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[Scarlet fever in Poland in 2002].

Following the last epidemic in 1995 the scarlet fever incidence in Poland has been gradually decreasing, on average 20% per year. The downward trend continued in 2002, the overall incidence rate being 10.6 per 100,000. It was the lowest incidence registered in Poland since the introduction of mandatory reporting of scarlet fever in 1918 (the lowest so far registered incidence rates were 15.2 in 2001 and 17.5 in 1918). Spatial distribution of cases was relatively even--incidence ranged from 5.0 per 100,000 in łódzkie voivodeship to 25.1 in opolskie voivodeship. As observed previously incidence in the urban areas (12.0) was significantly higher then in the rural areas (8.4) and the incidence in men (11.7) exceeded the incidence in women (9.6). The majority of cases occurred in children and adolescents younger then 15 years (mode--6 years). Two percent of cases were hospitalized. There were no deaths due to scarlet fever reported in 2002.

Adolescent↗

[Meningitis and encephalitis in Poland in 2002].

In Poland, 861 cases of bacterial meningitis and encephalitis, 307 cases of viral encephalitis, 1022 of viral meningitis and 286 cases of meningitis and encephalitis of other or unknown etiology were reported in 2002. Incidence of the bacterial central nervous system infections has been declining over the past decade and the level of viral infections, following the outbreak in the mid-nineties, remained stable. Etiological factor was determined in 365 (42%) cases of bacterial meningitis/encephalitis. Among them Neisseria meningitidis was found in 90 cases, Haemophilus influenzae in 72 cases and Streptococcus pneumoniae in 85 cases. As in the past type B was the predominant type of N. meningitidis cultured from the patients, but type C appears to be on the rise accounting for 35% of the serotyped strains. 126 cases of tick borne encephalitis were reported in Poland in 2002, most of them from endemic areas of north-eastern part of the country.

Adolescent↗

[Botulism in Poland in 2002].

A total of 85 foodborne botulism were registered in Poland in 2002, with corresponding incidence 0.22 per 100,000 population. In rural areas were registered 67% of cases and in urban areas--33% (adequately--incidence 0.39 and 0.12). There were 53 outbreaks of one person noted, 11 outbreaks of two people, 2 outbreaks of three, and 1 outbreak of four people. Meat dishes were the main vehicle of botulinum toxin (58 cases; 68.2%). Out of them, home made conserves (bottling jars) prepared from pork meat (23.5% of cases) and commercial produced sausages (20.0%) prevailed as vehicles. Five deaths (three men and two women) from foodborne botulism were registered in Poland in 2002.

Adolescent↗

[Hepatitis B in Poland in 2002].

Noticeable downward trend of hepatitis B incidence in Poland continued in 2002. In total 2,021 new cases were reported, 84 (4.2%) of which concerned people co-infected with HBV and HCV. The registered incidence, 5.3 per 100,000 population, was 15% lower then in 2001. As in previous years, the incidence in the urban areas (5.7) exceeded the incidence in the rural areas (4.6) and it was higher in men (6.6) then in women (4.0). Comparing the incidence across the regions, the rate ratio between the voivodeship with the highest and the lowest incidence (respectively 13.2 in kujawsko-pomorskie and 2.1 in podkarpackie) was 6.3. In the voivodeships with the highest incidence the age distribution differed significantly from the rest of the country suggesting the necessity of appropriate modifications in the national prevention program. Overall the most affected age groups were the elderly (incidence 8.1 in persons over 74 years of age, 7.9 in 65-74 year olds and 7.3 in 60-64 year olds) and young adults (incidence 6.5 among 20-24 year olds). Approximately 96% of cases were hospitalized. According to preliminary data there were 100 deaths due to acute of chronic hepatitis B in Poland in 2002.

Adolescent↗

[Tetanus in Poland in 2002].

In last decade gradual decrease in numbers of reported cases of tetanus was observed. In 2002, 20 cases of tetanus (12 women and 8 men) were reported in Poland. All those cases were among people of age 30 or more. Only one man more then 79 years old died. All cases were unvaccinated or vaccination status was unknown. The data show effectiveness of vaccination program in younger age groups, but they also show need for promotion of post exposure prophylaxis, especially among older people both in rural and in urban areas. No case of neonatal tetanus was noted in Poland since 1984.

Adolescent↗

[Human trichinellosis in Poland in 2002].

Total number of 42 cases of human trichinellosis were reported and registered in Poland in 2002. Comparable number of cases were occurred in podlaskie (15) and wielkopolskie (14) voivodeships, and relative lot (9 cases) in pomorskie voivodeship. Sources of infestation according to 25 cases were more than 3 boars, according to 15 cases--undetermined number of the pigs, according to 1 case--1 stag (suspected), and according to 1 case source and vehicle of the infestation were not discovered. Thirty cases were hospitalized. No deaths from trichinellosis were reported in Poland in 2002.

Adolescent↗

[Cestode infections in Poland in 2002].

In 2002, 264 intestinal cestode infections were registered in Poland. Among them 193 were caused by Taenia saginata, 3 by T. solium, 53 by Taenia sp., 1 by Hymenolepis nana, 1 by Diphyllobothrium latum, 1 by Hymenolepis diminuta. Moreover, 40 cases of cystic echinococcosis were also registered. The obtained results confirmed decreasing frequency of intestinal cestodoses in Poland.

Adolescent↗

[Malaria in Poland in 2002].

26 cases of malaria were reported in Poland in 2002. All cases were imported: 20 from Africa and 6 from Asia. Most of the cases (15) were caused by Plasmodium falciparum. 17 cases were men, 9 were women. Mean age was 40. The youngest patient was 11, the oldest 71. Table I presents complete [table see: text] list of cases by gender (M-male, K-female), age, etiologic factor and presumed country of infection. In only 4 cases some kind of chemoprophylaxis was documented. In other prophylaxis was not used or not documented. One death resulted from falciparum malaria in Poland in 2002.

Adolescent↗

[Poliomyelitis eradication in Poland--assessment of the program implementation].

The study aimed to investigate the quality of acute flaccid paralysis (AFP) surveillance in Poland prior to certification of polio-free status of the European Region in 2002. All cases reported to the National Institute of Hygiene in 1998-2002 were included in the study. To assess the surveillance quality we used the WHO indicators and timelines analysis of the undertaken actions. In total 320 AFP cases in children under 15 years were reported (annual incidence per 100,000 from 0.57 in 2000 to 1.05 in 2001 and 1.06 in 2002). Incidence was significantly higher in boys (RR = 1.42, p = 0.002) and in the age group 0-4 years (RR = 1.77, p < 0.0001). Mean incidence in voyvodeships ranged from 0.42 in Zachodnio-pomorskie to 1.45 in Swietokrzyskie. Percentage of cases with timely stool collection increased from 39% in 1998 to 82% in 2002 and the percentage of cases reported within 2 days from hospitalization--from 14% in 1998 to 48% in 2002. The median number of days from hospitalization to reporting decreased from 4 in 1998-2000 to 3 in 2001-2002 (p < 0.0001) and the median number of days from onset to first stool sample collection--from 7 in 1999-2000 to 5 in 2000-2002 (p < 0.0001). In the investigated 1350 stool samples from AFP cases and their contacts 76 strains of poliovirus were isolated--all Sabin-like. In conclusion the surveillance indicators improved during the study period. The quality of surveillance however is uneven on the sub-national level. Consequently, imported polio cases might be detected with delay. Continuation of enhanced AFP surveillance in Poland is warranted.

Adolescent↗

[Epidemiologic analysis of human Leptospirosis in Poland in 1995-2002. I. Clinical features and laboratory diagnosis].

The aim of the study was to formulate the case definition of Leptospirosis for surveillance in Poland. There were also discussed the laboratory criteria appropriate for epidemiological situation of leptospirosis in our country. The study based on statistical data and information from 66 epidemiological investigation cards of leptospira cases reported in Poland between 1995 and 2002. We analyzed the course of the disease, clinical symptoms as well as the status of laboratory confirmation.

Diagnosis, Differential↗

Prevalence of Hymenoptera venom allergy and its immunological markers current in adults in Poland.

BACKGROUND: The prevalence of insect venom allergy is still being assessed. The aim of our study was to estimate, on the basis of an interviewer-administered questionnaire survey, the frequency of post-sting allergic reactions and venom sensitization. MATERIAL/METHODS: The study was performed within the framework of the ECRHS. A random sampling of 3000 persons was selected from among 68,000 persons living in the area of Wrocław, Poland. Of the 2050 persons responding to a mailed screening questionnaire, 169 were randomly selected to complete a questionnaire designed only for insect allergy detection. Venom skin test and sIgE assessment were performed on 146 and 132 patients, respectively. RESULTS: Allergic post-sting symptoms were found in 20.7% of surveyed patients. Large local reactions (LLs) occurred in 11.8% and systemic reactions (SYSs) in 8.9% of the study population. SYS was most often manifested by urticaria (4.7%). The frequencies of SYS II, III and IV were 1.8%, 1.8%, and 0.6%, respectively. Only LLs were more frequent in subjects with other allergic diseases (p=0.03). The presence of positive skin tests and/or sIgE in serum were 42.8% of subjects with LL, 53.3% with SYS, and 17.1% of "asymptomatic" patients. No significant differences were found between these groups regarding venom skin test results and sIgE serum concentrations. Occurrence of sIgE to bee venom was frequently associated with the presence of sIgE to timothy grass. CONCLUSIONS: Insect venom allergy and asymptomatic venom sensitization in adults are common in Poland. Only some venom allergy cases are IgE dependent.

Adult↗

Human anaplasmosis in north-eastern Poland: seroprevalence in humans and prevalence in Ixodes ricinus ticks.

Sera of 500 inhabitants of north-eastern Poland, 450 suspected for Lyme borreliosis and 50 blood donors (control group), were analysed for the presence of IgG antibodies against Anaplasma phagocytophilum, the causative agent of human anaplasmosis (HA), known so far as human granulocytic ehrlichiosis (HGE). Forty one (9.1 %) sera of the study group and one serum (2 %) of the control group were positive using indirect fluorescence assay (IFA). The seropositivity tended to be more frequent among males (10.3 %) than females (7.6 %) and among the rural (10.3 %) than urban population (7.5 %); however, differences were of no statistical significance (p = 0.4). No age difference was found between the seropositive and the seronegative individuals (p = 0.77). The only factor increasing the risk of HA seropositivity found was forestry employment (p < 0.05). Additionally, a total of 559 Ixodes ricinus ticks, collected in the same area as sera, were investigated for the presence of A. phagocytophilum by the polymerase chain reaction (PCR) and 41 (8.7 %) of them were found to be positive. The infection level ranged from 2.3-13.7 %, depending on the area studied. Bacteria were significantly less frequently detected in nymphs - 2.1 % (5/235) than in adult ticks - 13.6 % (44/324) and in males--4.2 % (74/165) than in females--23.3 % (37/159) (p < or = 0.05). The obtained results confirm both the occurrence of HA foci in north-eastern Poland with I. ricinus as the principal vector of the A. phagocytophilum infection, and forestry workers as the main group at risk.

Adult↗

Distribution of HBV genotypes and mutants among hepatitis B infected patients from northern Poland.

Hepatitis B virus (HBV) infection is one of the major global epidemiological problems. The aim of our study was to determine the distribution of HBV genotypes in Poland since the data concerning the spread of HBV viruses in the central-eastern region of Europe is still very limited. HBV DNA was extracted from 58 serum samples. To quantify the level of HBV DNA the Roche Amplicor HBV Monitor Assay was used. To genotype and assign HBV subtypes DNA sequencing methods were performed. The HBV virus from 43 serum samples from hepatitis B infected patients was genotype A (74.1%), 12 cases had genotype D (20.7%), and 3 had the rare in Europe genotype F (5.2%). Prediction of HBV serological subtypes based on HBsAg sequencing showed almost 100% occurrence of subtype adw2 in the group of genotype A samples, three different subtypes in genotype D (ayw2, ayw3, and ayw4), and equal distribution of subtype adw4q- in all 3 cases of genotype F, also the most prevalent subtype in the Amerindians. Our results coincide with the general European HBV prevalence. However, HBV genotype F, which is not a common genotype in European countries, was detected and so was relatively high occurrence of genotype D, which may reflect historical and ethnical migration events in Poland in the past.

Adolescent↗

Karyotypes and cytogenetic diversity of the genus Cobitis (Pisces, Cobitidae) in Poland: a review. Cytogenetic evidence for a hybrid origin of some Cobitis triploids.

This work summarized the results of comparative chromosomal study of Cobitis fish from 13 locations in Poland. At least two distinct species C. taenia and C. elongatoides were cytogenetically recognized. The populations of C. taenia were detected in only three lakes located in northern Poland. One hybrid diploid, four triploid and four tetraploid forms were recognized among the samples. These hybrid forms or biotypes of Cobitis could not be distinguished by external characteristics. Based on the species-specific chromosome markers such as NORs, CMA3-positive and C-bands, it is hypothesized that C. taenia, C. elongatoides, and one or two other species have taken part in the origin of polyploids. Two different hybrid diploid-polyploid Cobitis complexes were distinguished. One was composed of C. taenia, two triploid hybrid forms and two tetraploids. The other complex included C. taenia and C. elongatoides, which have taken part in the origin of coexisting hybrid forms: diploid hybrid C. taenia-elongatoides, four different triploid and two tetraploid biotypes. The results obtained indicate the hypothetical mode of origin of some polyploid Cobitis forms.

Animals↗

A prospective study of the incidence of agranulocytosis and aplastic anemia associated with the oral use of metamizole sodium in Poland.

BACKGROUND: Metamizole is a common analgesic and antipyretic drug. However, its use has been associated with a risk of side-effects involving agranulocytosis and aplastic anemia. These reactions are rare and unpredictable. The aim of this prospective study was to evaluate the risks of these complications in Poland, where this medication is available without prescription. MATERIAL/METHODS: Six hematological centers, serving approximately 40% (ca. 15 million people) of the country's population, participated in the study. All cases of agranulocytosis and aplastic anemia were recorded and their severity and association with the use of drugs, especially metamizole sodium, were evaluated. All the patients receiving cytostatic or immunosuppressive drugs were excluded. RESULTS: During the 12 months of the study, 2 cases of aplastic anemia and no cases of agranulocytosis were confirmed which may have been associated with the use of metamizole. Overall, we recorded 16 cases of agranulocytosis and 27 cases of aplastic anemia. The two cases of metamizole sodium-induced aplastic anemia were non-fatal in character. CONCLUSIONS: Considering the consumption of 112,300,094 tablets of metamizole in Poland a year, the figures obtained result in an incidence of 0.25 cases of aplastic anemia per 1 million persons per day of treatment; this value being less than that for other nonsteroidal anti-inflammatory drugs. Nevertheless, caution is recommended in the application of metamizole, particularly over long periods and in large doses.

Administration, Oral↗

New EMF safety limits for occupational and public exposure in Poland.

On July 23, 2001, new safety limits for occupational exposure to electromagnetic fields (EMF) were introduced in Poland. The limits have been based on the analysis of international recommendations, e.g., ICNIRP (1998), WHO (1998), IEEE standard (1999), drafts of European standards (ENV 1995), and a critical review of the world literature on the biological effects of EMF and health effects of exposure to EMF. Derived from safety limits for occupational exposure, new safety exposure limits for general population were introduced on November 28, 2003. In this paper mandatory procedures for setting limits of exposure to agents harmful to health in the workplace and natural environment are presented. The most essential provisions of two regulations, one issued by the Minister of Labour and Social Policy and the other by the Minister of the Environment, forming the basis of the modern system of EMF exposure control in Poland, are also discussed.

Electromagnetic Fields↗

National programme of official control of animal feedingstuffs under surveillance of veterinary inspection in Poland.

Poland as a new EC country is obliged in agree with Directive 95/53/EC to drawn up one, coherent and coordinated national programme of official inspection, irrespective of the organisational structure, and the number of inspection authorities in a country. Taking these facts into account the author has worked out the Polish National Programme of an official control conducted by the Veterinary Inspection in the field of animal feedingstuffs sector in Poland. The objective of the programme is to lay down the substantive scope of official inspections and laboratory control testing of animal feedingstuffs, appropriate for the surveillance exercised by the Veterinary Inspection. The programme is under implementation process which has begun in 2004.

Animal Feed↗

Newborn outcome after assisted reproductive technology: experiences and reflections from Poland.

In spite of much ethical uncertainty and wide variations in obstetric and neonatal outcomes reported in the literature, we have studied the outcome of Polish newborns after assisted reproductive technology (ART). In all of our patients, both obstetrics and neonatal care were performed in the Level Three Center in Poznan, Poland. A total of 45 and 82 newborns were analyzed from the ART and the control group, respectively. We analyzed gestational age, birth weight, Apgar score, duration of hospitalization, newborn mortality, and congenital malformations. We found a far higher rate of mothers over 35 years and with university education in ART compared to controls. The incidence of cesarean section and birth weight <1,500 g was much higher in ART. Newborn mortality was much higher among ART newborns compared to controls and was related to premature delivery of triplet pregnancy. The most important factor resulting in high neonatal mortality in our study group was multiple pregnancy. We consider the lack of regulation in Poland concerning the number of replaced embryos as a main factor influencing newborns' outcome after ART.

Adult↗