Epidemiological Study of Ground-waterborne Norovirus GI.3-associated Gastroenteritis Outbreaks in Gyeonggi Province of South Korea in May 2011

In May 2011, five consecutive gastroenteritis outbreaks were reported at schools in Gyeonggi-do. Epidemiological inspection revealed that one food manufacture company provided 'Kimchi', a traditional Korean side-dish, to these five schools for catering services. Fecal specimens were collected from students and food-handlers to determine causative viral agents. Norovirus genogroup GI was detected from 58 samples out of total 239 specimens by reverse-transcription (RT)-PCR, whereas norovirus GII was found only from one sample. Epidemiological studies also revealed that the Kimchi was processed using groundwater in the food manufacture company. Four groundwater samples were collected from the company and around the area. Norovirus GI was detected from three samples. To determine the norovirus genotypes of positive specimens from clinical and groundwater samples, sequencing and phylogenetic analyses were performed. The genogroup GI from 58 clinical and three groundwater samples and the GII from one food-handler were identified as norovirus GI.3 and GII.18, respectively. Sequence alignment analysis with norovirus GI.3 isolates revealed that identity between clinical and groundwater samples was over than 99.1% in nucleotide level. In conclusion, norovirus GI.3-contaminated groundwater caused the gastroenteritis outbreaks of five schools, through Kimchi. This molecular epidemiological study was an important report in Korea that clearly identified all transmission routes of norovirus GI.3.

An Outbreak of Gastroenteritis Caused by Norovirus-Contaminated Groundwater at a Waterpark in Korea

In January 2008, an outbreak of acute gastroenteritis at a waterpark was reported to the Bundang-gu Public Health Center in Seongnam, Korea. To determine the etiological agent and mode of transmission, a retrospective cohort study was done using structured questionnaires and stool samples from patients who had current gastrointestinal symptoms and three food handlers were tested. A total of 67 (31.0%) students and teachers developed acute gastroenteritis. No food items were associated with an increased risk of the illness. Norovirus was detected in 3 stool specimens collected from 6 patients who had severe diarrhea using semi-nested RT-PCR. All the specimens contained the genogroup I strains of the norovirus. Norovirus was also detected in the groundwater samples from the waterpark. In the nucleotide sequencing analysis, all the genogroup I noroviruses from the patients and groundwater samples were identified as the norovirus genotype I-4 strain. They were indistinguishable by DNA sequencing with a 97% homology. We conclude the outbreak of acute gastroenteritis caused by the norovirus was closely related to the contaminated groundwater.

An Outbreak of Gastroenteritis Caused by Norovirus-Contaminated Groundwater at a Waterpark in Korea

In January 2008, an outbreak of acute gastroenteritis at a waterpark was reported to the Bundang-gu Public Health Center in Seongnam, Korea. To determine the etiological agent and mode of transmission, a retrospective cohort study was done using structured questionnaires and stool samples from patients who had current gastrointestinal symptoms and three food handlers were tested. A total of 67 (31.0%) students and teachers developed acute gastroenteritis. No food items were associated with an increased risk of the illness. Norovirus was detected in 3 stool specimens collected from 6 patients who had severe diarrhea using semi-nested RT-PCR. All the specimens contained the genogroup I strains of the norovirus. Norovirus was also detected in the groundwater samples from the waterpark. In the nucleotide sequencing analysis, all the genogroup I noroviruses from the patients and groundwater samples were identified as the norovirus genotype I-4 strain. They were indistinguishable by DNA sequencing with a 97% homology. We conclude the outbreak of acute gastroenteritis caused by the norovirus was closely related to the contaminated groundwater.

Macroglossia secondary to lymphangioma of the deep neck space: Report of two cases / 소아과

Lymphangioma is a rare, benign, and hamartomatous tumor of the lymphatic vessels that shows a marked predilection for the head and neck region. When this tumor occurs on the tongue or mouth floor or in the deep neck space, blockage of the efferent lymphatic vessels can result in secondary macroglossia. We report here two patients who showed unusual macroglossia from birth. Initially, there was no noticeable cervical or mandibular swelling. However, mandibular swellings were noted during follow-up examinations, which led to MRI scans on the two infant patients at 5 months and 5 weeks of age, respectively. Subsequently, both patients were diagnosed with lymphangioma or lymphangiohemangioma in the deep neck space.

The characteristic laboratory findings of non-responsiveness to intravenous immunoglobulin in children with Kawasaki disease / 소아과

PURPOSE: Although intravenous immunoglobulin (IVIG) treatment is an effective first-line treatment for Kawasaki disease, 10-20% of the patients develop persistent fever or coronary artery complications. Medical records of Kawasaki disease patients were reviewed to assess the characteristic laboratory findings of IVIG nonresponsiveness. METHODS: We reviewed the clinical records of 118 children with Kawasaki disease who were treated at the Chonnam National University Hospital from March 2003 to February 2008. The laboratory findings of the IVIG-responder group (n=110) and the IVIG-nonresponder group (n=8) were compared at admission day and at 48 hours and 14 days after IVIG administration. RESULTS: At admission, the level of creatine kinase (CK) was lower (P = 0.03) and that of total protein was higher (P < 0.01) in the nonresponders than in the responders. At 48 hours after IVIG administration, the white blood cell (WBC) count (P = 0.04) and neutrophil% (P < 0.01) was higher in the nonresponders than in the responders. The neutrophil% (P < 0.01) and CK (P = 0.01) level at admission was lower than that at 48 hours after IVIG administration in the responders; this decrease was not as apparent in the nonresponders. CONCLUSION: IVIG nonresponders have lower CK and higher total protein levels at admission and higher WBC count and neutrophil% at 48 hours after IVIG administration. The decrease in the neutrophil% and CK level between at admission and at 48 hours after IVIG administration is remarkably higher in responders than in nonresponders.