엔테로바이러스 실험실 감시 : 1999-2003 = Updates on Enterovirus Surveillance in Korea

국문 초록 (Abstract)

목 적 : 1999-2003년 기간 중 국내의 무균성 수막염, 수족구병, 포진성구협염, 급성 출혈성 결막염 등 엔테로바이러스 감염 의심환자로부터 엔테로바이러스 검출하고 유전자 분석을 실시하여 국내에서 유행하는 엔테로바이러스의 형을 확인하고자 하였다.재료 및 방법 : 동 기간 중 총 2,939건으로부터 3,260개의 검체가 의뢰되었으며 바이러스 분리를 위한 세포배양/중화시험과 유전자 분석을 병행하여 수행하였다. 결 과 : 총 2,939건 중 603건(20.5%)에서 바이러스가 분리되었으며 2000년에 엔테로바이러스 71형과 2002년 중 에코바이러스 13형, 콕사키바이러스 A24형 등을 분리하였으며 분리주간 상동성도 99-100%로 같은 유전자형의 바이러스가 국내유행을 일으킨 것을 확인하였다.
결 론:1999-2003년 중 총 2,939건 중 603건에서 엔테로바이러스를 분리하였으며 특히 2002년 중 무균성 수막염과 급성출혈성 결막염 환자로부터 에코바이러스 13형과 콕사키바이러스 A24형을 국내에서 최초로 분리하였다.

다국어 초록 (Multilingual Abstract)

Purpose:We identified the causative viruses from patients with aseptic meningitis, acute hemorrhagic conjunctivitis and other enterovirus-related diseases to understand the epidemiological patterns and prevailing strains of enterovirus infections each year.
Materials and Methods:During 1999-2003, we examined 3,260 specimens from 2,939 patients with aseptic meningitis or other clinical manifestations for the presence of enteroviruses by using both cell culture/ neutralisation test and reverse transcription-polymerse chain reaction-sequencing. To investigate the etiological agents which caused an epidemic of acute haemorrhagic conjunctivitis, conjunctival swab samples from acute haemorrhagic conjunctivitis patients showing cytopathic effects in HEp2 cells were tested by enteroviral specific PCR.
Results:We identified 603 isolates of enteroviruses (20.5%) among 2,939 cases and 22 serotypes of human enteroviruses were isolated during this 5 year period. Echovirus 13 and coxsackievirus A24 in 2002 and coxsackievirus A9 in 2003 were the first enterovirus to be indentified in Korea since we began the enterovirus surveillance in 1993. While an epidemic of echovirus 13 infection in Korea began in Gwangju and Jeolla province in 2002 and spread to Seoul, Gyunggi, Busan, Ulsan and other regions, echovirus 6 isolates in 2002 were mainly detected in Busan specimens and some Gwangju samples. From the nucleotide sequencing of enteroviral PCR products of conjunctival swab specimens, we found 85% nucleotide homology to coxsackievirus A24 (D90457).
Conclusions:We isolated 603 enteroviral isolates among 2939 cases during 1999-2003. Echovirus 13 and coxsackievirus A24 were the first enterovirus to be identified in Korea and caused nationwide epidemics in 2002.

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