Influenza in Poland in 2013 and 2013/2014 epidemic season

OBJECTIVE: Analysis of epidemiological situation of influenza in Poland in 2013 and 2013/14 epidemic season in reference to previous years and seasons. MATERIAL AND METHODS: Analysis was based on: 1) data collected within influenza routine surveillance system in Poland, including data published in annual bulletins "Infectious diseases and poisonings in Poland" as well as unpublished data gathered in the Department of Epidemiology of the NIPH-NIH; 2) data collected within influenza system - Sentinel, and beyond this system, concerning results of virological tests carried out in 2013/14 epidemic season in the Department of Influenza Research, National Influenza Center in the NIPHNIH and/or laboratories of provincial sanitary and epidemiological stations which are gathered in the National Influenza Center. RESULTS: Compared to 2012, the number of influenza and influenza-like cases increased more than twofold in 2013 in Poland. A total of 3 164 405 cases were reported. Incidence was 8 218.7 per 100,000 population (33 733.2 in 0-4 age group). As many as 0.45% of patients were referred to hospitals. According to the data of the Central Statistical Office, 115 deaths due to influenza were notified. Based on the data of the sanitary inspection (incomplete data), the percentage of population vaccinated against influenza was 2.4% (7.7% of persons aged more than 64 years). A total of 2 780 945 cases were registered in 2013/14 epidemic season. Its peak was reported in March 2014. Incidence was 7 224.0 per 100,000 population (35 172.8 in 0-4 age group). Compared to 2012/13 epidemic season, it was lower by 8.0%. Incidence rates ranged from 29 339.6 in pomorskie voivodeship to 1 306.5 in lubuskie voivodeship. Nearly a half of all cases (48.7%) were registered in children and adolescents up to 15 years. As many as 0.34% of patients were referred to hospitals (0.87% of persons aged more than 64 years). From the data of the Central Statistical Office transpires that 8 deaths due to influenza were reported in epidemic season. Type A influenza subtype H3N2 predominated in all influenza cases. Human respiratory syncytial virus (RSV) was the dominant agent in other viral infections of respiratory tract. Antigenic analysis of influenza strains showed their affinity with vaccine strains of the vaccine recommended for this epidemic season. CONCLUSIONS: In spite of slow improvements, influenza and influenza-like surveillance system in Poland is still not homogeneous and stable enough. It hinders the assessment of current epidemiological situation. For instance, there are difficulties in determining what is the effect of modifications in the surveillance on the increase in the number of influenza and influenza-like cases observed in Poland in recent years. A low percentage of population vaccinated against influenza (with a decreasing trend beginning from 2005) suggests a necessity of revising the methods of promotion and organization of these vaccines used so far. One of the public health priorities should be to increase the percentage of vaccinated population up to the average level in EU countries.

Scarlet fever in Poland in 2013.

OBJECTIVE: Assessment of the epidemiological situation of scarlet fever in Poland in 2013 in comparison with previous years. MATERIALS AND MATHODS. The evaluation was performed by reviewing surveillance data published in the bulletin, "Infectious diseases and poisonings in Poland in 2013" (Warsaw 2014, NIPH-NIH, CSI) and also in bulletins from previous years, and unpublished data collected under Statistical survey program of official statistics. RESULTS: In 2013 did not change the general view of the epidemiological situation of scarlet fever in Poland. Analysed data did not indicate the possibility of shortening an epidemic cycle of scarlet fever, nor suggest growing rate of epidemic curve or increase of average annual incidence which was observed in last twenty years. In 2013, in the country a total of 25 115 cases were registered with corresponding incidence 65.2 per 100,000 population (in voivodeships: from 22.9 in Lódzkie to 111.1 in Pomorskie). The highest incidence was notified in 5-year-old (949.2) and 4-year-old children (916.6), and the cases among children and young people up to 15 years accounted for 87.0% of all cases. The incidence among men (78.8) was higher over 50% than incidence among women (52.5). The incidence was higher in urban areas than in rural areas and was 68.7 (in rural area 59.9). 1.04% of patients were hospitalized. No deaths related to this disease were reported. SUMMARY: A sudden increasing incidence among men, especially in the 15-19 age group and growing proportion of cases among adults in comparison to the notified in previous years, according to authors' opinion, can be associated with compensatory epidemic of rubella (!). It is estimated, that about 10% scarlet fever cases reported to surveillance in a year are misclassified and could be unrecognized cases of rubella. Therefore, it is important to enhance specificity of epidemiological surveillance of scarlet fever. Additionally, it will give a better opportunity to monitor and supervise measles and rubella elimination program.

Influenza in Poland in 2011-2012 and in 2011/2012 and 2012/2013 epidemic seasons.

UNLABELLED: This paper aimed at evaluating the epidemiological situation of influenza in Poland in 2011-2012 and in 2011/2012 and 2012/2013 epidemic seasons and comparing it with the situation observed in the previous years. MATERIAL AND METHODS: An analysis was mainly based on three sources of data: (1) bulletins "Infectious diseases and poisonings in Poland in 2012" and "Vaccinations in Poland in 2012" (NIPH-NIH, CSI. Warsaw 2013) and analogically former bulletins, (2) "Reports on influenza cases and persons suspected of influenza", sent in 2013 and previous years to the Department of Epidemiology, NIPH-NIH by the Voivodeship Sanitary- Epidemiological Stations, (3) data of the Department of Influenza Research, National Influenza Centre, NIPH- NIH - results of virological testing performed in 2011/2012 and 2012/2013 epidemic seasons in the National Influenza Centre and/or laboratories of the Voivodeship Sanitary-Epidemiological Stations (VSES) within influenza surveillance - Sentinel as well as beyond this system. Data on influenza cases come from aggregated notifications which are sent obligatorily to the VSES by all health care units and physician practices. Influenza, influenza-like illness and acute respiratory infections, i.e. cases meeting the criteria recommended in influenza surveillance in the European Union are subject to mandatory notification. RESULTS: In 2011-2012, there was an increase in the number of influenza and influenza-like illness cases in Poland compared to 2010, i.e. 2- and 2,5-fold, respectively. In 2011, a total of 1 156 357 cases were reported and incidence amounted to 3 001.5 per 100,000 population (11 014.5 in age group 0-4 years). As many as 0.51% of infected persons were referred to hospital. According to the CSO data, 95 fatal cases of influenza were notified. Influenza vaccination coverage was 2.8%. In 2012, 1 460 037 cases were registered and incidence was 3 789.0 (17 807,1 in age group 0-4 years). A total of 0.33% of influenza cases were referred to hospital. As many as 4 deaths due to influenza were reported. Percentage of population vaccinated against influenza amounted to 2.3%. In 2011/12 epidemic season, 1 085 471 cases were noted and incidence was 2 816.6 per 100,000 population (12 792.3 in age group 0-4 years) while in 2012/13 epidemic season its number was nearly 3-fold higher, i.e. 3 025 258 cases and incidence - 7 851.0 (30 591.7 in age group 0-4 years). In both epidemic seasons, type A influenza subtype H1N1 and human respiratory syncytial virus (RSV) predominated in infections with influenza virus and other viral respiratory infections, respectively. Antigenic analysis of influenza strains showed their affinity with vaccine strains of the vaccines recommended for these epidemic seasons. SUMMARY: An increase in the number of notified cases of influenza and influenza-like illness, which is recently observed in Poland, is significantly affected by the improving quality (especially sensitivity) of surveillance system, commenced in the 2009 influenza pandemic. This surveillance system, however, is still not sufficiently uniform and stable. Low percentage of population vaccinated against influenza suggests the ineffectiveness of influenza vaccine promotion campaigns conducted so far. An increase in the influenza vaccination coverage to the average observed in the EU countries should be one of the priorities for the sanitary-epidemiological stations.

Scarlet fever in Poland in 2012.

OBJECTIVE: Assessment of the epidemiological situation of scarlet fever in Poland in 2012. MATERIALS AND METHODS: The evaluation was performed by analysing surveillance data published in the bulletin, "Infectious diseases and poisonings in Poland in 2012" (Warsaw 2013, NIPH-NIH, CSI) and also in bulletins from previous years, and unpublished data collected under Statistical survey program of official statistics. RESULTS: In the last 15-20 years in Poland has been observed more than 2-fold lengthening of scarlet fever epidemic cycle, slowdown in the decline and slower growth rate in epidemic curve and decrease in average annual incidence. In 2012, in the country a total of 25 421 cases were registered and incidence was 66.0 per 100 000 population (in voivodeships: from 25.8 in lódzkie to 114.2 in pomorskie). The highest incidence was notified in 5-year-old (1094.7) and 6-year-old children (877.3), however, the incidence among children and young people up to 15 years accounted for 95.6% of all cases. The incidence of men (74.8) was higher by almost 30% than the incidence of women (57.6). The incidence was higher in urban areas than in rural areas and was 72.7 (in rural area 55.7). 0.9% of patients were hospitalized. No deaths related to the disease were reported. SUMMARY: Distinct changes in the epidemiological situation of scarlet fever in recent decades are related to, i.a., aging of the Polish population and decline in the number of children, group particularly vulnerable to infection. In order to improve accuracy of surveillance data, it is recommended significantly increase percentage of cases in which clinical diagnosis will be confirmed by the result of bacteriological examination.

Scarlet fever in Poland in 2011.

OBJECTIVE: Assessment of the epidemiological situation of scarlet fever in Poland in 2011 MATERIALS AND MATHODS: The evaluation was performed by analysing the data published in the bulletin, "Infectious diseases and poisonings in Poland in 2011" (Warsaw 2012, NIPH-NIH, CSI) and also in bulletins from previous years. RESULTS: Since 2004 in Poland has been observed epidemic increase in the number of scarlet fever cases. However, the growth rate is significantly slower and incidence is considerably lower than in previous epidemic periods. In 2011, in the country a total of 18 267 cases were registered and incidence was 47.4 per 100,000 population (in provinces: from 23.4 in Lódzkie to 68.0 in Slaskie). The highest incidence was notified in 5-year-old and 6-year-old children (782.4), whereas the incidence of children and young people up to 15 years accounted for 96.9% of all cases. The incidence of men 53.7 by almost 30% was higher than the incidence of women (41.6). The incidence was higher in urban areas than in rural areas and was 53.3 (in rural area 38.3). 1.1% of patients were hospitalized. No deaths were reported. SUMMARY: An impact on the epidemiological situation of scarlet fever in Poland in the last two decades have i.a. demographic changes--decline in the population of children, i.e. in group which is particularly vulnerable to infection. In order to raising the reliability of surveillance data, it is recommended a prominent heightening of the percentage of cases which clinical diagnosis would be confirmed by the result of bacteriological examination.

Costs of Medically Attended Acute Gastrointestinal Infections: The Polish Prospective Healthcare Utilization Survey.

OBJECTIVES: The burden of acute gastrointestinal infections (AGIs) on the society has not been well studied in Central European countries, which prevents the implementation of effective, targeted public health interventions. METHODS: We investigated patients of 11 randomly selected general practices and 8 hospital units. Each patient meeting the international AGI case definition criteria was interviewed on costs incurred related to the use of health care resources. Follow-up interview with consenting patients was conducted 2 to 4 weeks after the general practitioner (GP) visit or discharge from hospital, collecting information on self-medication costs and indirect costs. Costs were recalculated to US dollars by using the purchasing power parity exchange rate for Poland. RESULTS: Weighting the inpatient costs by age-specific probability of hospital referral by GPs, the societal cost of a medically attended AGI case was estimated to be US $168. The main cost drivers of direct medical costs were cost of hospital bed days (US $28), cost of outpatient pharmacotherapy (US $20), and cost of GP consultation (US $10). Patients covered only the cost of outpatient pharmacotherapy. Considering the AGI population GP consultation rate, the age-adjusted societal cost of medically attended AGI episodes was estimated at US $2222 million, of which 53% was attributable to indirect costs. CONCLUSIONS: Even though AGIs generate a low cost for individuals, they place a high burden on the society, attributed mostly to indirect costs. Higher resources could be allocated to the prevention and control of AGIs.

[Scarlet fever in Poland in 2010]. / Plonica w Polsce w 2010 roku.

OBJECTIVE: Assessing the epidemiological situation of scarlet fever in Poland in 2010. MATERIALS AND METHODS: The analysis was based mainly on data published in the bulletin, "Infectious diseases and poisonings in Poland in 2010" (Warsaw 2011, NIPH-NIH , CSI). RESULTS: Since 2004, Poland is observed epidemic growth in the number of scarlet fever cases. However, incidence level is much lower than in previous epidemic periods. There were 13,940 cases registered in 2010 in total and the incidence was 36.5 per 100,000 population ranging from 18.1 in lódzkie voivodeship to 47.5 in mazowieckie voivodeship. Cases among children and adolescents of less than 15 years of age accounted for 97.0% of all cases. The highest incidence was observed among 4 years old children (603.1) and 5 years old children (624.9). Incidence in men (41.8) markedly exceeded the incidence in women (31.6) and incidence in urban areas (41.3) and in rural areas (29.0). Approximately 1.2% of all cases were hospitalized. Due to scarlet fever there were no deaths in Poland in 2010. SUMMARY: Favourable epidemiological situation of scarlet fever in Poland is largely a result of demographic changes--reducing the involvement of children in society. In terms of disease prevention and control is necessary to increase the proportion of cases in which clinical diagnosis is confirmed by the result of bacteriological tests.

[Influenza in Poland in 2010]. / Grypa w Polsce w 2010 roku.

UNLABELLED: THE PURPOSE OF STUDY: To assess the epidemiological situation of influenza and influenza like illnesses in Poland in 2010 compared to the situation in 2009. MATERIALS AND METHODS: We analyzed the data involved in the annual bulletins, among others. "Infectious diseases and poisonings in Poland in 2010" and "Vaccinations in Poland in 2010" issued by the Department of Epidemiology, National Institute of Public Health-National Institute of Hygiene and Chief Sanitary Inspectorate, Department of Prevention and Control of Infections and Infectious Diseases in Humans, reports of incidence of confirmed and suspected cases of influenza, sent to the Department ofEpidemiology, NIPH-NIH by the Provincial Sanitary-Epidemiological Stations. Information about the results of virological samples from patients that were performed at the Virus Research Institute, National Centre for Influenza NIPH - NIH and data on deaths of Demographic Surveys Division of the Central Statistical Office (GUS). RESULTS: Virological test results showed that among circulating influenza viruses in the population is dominant subtype is A/H1N1/pdm 09, and the flu-like virus, RSV, as compared to 2009, the share of the influenza virus type B incerased. Overall, recorded 551,054 cases of influenza-ATM 1443,0 per 100 thousand people was twice lower than in 2009, the reduction in the number of cases in each province was in the range from 3.1% to 95.3%. Incidence of influenza aged 0-14 years decreased by 38.7%. In 2010 vaccinated against influenza in Poland 1,168,432 people. CONCLUSIONS: The epidemiological situation of influenza in Poland in 2010. was typical for increased incidence post pandemic the year. It is necessary to improve the epidemiological surveillance of influenza, at least to the level of 2009 should increase the percentage of people vaccinated against influenza to the level achieved in other European countries.

[Influenza in Poland in 2009]. / Grypa w Polsce w 2009 roku.

A total number of 1,081,974 cases of influenza and influenza-like illness were registered in Poland in 2009 (incidence 2,835.9 per 100,000 population). It was nearly 5 times more than in 2008. The impact on increase of the number of reported cases have had two factors: the pandemic of influenza caused by virus A(H1N1)v, and increasing of the surveillance sensitivity. 3,177 (0.29%) cases was laboratory confirmed. In the area of particular regions incidence ranged from 805.2 in swietokrzyskie voivodeship to 5,257.9 in warmifisko-mazurskie voivodeship. Nearly 37% of cases were children under 15 years. The incidence in this age group was 6,851.2 (from 2,010.1 in Swietokrzyskie voivodeship, to 13,291.6 in warminsko-mazurskie voivodeship). The highest reported incidence was observed in age group 5-14 years (7,135.2). To hospitals, mainly for epidemiological reasons, 8,944 people were sent (0.83% all cases). According to Central Statistical Office data, there were 87 death cases, including 8 (9.2%) children in the age of 15. 70.1% of deaths were registered as cases caused by identified influenza virus.

[Scarlet fever in Poland in 2009]. / Plonica w Polsce w 2009 roku.

After the last outbreak of scarlet fever, when the peak was recorded in 1985, now is observed the visible extension of disease epidemic period and the weakness of the dynamics of the annual changes of incidence. In 2009, as in previous years, the scarlet fever incidence in Poland increased. There were 13,968 cases registered in total and the incidence was 36.6 per 100,000 population ranging from 18.4 in podkarpackie voivodeship to 62.1 in opolskie voivodeship. Cases among children and adolescents of less than 15 years of age accounted for 95.3% of all cases. The highest incidence was observed among 4 years old children (566.5) and 6 years old children (564.70). Incidence in men (41.5) markedly exceeded the incidence in women (32.1) and incidence in urban areas (40.5) and in rural areas (30.6). Approximately 1.1% of all cases were hospitalized. Due to scarlet fever there were no deaths in Poland in 2009.

[Influenza in Poland in 2008]. / Grypa w Polsce w 2008 roku.

A total number of 227,346 cases of influenza and influenza-like illness were registered in Poland in 2008 (incidence 596.5 per 100,000 population). Compared to 2007 on 39.2% incidence decrease was observed. Regionally the incidence varied from 142.3 in swietokrzyskie voivodeship to 1,830.6 in opolskie. Children and adolescents under 15 years of age accounted for 36% of all cases (age group incidence 1,415.6). In this age group the incidence varied regionally from 342.9 in swietokrzyskie voivodeship to 4,083.6 in opolskie. The highest reported incidence was observed in age group 0-4 years (1,545.6). 153 patients (0.07% of all cases) required hospital admission. There were 16 deaths due to influenza, of which 11 (68.8%) were among persons over 70 years of age. In the epidemic season 2007/08 infections with influenza virus registered in Poland were caused by type A (60% of laboratory confirmed influenza cases) as well as by type B (40% of laboratory confirmed influenza cases), similarly to other parts of Europe. Forty-four influenza strains were isolated, including 24 strains of subtype A/H1 and 20 strains of type B. All of them were antigenically similar to the vaccine strains recommended for the epidemic season 2007/2008.

[HIV and AIDS in Poland in 2008]. / Zakazenia HIV i zachorowania na AIDS w Polsce w 2008 roku.

In 2008 in total 808 newly detected HIV cases were registered in Poland (2,12 per 100,000 population), constituting 12.5% increase comparing to 2007 and 27.8% increase comparing to median number in 2001 - 2006. The total number of incident AIDS cases diagnosed in 2008 and registered up to the end of 2009 was 159 (incidence 0.42 per 100,000 population). There were 67 death of AIDS patients in 2008 registered up to the end of 2009. Among the newly diagnosed HIV cases as compared to 2007 an increase of the share of infections acquired through homosexual contact between men (up to 6.06% of all cases and 31% of cases with known transmission route) and heterosexual contact were observed, which most likely reflects significant changes in HIV epidemiology in Poland where the epidemic was for many years injection driven. Across the country HIV infection is the most frequently detected among young people (30 - 39 years) and among males (74%). In comparison to the year 2007, the number of reports without information about the possible route of transmission increased. Furthermore, the percentage of late presenters, as defined by time between HIV and AIDS diagnoses of less than 3 months, is still growing, suggesting low awareness of risk or suboptimal availability of diagnostic tests. The largest group among patients with AIDS are also males and people aged 30 to 39 years. Most of them were probably infected through injecting drugs. Despite the successful implementation of antiretroviral treatment program a significant increase of AIDS incidence was noted. Among incident AIDS cases in 2008, a small percentage had been treated before developing AIDS.

[HIV and AIDS in Poland in 2007]. / Zakazenia HIV i zachorowania na AIDS w Polsce 2007 roku.

In 2007 in total 718 newly detected HIV cases were registered in Poland (1.9 per 100,000 population), a comparable number to 2006. The total number of incident AIDS cases diagnosed in 2007 and registered up to the end of 2008 was 133 (incidence 0.35 per 100,000 population). There were 61 death of AIDS patients in 2007 registered up to the end of 2008. Among the newly diagnosed HIV cases as compared to 2006 a small increase of the share of infections acquired through heterosexual contact was observed (up to 7.8% of all and 38.4% of, which most likely reflects the spread of HIV in the general population in Poland. Across the country HIV infection is the most frequently detected among young people (20-29 years) and among males (77.6%). In comparison to the year 2006, the number of reports without information about the possible route of transmission increased. Furthermore, the percentage of late presenters, as defined by time between HIV and AIDS diagnoses of less than 3 months, is still growing, suggesting low awareness of risk or suboptimal availability of diagnostic tests. The largest group among patients with AIDS are also males and people aged 30 to 39 years. Most of them were probably infected through injecting drugs. Despite the successful implementation of antiretroviral treatment program a significant increase of AIDS incidence was noted. Among incident AIDS cases in 2007, a small percentage had been treated before developing AIDS.

[Ecologic study of the risk of tick-borne encephalitis in Poland--presentation of the method]. / Badania ekologiczne ryzyka zachorowan na kleszczowe zapalenie mózgu w polsce --omówienie metody.

Currently an ecologic study assessing the relationship between tick-borne encephalitis (TBE) with diverse environmental and social factors at the lowest administrative level is developed for Poland. Because the disease is affecting only part of the country, the authors will try to identify factors which could explain this uneven geographic distribution of the disease. To increase precision of the analysis we will utilize the highest possible resolution of the analysis, for which routinely collected data are available. Part of the data at the commune level will be obtained from the Polish communicable disease surveillance system and the Central Statistical Office, and part will be obtained using GIS tools from maps prepared by diverse institutions. The outcome studied will be TBE cases assigned to commune of residence or to place of exposure. The explanatory variables will be: land use categories (percent of commune area and their border length), meteorological variables (temperatures, rainfall), socio-economic status of communes (income per capita, unemployment rate), and Lyme borreliosis incidence (as a complex indicator of tick activity and human to tick exposure).

[Prodromal symptoms of schizophrenics syndrome in children and adolescent]. / Objawy prodromalne zespolów schizofrenicznych u dzieci i mlodziezy.

This presentation concentrates on modality and frequency analysis of prodromal schizophrenic symptoms of the children and adolescent. A sample (n-50) of children between 8 and 19 years was tested by structural interview. There were observed the signs resembling following symptoms: negative symptoms (74%), anxiety disorders (42%) and obsessive-compulsive disorders (20%).