Immunogenicity and Protective Effectiveness of Japanese Encephalitis Vaccine: A Prospective Multicenter Cohort Study / 소아감염

PURPOSE: This study aimed to study the antibody response of Japanese encephalitis vaccination in children using different kinds of vaccines (inactivated vaccine, live attenuated vaccine or interchanged) and evaluate the effectiveness of the vaccines to provide the basis of efficient immunization schedule of Japanese encephalitis. METHODS: Measurement of the neutralization antibody (NTAb) titers following Japanese encephalitis vaccination using different vaccines for 170 children, 2-6 year of age, who visited six university hospitals and are confirmed by immunization records. RESULTS: Among 170 children who were given primary immunization on Japanese encephalitis, 103 children were given inactivated vaccine, 64 children were given live attenuated vaccine and 3 children were given interchangeably. NTAb titers were more than 1:10 in all children of three groups. The geographic mean antibody titer was 322 in inactivated vaccine group and 266 in live attenuated vaccine group. However, there was no significant difference between two groups. In both groups, the NTAb titer showed the peak at 1-4 months after the third immunization and declined. The NTAb titers of three children who were given two kinds of vaccines alternately were 1:135, 1:632, and 1:2511, respectively. CONCLUSION: According to the results of this study in children younger than 6 years old, there is no significant difference in effectiveness between inactivated and live attenuated vaccines. However, further studies for the changes of antibody titers for a longer period of time on larger population are required.

Yellow Fever Vaccine-associated Viscerotropic Disease / 대한내과학회지

This report describes a case of yellow fever vaccine-associated viscerotropic disease (YEL-AVD) that occurred after vaccination in a 23-year-old male. Seven days after vaccination, our patient presented with fever, myalgia, and nausea. The IgM enzyme-linked immunosorbent assay (ELISA) for yellow fever virus was positive. After a 24 day hospitalization, he recovered and was discharged. Yellow fever is a viral hemorrhagic febrile illness caused by a flavivirus and transmitted by mosquitoes. The clinical presentation ranges from a mild febrile illness to a serious infection, leading to hepatic and renal failure, myocardial injury, hemorrhage, and shock, with a case fatality rate of 20-30%. Because yellow fever is a potentially fatal disease, vaccination is encouraged for people traveling to high-risk areas. Although considered a safe vaccine, severe adverse reactions have been reported. In 2001, rare, but severe, acute viscerotropic disease following vaccination was first described. We report the case of a 23-year-old male with fever and hepatitis following vaccination with 17D yellow fever vaccine.

Meningitis following vaccination with yellow-fever vaccine / 대한내과학회지

Yellow fever is the original viral hemorrhagic fever (VHF), a pansystemic viral sepsis with viremia, fever, prostration, hepatic, renal, and myocardial injury, hemorrhage, shock, and high lethality. Yellow fever was one of the most feared lethal diseases before the development of an effective vaccine. Yellow fever (YF) can be prevented by an attenuated vaccine. The yellow-fever 17D vaccine developed in the 1930s has been regarded as one of the most successful live attenuated vaccines, with few side effects or adverse events. The adverse effects associated with yellow-fever vaccine are generally mild and include headache, myalgia, and low-grade fever. Recently, however, some cases of severe neurologic disease and multi-organ system disease have been described in individuals who received yellow-fever vaccine. We report the case of a 39-year-old female with meningitis following vaccination with 17D yellow-fever vaccine.

Epidemiology and Prevention Strategies of Rabies in Korea / 한국역학회지

Rabies is a uniformly fatal encephalitis and cannot be treated, therefore efforts must be focused on preventing the disease. The incidence of rabies in humans and animals has decreased with the introduction of rabies vaccination for animals since the early 1950s in Korea. There was no rabies occurrence either in human or animal for 8 years from 1985 to 1992. However, a case of animal rabies recurred in 1993. Since then, rabies endemic areas were expanded into 17 counties near the demilitarized zone, and 6 human cases were reported from the endemic areas of animal rabies. According to epidemic studies, wild raccoon dogs were suspected to be the transmission source of rabies in dogs, domestic animals, and other wild animals, which resulted in human rabies. Rabies prevention strategies were aimed at the animals capable of transmitting rabies or vaccination for the high risk group and postexposure prophylaxis for the bitten patients. Unfortunately, these activities were not conducted appropriately and substantially. All rabies victims were either not treated or did not receive timely and appropriate postexposure treatment. Prevention of rabies can only be achieved by securing political and financial support for an effective rabies program. Key activities for rabies prevention should include changing current public perception regarding rabies, strengthening surveillance for the exposed person to suspected rabid animals, and laboratory-based rabies surveillance.