Kamińska Sylwia, Sadkowska-Todys Małgorzata
Department of Epidemiology, National Institute of Public Health - National Institute of Hygiene in Warsaw.
Przegl Epidemiol. 2015;69(2):239-42, 359-62.
The aim of this paper was to assess the epidemiological situation of yersiniosis in Poland in 2013 against previous years.
We reviewed surveillance data published in the annual bulletin "Infectious diseases and poisonings in Poland" from 2008 to 2013 (MP Czarkowski et al., NIH and GIS) and individual yersiniosis case reports from 2013 sent by the Sanitary-Epidemiological Stations. Additionally, we use data from the Department of Demographic Surveys in Central Statistical Office.
A total of 219 yersiniosis cases were reported in Poland in 2013, including 199 cases of intestinal and 20 cases of extraintestinal yersiniosis. Among those were infections caused by Y. enterocolitica, and Y. pseudotuberculosis--217 and 2 cases, respectively. The incidence rate was 0.57 per 100,000 inhabitants. Hospitalization required 54,8% of cases. Deaths related to the disease were not reported. Intestinal yersiniosis was manifested mostly by following symptoms: diarrhoea (91%), fever (74%), abdominal pain (49%) and vomiting (21%). The most affected group in intestinal infections were children younger than 4 years--126 cases (63% of all cases). There were less extraintestinal infections in comparison to 2012 (30 cases), manifested mainly by symptoms from the osteoarticular system, presented in 80% of patients. Similarly to 2012, the most cases of intestinal yersiniosis reported from Mazowieckie province (123 cases). Serotypes of isolated Y. enterocolitica strains were identified in 115 cases (53%), including serotypes: O3 (88.7%), O8 (8.7%) and O9 (2.6%). One household outbreak caused by Y. enterocolitica O3 occurred. In 2013 identified 10 infections with serotype O8.
Occurrence of a significantly higher number of yersiniosis cases during the third and fourth quarter of 2013 suggests the changes in seasonal distribution of infections in comparison to previous years. This may be related to a very low number of infections caused by serotype O8, reported in past years within the first half of the year. Maintaining a high percentage (47%) of a non-serotyped strains of Yersinia isolated from patients points to lack of serotyping in routine laboratory diagnostics. Reporting cases of extraintestinal yersiniosis from only few provinces may suggest that the real number of infections remains underreported.
本文旨在评估2013年波兰耶尔森氏菌病的流行病学情况，并与往年进行对比。
我们查阅了2008年至2013年年度公报《波兰的传染病与中毒》（MP Czarkowski等人，NIH和GIS）中公布的监测数据，以及2013年卫生防疫站发送的耶尔森氏菌病个案报告。此外，我们还使用了中央统计局人口调查部门的数据。
2013年波兰共报告了219例耶尔森氏菌病病例，其中199例为肠道型耶尔森氏菌病，20例为肠外型耶尔森氏菌病。其中分别由小肠结肠炎耶尔森氏菌和假结核耶尔森氏菌引起的感染——分别为217例和2例。发病率为每10万居民0.57例。54.8%的病例需要住院治疗。未报告与该疾病相关的死亡病例。肠道型耶尔森氏菌病主要表现为以下症状：腹泻（91%）、发热（74%）、腹痛（49%）和呕吐（21%）。肠道感染中受影响最大的群体是4岁以下儿童——126例（占所有病例的63%）。与2012年（30例）相比，肠外型感染较少，主要表现为骨关节系统症状，80%的患者出现该症状。与2012年类似，马佐夫舍省报告的肠道型耶尔森氏菌病病例最多（123例）。在115例（53%）病例中鉴定出了分离出的小肠结肠炎耶尔森氏菌菌株的血清型，包括血清型：O3（88.7%）、O8（8.7%）和O9（2.6%）。发生了1起由小肠结肠炎耶尔森氏菌O3引起的家庭暴发。2013年鉴定出10例O8血清型感染病例。
2013年第三和第四季度耶尔森氏菌病病例数量显著增加，这表明与往年相比，感染季节分布发生了变化。这可能与过去几年上半年报告的O8血清型感染数量极少有关。从患者中分离出的耶尔森氏菌非血清型菌株比例较高（47%），这表明常规实验室诊断中缺乏血清分型。只有少数省份报告了肠外型耶尔森氏菌病病例，这可能表明实际感染病例数仍未得到充分报告。
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