Stypułkowska-Misiurewicz Hanna, Czerwiński Michał
National Institute of Public Health – National Institute of Hygiene in Warsaw, Department of Bacteriology
National Institute of Public Health – National Institute of Hygiene in Warsaw, Department of Epidemiology,
Przegl Epidemiol. 2016;70(2):203-207.
The aim of the study was to assess the epidemiological situation of legionellosis in Poland in 2014.
We reviewed data published in the annual bulletin: “Infectious diseases and poisonings in Poland in 2014” and its prior versions along with the legionellosis case reports sent to the Department of Epidemiology of NIPH - NIH.
In Poland, both two forms of legionellosis - Legionnaires’ disease (a severe form of disease accompanied by pneumonia) and Pontiac fever (mild, influenza-like form of infection) - are routinely reported to the surveillance. In 2014, a total of 14 cases were reported (12 cases of Legionnaires’ disease and 2 cases of Pontiac fever); the incidence (0.036 per 100,000 population) was comparable to previous year as well as the median (incidence) for 2008-2012. The infections were reported in eight provinces, including five, which in previous years usually did not register any cases. The incidence in males (0.04 per 100,000) was slightly higher compared to females (0.03). Death rate of females was unusually high = 75%. No outbreaks or clusters were reported - only sporadic cases. All patients required hospitalization, including cases of Pontiac fever. The Sanitary Inspection reported three fatal cases – all women 49- 60 years/old. Twelve cases were likely acquired in the country, including two probably in hospital and three linked with inhalation of aerosols during professional activity. Two cases were associated with travels abroad (one to Italy and one to Germany).
In 2014 diagnosis of legionellosis cases was confirmed by rapid chromatographic test detecting legionella antigen in urine. The examinations were performed even in small town hospitals, so infections were detected and reported in provinces which usually did not register any cases. This study suggests, that legionellosis is likely under recognized and under diagnosed in all provinces of the country. Presumably physicians often do not suspect or not confirm the clinical diagnosis of Legionnaires’ disease in cases with atypical pneumonia.
本研究旨在评估2014年波兰军团病的流行病学情况。
我们查阅了年度公报《2014年波兰的传染病与中毒事件》及其以前版本中公布的数据，以及发送至国家公共卫生研究所（NIPH）-国家卫生研究院流行病学部的军团病病例报告。
在波兰，两种形式的军团病——军团病（伴有肺炎的严重疾病形式）和庞蒂亚克热（轻度、类似流感的感染形式）——均按常规向监测部门报告。2014年，共报告14例（12例军团病和2例庞蒂亚克热）；发病率（每10万人中0.036例）与上一年以及2008 - 2012年的发病率中位数相当。感染病例报告于8个省份，其中包括5个在前些年通常未记录任何病例的省份。男性发病率（每10万人中0.04例）略高于女性（每10万人中0.03例）。女性死亡率异常高 = 75%。未报告有疫情暴发或聚集性病例——仅有散发病例。所有患者均需住院治疗，包括庞蒂亚克热病例。卫生检查部门报告了3例死亡病例——均为49 - 60岁的女性。12例病例可能是在国内感染，其中包括2例可能在医院感染以及3例与职业活动期间吸入气溶胶有关。2例病例与出国旅行有关（1例前往意大利，1例前往德国）。
2014年，军团病病例的诊断通过检测尿中军团菌抗原的快速色谱试验得以确诊。即使在小镇医院也进行了这些检测，因此在通常未记录任何病例的省份也检测到并报告了感染病例。本研究表明，该国所有省份的军团病可能都未得到充分认识和诊断。推测在非典型肺炎病例中，医生常常未怀疑或未确诊军团病的临床诊断。
