한 병원 의료종사자의 A형 간염 혈청역학과 예방접종

김민수,채석래,김의석,장윤정,허희진,이진호 대한감염학회 2009 Infection and Chemotherapy Vol.41 No.5

Background:Recently, the incidence of hepatitis A has increased in Korea and an outbreak among healthcare workers (HCWs) has also been reported. This study was performed to evaluate the seroepidemiology of hepatitis A among HCWs and their response to vaccination recommendation at a Korean hospital. Materials and Methods:HCWs aged 20–39 years were tested for IgG antibodies against hepatitis A virus (HAV) using ARCHITECT HAVAb-IgG (Abbott Diagnostics Division, Wiesbaden, Germany) during July, 2008. Vaccination was recommended for the seronegative HCWs. Data on age, sex, place of birth, number of siblings, number of children, travel history to endemic areas, occupations, and vaccination history were collected. Statistical analyses were conducted to identify variables related to HAV seropositivity. Results:Among a total of 391 HCWs enrolled, 75 (19%) were males and 316 (81%) were females. The percentages of HCWs aged 20 to 24 years, 25 to 29 years, 30 to 34 years, and 35 to 39 years were 23%, 48%, 17%, and 12%, respectively. The study population comprised of physicians (11%), nurses (62%), nurse aides (5%), paramedical technicians (13%), and administrative staff (9%). Seropositivity for HAV significantly increased with age (P< 0.05):1.1% for 20–24, 8.6% for 25–29, 35.8% for 30–34, and 60.9% for 35–39 years-of-age. Multivariate analysis revealed that HAV seroprevalence correlated significantly with age, HCWs born in the non-metropolitan areas, and having ≥ 3 children (P<0.05). The types of work the HCWs do at the hospital were not significantly associated with HAV seropositivity in multivariate analyses. Of a total of 322 seronegative HCWs, 121 (38%) were not vaccinated in spite of recommendation. The reasons for non-compliance were lack of understanding on the necessity of vaccination (39%), lack of time (26%), expensive costs (16%), fear of injection (15%), and some other reasons including pregnancy (4%). Conclusions:Since the seropositivity for HAV is low, vaccination against Hepatitis A should be considered for all HCWs aged 20-39 years in Korea. Education on the necessity of vaccination is warranted to increase compliance. Background:Recently, the incidence of hepatitis A has increased in Korea and an outbreak among healthcare workers (HCWs) has also been reported. This study was performed to evaluate the seroepidemiology of hepatitis A among HCWs and their response to vaccination recommendation at a Korean hospital. Materials and Methods:HCWs aged 20–39 years were tested for IgG antibodies against hepatitis A virus (HAV) using ARCHITECT HAVAb-IgG (Abbott Diagnostics Division, Wiesbaden, Germany) during July, 2008. Vaccination was recommended for the seronegative HCWs. Data on age, sex, place of birth, number of siblings, number of children, travel history to endemic areas, occupations, and vaccination history were collected. Statistical analyses were conducted to identify variables related to HAV seropositivity. Results:Among a total of 391 HCWs enrolled, 75 (19%) were males and 316 (81%) were females. The percentages of HCWs aged 20 to 24 years, 25 to 29 years, 30 to 34 years, and 35 to 39 years were 23%, 48%, 17%, and 12%, respectively. The study population comprised of physicians (11%), nurses (62%), nurse aides (5%), paramedical technicians (13%), and administrative staff (9%). Seropositivity for HAV significantly increased with age (P< 0.05):1.1% for 20–24, 8.6% for 25–29, 35.8% for 30–34, and 60.9% for 35–39 years-of-age. Multivariate analysis revealed that HAV seroprevalence correlated significantly with age, HCWs born in the non-metropolitan areas, and having ≥ 3 children (P<0.05). The types of work the HCWs do at the hospital were not significantly associated with HAV seropositivity in multivariate analyses. Of a total of 322 seronegative HCWs, 121 (38%) were not vaccinated in spite of recommendation. The reasons for non-compliance were lack of understanding on the necessity of vaccination (39%), lack of time (26%), expensive costs (16%), fear of injection (15%), and some other reasons including pregnancy (4%). Conclusions:Since the seropositivity for HAV is low, vaccination against Hepatitis A should be considered for all HCWs aged 20-39 years in Korea. Education on the necessity of vaccination is warranted to increase compliance.

Seroepidemiology of Toxocariasis and Its Clinical Implications in Gwangju and Jeonnam-province, Korea

원은정,김진,신명근,신종희,서순팔,양동욱 대한진단검사의학회 2015 Annals of Laboratory Medicine Vol.35 No.4

We investigated the seroepidemiological, clinical, and laboratory characteristics of patients suspected to have toxocariasis in Gwangju and Jeonnam-province, Korea. In total, 228 specimens were analyzed for anti-Toxocara canis IgG at two university hospitals from 2010 to 2012. The overall seropositive rate was 67.1%, and the seropositive rates among the eosinophilic and non-eosinophilic groups were 76.1% (105/138) and 53.3% (48/90), respectively. Risk factors for eosinophilia and toxocariasis were male sex (odds ratios [OR]=2.632 and 3.477, respectively) and a history of ingesting raw meat (OR=2.884 and 3.274, respectively), especially raw cow liver (OR=2.089 and 10.038, respectively). T. canis seropositivity (OR=5.807, P=0.004) and a history of consuming raw cow liver (OR=2.766, P=0.052) were risk factors for organ involvement. The anti-T. canis IgG level showed weakly positive correlations with eosinophil counts (r=0.234, P<0.001) and the duration of eosinophilia (r=0.155, P=0.019). Although limited to the regions of Gwangju and Jeonnam-province, this study supports the opinion that toxocariasis is a reasonable focus as a cause of eosinophilia and that it is also associated with organ involvement.

Seroepidemiology of Varicella-Zoster Virus in Korea

이현주,김경효,조혜경 대한의학회 2013 Journal of Korean medical science Vol.28 No.2

This study was designed to assess the immune status of the Korean population against varicella-zoster virus (VZV) through a seroepidemiologic study. Residual blood samples were collected from diagnostic laboratories throughout Korea. Samples were collected in October 2009 to March 2010 from persons 0-79 yr of age and were tested by ELISA (Enzygnost®; Dade Behring, Schwalbach, Germany). Total seroprevalence in subjects 1-79yr of age was 89.6%. Seroprevalence increased as age increased from 67.3% in subjects 1-4 yr of age to 94.2% in subjects 10-14 yr of age and in subjects over 20 yr of age seroprevalence ranged from 98.0% to 100%. In children under 1 yr of age, passive immunity waned after birth with none of the subjects having antibodies from 7 months of age and over. Among subjects 1-79 yr of age, susceptible subjects to VZV were mainly under 20 yr of age. These results provide information in understanding the dynamics of varicella disease in Korea, which is important in building up strategies for disease control.

학동기 아동에서 A형 및 B형 간염의 혈청학적 역학조사 -1998년 현재 서울 일부지역을 대상으로-

고재성,배선환,정주영,정준기,서정기,Ko, Jae-Sung,Bae, Sun-Hwan,Chung, Ju-Young,Chung, June-Key,Seo, Jeong-Kee 대한소아소화기영양학회 1999 Pediatric gastroenterology, hepatology & nutrition Vol.2 No.1

Purpose: The aim of this study is to investigate the seroepidemiology of hepatitis A and hepatitis B in Korean children. Methods: 801 children aged 6 to 12 years were enrolled. IgG antibody to hepatitis A virus (anti-HAV), hepatitis B surface antigen (HBsAg), antibody to HBsAg (anti-HBs), and IgG antibody to HBc (anti-HBc) were measured by radioimmunoassay. Results: Of the 801 children, the seroprevalence of anti-HAV was 0%. Three (0.4%) were seropositive for HBsAg. The seroprevalence of anti-HBs was 61.8%. Two (0.4%) of 495 anti-HBs positive subjects were positvie for anti-HBc. Of the 801 children, 658 (82.1%) had received hepatitis B vaccination. Conclusions: Since natural anti-HAV is not acquired in the childhood, the outbreak of hepatitis A is possible in adolescents and young adults. The decrease in seroprevalence of HBsAg and the increase in seroprevalence of anti-HBs might result from hepatitis B vaccination program in childhood. 목 적: 1998년 학동기 소아에서 anti-HAV 보유율과 HBsAg, anti-HBs의 보유율을 조사하고자 본 연구를 시행하였다. 방 법: 서울지역의 한 초등학교에서 6~12세의 학생 801명을 대상으로 anti-HAV, HBsAg, anti-HBs, anti-HBc IgG를 radioimmunoassay법으로 검사하였다. 결 과: 전체 801명 중 anti-HAV 보유율은 0%이었다. HBsAg 양성은 801명 중 3명(0.4%)이었다. anti-HBs 양성은 495명(61.8%)이었다. 연령별로는 6세 60.7%, 7세 60.0%, 8세 53.7%, 9세 68.1%, 10세 59.3%, 11세 69.0%이었다. anti-HBs 양성자 중 2명(0.4%)이 anti-HBc 양성으로 나와 anti-HBs 양성의 대부분은 예방접종에 의해 생긴 것으로 생각한다. B형 간염 백신을 접종받은 아동은 658명으로 예방접종률은 82.1%이었다. 결 론: 소아에서 A형 간염 항체의 자연 획득이 거의 없는 상태에서 청소년과 성인에서 A형 간염의 집단 발병이 일어날 가능성이 있다. 소아에서 B형 간염 예방접종이 실시된 결과로 소아에서 B형 간염 항원 보유율은 감소하고 항체 보유율은 증가하고 있다.

1991년 韓國에서 發生한 신증후출혈열, 쯔쯔가무시병, 발진열, 홍반열 및 렙토스피라증 환자의 혈청역학적 조사

李光來,白樂柱,宋琪峻,禹永大,李容周,李鎬汪 고려대학교 의과대학 1994 고려대 의대 잡지 Vol.31 No.1

Acute febrile hemorrhagic diseases that occurred in Korea have been confirmed as Hemorrhagic fever with renal syndrome (HFRS), Scrub typhus, Murine typhus, Spotted fever and Leptospirosis. We accumulated 2,679 sera from patients who showed symptoms of Acute febrile hemorrhagic diseases during the year of 1991 and confirmed serologically via examining the antibodies to the etiologic agents of Hemorrhagic fever with renal syndrome, Scrub typhus, Murine typhus, Spotted fever and Leptospirosis, then analysed their seroepidemiologic characteristics. The results were as follows : 1. Of 1,234 serologically confirmed HFRS cases during the year of 1991 in Korea, 374 cases were confirmed at the Institute for Viral Diseases, Korea University, 432 cases at Seoul Nat'l University Colleage of Medicine, 150 cases at NIH, Republic of Korea and 278 cases at Korea Green Cross Hospital. 2. Of 2,679 sera from acute febrile hemorrhagic disease patients tested in 1991, 374 cases of HFRS, 150 cases of Murine typhus, 377 cases of Scrub typhus, 10 cases of Spotted fever and 15 cases of Leptospirosis were confirmed serologically. 3. Analysis of geographic distribution of acute febrile hemorrhagic disease patients revealed that the majority of HFRS patients occurred in Kyunggi-do, Seoul city, Chungcheongnam-do and Jeollanam-do and Murine typhus occurred mostly in Seoul city, Kyunggi-do and Chungcheongnam-do and Scrub typhus occurred mostly in Seoul city, Kyunggi-do, Chungcheongnam-do and Jeollabuk-do and 8 cases of Spotted fever confirmed in Seoul city and Chungcheongnam-do and few Leptospirosis patients occurred in Seoul city, Kyunggi-do and Kangwon-do. 4. Seasonal and monthly incidence of acute febrile hemorrhagic diseases indicated that HFRS in civilian population had two seasonal peaks, summer and fall but, in military persons one seasonal peak, fall and Murine typhus occurred mostly between July and December and Scrub typhus occurred mostly in October and December and Spotted fever and Leptospirosis occurred only in summer. 5. Sex distribution of acute febrile hemorrhagic diseases showed that HFRS occurred mainly in male and the incidence of male was twice as much as that of female and Murine typhus also occurred mainly in male and Scrub typhus occurred in female but incidence of female to male was nearly same and Spotted fever and Leptospirosis occurred mostly in male. 6. Age distribution of acute febrile hemorrhagic diseases showed that HFRS occurred mainly in adult and Scrub typhus occurred in all age groups, but, occurred especially in older age groups between 40 year old and 80 year old age and Spotted fever and Leptospirosis occurred chiefly in adult. 7. In 1991, 44 HFRS patients occurred between October and December, but, there was no incidence of HFRS in summer in Korean Army. Only 1 Scrub typhus and 1 Murine typhus patients occurred in Korean Army. Above results revealed that HFRS, murine typhus, scrub typhus, spotted fever and leptospirosis patients occurred throughout the year in Korea but, the fact that about 60% of clinical cases of acute febrile hemorrhagic diseases patients were still not diagnosed serologically revealed that another diseases Will be exist.

한 병원 의료종사자의 A형 간염 혈청역학과 예방접종

김민수,김의석,장윤정,허희진,채석래,이진호 대한감염학회 2009 감염과 화학요법 Vol.41 No.5

Background : Recently, the incidence of hepatitis A has increased in Korea and an outbreak among healthcare workers (HCWs) has also been reported. This study was performed to evaluate the seroepidemiology of hepatitis A among HCWs and their response to vaccination recommendation at a Korean hospital. Materials and Methods :HCWs aged 20-39 years were tested for IgG antibodies against hepatitis A virus (HAV) using ARCHITECT HAVAb-IgG (Abbott Diagnostics Division, Wiesbaden, Germany) during July, 2008. Vaccination was recommended for the seronegative HCWs. Data on age, sex, place of birth, number of siblings, number of children, travel history to endemic areas, occupations, and vaccination history were collected. Statistical analyses were conducted to identify variables related to HAV seropositivity. Results : Among a total of 391 HCWs enrolled, 75 (19%) were males and 316 (81%) were females. The percentages of HCWs aged 20 to 24 years, 25 to 29 years, 30 to 34 years, and 35 to 39 years were 23%, 48%, 17%, and 12%, respectively. The study population comprised of physicians (11%), nurses (62%), nurse aides (5%), paramedical technicians (13%), and administrative staff (9%). Seropositivity for HAV significantly increased with age (P<0.05):1.1% for 20.24, 8.6% for 25-29, 35.8% for 30-34, and 60.9% for 35-39 years-of-age. Multivariate analysis revealed that HAV seroprevalence correlated significantly with age, HCWs born in the non-metropolitan areas, and having ≥ 3 children (P<0.05). The types of work the HCWs do at the hospital were not significantly associated with HAV seropositivity in multivariate analyses. Of a total of 322 seronegative HCWs, 121 (38%) were not vaccinated in spite of recommendation. The reasons for non-compliance were lack of understanding on the necessity of vaccination (39%), lack of time (26%), expensive costs (16%), fear of injection (15%), and some other reasons including pregnancy (4%). Conclusions : Since the seropositivity for HAV is low, vaccination against Hepatitis A should be considered for all HCWs aged 20-39 years in Korea. Education on the necessity of vaccination is warranted to increase compliance.

정상 성인에 있어서의 B형 간염 바이러스 감염에 관한 혈청역학적 연구

유근영,박병주,안윤옥,Yoo, Keun-Young,Park, Byung-Joo,Ahn, Yoon-Ok 대한예방의학회 1988 Journal of Preventive Medicine and Public Health Vol.21 No.1

While there have been not a few reports on the seroepidemiological characteristics of hepatitis B virus (HBV) infection in Korea, most of them, however, have had several limitations; operational definition of HBV infection, validity of detection methods of HBV serologic markers, size of the study population, and confirmation of the vaccination history against HBV, etc. In order to avoid such limitations, authors randomly selected 1,495 healthy adults among the 217,511 insured (target population) of Korean Medical Insurance Corporation, living in seoul, and tested HBV serologic markers by RIA method and conducted direct interview to them. Although HBV serologic markers (HBsAg, anti-HBs and anti-HBc) of all the subjects were tested, 392(26.2%) of interview failure cases and 361 vaccinee were excluded from the actual population. Finally, the serologic markers tested of 742 nonvaccinee (study population) only were analysed for the seroepidemiologic observation of the natural infection of HBV. The seroepidemiological characteristics of HBV infection in Korea were as follows ; 1. Point prevalence of HBs antigenemia was 11.7(9.1{\sim}14.3)% in male, which was slightly higher than that of female, 9.5($3.7{\sim}15.3$)%. This level was one of the highest among those of Asian-Pacific countries. Decreasing tendency of HBsAg prevalence alter the age of 50 was observed, which seems to be due to selective attrition of HBV chronic carriers among the healthy adults and/or to the limited-lasting duration of the HBs antigenemia, in part. 2. Point prevalence of anti-HBc(78.8% in male,50.9% in female) was higher than that of anti-HBs(65.2% in male,46.6% in female), respectively. And both of them were higher in male than in female. Increasing tendency of the prevalence of both antibodies was observed by age, which seems to be largely due to recurrent infection in adults and to some cumulative effect, in part, of their relatively longer-lasting duration. 3. The level of HBV infection defined by positive for at least one of the 3 serologic markers of HBV by RIA method was 84.7($81.8{\sim}87.6$)% in male and 61.2($51.9{\sim}70.5$)% in female, which was also one of the highest among those of Asian-Pacific countries. The proportion of susceptible population to HBV infection among healthy adults was 15.3% in male and 38.8% in female. 4. The relative frequency of current or past infection and chronic carrier among HBV infected person was estimated. The currently or past infected was estimated 75.7% in male and 71.8% in female, and chronic carrier state, 13.8% in male and 14.1% in female. The analysis of the geometric mean of the antibody titer in anti-HBs positive sera indicated also to be compatible with the above findings, suggesting that active, even though inapparent, infection of HBV occur so frequently among healthy adults in Korea.

중국 연변지역 주요 기생충질환에 대한 혈청역학적 조사

주경환,전복실,권혜수,조성원,이순옥,Joo, Kyoung-Hwan,Quan, Fu Shi,Kwon, Hye-Soo,Cho, Sung-Weon,Li, Shun Yu 한국농촌의학지역보건학회 1998 농촌의학·지역보건 Vol.23 No.2

간흡충(Clonorchis sinensis), 폐흡충(Paragonimus westermani), 스팔가눔(sparganum), 뇌낭미충(Cysticercus cellulosae), 아니사키스(Anisakis spp.), 선모충(Trichinella spiralis), 개화충(Toxocara canis)에 대한 IgG항체반응을 ELISA를 이용하여 연변지역주민의 혈청역학적 조사를 시행하고 그 결과를 PC-SAS 시스템으로 통계분석하여 다음과 같은 결과를 얻었다. 1995년 10월부터 1997년 6월 사이에 수집된 총 975명의 혈청에 대한 검사결과 23.87%에서 한 종류이상의 혈청항체 양상을 나타내였다. 이중 간흡충증은 5.74%, 폐흡충증은 4.92%, 낭미충증은 1.54%, 스팔가눔증은 8.51%, 아니사키스증은 1.85%, 개회충증은 12.51%, 선모충증은 7.08%의 혈청항체 양성률을 나타내었다. 판정된 양성혈청을 통계분석한 결과 간흡충(p<0.01), 혜흡충(p<0.01), 아니사키스(p<0.05), 개회충(p<0.01), 선모충(p<0.01)의 각 연령그룹비교에서 통계학적으로 유의한 차이를 나타내었고 스팔가눔증은 성별 사이에 유의한 차이가 보였다(p<0.05). 간흡충과 폐흡충은 50대 연령층에서 높은 양성항체가를 나타내는 반면 개회충과 선모충은 20대에서 높은 항체가를 보여주었다. 또한 내과질병으로 않고 있는 환자혈청은 낭미충증을 제외한 6종류 윤충류에서 정상대조인과 비교하여 볼 때 모두 통계학적으로 유의한 차이를 나타내었다(p<0.05 혹은 p<0.01). 즉 환자가 정상대조인보다 혈청양성률이 훨씬 높았다. 이상의 결과는 물론 선충사이의 교차반응이 있을거라고 추측되며 정확한 진단을 위해서는 EITB를 시행해야 한다고 생각한다. 이번 조사는 중국 연변에서 처음으로 되는 혈청역학조사이며 앞으로 기생충진환 퇴치대책에 아주 중요한 기초자료가 될 수 있을 것으로 생각한다. Antibody responses(IgG) to Paragonimus westermani. Clonorchis sinensis, Cysticercus cellulosae, Sparganum Anisakis simplex, Toxocara canis and Trichinella spiralis were studied. The ELISA technique was performed to determine the prevalence of above helminthic diseases. 975 cases obtained from Yanbian of China during October, 1995 to July, 1997 were examined with a positive antibody titer of 5.74% in clonorchiasis, 4.92% in paragonimiasis, 1.54% in cysticercosis. 8.51% in sparganosis, 1.85% in anisakiosis, 12.51% in toxocariasis, and 7.08% in trichinosis respectively. And 23.87% in showed positive antibody titer at least one of the seven helminths. The differences of the age and sex in the positive sera were analysed by the Chi-squared test and the level of significance accepted was p<0.05. The significant differences in positive antibody production were P.W.(p<0.01). C.S.(p<0.01), A.S.(p<0.05). T.C.(p<0.001), and T.S.(p<0.01) respectively in age groups. sparganosis(p<0.05) in sex groups. Other parasites showed that there were no significant differences among age groups and sex groups(males and females). Higher positive antibody rate of C.S. and P.W. occured in the 50-59 years old and those of T.C. and T.S. happened in the 20-29 years old. Patients of internal disease showed more positive antibody titer, that is to say, there was significant difference between positive rate of internal diseases and that of control (p<0.01. p<0.05) in 6 helminths except cysticercosis. The result showed that some cross reactions existed among nematodes, and the developed techniques(EITB) should be done for a correct diagnosis. Also the prevalence of some important helminths may be evaluated from the result and it would be a basic data for controlling parasitic diseases in Yanbian.

건강한 한국 소아에서 인 헤르페스 바이러스 6형의 면역혈청학적 역학 및 감염형에 관한 연구

이란,허재균,김종현,신완식,최정현,한훈,강진한 대한감염학회 2000 감염 Vol.32 No.6

Investigation of seroepidemiology of Mycoplasma hyopneumoniae infection and establishment of on-farm eradication protocol

석호봉,주한수,Seok, Ho-bong,Joo, Han-soo The Korean Society of Veterinary Science 1999 大韓獸醫學會誌 Vol.39 No.6

The purposes of this study are to examine seroprevalence of Mycoplasma hyopneumoniae infection in pigs of different age groups, and retrospectively determine if nursery depopulation (ND) could influence the seroprevalence of M hyopneumoniae infection in nurseries. Sera of 4, 8, 12, 16, and 20 weeks old pigs from 7 farms were first selected from a serum bank to examine serologic profiles for M hyopneumoniae infections. Availability of representative sera in the serum bank was a major criterion for farm selection. The sera were tested for M hyopneumoniae antibodies by an enzyme linked immunosorbent assay (ELISA) using Tween-20 extracted antigen. Serum samples were also selected from 15 of 34 swine farms that previously participated in a ND study. In order to evaluate M hyopneumoniae infection following ND, ELISA was performed with sera of 8~10 weeks old nursery pigs collected prior to and after ND for up to 12 months from the 15 farms. Serological profiles showed positive ELISA titers for 2 of 7 farms at 8 weeks, 4 of 7 farms at 12 weeks, 6 of 7 farms at 16 weeks, 6 of 6 farms at 20 weeks of age. Prior to ND, 11 of the 15 farms had positive titers in sera of 8~10 weeks old pigs. Sera of 8~10 weeks old pigs collected from 7 of the 11 farms (63.6%) were ELISA antibody negative for up to 12 months following ND. In conclusion, seroconversion to M hyopneumoniae was detected commonly between 10~16 weeks of age, indicating the occurrence of natural infection during the nursery age. The ND appeared to be an effective method to prevent M hyopneumoniae infection within the nursery pig in some farms.