Stypułkowska-Misiurewicz Hanna, Baumann-Popczyk Anna
Narodowy Instytut Zdrowia Publicznego - Państwowy Zakład Higieny w Warszawie.
Przegl Epidemiol. 2012;66(2):235-9.
Dysentery as infective and contagious disease is registered by all EU and EFTA countries only as shigellosis according to etiological classification of the infectious diseases. The cases are also registered by ECDC. According to ECDC Report for 2006-2008 the incidence rate in Poland < 0.01/100 000 was the lowest from all EU/EFTA countries that have send the data to ECDC as the cumulative for EU countries was 1.78/100 000.
Epidemiological data were collected by Regional Epidemiological Sanitary Stations, send to the National Register of Infectious Diseases, evaluated, calculated and published by Department of Epidemiology National Institute of Public Health (NIZP-PZH) in Annual Bulletin "Infections and Intoxications in Poland in 2010", Warsaw NIZP-PZH and GIS (Chief Sanitary Inspectorate ) 2010. Laboratory data were collected as reports from all Regional Sanitary Laboratories send to NIZP-PZH Department of Bacteriology, data from epidemiological investigation of outbreaks including data from identification of Shigella strains obtained from the Reference Laboratory for Gram-negative Bacilli of NIZP-PZH Bacteriology Department.
In 2010 thirty cases of shigellosis were registered (incidence was 0.08/100 000 inhabitants) the same number of cases and incidence was observed in 2009, nearly the same in 2008 - 33 cases (incidence 0.09). The numbers were lower than the median in 2004-2008 (64 cases, incidence 0.17/100 000). According to laboratory reports in all 16 Regional Sanitary Stations only 14 persons were Shigella positive, in spite that more than 600 000 were examined: 10 persons were infected by S. sonnei, 4 by S. flexneri. Only one strain of S. sonnei was isolated from a patient with diarrhea. It was in the Regional Sanitary Station laboratory of the małopolskie voievodeshaft. No one strain of S. boydii or S. dysenteriae was isolated.
Most of the dysentery cases were examined by other laboratories than laboratories of sanitary epidemiological service. The obligation of private payment for bacteriological examination of suspected cases is one of reason that patient is treated with antibacterial drugs without determination of etiological agent of the infection. It concern the population of small and medium towns as well as population of farmers living in the country, children and youth. The registration of shigellosis in Poland is not valuable. In 2010 no case of amoebiasis was registered as in 2008 the disease no more should be obligatory registered.
根据传染病的病因分类,欧盟和欧洲自由贸易联盟(EFTA)所有国家仅将痢疾作为感染性和传染性疾病登记为志贺菌病。这些病例也由欧洲疾病预防控制中心(ECDC)登记。根据ECDC 2006 - 2008年的报告,波兰的发病率<0.01/10万,是向ECDC发送数据的所有欧盟/EFTA国家中最低的,欧盟国家的累计发病率为1.78/10万。
流行病学数据由地区流行病学卫生站收集,发送至国家传染病登记处,由国家公共卫生研究所(NIZP - PZH)流行病学部在年度公报《2010年波兰的感染与中毒》中进行评估、计算和发布,该公报由华沙的NIZP - PZH和GIS(首席卫生检查局)于2010年发布。实验室数据收集自所有地区卫生实验室发送至NIZP - PZH细菌学部的报告,以及疫情流行病学调查数据,包括从NIZP - PZH细菌学部革兰氏阴性杆菌参考实验室获得的志贺菌菌株鉴定数据。
2010年登记了30例志贺菌病病例(发病率为0.08/10万居民),2009年观察到相同数量的病例和发病率,2008年情况相近——33例(发病率0.09)。这些数字低于2004 - 2008年的中位数(64例,发病率0.17/10万)。根据实验室报告,在所有16个地区卫生站中,尽管检查了60多万人,但只有14人志贺菌呈阳性:10人感染宋内志贺菌,4人感染福氏志贺菌。仅从一名腹泻患者中分离出一株宋内志贺菌,来自小波兰省地区卫生站实验室。未分离出鲍氏志贺菌或痢疾志贺菌菌株。
大多数痢疾病例是由卫生流行病学服务实验室以外的其他实验室检查的。对疑似病例的细菌学检查需自费是患者在未确定感染病原体的情况下接受抗菌药物治疗的原因之一。这涉及中小城镇人口以及农村的农民、儿童和青年群体。波兰志贺菌病的登记情况并无太大价值。2010年未登记到阿米巴病病例,因为自2008年起该病不再要求强制登记。