A Fatal Case of Disseminated Tuberculosis Coincident with Measles-Rubella Vaccination / 한국역학회지

The authors report a fatal case of disseminated tuberculosis in a 14-yr-old girl, which developed immediately after a measles-rubella (MR) vaccination. Despite a markedly accelerated clinical course which led to death within two weeks, the authors could not identify any possible cause of the tuberculosis aggravation in this case, with the exception of the MR vaccination. The possible role that MR vaccination had on the clinical course of tuberculosis in this case is discussed.

Current Situation of Re-emerging Malaria and Elimination Plan in Republic of Korea

No abstract available.

Current Situation and Elimination Plan of Water-borne Infectious Diseases

No abstract availabe.

Cause of Enterohemorrhagic Escherichia coli Infection in Ulju County, Korea / 예방의학회지

OBJECTIVES: Two related cases of Hemolytic-Uremic Syndrome (HUS) were reported to the Korea National Institute of Health in May, 2001. Shiga toxin 2 genes were detected in both stool samples. We suspected an enterohemorrhagic Escherichia coli (EHEC) infection as the cause of the HUS, and conducted an investigation to find the source of the infection and its route of transmission. METHODS: We performed case investigations on these two related HUS cases, and obtained interviews and rectal swabs form the family members and other close contacts. Additionally, we performed rectal swabs on the cattle raised by the household of the index patient. RESULTS: We found a 20 month old index patient and a 6 year-old cousin had developed HUS, where there had been a 2 day history of contact with the index, and bacteriological examinations for these two patients revealed, indistinguishably, the same E. coli O171. The grandmother of the index patient was found to be asymptomatic, but E. coli O26 was isolated. We also found a probable case in the mother of the cousin. She reported a history of contact with the index, and developed bloody diarrhea of 3 days duration. The test results for the cattle revealed E. coli O26 in one cow, and E. coli O26 and O55 in another. E. coli O26, which was isolated in both cows and the grandmother of the index, were indistinguishably the same. CONCLUSIONS: We found that the E. coli O26 in the grandmother had originated from the cows, and that the E. coli O171 found in the index patient had been transmitted to the cousin through person-to-person contact.

Survey on the Epidemiological Characteristics of Measles Incidence between 1980 and 1999 Year in Korea / 감염

BACKGROUND: This study reports the incidences of measles in Koea and the epidemiologic characteristics for the incidence reported for the period 1980~1999. It provides the epidemeologic adta for measles before implementing the catch-up campaign in 2001. METHODS: We obtained information for the survey from the data for the incidence reported from health centers. Incidences per 100,000 population were calculated for the 1963~1999. And the following variables were studied: seasonal or regional distribution for the 1980~1999. RESULTS: The incidence rate of measles declined after the systemic immunization in 1990, the outbreak of measles occurred periodically and incidences per 100,000 population increased from 8.4 cases in 1990 to 17.7 in 1994. In 1990 and 1994, measles cases centered around the 5~6th month. On the other hand, in non-epidemic year measles cases were scattered around the year. The incidence rates of measles by the province were greatly defferent whenever the outbreak of measles occurred. CONCLUSION: In 1990s, the outbreak of measles occurred periodically at the interval of 4 years until 1994. The seasonal distribution may be caused by Iimitation of transmission due to the increased measles immunity in outbreak region. Our results showed that the measles outbreak did not occur in the specific province, but it occurred nationwide whenever measles outbreak occurred, even though the incidence rates of the provinces were different.

Epidemiological Characteristics of Measles Outbreakin 2000~2001, Korea / 감염

BACKGROUND: In 2000~2001 there was a nationwide outbreak of measles in the Republic of Korea. Since supplementary vaccination program was implemented in 2001, the control strategy of this measles outbreak has been stepped up from the control phase to the elimination phase. We here present the result of survey for the epidemiologic characteristics of the nationwide outbreak of measles in 2000~2001. METHODS: Using the data based on the sheet of epidemiologic investigation, incidences rates per 100,000 population and distributions of cases with vaccination history were investigated by the age. The seasonal or regional distribution were also studied with the onset days of cases. RESULTS: In 2000~2001, a measles outbreak occurred with 52,897 reported cases. The incidence rate per 100,000 population of measles was 111.9 cases and that of geopolitical unit (province) was high nationwide, 35.9~386.3 cases. The incidence rates were very high in less than 12 months and 10 years of age, 954.4 and 714.9, respectively. The 1st vaccination rate of measles/mumps/rubella (MMR) in 1~3 years old was 26.3~77.1%, and especially, that of 1 year old showed very low coverage, 26.3%. However, there was no special propensity in the 1st vaccine coverage in the age of 7~15 years, which had 87.7~91.4%. On the other hand, the 2nd MMR vaccination rate of the cases was very low, 17.7% at the age of 7~10 years. From the 21st May, 2001 a mass catch-up campaign with measles/rubella (MR) vaccine was launched, resulting in prominent reduction in the incidence of measles case. CONCLUSION: This survey showed that the measles outbreak in 2000~2001 had a high incidence nationwide from October 2000 to April 2001 and in less than 12 month and 10 years of age. Our results also showed that no routine immunization made the age group under 1 year vulnerable to measles infection. In cases of school-age group after 7 years of age, some cases with vaccination history were also infected. The characteristics of recent outbreaks indicates the need for the introduction of a specific vaccination programme at that age group. This survey was helpful to establish the effective vaccination strategy and it would be used as reference data on survey continuously for the epidemiologic characteristics of measles case for elimination of indigenous measles transmission in Republic of Korea.

Status of Vivax Malaria in the Republic of Korea in 2000 / 감염

BACKGROUND: Since 1997, the annual case occurrence of vivax malaria in the Republic of Korea have exceeded 1,000 cases since 1997. The military is thought to be an important source of the current outbreak. We collected various informations about malaria cases (soldiers, veterans and civilians) which occurred in 2000, and analyzed the characteristics of the current outbreak. METHODS: Informations about malaria cases of soldiers, veterans and civilians, including name, age, sex, day of onset, region, etc., were collected through the National Institute of Health. RESULTS: Out of total 4,141 cases, 1,288 (31.1%) occurred in the military, 1,273 (30.7%) occurred among the veterans, and 1,580 (38.2%) occurred among civilians. The monthly case occurrence reached its peak in early August. Areas such as Cheolwon, Yeoncheon and Paju showed the highest prevalence. CONCLUSION: It is considered that the current malaria outbreak has escaped from the exponential growth phase, however, more attention should be paid to prevent further spreading of malaria infection.

A Epidemic Survey of the Shigellosis in Jeju Island during the First Half of Year 2000 / 한국역학회지

PURPOSE: A field investigation was done to evaluate the level of the epidemic of Shigellosis in Jeju Island during the first half of year 2000. METHODS: Confirming the Shigellosis was done by the structured questionnaire and the result of rectal swab for the residents having a diarrhea. RESULTS: As the confirmed patients with Shigella sonnei were 933 from 25 April to 14 August 2000, the crude incidence rate was 174 per 100,000 persons. The highest incidence rate was shown in 5-9 year-old group. Especially the south area of Jeju Island, called as Namjejugun, had the major epidemic occurrence. CONCLUSIONS: The huge and chronic epidemic of Shigellosis was confirmed. The nature of this epidemic suggested that the endemic occurrence had been existed in Jeju Island.

Epidemiology of Malaria in Korea, 2000 / 한국역학회지

PURPOSE: In Korea, vivax malaria re-emerged in 1993 and the outbreak continued in several areas near the DMZ until now. This study was conducted to define the epidemiologic pattern of malaria in Korea and to examine the changes comparing to the one in 1999. METHODS: We collected information about civilian, veteran patients through the National malaria surveillance system and soldier from the Ministry of National Defense. We analyze epidemiological characteristics of malaria by groups (civilian, veteran, soldier). RESULTS: The reported cases of malaria in 2000 were 4,142 that number is an increase of 14% in numbers compared with those of 1999's. Most of cases occured in 17 counties nearby DMZ and from May to October(98.7%) seasonally. The incidence rates (per 100,000) in 2000 by residence were 17.0 in Gangwon-Do, 15.5 in Incheon Metropolitan city, 10.3 in Gyeonggi-Do was dereased. The risk area in 2000 were 17 counties located nearly DMZ and the high risk area were 5 counties where the incidence rate greater than 100. In case of civilian and veteran, the time required to diagnosis from onset of symptom was 8.1 days on the average. CONCLUSION: Epidemiologic pattern of malaria in 2000 did not differ from the one in 1999. Et showed regional spread (increasing risk area) but incidence rate was lowered in the high risk area of 1999. And it is necessary that we pay more attention to Gangwon-Do and Incheon metrocity to reduce the incidence rate in 2001.

An Outbreak of Vivax Malaria in Republic of Korea in 1999 / 감염

BACKGROUND: Annual occurrence of vivax malaria in Republic of Korea (ROK) has exceeded 1,000 cases since 1997. Military system is thought to be a important source of the current outbreak. We collected the information on malaria cases of ROK army, veterans and civilians which occurred in 1999, and analyzed the characteristics of the current outbreak. METHODS: Informations on malaria cases of ROK army, including name, age, sex, rank, force, day of onset, region, etc., were collected through the Office of Surgeon General at Headquarters of ROK army and then analyzed. Informations about malaria cases of veterans and civilians, including age, sex, day of onset, region, etc., were collected through the National Institute of Health and then analyzed. RESULTS:Among a total of 3,628 cases in 1999, 1,085 (29.91%) occurred in the military, 996 (27.45%) occurred in veterans, and 1,547 (42.64%) occurred in civilians. Monthly occurrence reached its peak level at July and had maintained to August. Yeoncheon, Cheolwon and Paju were the highest prevalence region. CONCLUSION: Case occurrence in ROK decreased in 1999 and it was contributed by chemoprophylaxis which has been done since 1997 in the military. It is thought that more attention must be given to protect the further spread of malaria infection.