Epidemiological Characteristics of Imported Influenza A (H1N1) Cases during the 2009 Pandemic in Korea / 한국역학회지

OBJECTIVES: Quarantine measure for prevention of epidemic disease and further evaluations of their efficiency are possible only by elaborating analyses of imported cases. The purpose of this study was to analyze descriptive epidemiological characteristics of pandemic influenza A (H1N1) cases imported to Korea. METHODS: We collected two sets of data. The first set, comprised daily reported cases of H1N1 obtained from local cities in accordance with government policy about mandatory reporting of all H1N1 cases during May 1 to August 19, 2009. The second set, including 372 confirmed imported H1N1 cases, identified from 13 National Quarantine Stations in the Korea Centers for Disease Control and Prevention from May 24 to December 31, 2009. However, given the lack of information on the nature of the imported H1N1 cases from the two data sets during the over lapping period from May 24 to August 19, we express the number of imported cases as a range for this period. RESULTS: We estimated that the number of imported H1N1 cases from May 1 to August 19, 2009, was between 1,098 and 1,291 and the total number of cases was 2,409 to 2,580. We found the number of imported cases was beginning to diminish as of August. A analysis of the second data set showed that the distribution of sex was similar (males 50.7%, females 49.3%) and the age distribution from 20 to 59 was 61.5% and that of 60 and over was 0.8% of the 372 cases. We identified 25 countries where people infected with H1N1 traveled and 67.5% were in Asia. But the proportion of cases (/1,000) by region shows Oceania (0.199), South America (0.118), Southeast Asia (0.071), North America (0.049), Europe (0.035), and Northeast Asia (0.016) in that order. The order of H1N1 peaking was the Southern Hemisphere, Tropics, and the Nothern Hemisphere. CONCLUSIONS: This study provided information that could make possible the evaluation of the government quarantine measure for stopping imported disease from causing community-acquired spread in the future.

Four Cases of Dengue Fever-Dengue Hemorrhagic Fever and Domestic Literature Review / 감염과화학요법

Dengue virus infection is an emerging imported disease in Korea. A total of 4 cases of dengue fever or dengue hemorrhagic fever diagnosed at Soonchunhyang University Hospital in Bucheon between January 2001 and December 2007 were retrospectively reviewed. In addition, relevant domestic literatures from Korean bibliographic databases, which matched 'dengue fever', 'dengue hemorrhagic fever' or 'dengue shock syndrome' as key words, have been reviewed. Ten articles (13 patients) met the inclusion criteria and were included in this review. All the patients except for one, who was infected in Africa, were infected in Asian countries: Philippines (4), Indonesia (3), India (2), Cambodia (2), Sri Lanka (1), Thailand (1), Bangladesh (1), Myanmar (1), and Malaysia (1). Clinical manifestations after returning from abroad were as follows: fever (100%), chills (82%), headache (65%), myalgia (53%), nausea (41%), neutropenia (82%), thrombocytopenia (82%), and elevation of AST (82%) and ALT (53%). Most of the patients improved with conservative care except for one who died of dengue shock syndrome.

Four Cases of Dengue Fever-Dengue Hemorrhagic Fever and Domestic Literature Review / 감염과화학요법

Dengue virus infection is an emerging imported disease in Korea. A total of 4 cases of dengue fever or dengue hemorrhagic fever diagnosed at Soonchunhyang University Hospital in Bucheon between January 2001 and December 2007 were retrospectively reviewed. In addition, relevant domestic literatures from Korean bibliographic databases, which matched 'dengue fever', 'dengue hemorrhagic fever' or 'dengue shock syndrome' as key words, have been reviewed. Ten articles (13 patients) met the inclusion criteria and were included in this review. All the patients except for one, who was infected in Africa, were infected in Asian countries: Philippines (4), Indonesia (3), India (2), Cambodia (2), Sri Lanka (1), Thailand (1), Bangladesh (1), Myanmar (1), and Malaysia (1). Clinical manifestations after returning from abroad were as follows: fever (100%), chills (82%), headache (65%), myalgia (53%), nausea (41%), neutropenia (82%), thrombocytopenia (82%), and elevation of AST (82%) and ALT (53%). Most of the patients improved with conservative care except for one who died of dengue shock syndrome.

A Case of Dengue Fever Complicated by Rhabdomyolysis / 감염과화학요법

The dengue virus causes dengue fever and dengue hemorrhagic fever. It is an arbovirus and is transmitted by mosquitoes, Aedes aegypti. Dengue fever is an acute viral illness characterized by fever, skin rash, severe headache, myalgia and arthralgia. Rabdomyolysis rarely occurs in dengue fever in contrast with other viral infections. In this case, the patient was suffering from fever and severe myalgia, especially both lower extremities, after traveling to Philippines. He was diagnosed with dengue fever complicated by rhabdomyolysis as a result of serologic test and bone scan. He completely recovered with conservative care and nutritional support. We experienced a case of dengue fever complicated by rhabdomyolysis, which was treated successfully with conservative care.

A Case of Dengue Fever Complicated by Rhabdomyolysis / 감염과화학요법

The dengue virus causes dengue fever and dengue hemorrhagic fever. It is an arbovirus and is transmitted by mosquitoes, Aedes aegypti. Dengue fever is an acute viral illness characterized by fever, skin rash, severe headache, myalgia and arthralgia. Rabdomyolysis rarely occurs in dengue fever in contrast with other viral infections. In this case, the patient was suffering from fever and severe myalgia, especially both lower extremities, after traveling to Philippines. He was diagnosed with dengue fever complicated by rhabdomyolysis as a result of serologic test and bone scan. He completely recovered with conservative care and nutritional support. We experienced a case of dengue fever complicated by rhabdomyolysis, which was treated successfully with conservative care.

Infectious Disease Prevention for Travelers

Vaccination against yellow fever is recommended for travelers to areas where yellow fever has been reported, and they should be vaccinated 10 days before the travel at an approved center for the vaccination. When traveling to areas where chloroquine-resistant P. falciparum has not been reported, once-a-week use of chloroquine alone is recommended, but when traveling to areas where chloroquineresistant P. falciparum has been reported, other agents such as mefloquine, doxycycline, atovaquone/proguanil and primaquine should be chosen. Other recommended immunizations are typhoid vaccine and hepatitis A/B vaccine. Traveler's diarrhea is one of the major health problems in terms of frequency, but antimicrobial prophylaxis is not routinely recommended.

A Case of Dengue Shock Syndrome Imported from Myanmar / 감염과화학요법

Dengue fever/dengue shock syndrome is an acute febrile illness caused by a Flaviviridae virus. Dengue virus infection can cause a wide spectrum of illness, and disease is characterized by sudden onset of high fever, chill, severe headache, skin rash, general malaise and thrombocytopenia with hemoconcentration. Dengue fever is endemic in most tropical areas of world, including the Caribbean, Central and South America, Africa, and Southeast Asia. Tourists to these areas are liable to infection. We experienced a Korean female who returned to Korea from Myanmar in severely ill state. She was confirmed serologically to be inblieted with Dengue shock syndrome. In spite of intensive medical care, she died of Dengue shock syndrome. We emphasize that favorable prognosis depends mainly on the early recognition and treatment of shock.

A Case of Dengue Shock Syndrome Imported from Myanmar / 감염과화학요법

Dengue fever/dengue shock syndrome is an acute febrile illness caused by a Flaviviridae virus. Dengue virus infection can cause a wide spectrum of illness, and disease is characterized by sudden onset of high fever, chill, severe headache, skin rash, general malaise and thrombocytopenia with hemoconcentration. Dengue fever is endemic in most tropical areas of world, including the Caribbean, Central and South America, Africa, and Southeast Asia. Tourists to these areas are liable to infection. We experienced a Korean female who returned to Korea from Myanmar in severely ill state. She was confirmed serologically to be inblieted with Dengue shock syndrome. In spite of intensive medical care, she died of Dengue shock syndrome. We emphasize that favorable prognosis depends mainly on the early recognition and treatment of shock.

A case of imported dengue fever / 대한내과학회지

Dengue fever (DF) is an acute febrile viral disease frequently presenting with headache, bone or joint and muscular pain, rash and leukopenia. Dengue hemorrhagic fever (DHF) is characterized by four major clinical manifestations: high fever, hemorrhagic phenomena, often with hepatomegaly and in severe cases, signs of circulatory failure. Such patients may develop hypovolemic shock resulting from plasma leakage. This is called dengue shock syndrome (DSS) and can be fatal. The disease is one of the leading causes of hospitalization and death in children in several Asian, central and south American and African countries. Dengue fever and Dengue hemorrhagic fever have steadily increased in both incidence and distribution over the past 40 years. With an increased air travel, more travelers to the tropics and subtropics are returning within the incubation period of acute febrile infection. We experienced a Korean engineer with complaints of fever, chill, headache, nausea and myalgia after return from Malaysia and confirmed as dengue fever.