Stypułkowska-Misiurewicz Hanna, Pancer Katarzyna
Narodowy Instytut Zdrowia Publicznego- Państwowy Zakład Higieny, ul. Chocimska 24, 00-791 Warszawa.
Przegl Epidemiol. 2008;62(2):261-5.
In 2006 the 89 cases and in 2005 the 21 cases of legionellosis were reported in Poland, the incidence rate was respectively 0.23 and 0.055/100 000. Legionellosis is a notified disease in Poland since 2002, but laboratory diagnostic methods were introduced even earlier, in 1997. The increasing trend in incidence rate was due to an active cooperation with some hospital staff and financial support from Polish Committee of Research Activity. The first time nosocomial Legionella infections were observed in Poland. The outbreak occurred among patients of ophthalmic ward. Five cases with pneumonia were examined by laboratory methods: for two the diagnose was confirmed, for two were presumptive, for one was not confirmed. Three persons died (two with diagnose presumptive, one with confirmed). Every registered case was laboratory examined in National Institute of Hygiene, the only place where laboratory tests were performed. Most of the cases were diagnosed with serological tests--determination with ELISA test the anti-legionella antibodies in IgM fraction as the most recent answer for Legionella infection, few by detection of legionella antigen in urine. All BAL specimens from several patients were negative when examined with culture method, but some were positive with PCR only. Since 1987 to 2006 the 17 foreign tourists were registered in EU countries as probably infected in Poland. Epidemiological investigation with the examination of water system for Legionella sp., cleaning and disinfection (if needed) was done in suspected hotels.
2006年波兰报告了89例军团病病例,2005年报告了21例,发病率分别为0.23和0.055/10万。自2002年起军团病在波兰成为须报告的疾病,但实验室诊断方法早在1997年就已引入。发病率呈上升趋势是由于与一些医院工作人员的积极合作以及波兰研究活动委员会的资金支持。波兰首次观察到医院内军团菌感染。疫情发生在眼科病房的患者中。对5例肺炎患者进行了实验室检查:2例确诊,2例疑似,1例未确诊。3人死亡(2例疑似诊断,1例确诊)。每例登记病例都在国家卫生研究所进行了实验室检查,该所是唯一进行实验室检测的地方。大多数病例通过血清学检测确诊——用ELISA试验测定IgM组分中的抗军团菌抗体作为军团菌感染的最新诊断方法,少数通过检测尿中的军团菌抗原确诊。几名患者的所有支气管肺泡灌洗标本经培养法检测均为阴性,但有些仅通过PCR检测呈阳性。1987年至2006年期间,有17名外国游客在欧盟国家登记,可能是在波兰感染的。对疑似酒店进行了针对嗜肺军团菌的水系统检查、清洁和消毒(如有必要)的流行病学调查。