease in health care settings.

Legionellosis in Poland in 2016

OBJECTIVE: The aim of the study was to assess the epidemiological situation of legionellosis in Poland in 2016 in comparison to the preceding years. MATERIAL AND METHODS: The assessment was based on national surveillance data published in the annual bulletin: "Infectious diseases and poisonings in Poland in 2016" and its prior versions along with data from legionellosis case reports sent from Sanitary-Epidemiological Stations to the Department of Epidemiology of NIPH - NIH. RESULTS: In Poland, both two main forms of legionellosis - Legionnaires' disease and Pontiac fever are routinely reported to the surveillance system. In 2016, a total of 27 cases of legionellosis were registered, including 25 cases of Legionnaires' disease and 2 cases of Pontiac fever; in 2016, a total of 27 cases of legionellosis have been reported, including 25 cases of Legionnaires' disease and 2 cases of Pontiac fever; the annual incidence rate 0.070 (per 100,000 population) was comparable to previous year (0.060) but almost twice as high as the median (incidence) for 2010-2014. The infections were reported in 11 provinces, including two, which in previous years usually did not register any cases; only two provinces (out of 16 in the country) have reported no cases in recent years. The incidence in men (0.080 per 100,000) was higher compared to women (0.055). All reported cases were sporadic and, except for one mild case of Legionnaires' disease, required hospitalization. The Sanitary Inspection reported two fatal cases ­ both women aged 59 and 69. Twenty cases were autochthonous including four cases linked with contaminated water systems in hospitals. Seven cases were associated with travel abroad (to Germany, Russia, Greece, Australia, USA and Thailand). SUMMARY AND CONCLUSIONS: Despite the increase in the number of cases in recent years as well as number of provinces, which detected cases, the annual incidence of legionellosis in Poland remains one of the lowest in the EU, which suggests that this infection is likely under-recognized and underdiagnosed in all provinces of the country.

Legionellosis in Poland in 2015

OBJECTIVE: The aim of the study was to assess the epidemiological situation of legionellosis in Poland in 2015 in comparison to the preceding years. MATERIAL AND METHODS: We reviewed data published in the annual bulletin: "Infectious diseases and poisonings in Poland in 2015" and its prior versions along with the legionellosis case reports sent from Sanitary- Epidemiological Stations to the Department of Epidemiology of NIPH - NIH. RESULTS: In Poland, both two forms of legionellosis - Legionnaires' disease (a severe form of disease accompanied by pneumonia) and Pontiac fever (mild, influenza-like form of infection) - are notifiable. In 2015, a total of 23 cases of Legionnaires' disease have been reported (there were no reports of Pontiac fever). The annual incidence rate 0.060 (per 100,000 population) slightly increased when compared to previous year as well as to the median (incidence) for 2009-2013. The infections were reported in 10 provinces, including five, which in previous years usually did not register any cases; however, there is a number of provinces that did not identify any LD cases in recent years. The incidence in males (0.097 per 100,000) was almost 4-times higher compared to females (0.025). Except for one cluster of two, all cases were sporadic; All patients required hospitalization. The Sanitary Inspection reported four fatal cases ­ all men 43- 67 years/old. Eighteen cases were likely acquired in the country, including a cluster of two cases linked with contaminated building water system. Four cases were associated with travels abroad (to Russia, Croatia, United Arab Emirates and USA) and in one case the exposure occurred during the transport of goods (lorry driver). SUMMARY AND CONCLUSIONS: This study suggests, that legionellosis is likely under recognized and under diagnosed in all provinces of the country. Geographical variations in incidence may reflect local differences in availability of laboratory tests for LD. Number of detected cases - without information on the number of laboratory tests performed - do not appear to be sufficient to fully assess the epidemiological situation.

Wladyslaw Bieganski, MD (1857-1917)

Dr W. Bieganski was an eminent doctor of internal medicine mostly the acute infectious diseases and tuberculosis, he was scientist doing the research on the origin of the diseases and on the medical ethics, but more he was also a social activist taking care on the public health of the society in his time still living under the Russian rule. W. Bieganski living on the XIX/XX century in small provincial town, grace to his knowledge, self education and energy created the important scientific center in the municipal small hospital. His philosophic works and especially knowledge published under the shape of aphorisms on the medical ethics were several time published still after his death. The century of the death of Dr W. Bieganski the Senat of RP, the Higher Chamber of the Polish Parliament, celebrated by nominating him as one of the eminent persons for the year 2017. This publication was prepared to memorize the achievements of a medical doctor, scientists and social Dr W. Bieganski activists, that can be jugged as the precursor of the public health activist, and whose philosophical findings are still worth to be remember.

Past and present history of cholera epidemics. Hundred years of operation of National Institute of Hygiene for the prevention and control of cholera

BACKGROUND: Cholera is an infectious disease that in the epidemic form should not continue to appear now, as is known from the experience of developed countries AIM: The aim of this work is to bring to memory the epidemics of cholera, that were introduced to the territory of Poland, in the past and the role of National Institute of Hygiene (PZH) in the fight against them and to demonstrate contemporary danger from cholera outbreaks that still exists in the world MATERIAL AND METHODS: The information from the historic publications were analyzed, the results Polish research performed in National Institute of Hygiene in the second half of the XX century were collected and demonstrated the most recent information from in the world science publications on the subject of cholera and the conditions that were in the origin of the recent outbreaks of cholera mentioned RESULTS: The data available for the number of cholera victims in the epidemics of XIX century is concerning the persons ill with characteristic clinical symptoms, but the data for XX century is concerning only patients that were infected with by the strain Vibrio cholerae O1 classic type, the bacteria that were described by R. Koch, but from the 70-years of XX century mostly the cases infected with Vibrio cholerae O1 type El-Tor, that was the etiologic agent of the seventh cholera pandemic SUMMARY AND CONCLUSIONS: The origin of the epidemic cholera is depending on several conditions :appearance in water the infectious agent with the toxin producing character, ecological conditions of the surface waters, and on living conditions of human society which might be infected from the source of infection in water. The presence of the infectious agent in the natural waters should be always taken under special consideration car any worsening of living condition of the human population like natural disaster or war, may still create the dangers of the epidemic of infectious disease, as recently has happened with the outbreak of epidemic of cholera in Yemen

Legionellosis in Poland in 2014

OBJECTIVE: The aim of the study was to assess the epidemiological situation of legionellosis in Poland in 2014. MATERIAL AND METHODS: We reviewed data published in the annual bulletin: "Infectious diseases and poisonings in Poland in 2014" and its prior versions along with the legionellosis case reports sent to the Department of Epidemiology of NIPH - NIH. RESULTS: In Poland, both two forms of legionellosis - Legionnaires' disease (a severe form of disease accompanied by pneumonia) and Pontiac fever (mild, influenza-like form of infection) - are routinely reported to the surveillance. In 2014, a total of 14 cases were reported (12 cases of Legionnaires' disease and 2 cases of Pontiac fever); the incidence (0.036 per 100,000 population) was comparable to previous year as well as the median (incidence) for 2008-2012. The infections were reported in eight provinces, including five, which in previous years usually did not register any cases. The incidence in males (0.04 per 100,000) was slightly higher compared to females (0.03). Death rate of females was unusually high = 75%. No outbreaks or clusters were reported - only sporadic cases. All patients required hospitalization, including cases of Pontiac fever. The Sanitary Inspection reported three fatal cases ­ all women 49- 60 years/old. Twelve cases were likely acquired in the country, including two probably in hospital and three linked with inhalation of aerosols during professional activity. Two cases were associated with travels abroad (one to Italy and one to Germany). SUMMARY AND CONCLUSIONS: In 2014 diagnosis of legionellosis cases was confirmed by rapid chromatographic test detecting legionella antigen in urine. The examinations were performed even in small town hospitals, so infections were detected and reported in provinces which usually did not register any cases. This study suggests, that legionellosis is likely under recognized and under diagnosed in all provinces of the country. Presumably physicians often do not suspect or not confirm the clinical diagnosis of Legionnaires' disease in cases with atypical pneumonia.

Human babesiosis.

Babesiosis is an emerging parasitic, anthropo-zoonotic tick-borne disease, seldom diagnosed in humans. Caused by Protozoa, Babesia (also called Piroplasma) intraerytrocytic piriform microorganism. Infection of vertebrates is transmitted by ticks. Out of more than 100 Babesia species/genotypes described so far, only some were diagnosed in infected humans, mostly B. microti, B. divergens and B. venatorum (Babesia sp. EU1). Infection in humans is often asymptomatic or mild but is of a particular risk for asplenic individuals, those with congenital or acquired immunodeficiencies, and elderly. Infections transmitted with blood and blood products raise concerns in hemotherapy. Epidemiological situation of babesiosis varies around the world. In Europe, no increase in the number of cases was reported, but in the USA its prevalence is increasing and extension of endemic areas is observed. The aim of this publication is to describe the problems connected with the current epidemiological situation, diagnosis and treatment of human babesiosis with regard to clinical status of patients.

Legionellosis in Poland in 2013.

OBJECTIVE: The objective of the article is to assess the epidemiological situation of legionellosis in Poland in 2013 in comparison to the preceding years. MATERIAL AND METHODS. The analysis of epidemiological situation was based on the data published in the annual bulletin: "Infectious diseases and poisonings in Poland in 2013" and its prior versions as well as the legionellosis case reports sent to the Department of Epidemiology of NIPH-NIH. RESULTS: In Poland, all cases of legionellosis, including Legionnaires' disease--a form of disease accompanied by pneumonia and mild, influenza-like form of infection--Pontiac fever are routinely reported to the surveillance. In 2013, a total of 11 legionellosis cases were reported (all 11 were cases of Legionnaires' disease and no one case of Pontiac fever); the incidence was 0.029 per 100,000 population which was a bit higher compared to the previous year but was 40 % lower from the median incidence for 2007-2011. The infections were reported in 7 provinces. The incidence in males (0.04 per 100,000) was slightly higher compared to females (0.02). No legionellosis outbreaks were registered--all infections were of sporadic nature. All cases were hospitalized., of these, seven were infected in the country, including three hospital acquired infections. Four infections were associated with travels abroad (one to Austria, one to Bulgaria, one to Germany and one to Italy). All the four cases connected with travel abroad survived., but 5 cases from 7 infected in Poland were fatal. The sanitary inspection reported that four fatal cases were over the age of 50, but one girl was 14 years old CONCLUSIONS: In 2013, no changes of fundamental features of legionellosis epidemiological situation in Poland were observed. It is recommended to enhance the surveillance for legionellosis, with emphasis on conducting environmental investigation in areas where infections have occurred.

Legionellosis in Poland in 2012.

OBJECTIVE: The objective of the article is to assess the epidemiological situation of legionellosis in Poland in 2012 in comparison to the preceding years. MATERIAL AND METHODS: The analysis of epidemiological situation was based on the data published in the annual bulletin: "Infectious diseases and poisonings in Poland in 2012" and its prior versions as well as the legionellosis case reports sent to the Department of Epidemiology of NIPH-NIH. RESULTS: In Poland, all cases of legionellosis, including Legionnaires' disease - a form of disease accompanied by pneumonia and mild, influenza-like form of infection - Pontiac fever are routinely reported to the surveillance. In 2012, a total of 10 legionellosis cases were reported (8 cases of Legionnaires' disease and 2 cases of Pontiac fever); the incidence was 0.026 per 100 000 population which compared to the previous year and median incidence for 2006-2010 was 45% and 65% lower, respectively. The infections were reported in 6 provinces. The incidence in males (0.03 per 100 000) was slightly higher compared to females (0.02). No legionellosis outbreaks were registered - all infections were of sporadic nature. All cases were hospitalized. The sanitary inspection reported two fatal cases over the age of 60. Of these infections, seven were developed in the country, including one hospital- and one sanatorium-acquired infection. Two infections were associated with travels abroad (one to Spain and one to Egypt) and one infection occurred in driver while transporting the goods to the Netherlands. CONCLUSIONS: In 2012, no changes of fundamental features of legionellosis epidemiological situation in Poland were observed. It is recommended to enhance the surveillance for legionellosis, with emphasis on conducting environmental investigation in areas where infections have occurred.

Shigellosis in Poland in 2012.

BACKGROUND: Shigellosis according to European Centre for Disease Control (ECDC) Report is registered in all countries of the European Union (EU) and of the European Free Trade Association (EFTA) with exception of Italy and Luxemburg. The incidence rate in Poland below 0.1/100 000 of population is the lowest among the EU/EFTA countries. AIM: To assess epidemiological situation of shigellosis in Poland in 2012 in comparison to preceding years. MATERIALS AND METHODS: An assessment of the epidemiological situation of shigellosis was based on the results from an analysis of the yearly annual bulletins: "Infectious diseases and poisonings in Poland in 2012", reports from bacteriological laboratories and reports from individual cases and epidemiological investigations of outbreaks linked to shigellosis, sent by Sanitary-Epidemiological Stations to the Department of Epidemiology at NIZP-PZH. RESULTS: In 2012 the tendency that the number of registered cases of shigellosis was lower than in the former years continued - only 13 confirmed cases of shigellosis were registered (incidence rate 0.03 per 100 000 inhabitantsbut in the previous year the 18 cases ( incidence rate 0.05). Cases were registered only by 6 provinces, most of the cases by the Lodz province - 4. All together 5 persons nearly 40% were infected in travel to the foreign countries. According to data from laboratories of Sanitary-Epidemiological Stations, Shigella was detected only 4 convalescents and 2 carriers. All cases of shigellosis registered in 2012, were confirmed by a hospital laboratory or a private laboratory. CONCLUSIONS: In our opinion the above mentioned data concerning the cases of shigellosis in Poland in 2012 are not reflecting the true epidemiological situation of shigellosis in Poland. The sanitary situation was changing nearly every year for better than in former years but the surveillance of dysentery require more active epidemiological measures.

[Sequence-based typing--molecular typing of Legionella pneumophila strains within the framework of an international external quality assessment]. / Sequence-based typing--molekularne typowanie szczepów Legionella pneumophila w ramach miedzynarodowego sprawdzianu external quality assessment.

INTRODUCTION: The aim of the study was evaluation results of molecular typing L. pneumophila strains that was carried by using SBT (Sequence-Based Typing) method, obtained by laboratory of Department of Bacteriology NIZP-PZH within the framework of the ninth international external quality assessment (ELDSNet Legionella pneumophila DNA SBT) and their comparision with the results obtained by other reference laboratories in EU. MATERIAL AND METHODS: The panel of five coded isolates of L. pneumophila was investigated. Genomic DNA of Legionella were extracted and defined regions of seven genes were amplified by PCR and sequenced. Then, consensus sequence of the correct length were generated. In order to determine the complete allelic profile and Seqence Type (ST) forward and reverse sequence for each allele were submitted online by using the L. pneumophila database. RESULTS: All of L. pneumoniae isolates sent to genotyping by SBT method were correctly identified in our laboratory. CONCLUSIONS: Results of the ninth international external quality assessment have confirmed competences of laboratory of Department of Bacteriology NIZP-PZH in typing of L. pneumophila isolates accordance with the requirements of the international classification.

Legionellosis in Poland in 2011.

OBJECTIVES: The main objective of this article is to assess the epidemiology of legionellosis in Poland in 2011, using national surveillance data. MATERIALS AND METHODS: We reviewed surveillance data published in the annual bulletin "Infectious diseases and poisonings in Poland" from 2005 to 2011, and legionellosis case reports from 2011 sent to the Department of Epidemiology NIPH-NIH by Sanitary-Epidemiological Stations. RESULTS: In 2011, a total 18 Legionnaires' disease (Legionnaires' pneumonia) cases was reported. Annual incidence rate (0.05 per 100,000 population) has dropped by more than 50% compared to previous year, but was similar to the median incidence reported in years 2005-2009. For several years, the legionellosis incidence varies for different regions, but generally is slightly higher in Mazowieckie province; the incidence among men (0.06 per 100,000) is slightly higher than the incidence among women (0.04). In 2011, only sporadic cases have been reported. All patients presented with pneumonia (no Pontiac fever cases) and were hospitalized. Four deaths related to the disease (in patients above 55 years of age) were reported. Source of infection was identified only in one hospital-acquired legionellosis. Furthermore, one case was associated with a treatment at a sanatorium; There were two imported cases associated with travel to Italy and France. CONCLUSIONS: We concluded, that national surveillance shall be shifted toward collecting more information about possible environmental sources of infection/exposures to Legionella.

Shigellosis in Poland in 2011.

BACKGROUND: Shigellosis, also known as bacillary dysentery, is a contagious and infectious disease. In the European Union, on the basis of the Commission Decision of 2 April 2009 and the Commission Decision of 28 April 2008, a unified system for collecting epidemiological data on infectious diseases was introduced, including shigellosis. This makes it possible to compare data collected at different times and in different countries. AIM: The aim of the article is to evaluate the epidemiological situation of shigellosis in Poland in 2011. MATERIALS AND METHODS: An assessment of the epidemiological situation of shigellosis was based on the results from an analysis of the yearly annual bulletins: "Infectious diseases and poisonings in Poland in 2011", reports from bacteriological laboratories and reports from individual cases and epidemiological investigations of outbreaks linked to shigellosis, sent by Sanitary Epidemiological Stations to the Department of Epidemiology at NIZP-PZH. RESULTS: In Poland, 17 confirmed cases of shigellosis were registered in 2011. The incidence of 0.04 per 100,000 inhabitants was lower when compared to the previous year. The number of cases is lower by 48% when compared with the median of years 2005-2009--35 cases (incidence 0.09/100,000). Most of the cases were registered in the Silesian province--7 (incidence 0.15 /100,000). According to data from 16 laboratories of Sanitary Epidemiological Stations, Shigella was not detected among the subjects. All cases of shigellosis registered in 2011, were confirmed by a hospital laboratory at or a private laboratory. CONCLUSIONS: In Poland, we have observed a decline in the number of cases of shigellosis and the incidence remains at a relatively steady level and constitutes less than 0.1/100,000 inhabitants. Compared to the rest of the countries belonging to the EU/EFTA, the current epidemiological situation of shigellosis in Poland is good. Poland is a country with the lowest incidence. In spite of this, the surveillance of shigellosis required more active epidemiological measures. Special attention should be paid to the bacteriological testing of people living in rural areas, children and young people.

[Legionellosis in Poland in 2010]. / Legioneloza w Polsce w 2010 roku.

METHODS: The main objective of this article is to assess the epidemiology of legionellosis in Poland in 2010, using national surveillance data. In Poland, legionellosis is a mandatory notifiable disease based on the European Union (probable or confirmed) case definition, however Legionella pnemophila of unknown serogroup specific antybody response meets also laboratory criteria for case confirmation. RESULTS: The number of legionellosis cases reported has increased over the past years. Between 2004-2008 the median annual number of cases in years 2004-2008 was 21. In 2009, alone, was 10 cases. In 2010 a total 36 legionellosis cases (0.09 per 100,000 inhabitants)--including 9 confirmed cases (6 cases with detected Legionella pneumophila antigen in urine and 3 cases with Legionella spp. specific antybody response) and 27 probable cases--were registered. Among probable cases--21 were reported on the basis of clinical symptoms (e.g. pneumonia) and the presence of an 'epidemiological link' (exposure from the same source), without laboratory confirmation. Sporadic cases (12) represented only one-third of the total number of registered cases. A total of 3 outbreaks were reported, all in the province Slaskie, the largest involved 19 patients. All outbreaks were caused by the presence of Legionella in the public hot water systems. Incidence among men (0.12 per 100 000 population) was slightly higher than the incidence among women (0.07); the highest incidence was observed among people aged 60-69 years. Nearly 78% of cases (28) were people aged over 49 years of age. All patients presented with pneumonia, and all except 1 were hospitalized. No deaths related to the disease were reported. Furthermore, there were no imported cases nor cases associated with travel. CONCLUSIONS: We conclude that there is an urgent need to improve surveillance of Legionellosis in Poland, particularly in terms of laboratory capacity. Introduction of rapid tests for detection of Legionella antigen in urine should increase the number of diagnosed patients who present with symptoms of pneumonia.

[Dysentery and amoebiasis in Poland in 2010]. / Czerwonka bakteryjna i pelzakowa w Polsce w 2010 roku.

INTRODUCTION: Dysentery as infective and contagious disease is registered by all EU and EFTA countries only as shigellosis according to etiological classification of the infectious diseases. The cases are also registered by ECDC. According to ECDC Report for 2006-2008 the incidence rate in Poland < 0.01/100 000 was the lowest from all EU/EFTA countries that have send the data to ECDC as the cumulative for EU countries was 1.78/100 000. MATERIAL AND METHODS: Epidemiological data were collected by Regional Epidemiological Sanitary Stations, send to the National Register of Infectious Diseases, evaluated, calculated and published by Department of Epidemiology National Institute of Public Health (NIZP-PZH) in Annual Bulletin "Infections and Intoxications in Poland in 2010", Warsaw NIZP-PZH and GIS (Chief Sanitary Inspectorate ) 2010. Laboratory data were collected as reports from all Regional Sanitary Laboratories send to NIZP-PZH Department of Bacteriology, data from epidemiological investigation of outbreaks including data from identification of Shigella strains obtained from the Reference Laboratory for Gram-negative Bacilli of NIZP-PZH Bacteriology Department. RESULTS: In 2010 thirty cases of shigellosis were registered (incidence was 0.08/100 000 inhabitants) the same number of cases and incidence was observed in 2009, nearly the same in 2008 - 33 cases (incidence 0.09). The numbers were lower than the median in 2004-2008 (64 cases, incidence 0.17/100 000). According to laboratory reports in all 16 Regional Sanitary Stations only 14 persons were Shigella positive, in spite that more than 600 000 were examined: 10 persons were infected by S. sonnei, 4 by S. flexneri. Only one strain of S. sonnei was isolated from a patient with diarrhea. It was in the Regional Sanitary Station laboratory of the malopolskie voievodeshaft. No one strain of S. boydii or S. dysenteriae was isolated. DISCUSSION AND CONCLUSION: Most of the dysentery cases were examined by other laboratories than laboratories of sanitary epidemiological service. The obligation of private payment for bacteriological examination of suspected cases is one of reason that patient is treated with antibacterial drugs without determination of etiological agent of the infection. It concern the population of small and medium towns as well as population of farmers living in the country, children and youth. The registration of shigellosis in Poland is not valuable. In 2010 no case of amoebiasis was registered as in 2008 the disease no more should be obligatory registered.

[Demographic characteristics of reported cases of legionellosis in years 2005-2009 in Poland in comparison to EWGLI data]. / Charakterystyka demograficzna zachorowan na legioneloze w Polsce w latach 2005-2009 w swietle danych gromadzonych przez European Working Group for Legionella Infections (EWGLI).

In Poland, all forms of legionellosis are obligatory reported: Legionella pneumonia and extrapulmonary legionellosis (such as Pontiac fever). Total 210 cases caused by Legionella sp. were reported in years 2003-2010. In our study analysis of age, sex, place of residence of 163 patients with legionellosis reported in 2005-2009 were done. The majority (74.2%) cases were reported in Region Mazowieckie. Age and sex structure of patients in Poland in years 2005-2009 differ from the data of EWGLI. In Poland, legionellosis was much more frequently reported in children - 46.6% of the total reported, than in other countries. It might be a result of collaboration with the paediatricians during research conducted by our team in 2005-2007. Reported cases of legionellosis were also observed in 10 children aged < or = 2 years. Totally, legionellosis was observed more frequently among girls than in boys (M: F = 1:1,71), and in males (M: F = 1,64:1). It was also found that in smaller towns (< 100 thousand inhabitants) legionellosis was much more frequently diagnosed in girls (Po = 0.0152, 71.1% of ill children) and men (65.8% of adults). In larger cities (> 100 thousand.) differences in incidence between girls and boys and men and women were lower. To sum up: the number of reported cases of legionellosis depends largely on the availability of laboratory tests and the knowledge of physicians. Extension of diagnostic testing in the direction of Legionnaires' disease patients belonging to other than the high risk group increased number of detected cases, including those not so severe.

[Legionellosis in Poland in 2009]. / Legioneloza w Polsce w 2009 roku.

In 2009--10 cases of legionellosis were reported in Poland, the incidence rate was 0.026/100 000 (in 2008--15 cases, incidence rate 0.039). All cases were laboratory confirmed. Most of them were diagnosed with serological tests--determination with ELISA test the anti-legionella antibodies in IgM fraction of serum gamma globulins, as the most recent reaction for Legionella infection. Four cases were diagnosed by detection of legionella antigen in urine. In 2005-2009 27 cases were associated with tr avel, including 24 imported cases.

[Dysentery and amoebiasis in Poland in 2009]. / Czerwonka bakteryjna i pelzakowa w Polsce w 2009 roku.

Only 30 cases were notified (incidence rate 0.08/100 000 population) in the year 2009, while the 33 cases were notified in 2008 (incidence rate 0.09/100 000), and median in the 2003-2007 years was 74 cases, incidence rate 0.19/100 000 population. Since 2000 no one-death case was notified. In the period of low frequency of Shigella infections, the external quality assessment control of the quality of bacteriological media, laboratory and prae-laboratory procedures for detection of different Shigella groups and types should be executed. In 2009 no one amoebiasis case was notified.

[Legionellosis in Poland in 2008]. / Legioneloza w Polsce w 2008 roku.

In 2008 the 15 cases of legionellosis were reported in Poland, the incidence rate was 0.039/100 000, while 28 (incidence rate 0.073/100 0000 in 2007 and 86 cases (incidence rate 0.23/100 000) in 2006. The decrease in number and in incidence rate was due to lower number of examined specimens from patients as the financial support from Polish Committee of Research Activity has expired. All the cases were laboratory diagnosed in National Institute of Hygiene, the only place where laboratory tests are performed. Most of them were diagnosed with serological tests -determination with ELISA test the anti-legionella antibodies in IgM fraction of serum gamma globulins, as the most recent reaction for Legionella infection. Only few cases were diagnosed by detection of legionella antigen in urine. All BAL specimens from several patients were negative when examined with culture method, but some were positive with PCR only. No outbreaks were registered: In 2005-2008 the 22 cases were connected with travel: 19 - foreign travel cases, 3 in Poland. Since 1987 to 2007 the 17 foreign tourists were registered in EU countries as probably infected in Poland.

[Dysentery and amoebiasis in Poland in 2008]. / Czerwonka bakteryjna i pelzakowa w Polsce w 2008 roku.

The number as well as incidence rate of notified as shigellosis, bacillary dysentery cases in XXI century are every year lower. Only 33 cases were notified in the year 2008 (incidence rate 0.09/100 000 population), while the 64 cases were notified in 2007 (incidence rate 0.17/100 000), but 35 (incidence rate 0.09) were notified in 2006 and median in the 2002-2006 years was 75 cases, incidence rate 0.2/100 000 population. Since 2000 no one-death case was notified. Several imported cases were notified as they got infection being abroad, polish citizens on holiday abroad, and foreign children coming for vacations in Poland from countries with higher incidence rate for ex. from Ukraine. Out of 11 imported cases three were due to Shigella sp., eight to S. sonnei. Two persons were found infected by S. boydii 8-11 but no one of S. dysentery. In the period of low frequency of Shigella infections, the external quality assessment control of the quality of bacteriological media, laboratory and prae-laboratory procedures for detection of different Shigella groups and types should be executed. A lower number of amoebic dysentery cases were registered 5 cases in 2008 (incidence rate 0.013/100 000 population), but in 2007: the 19 cases, incidence rate 0.05/100 000, and even more in 2006 the 21 cases, incidence rate 0.055/100 000. The cases were registered in 3 voivodeships; infection was probably imported from underdeveloped countries.