Objectives: Evaluation of the epidemiological situation of hepatitis B in Poland in 2012 in comparison with previous years.
Material and methods: The evaluation was based on the results of analysis of individual case reports of acute hepatitis B recorded by the Sanitary-Epidemiological Stations and aggregate data of national surveillance published in annual bulletins "Infectious diseases and poisonings in Poland" for the years 2006-2012.
Results: In Poland, in 2012 a total of 1 583 cases of hepatitis B were reported, including 33 cases of dualinfection with hepatitis B virus (HBV) and hepatitis C virus (HCV). The incidence was 4.11 per 100 000 inhabitants and compared to the preceding year its value did not change. The acute cases accounted for 4.9% of all hepatitis B cases, the incidence - 0.20 per 100 000 population. Compared to 2011, there was a further decline in both incidence and share of acute stage of infection in the total number of cases. The highest incidence of acute and chronic form of hepatitis B was reported in Opolskie (0.49 per 100 000) and Łódzkie provinces (8.62 per 100 thousand.), respectively. More frequently men and urban dwellers were ill. In the age group 0-14 years, which was entirely covered by universal vaccination of infants, no acute cases were found while the incidence of chronic hepatitis B in this age group was 0.14 per 100 000. Chronic hepatitis B was most frequently detected in people aged 40-44 years (incidence 7.13 per 100 000) and acute disease - in those aged 45-49 years (incidence 0.46 per 100 000). Medical procedures in healthcare settings were still the predominant route of infection (56% of all acute cases). Infections contracted via sexual contacts, household contact with an infected person and through injection drug use accounted together for 14% of all acute hepatitis B cases. In 2012, 11 and 41 persons died due to acute and chronic stage of hepatitis B, respectively.
Conclusions: A clear downward trend of the incidence of acute hepatitis B with an unchanged mode of HBV transmission in Poland, indicates an improvement in compliance with recommended infection control procedures at all levels of medical care. The maintenance of the incidence of acute hepatitis B at a low level is possible due to the continuation of an universal vaccination program against HBV in combination with measures that stop the spread of infections. In view of persistent pattern of hepatitis B transmission in Poland in medical settings, it is advisable to recommend immunization not only to individuals at increased risk but also all previously unvaccinated persons. Simultaneously, activities leading to the improvement of detectability and the availability of the recommended treatment of chronic hepatitis B should be strengthened.
Keywords: 2012; Poland; epidemiology; hepatitis B; immunization; infectious diseases; public health.