Associations of Relative Humidity and Lifestyles with Metabolic Syndrome among the Ecuadorian Adult Population: Ecuador National Health and Nutrition Survey (ENSANUT-ECU) 2012

The effects of the physical environment on metabolic syndrome (MetS) are still largely unexplained. This study aimed to analyze the associations of relative humidity of residence, lifestyles, and MetS among Ecuadorian adults. Data from 6024 people aged 20 to 60 years were obtained from an Ecuador national population-based health and nutrition survey (i.e., ENSANUT-ECU, 2012) and the mean annual relative humidity (%) from the Ecuador National Institute for Meteorology and Hydrology (2012). Odds ratio (OR) with 95% confidence intervals (CI) for MetS according to groups of relative humidity were calculated using multiple logistic regression. Living in high relative humidity (>80%) increased ORs of reduced high-density lipoprotein (HDL) cholesterol (1.25; 95 % CI, 1.06–1.56) and MetS (OR = 1.20; 95 % CI,1.01–1.42) in women. Furthermore, physically active men living in high relative humidity showed lower OR of elevated triglycerides (0.56; 95 % CI,0.37–0.85) while menopausal women living in high relative humidity showed increased ORs of MetS (5.42; 95 % CI, 1.92–15.27), elevated blood pressure (3.10; 95 % CI, 1.15–8.35), and increased waist circumference (OR = 1.34; 95 % CI, 1.09–1.63). Our results show that residence in high relative humidity and menopausal status increase ORs of MetS and its components in Ecuadorian women; however, physical activity significantly reduces the OR of elevated triglycerides in men. The obtained findings may help make public health policies regarding environmental humidity management, nutritional education, menopausal care, and physical activity promotion to prevent the onset of MetS among Ecuadorian adults.

Aspects of Illness and Death among Roma-Have They Changed after More than Two Hundred Years?

Augustini studied Roma and published reports in 1775–1776 on their illnesses and death. Our intention was to compare the features of these two topics described by him in the late 18th century with those in the present time. We studied Augustini’s work on illnesses and death in the past. The present qualitative study was conducted in 2012–2013 in the same geographical area in which Augustini lived and worked more than two hundred years ago, i.e., the Tatra Region in Slovakia; our findings were evaluated in 2017–2018. We carried out semi-structured interviews with more than 70 informants and organised two sessions of focus groups. Data were analysed using content analysis (Augustini) and an open coding process. Our findings suggest that illnesses in Roma are treated differently nowadays compared with 1775–1776. For example, the traditional forms of healing have completely disappeared in the area of investigation. We did not observe any differences in dying and death perceptions between the past and nowadays. Although data and knowledge on health disparities and related mechanisms exist, and much more about perceptions of Roma regarding illnesses is now known compared with 1775–1776, so far, this knowledge has not helped to design effective interventions to overcome them. Substandard living conditions in marginalised Roma communities have not significantly improved since 1775–1776, which may contribute to their higher morbidity and mortality also nowadays. Political and social consensus should lead to a comprehensive vision for enhancing the social situation and living conditions in segregated settlements, especially providing housing for the poorest classes and overcoming health disparities.

The second nationwide surveillance of the antimicrobial susceptibility of Neisseria gonorrhoeae from male urethritis in Japan, 2012-2013

Worldwide, the most important concern in the treatment of sexually transmitted infections is the increase in antimicrobial resistant Neisseria gonorrhoeae strains including resistance to cephalosporins, penicillins, fluoroquinolones or macrolides. To investigate the trends of antimicrobial susceptibility among N. gonorrhoeae strains isolated from male patients with urethritis, a Japanese surveillance committee conducted the second nationwide surveillance study. Urethral discharge was collected from male patients with urethritis at 26 medical facilities from March 2012 to January 2013. Of the 151 specimens, 103 N. gonorrhoeae strains were tested for susceptibility to 20 antimicrobial agents. None of the strains was resistant to ceftriaxone, but the minimum inhibitory concentration (MIC) 90% of ceftriaxone increased to 0.125 μg/ml, and 11 (10.7%) strains were considered less susceptible with an MIC of 0.125 μg/ml. There were 11 strains resistant to cefixime, and the MICs of these strains were 0.5 μg/ml. The distributions of the MICs of fluoroquinolones, such as ciprofloxacin, levofloxacin and tosufloxacin, were bimodal. Sitafloxacin, a fluoroquinolone, showed strong activity against all strains, including strains resistant to other three fluoroquinolones, such as ciprofloxacin, levofloxacin and tosufloxacin. The azithromycin MICs in 2 strains were 1 μg/ml.

Meningitis and encephalitis in Poland in 2012

AIM OF THE STUDY

The aim of this study was to assess the epidemiology of meningitis and/or encephalitis in Poland in 2012.

INTRODUCTION

About 2 500-3 000 cases of meningitis and/or encephalitis of viral or bacterial etiology are recorded in Poland every year.

MATERIALS AND METHODS

Assessment of the epidemiological situation of meningitis and/or encephalitis in Poland in 2012, was based on the results of analysis of epidemiological reports sent to the NIZP-PZH by the Regional Sanitary-Epidemiological Stations published in the annual bulletin "Infectious diseases and poisonings in Poland in 2012" and "Preventive immunizations in Poland in 2012" (Czarkowski MP. et al., Warsaw, 2013, NIZP-PZH, GIS).

RESULTS

In 2012 in Poland 3 088 cases of meningitis and/or encephalitis were recorded. More than 50% of these were viral infections.

SUMMARY AND CONCLUSIONS

The epidemiological situation of inflammatory meningitis and encephalitis in Poland in 2012 compared to 2011 did not change significantly.

Hepatitis B in Poland in 2012

OBJECTIVES

Evaluation of the epidemiological situation of hepatitis B in Poland in 2012 in comparison with previous years.

MATERIAL AND METHODS

The evaluation was based on the results of analysis of individual case reports of acute hepatitis B recorded by the Sanitary-Epidemiological Stations and aggregate data of national surveillance published in annual bulletins "Infectious diseases and poisonings in Poland" for the years 2006-2012.

RESULTS

In Poland, in 2012 a total of 1 583 cases of hepatitis B were reported, including 33 cases of dualinfection with hepatitis B virus (HBV) and hepatitis C virus (HCV). The incidence was 4.11 per 100 000 inhabitants and compared to the preceding year its value did not change. The acute cases accounted for 4.9% of all hepatitis B cases, the incidence - 0.20 per 100 000 population. Compared to 2011, there was a further decline in both incidence and share of acute stage of infection in the total number of cases. The highest incidence of acute and chronic form of hepatitis B was reported in Opolskie (0.49 per 100 000) and Łódzkie provinces (8.62 per 100 thousand.), respectively. More frequently men and urban dwellers were ill. In the age group 0-14 years, which was entirely covered by universal vaccination of infants, no acute cases were found while the incidence of chronic hepatitis B in this age group was 0.14 per 100 000. Chronic hepatitis B was most frequently detected in people aged 40-44 years (incidence 7.13 per 100 000) and acute disease - in those aged 45-49 years (incidence 0.46 per 100 000). Medical procedures in healthcare settings were still the predominant route of infection (56% of all acute cases). Infections contracted via sexual contacts, household contact with an infected person and through injection drug use accounted together for 14% of all acute hepatitis B cases. In 2012, 11 and 41 persons died due to acute and chronic stage of hepatitis B, respectively.

CONCLUSIONS

A clear downward trend of the incidence of acute hepatitis B with an unchanged mode of HBV transmission in Poland, indicates an improvement in compliance with recommended infection control procedures at all levels of medical care. The maintenance of the incidence of acute hepatitis B at a low level is possible due to the continuation of an universal vaccination program against HBV in combination with measures that stop the spread of infections. In view of persistent pattern of hepatitis B transmission in Poland in medical settings, it is advisable to recommend immunization not only to individuals at increased risk but also all previously unvaccinated persons. Simultaneously, activities leading to the improvement of detectability and the availability of the recommended treatment of chronic hepatitis B should be strengthened.

Hepatitis C in Poland in 2012

INTRODUCTION

In Poland, an estimated 2 000 HCV infections are reported annually, of which chronic stage of infections predominates (>95%). It is estimated that seroprevalence of anti-HCV and prevalence of active infections in the general population amount to ca 0.95% (more than 320 000 persons) and 0.6% (230 000 persons), respectively. The alarming finding is that approximately 90% of persons diagnosed with HCV infection are unaware of the condition and consequently hepatitis C virus may be transmitted to their contacts.

OBJECTIVE

The objective of the present article is to determine the epidemiology of HCV infections in Poland in 2012 comparing to the preceding years.

MATERIAL AND METHODS

The assessment of epidemiological situation of HCV infections in Poland was based on the analysis of aggregated data from the State Sanitary Inspection, published in "Infectious diseases and poisonings in Poland in 2012" (Czarkowski MP et al. "Infectious diseases and poisonings in Poland in 2012" Warsaw, NIPH-NIH and CSI). The data on mortality due to hepatitis C, which was obtained from the Demographic Surveys and Labour Market Department of Central Statistical Office, were also employed.

RESULTS

In 2012, Poland reported 2 292 HCV infections, meeting 2005 definition (incidence 5.95), of which 1.4% were co-infections with HCV and HBV (33 cases). Compared to the data of 2011, the incidence was slightly lower (2 338; 6.07). Given 2009 definition, a total of 2 265 cases were reported (5.88), which constituted an increase of 3.5% compared to the data from the previous year (2 241; 5.82). Overall, 217 fatal cases due to hepatitis C were reported in 2012, of whom only 9 (4%) were due to acute stage of infection.

CONCLUSIONS

Compared to the data from 2011, the epidemiological situation of hepatitis C in Poland has not changed significantly. The alarming fact is the increasing number of deaths due to hepatitis C. Probably, it suggests delayed diagnosis of HCV infections. Thus, it is a necessity to promote early diagnosis of HCV infections which can prevent life and health-threatening sequelae of hepatitis C.

Tuberculosis in Poland in 2012

AIM OF THE STUDY

To evaluate the main features of TB epidemiology in 2012 in Poland and to compare with the corresponding EU data.

METHODS

Analysis of case- based clinical and demographic data on TB patients from Central TB Register, of data submitted by laboratories on anti-TB drug susceptibility testing results in cases notified in 2012, data from National Institute of Public Health - National Institute of Hygiene on cases of tuberculosis as AIDS-defining disease, from Central Statistical Office on deaths from tuberculosis based on death certificates, data from ECDC report "Tuberculosis Surveillance in Europe, 2014 (situation in 2012).

RESULTS

7 542 TB cases were reported in Poland in 2012. The incidence rate was 19.6 cases per 100 000, with large variability between voivodships from 10.6 to 30.2. The mean annual decrease of TB incidence in 2008-2012 was 2.4%. 6 665 cases had no history of previous treatment; 17.3 per 100 000. The number of all notified pulmonary tuberculosis cases was 7 018; 18.2 per 100 000. The proportion of extrapulmonary tuberculosis among all registered cases was 6.9% (524 cases). In 2012, 36 patients had fibrous-cavernous pulmonary tuberculosis (0.5% of all cases of pulmonary tuberculosis). TB was diagnosed in 95 children (1.3% of all cases, incidence 1.6). The incidence of tuberculosis increased progressively with age to 34.8 among patients 65 years old and older. The mean age of new TB cases was 53.1 years. The incidence among men (27.4) was more than two times higher than among women (12.2). The incidence rate in rural population was lower than in urban; 20.2 vs. 18.6. Bacteriologically confirmed pulmonary cases (4870) constituted 69,4% of all pulmonary TB cases. The number of smear positive pulmonary TB cases was 2 778 (39.6% of all pulmonary cases). In 2012 in the all group of TB patients in Poland there were 276 (3.7%) of homeless and 1 905 (25.3%) of unemployed. There were 48 foreigners registered among all cases of tuberculosis in Poland (0.6%) and 243 cases registered among prisoners (rate 288.0). There were 31 patients with MDR-TB (0.7% of 4659 cases with known anti-TB DST results). TB was initial AIDS indicative disease in 26 cases. There were 640 deaths due to tuberculosis in 2011 (1.7 TB deaths per 100 000). Mortality among males - 2.7 - was four times higher than among females - 0.7.

CONCLUSIONS

CONCLUSIONS. In Poland in 2012 the incidence of tuberculosis was higher than the average in EU countries. The highest incidence rates occurred in older age groups. The incidence in men was more than 2 times higher than in women. The incidence of tuberculosis in children and the percentage of patients with drug-resistant tuberculosis are lower than average in EU and that is favorable for epidemiological situation of tuberculosis in our country.

Foodborne infections and intoxications in Poland in 2012

AIM

The purpose of the study is to assess the epidemiological situation of foodborne infections and intoxications in Poland in 2012.

MATERIALS AND METHODS

The evaluation was based on analysis of information from reports of epidemiological investigations in foodborne outbreaks, 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", 2006-2012. Warsaw, NIPH-NIH and CSI).

RESULTS

In Poland in 2012 there was observed decrease in the number of infections intoxications both of bacterial and viral origin. It was recorded only one case of trichinellosis. There were reported 491 outbreaks of foodborne poisonings or infections included 5 774 people, among them 718 children 1-14 years old. Out of them 1 364 people were hospitalized. Unlike last year, the predominant etiological agent in those outbreaks were zoonotic Salmonella serotypes which caused 38.1% outbreaks and 26.7% outbreak cases. The viruses have caused 27.1% of outbreaks and 36.2% of cases. In 23.8% of outbreaks etiological agent has not been established. Most often the settings of an outbreak was a private household - 236 outbreaks and a hospital (84 outbreaks). As in previous years, the most common vehicle of infection were foods prepared with milk and eggs -11.8% of outbreaks and egg dishes - 9.0%. In 57.6% of oubreaks vehicle of infection has not been established. Among outbreaks reported in 2012, there were 4 which involved more than 100 people. In 163 outbreaks of food items had been tested and in 33% of them the results were positive.

CONCLUSIONS

The increasing negative results of bacteriological examinations of food items, suggested necessity to start testing food contamination with viruses.

Echinococcosis and cysticercosis in Poland in 2012

AIM

The aim of the study was to assess the epidemiological situation of echinococcosis and cysticercosis in 2012 as compared to previous years.

MATERIALS AND METHODS

The assessment of the epidemiological situation was based on data contained in the individual reports on cases sent to the Department of Epidemiology NIPH-NIH by the Regional Sanitary- Epidemiological Stations and on the pooled data published in the annual bulletin "Infectious diseases and poisonings in Poland".

RESULTS

In 2012, the total number of reported cases of echinococcosis in Poland was 28. This included: 11 undefined cases (39% of all cases), 7 alveolar echinococcosis cases (41% out of l7 cases in which the species of Echinococcus was recognized) and 10 cystic echinococcosis (59% of all defined cases). The total incidence of echinococcosis was 0.073/100 000. Cases were registered in 8 provinces. Most cases (9) and the highest incidence (0.620) was recorded in Warmińsko-Mazurskie. Echinococcus infections were reported in people aged 15 to 82 years, mostly adults (mean age 49.2 years, median 54.0). Echinococcosis was more frequent among women (incidence 0.096) than among men (incidence 0.048). The incidence of echinococcosis in rural areas was higher than in the city (0.125 vs. 0.039). Cysticercosis, which occurs sporadically in Poland, was not reported in 2012.

CONCLUSIONS

For the purposes of epidemiological surveillance it would be advisable to introduce the obligatory differentiation of alveococcosis and hydatidosis, as well as a case definition for cysticercosis. In order to reduce the risk of contracting tapeworm infections, it is advisable to intensify educational efforts.

HIV and AIDS in Poland in 2012

INTRODUCTION AND AIM

From 1985 until the end of 2013, 17 565 cases of HIV infection, 3 062 AIDS cases and 1 246 deaths due to AIDS were registered in Poland. In this paper we aim to analyze the epidemiological situation of newly diagnosed HIV infections and AIDS cases in Poland in 2012.

MATERIALS AND METHODS

Descriptive analysis of newly detected HIV cases and incident AIDS cases was performed based on routine notifications by clinicians and laboratories. Data on the number of HIV tests from annual survey among laboratories were also used.

RESULTS

In 2012 there were 1 093 HIV cases diagnosed in Poland (detection rate 2.84 per 100 000 population), including 27 non-Polish citizens. The detection rate remained comparable to 2011, but approximately 30% higher than in 2006-2010. The total number of AIDS cases was 155 (incidence 0.40 per 100 000) and 57 AIDS patients died (0.15 per 100 000). HIV infection is mainly detected among people aged 20-39 years (72.6%) and males (83.5%). As many as 70% of newly diagnosed infections with known route of transmission occurred among men who have sex with men (MSM). The number of infections in this group increased by 9% from 2011 and over 3 times compared to 2006-2010 average. The percentage of late presenters (defined by the time between HIV and AIDS diagnoses of less than 3 months) decreased in comparison with 2011 (7.9% of newly diagnosed HIV infections).

CONCLUSIONS

HIV epidemic is still spreading among MSM in Poland. However, assessment of epidemiological situation is limited by the lack of data on the probable transmission route in a large percentage of reports of newly diagnosed HIV cases.

Chickenpox in Poland in 2012

BACKGROUND

A number of chickenpox cases, occurring especially in children, indicates the rationale for the use of chickenpox vaccinations. In Poland since 2002, chickenpox vaccination is included in the National Immunisation Programme as recommended.

AIM

To assess epidemiological situation of chickenpox in Poland in 2012 in comparison to previous years.

METHODS

The descriptive analysis was based on data retrieved from routine mandatory surveillance system and published in the annual bulletins "Infectious diseases and poisonings in Poland in 2012" and "Vaccinations in Poland in 2012" (Czarkowski MP i in., Warszawa 2013, NIZP-PZH i GIS). National Immunisation Programme for year 2012 was also used.

RESULTS

In 2012, 208 276 cases of chickenpox were registered in Poland. The highest number of cases was reported in Śląskie voivodeship, the lowest in Podlaskie voivodeship. Mumps incidence was 540.5 per 100 000 and was higher than in 2011 (448.7). The highest incidence was recorded in children aged 4 years (7 611.5 per 100 000). The chickenpox incidence among men (570.7) was higher than among women (512.2). The incidence among rural residents (553.9) was higher than among urban residents (531.8). Number of cases hospitalized due to mumps was 1 361. Number of people vaccinated against chickenpox was 56 213.

SUMMARY

In 2012, there was an increase in the incidence of smallpox in Poland. This trend is continuing since 2004, which can be partly explained by improved surveillance of the disease.

Yersiniosis in Poland in 2012

AIM

The aim of this study is to assess the epidemiology of yersiniosis in Poland in 2012 compared to previous years.

MATERIAL AND METHODS

We reviewed surveillance data published in the annual bulletin "Infectious diseases and poisonings in Poland" from 2007 to 2012 (MP Czarkowski et al., NIH and GIS) and individual yersiniosis case reports from 2012 sent by the Sanitary-Epidemiological Stations. Additionally, we used data from the Department of Demographic Surveys in Central Statistical Office.

RESULTS

In Poland in 2012 a total of 231 yersiniosis cases were reported including 201 cases of intestinal and 30 cases of extraintestinal yersiniosis; 61.9% of patients were hospitalized. The incidence rate was 0.6 per 100 000 inhabitants. No deaths related to the disease were reported. Intestinal yersiniosis was manifested mostly by following symptoms: diarrhoea (87%), fever (76%), abdominal pain (47%) and vomiting (31%). The most affected group in intestinal infections were children younger than 4 years - 145 cases (72% of all cases). Extraintestinal form of infection was more common than in 2011 (19 cases) and usually involved symptoms from the osteoarticular system, noted in 90% of patients. Similarly to the previous year (2011) most cases of yersiniosis were reported from Mazowieckie province (103), no case has been reported from Świętokrzyskie province. Serological types of Yersinia enterocolitica were identified in 120 cases (52%): serotype O3 (96.7%), O8 (2.5%) and O9 (<1%). There were two household outbreaks. In comparison to previous years the total number of cases caused by serotype O8 has significantly decreased - from 55 cases in 2011 to 3 cases in 2012.

CONCLUSIONS

A large percentage (48%) of unknown Yersinia serotypes is a consequence, that physicians do not always request serotyping in routine diagnostics. Reporting cases of extraintestinal yersiniosis from only few provinces may suggest that the real number of infections remains underreported.

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.

Campylobacteriosis in Poland in 2012

AIM

The aim of this paper is to evaluate epidemiological situation of campylobacteriosis in Poland in 2012, compared to the situation in previous years.

MATERIALS AND METHODS

The evaluation was based on analysis of data from the annual bulletin "Infectious diseases and poisonings in Poland" 2011-2012 (MP Czarkowski et al., NIZP-PZH and Chief Sanitary Inspectorate-GIS), information from the forms of individual cases reports from the epidemiological investigations in outbreaks of campylobacteriosis, submitted by the sanitary-epidemiological stations to the Department of Epidemiology and data from the Department of Demographic Studies of the Central Statistical Office. Cases were classified according to a surveillance case definition.

RESULTS

In 2012, 431 cases of campylobacteriosis were registered in Poland, which was 30% more than in 2011. The incidence was 1.12/100 000. All reported cases were classified. No deaths were recorded. More than 84% of cases of campylobacteriosis occurred in four provinces - Warmińsko-Mazurskie (35%), Śląskie (22%), Mazowieckie (14%) and the Malopolskie (14%). The highest incidence was observed in the Warmińsko-Mazurskie- 6.47/100 000. As in previous years, the percentage of hospitalized cases was 57.5%. Campylobacter species was identified in more than 77% of patients, and it was found that 70% of the cases were caused by C. jejuni and about 7% by C. coli. As in previous years, the majority of cases (343, 79%) occurred in the age group 0-4. Five family outbreaks caused by Campylobacter were recorded in 2012.

CONCLUSIONS

In Poland Campylobacteriosis is rarely diagnosed, confirmed and reported. Routine diagnosis of infection with Campylobacter sp. is performed only in the two provinces.

Rubella in Poland in 2012

BACKGROUND

In 2004, Poland has adopted the WHO goal of rubella elimination and congenital rubella syndrome prevention. Participation in the rubella elimination program requires clinical diagnosis of rubella to be confirmed with laboratory test. In Poland, until 2003, national vaccination recommendation included a dose of rubella vaccine only for girls aged 13 years. Among men, the incidence of measles remained high creating a risk of infection of non-immune pregnant women which may lead to the development of congenital rubella syndrome in the child.

AIM

To assess epidemiological situation of rubella in Poland in 2012, including vaccination coverage in Polish population.

METHODS

The descriptive analysis was based on data retrieved from routine mandatory surveillance system and published in the annual bulletins "Infectious diseases and poisonings in Poland in 2012" and "Vaccinations in Poland in 2012".

RESULTS

In 2012, there was a significant increase in the number of cases of rubella - 6 263 cases (in 2011, 4 290 cases) - and the increase in incidence (from 11.1 per 100 thousand. 16.3). The highest incidence rate, regardless of gender and the environment, was observed among adolescents aged 15-19 years (118.0 per 100 000). As in 2011, the incidence of rubella in boys and men was higher than the incidence in girls and women (25.6 versus 7.5). In 2012, no cases of congenital rubella syndrome were registered.

SUMMARY AND CONCLUSIONS

The proportion of laboratory tests confirming/excluding rubella infection is still very low in Poland. In 2012, only 0.2% of rubella cases were laboratory confirmed.

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.

Pertussis in Poland in 2012

INTRODUCTION

The epidemiological situation of pertussis in recent years has changed dramatically. There is a high percentage of cases of pertussis among adolescents and adults. Infected adults can be a source of infection for non-immune individuals such as infants. The best strategy to prevent illness remains the implementation of vaccination in accordance with the applicable calendar.

THE AIM OF THE STUDY

To assess the epidemiological situation of pertussis in Poland in 2012 in comparison to previous years and evaluation of vaccine coverage of children.

MATERIALS AND METHODS

Assessment of the epidemiology of pertussis in Poland was based on analysis of individual reports of suspected cases of pertussis sent to the NIPH-NIH by the Regional Sanitary-Epidemiological Stations, data from the bulletin "Infectious diseases and poisonings in Poland in 2012" and bulletin "Immunizations in Poland in 2012 "(MP Czarkowski et al., Warsaw 2013, NIPH-NIH, GIS).

RESULTS

In 2012, number of registered cases of whooping cough was 4 684. The incidence was 12.2 per 100 000 children which was three times as many as in the previous year (4.3) The majority of cases was among adolescents aged 10-14 years and above 15 years of age (77%). Number of hospitalized persons was 1503, (32%) of reported cases. In 2012, there were no deaths from whooping cough.

SUMMARY AND CONCLUSIONS

Observed in 2012, the epidemic increase in the incidence of pertussis in comparison with previous years, indicates the circulation of bacteria in the environment and the high sensitivity of the population to infection.

Salmonellosis in Poland in 2012

AIM

The purpose of the study was evaluation of epidemiological situation of salmonellosis in Poland in 2012 compared to the previous years.

MATERIALS AND METHODS

The main source of data for this study are statistical overviews contained in the annual bulletins "Infectious Diseases in Poland in 2012" (NIZP-PZH, GIS, Warsaw 2013), reports from investigations obtained from the sanitary epidemiological stations. Information on deaths due to infectious and parasitic diseases registered in Poland in 2012 and earlier years is based on the data from the Department for Demographic Research of Central Statistical Office. For the purpose of surveillance cases were classified according to the case definition.

RESULTS

In Poland in 2012, it was reported a total of 8 444 cases of zoonotic salmonellosis including 8 267 cases of intestinal salmonellosis and 177 of extraintestinal one. The incidence was 21.9/100 000. The criteria for a confirmed case met more than 94% of cases. The number of reported cases was lower than in 2011, reflecting the continued downward trend in the number of cases of salmonellosis in Poland. A very high percentage (69.4%) hospitalizations of people infected with zoonotic Salmonella remains. In outbreaks proportion of hospitalizations accounted for one third of the cases. Predominated children under the age of 5 years. Seven people died of salmonellosis. In 2012, it was reported 181 outbreaks caused by Salmonella in which 1 511 people still. They were mostly small family outbreaks. The most common etiological agent of salmonellosis in Poland is S. enteritidis, but slightly increases the percentage cases, for which no serologic type was determined. In 2012 it stood at 14%. This proportion was highest in the Pomorskie province and amounted to 58%.

CONCLUSIONS

Keeping up for more than 10 years in the percentage of salmonellosis hospitalization rate at 70%, indicates underreporting of the disease in the country and mostly detection of the cases requiring hospital treatment. Growing proportion of Salmonella that are not serotyped, reaching in some regions more than 30% indicates problems with laboratory diagnostics salmonellosis.

Hepatitis A in Poland in 2012

AIM

The aim of the article is evaluation of the epidemiological situation of hepatitis A in Poland in 2012.

MATERIALS AND METHODS

Assessment of epidemiological situation of hepatitis A was based on results from analysis of the annual bulletins: "Infectious diseases and poisonings in Poland in 2012", "Vaccinations in Poland in 2012", reports from individual cases and epidemiological investigations of outbreaks linked to hepatitis A, sent by Epidemiological Departments in Sanitary Epidemiological Stations to the Department of Epidemiology at NIPH-NIH.

RESULTS

In Poland, 71 cases of hepatitis A were registered in 2012. The incidence of 0.17/ per 100 000 inhabitants was slightly higher than previous year. The incidence of hepatitis A ranged from 0.08/100 000 in Łódzkie and Podlaskie to 0.35/100 000 in Śląskie. The incidence of hepatitis A in men and women was at an approximate level and amounted to 0.19 and 0.18/100 000 respectively. The peak of incidence was recorded during the summer and autumn-winter months. In 2012 imported cases constituted 52.1% of all cases of hepatitis A. There were five outbreaks involving of 11 registered cases in 2012.

CONCLUSIONS

In 2012, there was a slight increase in the incidence of hepatitis A in compared with the previous year. However, apart from that there were no significant changes in the epidemiological situation of hepatitis A. In Poland there is still very low endemicity for hepatitis A. Decreased incidence and the small number of people vaccinated against hepatitis A facilitates the accumulation of a fairly numerous population of persons susceptible to infection which is connected with the possibility to increase the number of cases of hepatitis A. Despite the fact that the current epidemiological situation of hepatitis A in Poland is good, the disease still requires monitoring and analysis within the framework of epidemiological surveillance system.

Tetanus in Poland in 2012

INTRODUCTION

Despite of the small number of cases reported in Poland tetanus is a permanent risk to unvaccinated people. The severity of the disease is associated with high case fatality, especially among people in older age groups.

THE PURPOSE OF THE STUDY

The aim of this paper is to present the data of epidemiological surveillance of tetanus in 2012.

MATERIAL AND METHODS

Principal source of the data is bulletin: "Infectious diseases and poisonings in Poland in 2012, and individual reports of cases of tetanus sent to the Department of Epidemiology, NIPH -NIH.

RESULTS

In 2012, there were reported 19 cases of tetanus. 6 cases occurred in men, and 13 women. 13 cases occurred in persons over 69 years of age and in those age groups 6 cases were fatal. The paper describes the geographical distribution and the month of infection, the nature of the wounds which were portals of infection and the duration of incubation period of the cases.

SUMMARY AND CONCLUSIONS

Severity of tetanus, despite a small number of cases each year leads to several deaths, which could be prevented by vaccination.

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 łódzkie 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.

Measles in Poland in 2012

BACKGROUND

In 1998 Poland, along with all other Member States in the WHO European Region, implemented Measles Elimination Program coordinated by WHO. It requires achieving and maintaining very high vaccine coverage (>95%), recording all cases and suspected cases of measles, and laboratory testing of all suspected measles cases in the WHO Reference Laboratory. In Poland it is a Laboratory of Department of Virology, NIPH-NIH.

AIM

To assess epidemiological situation of measles in Poland in 2012, including vaccination coverage in Polish population, and Measles Elimination Program implementation status.

METHODS

The descriptive analysis was based on data retrieved from routine mandatory surveillance system and published in the annual bulletins "Infectious diseases and poisonings in Poland in 2012" and "Vaccinations in Poland in 2012", and measles case-based reports from 2012 sent to the Department of Epidemiology NIPH-NIH by Sanitary-Epidemiological Stations.

RESULTS

In total, there were 70 measles cases registered in Poland in 2012 (incidence 0.18 per 100 000). The highest incidence rate was observed among infants (2.08 per 100 000) and children aged 1 year (2.47 per 100 000). In 2012, 37 cases (52,9%) were hospitalized due to measles. No deaths from measles were reported. Vaccination coverage of children and youth aged 2-11 years ranged from 83.6% do 99.6% (primary vaccination in children born in 2011-2006) and from 76.6% do 96.7% (booster dose in children born in 2003-2001). Performance of the surveillance system was insufficient with only 127 measles-compatible cases reported in 2012 (33% of expected reports). Fifty cases (71%) were confirmed by IgM ELISA test.

SUMMARY AND CONCLUSIONS

The epidemiological situation of measles deteriorated in 2012 in comparison to proceding year. The results indicate a need to further promote Measles Elimination Program in Poland, maintain the high immunisation coverage and improve measles surveillance system.

Foodborne botulism in Poland in 2012

OBJECTIVES

The main objective of this article is to assess the epidemiology of foodborne botulism in Poland in 2012 compared to previous years, using national surveillance data.

MATERIALS AND METHODS

We reviewed surveillance data published in the annual bulletin "Infectious diseases and poisonings in Poland in 2012" and in previous publications, and botulism case reports for 2012 sent to the Department of Epidemiology NIPH-NIH by Sanitary-Epidemiological Stations.

RESULTS

In 2012, a total of 22 foodborne botulism cases (including 9 laboratory confirmed cases) was reported, corresponding to the lowest annual incidence rate (0.06 per 100 000 population) since the introduction of botulism as mandatory notifiable disease. The highest incidence in the country was reported in Lubelskie (0.23) and Wielkopolskie (0.20). Incidence in rural areas (0.07 per 100 000 population) was slightly higher than the incidence in urban areas (0.05). Men had more than 2 times higher incidence than women; the highest incidence rate (0.20 per 100 000 population) was observed among men in the age group of 30-39 years. Most cases were associated with consumption of different types of commercially canned meat. Commercially canned fish was also a common vehicle. All cases were hospitalized. One death related to the disease was reported.

CONCLUSIONS

In 2012, in Poland a downward trend in the incidence of foodborne botulism was maintained. From the point of view of national surveillance, it is necessary to increase the percentage of cases investigated with laboratory tests.

Lyme disease in Poland in 2012

INTRODUCTION

In Poland registration of all cases of Lyme disease is conducted by the Epidemiological Unit of National Institute of Public Health - National Institute of Hygiene. Most cases of Lyme disease occur in the North- East region of Poland; however, it is important to note that the disease is no longer solely a problem of this region of Poland.

OBJECTIVES

The aim of this work is to assess the epidemiological situation of Lyme disease in Poland in 2012 as compared to the situation in the previous years.

MATERIALS ANDD METHODS

Assessment of the epidemiological situation of Lyme disease in Poland was made on the basis of an analysis of individual notifications of suspected Lyme disease submitted to NIZP-NIH by the Provincial Sanitary- Epidemiological Stations; as well as data from "Infectious diseases and poisoning in Poland in 2012" bulletin, and "Vaccinations in Poland in 2012" bulletin (MP Czarkowski and Co, Warsaw 2013, NIPH-NIH, NCI).

RESULTS

In 2012 there were 8 782 registered cases of Lyme disease and it is 4.3% higher than in the previous year. The overall incidence in the country amounted to 23.8 per 100 000 people. The highest incidence rate was recorded in Podlaskie province - 75.5 per 100 000 people. 2 063 people were hospitalized due to Lyme disease.

SUMMARY AND CONCLUSIONS

In 2012 incidence rate of Lyme disease was gradually dropping down. The registered number of cases was reduced by 4.1% in comparison to the previous year. There is still a fairly low percentage of cases detected with diagnostic test called Western blot method.

Malaria in Poland in 2012

OBJECTIVE

To describe the epidemiological situation of imported malaria in Poland in 2012 as compared with previous years.

MATERIAL AND METHODS

Evaluation of malaria epidemiological situation in Poland in 2012, based on the results of the analysis of individual reports sent to the NIPH-NIH by the Sanitary-Epidemiological Stations and aggregate data published in the annual bulletins "Infectious Diseases and Poisonings in Poland". Cases were registered according to the case definition approved in the EU countries.

RESULTS

In 2012, a total of 21 malaria cases were registered in Poland, including one fatal case. All cases were imported from malaria-endemic countries: 52% from Africa and remaining cases from Asia. Overall, compared to 2011, 7 more cases were reported. Given a median for the years 2006-2010, the number remained at the same level. In one patient the recurrence of malaria falciparum was observed following the failure of treatment undertaken in Cameroon. Plasmodium species was determined in 18 cases (86%); including 10 (61%) caused by P. falciparum, 6 (33%) by P. vivax and one by P. malariae. One patient was diagnosed with mixed invasion. Infections were occurred most frequently during work-related trips (43%) or tourist trips (38%), in other cases the purpose of the journey was to visit the country of origin (14%) or its purpose remained unknown. Only four people took any chemoprophylaxis; in one case, a drug matched inappropriately to the destination was applied, the remaining three persons applied drugs contrary to the recommended drug regimen.

CONCLUSIONS

The number of cases of imported malaria in Poland remained at a low level, similar to that observed in previous years. A large number of delayed diagnoses (more than half of the reported cases) and another case of fatal outcome in the course of malaria indicate still low awareness of malaria threat among both travelers and primary care physicians.

Infectious diseases in Poland in 2012

AIM

The aim of the study is to assess the epidemiological situation for infectious and parasitic diseases in Poland in 2012.

MATERIALS AND METHODS

The main source of data for this study are statistical overviews contained in the annual bulletins "Infectious Diseases in Poland in 2012" and "Immunizations in Poland in 2012" (NIPH-NIH, Warsaw 2013) and data contained in the articles presented in this issue of Przegląd Epidemiologiczny. Information on deaths due to infectious and parasitic diseases registered in Poland in 2012 and earlier years is based on the data of the Department for Demographic Research of Central Statistical Office.

RESULTS

Upper respiratory tract infection classified as "influenza and influenza-like illness" were reported in 2012 in a total number of 1 460 037 cases. In comparison with 2011, it was an 26.2% increase of incidence, and as compared to the median of 2006-2010 of 286.1%. In 2012, with still the clear predominance of salmonellosis among intestinal bacterial infections, downward trend in the incidence of intestinal infections of this etiology persisted. In 2012 reported number of intestinal infections caused by Salmonella was, 8 267 (21.5/100 000), which represents incidence decrease of 4.5%. Foodborne infections of viral etiology were reported in 39462 cases (102.4/100 000). Most frequent were caused by rotaviruses - 23 692 (61.5/100 000). In 2012, there were 4 684 reported cases of pertussis (12.2/100 000), which means an increased incidence compared with the previous year by 180%. In 2012, there was an increase in the number of cases of mumps by 7.5% (from 2 585 to 2 779 cases), and of rubella by 46.0%, but compared to the median of the years 2006 to 2010 it was a decrease of 52.9%. In 2012, there was not any case of congenital rubella. Number of measles cases was 70 (0.18/100 000). In 2012, there was an increase in the number of cases of invasive disease caused by H. influenzae from 31 in 2011 to 36 in 2012. Number of infections caused by Streptococcus pneumoniae remained in 2012 as compared to 2011, on almost the same level: 436 in 2012 and 430 in 2011. However, there was a 36% increase in the number of sepsis cases caused by this organism. The incidence of tuberculosis in total (all forms of TB) in 2012 decreased compared to the previous year from 22.0 to 19.6 /100000, and pulmonary tuberculosis from 20.5 to 18.2. In 2012, were reported 1 093 cases of HIV infections (2.84/100 000), compared with the previous year, it was a fall in incidence of 2.4%. 21 cases of malaria occurred in people, who infection acquired abroad in malaria endemic areas. In 2012, there were no cases of diphtheria, poliomyelitis, rabies and viral haemorrhagic fevers outside of dengue, of which 5 cases of infections acquired in endemic areas were reported to National Sanitary Inspection. Total number of people who died in Poland in 2012 due to infectious and parasitic diseases, was 2 774. The share of deaths from these causes in the total number of deaths was 0.72%, and the mortality rate - 7.2/100 000. Out of all those deaths 41.1% were due to sepsis.

Mumps in Poland in 2012

BACKGROUND

Vaccination against mumps, introduced initially as recommended, from 2003 is mandatory in Poland and given as two dose scheme with MMR vaccine (mumps, measles, and rubella). Despite observed decline in mumps incidence for over a decade which is a result of conducted vaccinations, mumps is still a common childhood disease in Poland.

AIM

To assess epidemiological situation of mumps in Poland in 2012, including vaccination coverage in Polish population, in comparison to previous years.

METHODS

The descriptive analysis was based on data retrieved from routine mandatory surveillance system and published in the annual bulletins "Infectious diseases and poisonings in Poland in 2012" and "Vaccinations in Poland in 2012" (Czarkowski MP i in., Warszawa 2013, NIZP-PZH i GIS). Mumps cases were classified according to the criteria of surveillance case definition implemented in the European Union (Commission Decision of 28 April 2008 amending Decision 2002/253/EC). National Immunisation Programme for year 2012 was also used.

RESULTS

In total, there were 2779 mumps cases registered in Poland in 2012. Incidence of mumps was 7.2 per 100 000 and it was higher by 7.5% in comparison with 2011 and lower by 19.4% in comparison to median for the years 2006-2010. The highest incidence rate was observed among children aged 5 years (71.8 per 100 000). Incidence in women (5.9) was lower than in men (8.6). In 2012, 25 people were hospitalized due to mumps. Vaccination coverage of children aged 3 years in Poland in 2012 was 97.9%.

CONCLUSIONS

Systematic execution of mumps vaccination in accordance with the National Immunisation Programme resulted in a significant decrease in the number of registered cases. Due to the high vaccination coverage further decline in the number of cases is expected.

The year in burns 2012

Approximately 2457 research articles were published with burns in the title, abstract, and/or keyword in 2012. This number continues to rise through the years; this article reviews those selected by the Editor of one of the major journals in the field (Burns) and his colleague that are most likely to have the greatest likelihood of affecting burn care treatment and understanding. As done previously, articles were found and divided into these topic areas: epidemiology of injury and burn prevention, wound and scar characterization, acute care and critical care, inhalation injury, infection, psychological considerations, pain and itching management, rehabilitation, long-term outcomes, and burn reconstruction. Each selected article is mentioned briefly with comment from the authors; readers are referred to the full papers for further details.

Prediction of cancer incidence and mortality in Korea, 2012

PURPOSE

To estimate the current cancer burden in Korea, cancer incidence and mortality rates were projected for the year 2012.

MATERIALS AND METHODS

The cancer incidence data from 1999 to 2009 were obtained from the Korea National Cancer Incidence Database, and the cancer mortality data from 1993 to 2010 were obtained from Statistics Korea. Cancer incidence in 2012 was projected by fitting a linear regression model on observed age-specific cancer incidence rates against observed years, then multiplying the projected age-specific rates by the age-specific population. For cancer mortality, a similar procedure was applied, except that a Joinpoint regression model was used to determine at which year the linear trend significantly changed.

RESULTS

A total of 234,727 new cancer cases and 73,313 cancer deaths are projected to occur in Korea in 2012. For all sites combined, the crude incidence rates are projected to be 465.6 and 459.7, and the age-standardized incidences to be 345.1 and 300.9 per 100,000 respectively for males and females.

CONCLUSION

Cancer has become an important public health concern in Korea, and as the Korean population ages, the cancer burden will continue to increase.