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1987년 한국에서 발생한 렙토스피라병의 혈청역학적 조사
이증훈,박영수,이우곤,김석용,정선식,우준희,박성광,박경희,송영욱,김선영,기정일,최두혁,강성귀,김주완,최강원,김우열,최명식,최인학,장우현,윤성열 대한감염학회 1988 감염 Vol.20 No.3
Human leptospirosis was an unfamiliar disease in Korea until 1984 that outbreak of leptospirosis occurred among farmers and soldiers after field works for harvesting rice. During that time, Lee and Jo confirmed the first Korean cases of leptospirosis by serological test, isolation of causative agent and autopy findings. Afterward several outbreaks occurred also during autumn especially after flood in every years and some characterisitcs of leptospirosis in Korea such as clinical manifestations, serotypes and seroepidemiological features has been revealed by many investigators. Because of the major mode of transmission between rodents and human is by direct contact with leptospiral urine of rodents or contaminated soil by the urine, leptospirosis in Korea has been primarily a disease of person in occupations heavily exposed to contaminated soil or infected urine such as farmer, army and etc. Therefore it seems that leptospirosis is one of the main communicable diseases to be controlled urgently in Korea, for an agricultural people account for almost half of total Korean people. For clarifying the seroepidemiological patterns of human leptospirosis in Korea by sex, month region and main reacting serovars of L. interrogans among acute febrile disease occurred in 1987, 1,773 patient's sers with acute febrile episodes were tested by microagglutination test using 19 representative strains of leptospiral serogroup as antigen. All of those sera were collected from 10 collaborative clinics located in Kyunggi, Kangwon, Chungbuk, Chungnam, Chonbuk, Chonnam province and Seoul. The results wee summerized as follows. 1) Among 1,773 sera of patients with acute febrile episodes, 219 (12.4%) were seropositive to L. interrogans, 487(27.5%) to R. tsutsugamushi, 241(13.6%) to R.typhi and 160(90.0%) to Hantaan virus. 2) Among seropositives to L.interrogans, the male outnumbered the female, 65% and 35%. 3) For age distribution, 26.9% of seropositives to L.interrogans were fifties, 19.6% were forties, 9.1% were sixties, 5.9% were thirties and 4.1% were twenties. 4) Eighty three percent of seropositives had occurred between September and October in 1987 with a peak in September. 5) Main leptospiral serovars reactive to patient's sera were Icterohaemorrhagiae(54.3%), Canicola(31.0%), CH-48(13.2%), Tarassovi(0.9%)and Cynopteri(0.5%). 6) For regional distribution, 65.8% of seropositives to L.interrogans were residents from Chonbuk, 12.3% were Chonnam, 7.3% were Chungnam, 5.5% were Kyunggi and 1.4% were Kangwon.
충청지역에서 발생한 쭈쭈가무시병의 임상상, 원인균의 혈청형 및 혈청역학적 연구
김선영,김윤성,박장규,윤태영,강재승,송인숙,최명식,최인학,차창룡,이우곤,박종우,이증훈,장우현,유영해,윤광혁,송계용 대한감염학회 1989 감염 Vol.21 No.2
From September to december 1987, eighty-six cases of tsutsugamushi disease were diagnosed by indirect immunofluorecent test or by isolating the causative agent in Chungcheung area. Their clinical features and patterns of antibody response to R. tsutsugamushi were analyzed. For the indenfication of prevalent antigenic types of R. tsutsugamushi in Chungcheung area, twenty-seven strains isolated were tested by indirect immunofluorescent test. To assess the extent of exposure to R.tsutsugamushi of a general population in Korea, the prevalence of antibody was investigated in 6,572 sera obtained from the residents of Chungcheung area by indirect immunofluorescent test. The female patients slightly outnumbered the male patients. More cases (68%) were older than 40 years of age. The epidemic peaked in October. The mean incubation period estimated was about 8 days. The major clinical features were fever and chill, headache, rash, eschar, and lymphadenopathy. Increased serm transaminase was the most singificant laboratory findings. Abnormalities in the chest roentgenography were often observed. The antibody titer rose rapidly 5 days after the onset, reached its peak at 20 days (1:640), and then declined agradually until 7 months(1:20). The seroype of 23 out of the 27 isolates wase found to be karp, one was Gilliam, and 3 isolates could not be classified by using polyclonal mouse hyperimmune sera. The prevalence of antibody to R.tsutsugamushi in the residents of Chungcheung area was 4.8%. The prevalence of antibody was higher in the female than in the male. The prevalence was higher in the residents of age above 40 years than below 40 years, and was the lowest in the children less than 10 years of age. Of the 318 positive sera from normal residents, only 2 sera showed the titers higher than 1:80.