Journal of Preventive Medicine and Public Health

COVID-19: Original Article

Sources of Infection Among Confirmed Cases of COVID-19 in Jeju Province, Korea: Moonkyong Hwang, Jong-Myon Bae; J Prev Med Public Health. 2021;54(4):245-250. Published online June 30, 2021; DOI: https://doi.org/10.3961/jpmph.21.286

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Abstract Summary PDF Supplementary Material

Objectives
Jeju Province in Korea reported 627 coronavirus disease 2019 (COVID-19) cases between January 20, 2020, and March 31, 2021. This study analyzed the sources of infection among confirmed cases in Jeju Province, a self-governed island.
Methods
The sources of infection were broadly categorized as follows: (1) infections from overseas (confirmed patients who reported travel overseas or contact with overseas travelers); (2) infections from outside Jeju Province (confirmed patients who had visited other provinces or had contact with individuals who had traveled to other provinces in Korea); and (3) unknown sources of infection (confirmed patients who were infected following contact with an infected person whose source of infection was unknown). The chi-square test was used to analyze the differences in the distributions of related variables for each source of infection.
Results
Of the 627 confirmed cases, 38 (6.1%) were infections from overseas sources, 199 (31.7%) were from outside of Jeju Province, and 390 (62.2%) were from unknown sources. Jeju Province had no cases with an unknown source of infection during the first and second waves of the nationwide outbreak.
Conclusions
Infections from overseas sources could be blocked from spreading to local communities in Jeju Province by conducting screening at the airport, along with the preemptive suspension of visa-free entry. In addition, considering the scale of the nationwide outbreak, measures must be established to delay outbreaks from unknown sources of infection caused by sources outside Jeju Province.

Summary

Korean summary
제주도 COVID-19 확진지의 감염원은 다음의 3가지로 대분할 수 있었다. (1) 해외유입 감염원: 해외 방문력이 있거나 해외 방문력이 있는 확진자와 접촉한 적이 있는 확진자; (2) 도외유입 감염원: 국내 타시도 방문력이 있거나 타시도 확진자와 접촉한 적이 있는 확진자; (3) 감염원 미상: 감염경로를 특정할 수 없는 도내 확진자와 이들과 접촉하여 확진자가 된 경우. 이중 해외유입군에 대하여는 선제적인 무비자 중지 결정과 함께 공항만에서의 선별검사를 시행하여 해외유입에 의한 지역사회 전파 가능성을 막을 수 있음을 확인하였다. 반면, 전국의 유행 크기와 맞물러, 도외 유입군으로 인한 감염미상군 발생 시점을 최대한 미룰 수 있는 방안들을 개발할 필요가 있겠다.

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The Impact of the South Korean Local Government's Public Health and Healthy Urban Planning Policies in Combating COVID-19
Fatih ULAŞAN
Kent Akademisi.2023;[Epub] CrossRef
Clinical Characteristics and Risk Factors for Severe Disease of Coronavirus Disease 2019 in a Low Case Fatality Rate Region in Korea
Misun Kim, Jeong Rae Yoo, Sang Taek Heo, Hyang Ran Lee, Hyunjoo Oh
Infection & Chemotherapy.2021; 53(4): 718. CrossRef

Brief Report

Community-acquired Legionnaires’ Disease in a Newly Constructed Apartment Building: Sukhyun Ryu, Kyungho Yang, Byung Chul Chun; J Prev Med Public Health. 2017;50(4):274-277. Published online June 28, 2017; DOI: https://doi.org/10.3961/jpmph.17.066

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Abstract PDF

Objectives
Legionnaires’ disease (LD) is a severe type of pneumonia caused by inhalation of aerosols contaminated with Legionella. On September 22, 2016, a single case of LD was reported from a newly built apartment building in Gyeonggi province. This article describes an epidemiologic investigation of LD and identification of the possible source of infection. Methods: To identify the source of LD, we interviewed the patient’s husband using a questionnaire based on the Legionella management guidelines from the Korea Centers for Disease Control and Prevention. Water samples from the site were collected and analyzed. An epidemiological investigation of the residents and visitors in the apartment building was conducted for 14 days before the index patient’s symptoms first appeared to 14 days after the implementation of environmental control measures. Results: Legionella pneumophila serogroup 1 was isolated from the heated-water samples from the patient’s residence and the basement of the apartment complex. Thirty-two suspected cases were reported from the apartment building during the surveillance period, yet all were confirmed negative based on urinary antigen tests. Conclusions: The likely source of infection was the building’s potable water, particularly heated water. Further study of effective monitoring systems in heated potable water should be considered.

Summary

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Turnover Intention among Field Epidemiologists in South Korea
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International Journal of Environmental Research and Public Health.2017; 14(11): 1296. CrossRef

Original Articles

Respiratory Syncytial Virus Outbreak in the Basic Military Training Camp of the Republic of Korea Air Force: Won-Ju Park, Seok-Ju Yoo, Suk-Ho Lee, Jae-Woo Chung, Keun-Ho Jang, Jai-Dong Moon; J Prev Med Public Health. 2015;48(1):10-17. Published online January 14, 2015; DOI: https://doi.org/10.3961/jpmph.14.037

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Abstract PDF

Objectives
An outbreak of acute febrile illness occurred in the Republic of Korea Air Force boot camp from May to July 2011. An epidemiological investigation of the causative agent, which was of a highly infective nature, was conducted.
Methods
Throat swabs were carried out and a multiplex reverse transcriptase-polymerase chain reaction (RT-PCR) assay was performed to identify possible causative factors.
Results
The mean age of patients who had febrile illness during the study period was 20.24 years. The multiplex RT-PCR assay identified respiratory syncytial virus (RSV) as the causative agent. The main symptoms were sore throat (76.0%), sputum (72.8%), cough (72.1%), tonsillar hypertrophy (67.9%), and rhinorrhea (55.9%). The mean temperature was 38.75°C and the attack rate among the recruits was 15.7% (588 out of 3750 recruits), while the mean duration of fever was 2.3 days. The prognosis was generally favorable with supportive care but recurrent fever occurred in 10.1% of the patients within a month.
Conclusions
This is the first epidemiological study of an RSV outbreak that developed in a healthy young adult group. In the event of an outbreak of an acute febrile illness of a highly infective nature in facilities used by a young adult group, RSV should be considered among the possible causative agents.

Summary

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Respiratory syncytial virus infection and the need for immunization in Korea
Hye Young Kim, Ki Wook Yun, Hee Jin Cheong, Eun Hwa Choi, Hoan Jong Lee
Expert Review of Vaccines.2023;[Epub] CrossRef
COVID-19 outbreak in a military unit in Korea
Chanhee Kim, Young-Man Kim, Namwoo Heo, Eunjung Park, Sojin Choi, Sehyuk Jang, Nayoung Kim, Donghyok Kwon, Young-Joon Park, Byeongseop Choi, Beomman Ha, Kyounghwa Jung, Changbo Park, Sejin Park, Heeyoung Lee
Epidemiology and Health.2021; 43: e2021065. CrossRef

Epidemiological Investigation of an Outbreak of Hepatitis A at a Residential Facility for the Disabled, 2011: Hyun-Sul Lim, Kumbal Choi, Saerom Lee; J Prev Med Public Health. 2013;46(2):62-73. Published online March 28, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.2.62

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Abstract PDF

Objectives

An outbreak of hepatitis A occurred at a residential facility for the disabled in July 10, 2011. This investigation was carried out to develop a response plan, and to find the infection source of the disease.

Methods

A field epidemiologist investigated the symptoms, vaccination histories, living environments, and probable infection sources with 51 residents and 31 teachers and staff members. In July 25, 81 subjects were tested for the hepatitis A virus antibody, and specimens of the initial 3 cases and the last case were genetically tested.

Results

Three cases occurred July 10 to 14, twelve cases August 3 to 9, and the last case on August 29. Among the teachers and staff, no one was IgM positive (on July 25). The base sequences of the initial 3 and of the last case were identical. The vehicle of the outbreak was believed to be a single person. The initial 3 patients were exposed at the same time and they might have disseminated the infection among the patients who developed symptoms in early August, and the last patient might have, in turn, been infected by the early August cases.

Conclusions

The initial source of infection is not clear, but volunteers could freely come into contact with residents, and an infected volunteer might have been the common infection source of the initial patients. Volunteers' washing their hands only after their activity might be the cause of this outbreak. Although there may be other possible causes, it would be reasonable to ask volunteers to wash their hands both before and after their activities.

Summary

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Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2020
Noele P. Nelson, Mark K. Weng, Megan G. Hofmeister, Kelly L. Moore, Mona Doshani, Saleem Kamili, Alaya Koneru, Penina Haber, Liesl Hagan, José R. Romero, Sarah Schillie, Aaron M. Harris
MMWR. Recommendations and Reports.2020; 69(5): 1. CrossRef
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Infection Control & Hospital Epidemiology.2018; 39(07): 881. CrossRef
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Epidemiology and Infection.2014; 142(7): 1450. CrossRef

Special Article

The Singapore Field Epidemiology Service: Insights Into Outbreak Management: Peng-Lim Ooi, Theresa Seetoh, Jeffery Cutter; J Prev Med Public Health. 2012;45(5):277-282. Published online September 28, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.5.277

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Abstract PDF

Field epidemiology involves the implementation of quick and targeted public health interventions with the aid of epidemiological methods. In this article, we share our practical experiences in outbreak management and in safeguarding the population against novel diseases. Given that cities represent the financial nexuses of the global economy, global health security necessitates the safeguard of cities against epidemic diseases. Singapore's public health landscape has undergone a systemic and irreversible shift with global connectivity, rapid urbanization, ecological change, increased affluence, as well as shifting demographic patterns over the past two decades. Concomitantly, the threat of epidemics, ranging from severe acute respiratory syndrome and influenza A (H1N1) to the resurgence of vector-borne diseases as well as the rise of modern lifestyle-related outbreaks, have worsened difficulties in safeguarding public health amidst much elusiveness and unpredictability. One critical factor that has helped the country overcome these innate and man-made public health vulnerabilities is the development of a resilient field epidemiology service, which includes our enhancement of surveillance and response capacities for outbreak management, and investment in public health leadership. We offer herein the Singapore story as a case study in meeting the challenges of disease control in our modern built environment.

Summary

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Original Article

Epidemiologic Investigation into the Outbreak of Acute Hemorrhagic Conjunctivitis in Gyeongju-City, South Korea, in 2002.: Hong Hwan Kim, Hyun Sul Lim, Young Sun Min; J Prev Med Public Health. 2004;37(4):312-320. Published online November 30, 2004

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Abstract PDF: OBJECTIVES
An outbreak of acute hemorrhagic conjunctivitis (AHC) caused by coxsackie A24 (CA24) virus occurred in South Korea in 2002. CA24 was isolated for the first time from patients with AHC. Therefore, this study was conducted to understand the transmission routes and prevent another AHC outbreaks. METHODS: The authors conducted a questionnaire survey among 1, 730 students from 2 middle schools and 1 technical high school in Gyeongju city. For statistical analysis the chi-square test was used, and chi-square for trend method showing a level of significance less than p< 0.05 was proven to be significant. Variables which were proven to be significant in univariate analysis were analysed by multiple logistic regression. RESULTS: The attack rate was 57.1%. The student groups with rubbing one's own eyes, computer usage, and sharing cellular phone had a significantly higher AHC attack rate (p< 0.05). According to the multiple logistic regression, the odds ratios for male, high school, computer use, sharing cellular phone, and rubbing one's own eyes were significant (p< 0.05). CONCLUSION: The most significant feature of this outbreak was that many students rubbed their own eyes following contact with AHC patients in a deliberate attempt to avoid going to school. Other transmission methods were computer usage and sharing cellular phone. In the future, health and school authorities must plan new strategies for the prevention of AHC.; Summary

English Abstract

Epidemiological Investigation for Outbreak of Food Poisoning Caused by Bacillus cereus Among the Workers at a Local Company in 2010.: Kum Bal Choi, Hyun Sul Lim, Kwan Lee, Gyoung Yim Ha, Kwang Hyun Jung, Chang Kyu Sohn; J Prev Med Public Health. 2011;44(2):65-73.; DOI: https://doi.org/10.3961/jpmph.2011.44.2.65

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OBJECTIVES
In July 2 2010, a diarrhea outbreak occurred among the workers in a company in Gyeungju city, Korea. An epidemiological investigation was performed to clarify the cause and transmission route of the outbreak. METHODS: We conducted a questionnaire survey among 193 persons, and we examined 21 rectal swabs and 6 environmental specimens. We also delegated the Daegu Bukgu public health center to examine 3 food service employees and 5 environmental specimens from the P buffet which served a buffet on June 30. The patient case was defined as a worker of L Corporation and who participated in the company meal service and who had diarrhea more than one time. We also collected the underground water filter of the company on July 23. RESULTS: The attack rate of diarrhea among the employees was 20.3%. The epidemic curve showed that a single exposure peaked on July 1. The relative risk of attendance and non-attendance by date was highest for the lunch of June 30 (35.62; 95% CI, 2.25 to 574.79). There was no specific food that was statistically regarded as the source of the outbreak. Bacillus cereus was cultured from two of the rectal swabs, two of the preserved foods and the underground water filter. We thought the exposure date was lunch of June 30 according the latency period of B. cereus. CONCLUSIONS: We concluded the route of transmission was infection of dishes, spoons and chopsticks in the lunch buffet of June 30 by the underground water. At the lunch buffet, 50 dishes, 40 spoons, and chopsticks were served as cleaned and wiped with a dishcloth. We thought the underground water contaminated the dishes, spoons, chopsticks and the dishcloth. Those contaminated materials became the cause of this outbreak.

Summary

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Surveillance of Bacillus cereus Isolates in Korea from 2012 to 2014
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Osong Public Health and Research Perspectives.2017; 8(1): 71. CrossRef
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Brief Communication

An Outbreak of Novel Influenza A (H1N1) in the English Language Institute.: Joon Hyung Kim, Han Sung Lee, Hye Kyung Park, Jin Seok Kim, Sang Won Lee, Seong Sun Kim, Jong Koo Lee; J Prev Med Public Health. 2010;43(3):274-278.; DOI: https://doi.org/10.3961/jpmph.2010.43.3.274

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OBJECTIVES
This report describes the results of an investigation on an outbreak of novel influenza A (H1N1) in an English language Institute in Seoul, Korea in May 2009. METHODS: In this outbreak, novel influenza A (H1N1) was confirmed in 22 of 91 trainees, trainers and staff members. The trainees and 2 staff members were isolated in an assigned facility and the rest were isolated in their homes after we discovered the first patient with novel influenza A (H1N1). After the isolation, the people in the assigned facility were educated to use N95 respirators and they received oseltamivir for prophylaxis. RESULTS: The initial findings in this study suggest that the symptoms were mild and similar to those of seasonal influenza. The classmates and roommates of the infected patients were more likely to get infected with novel influenza A (H1N1) than the trainees who were not classmates or roommates of the patients (OR: 3.19, 95% CI=0.91 - 11.11 for classmates and OR: 40.0, 95% CI=7.4-215.7 for roommates). CONCLUSIONS: The public health response seems successful in terms of preventing the spread of this virus into the local community.

Summary

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In-Flight Transmission of Novel Influenza A (H1N1)
Joon Hyung Kim, Dong-Han Lee, Sang-Sook Shin, Chun Kang, Jin Seok Kim, Byung Yool Jun, Jong-Koo Lee
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English Abstract

Mumps Transmission Control Status and Inapparent Infection Rate among Middle and High School Students during the 2007-2008 Mumps Outbreak in Daegu.: Kyo Hyun Kim, Chang Hwi Kim, Bo Youl Choi, Un Yeong Go, Dong Han Lee, Moran Ki; J Prev Med Public Health. 2009;42(6):408-415.; DOI: https://doi.org/10.3961/jpmph.2009.42.6.408

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Abstract PDF

OBJECTIVES
This study was performed to investigate the mumps transmission control status and inapparent infection rate among middle and high school students in Daegu City during a mumps outbreak. METHODS: Nine schools (two middle schools and seven high schools), which reported a number of mumps cases between 2007 and 2008 were selected for investigation. During March-May 2008, a standard questionnaire was distributed to gather information about case identification, instructed isolation measure, isolation status of mumps cases and related factors, and outdoor activities of non-isolated mumps case. Inapparent infection rate was estimated by serum mumps IgM and IgG antibodies status and self-reported mumps symptoms in three of the nine schools. RESULTS: Among 2,560 respondents, more than half of students answered that they did not receive instructions in mumps transmission control measures during the outbreak. Among the 327 mumps cases identified by the questionnaire, 131 cases (40.1%) were considered as isolated and the isolation rates were significantly different among schools, grades, and gender. Of the non-isolated cases, 88.3% continued attending school. Inapparent mumps infection rates were between 56.3% and 70.2%. CONCLUSIONS: Mumps transmission control was inadequate to control the mumps outbreak. Although high inapparent infection rate would mitigate the transmission control effect of case isolation, this measure is fundamental for infection control. The reasons of this inadequate status need to be explored to develop an effective intervention strategy.

Summary

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Journal of Medical Virology.2017; 89(9): 1528. CrossRef
Resurgence of Mumps in Korea
Sun Hee Park
Infection & Chemotherapy.2015; 47(1): 1. CrossRef
An Outbreak of Mumps in a High School, Seoul, 2013
Ha Ra Kang, Sung Yoon Kim, Hyo Hyun Cha, Young Min An, In Ah Park, Hae Ji Kang, Byung Wook Eun
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Original Articles

Epidemiologic Investigation on an Outbreak of Cholera in Gyeongsangbuk-do, Korea, 2001.: Jun Ho Lee, Hyun Sul Lim, Kwan Lee, Jun Chul Kim, Sang Won Lee, Un Yeong Go, Byung Kuk Yang, Jong Koo Lee, Moon Sik Kim; Korean J Prev Med. 2002;35(4):295-304.

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Abstract PDF: OBJECTIVES
This study was carried out to investigate the cause, magnitude and transmission route of the cholera outbreak in 2001. METHODS: The study population were those persons who ingested foods at the restaurant, were confirmed as cholera patients, had symptoms of diarrhea and served as workers at the restaurant. A questionnaire survey and microbiological examinations on the microbes isolated from rectal swabs were conducted. Of the cases, 316 food histories were surveyed by an analysis of the restaurant menu. RESUJLTS: There were 139 confirmed cases of cholera reported in Korea in 2001. Of these, 104 were related to the restaurant. By region, Gyeongsangbuk-do had the highest incidence with 91 cases. Of these 91 cases, 74 had ingested foods at the restaurant, 2 were employees and 3 were secondary infection cases within the families. The results of the odds ratio analysis of the 316 persons having ingested foods at the restaurant were as follows: sandwiches 5.07 (95% CI, 1.85-14.59), soybean curd 2.45 (95% CI, 1.09-5.56), noodles 2.34 (95% CI, 1.24-4.42), steamed squid 2.01 (95% CI, 1.17-3.47) and vinegared rice 1.82 (95% CI, 1.08-3.09). It was certain the restaurant in question was the cause of the 2001 outbreak. CONCLUSIONS: We suspected that more than one restaurant employee contaminated foods served at the restaurant. In addition, eating raw fishes purchased at the Pohang Fisheries infected the employees of the restaurant. There is a possibility that these raw fishes were themselves contaminated by cholera bacilli in the sea.; Summary

Evaluation of Measles Vaccine Effectiveness in a Community Outbreak.: Byung Chan Park, Hae Kwan Cheong, Sue Kyung Park; Korean J Prev Med. 2002;35(1):33-40.

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Abstract PDF: OBJECTIVE
From an analysis of a community outbreak of measles in Youngju, Gyeongbuk, in March 2000, the authors evaluated the effectiveness of the measles vaccination and its determinants to provide an epidemiologic basis for the establishment of a vaccination policy. METHODS: Information was collected regarding the vaccinations from the health records of four primary schools and through a questionnaire survey of the parents of students in two middle and two high schools (N=4638). Measles cases were surveyed from the patient list of each school and from case reports in the public health center. The attack rate and vaccine effectiveness of measles was evaluated by school; grade; frequency, region, and institution of vaccination. RESULTS: The attack rate of measles, 6.3% among the total subjects, was higher in middle school students (15.8%) than in primary (2.0%, p<0.05) and high school students (8.9%, p<0.05). The attack rate of the unvaccinated group was 4.6-fold higher than the vaccinated group in primary schools (p<0.05). Vaccine effectiveness was 83.2% among lower graders of primary schools, 34.0% among higher graders of primary schools, 26.1% in middle schools, and -7.0% in high schools. In multiple logistic regression analysis, grade in school (odds ratio, 0.77; 95% CI=0.67-0.87) and frequency of vaccination (odds ratio, 0.57; 95% CI=0.37-0.88) were significant predictors of the outcome. CONCLUSIONS: We concluded that the explosive outbreak of measles in this area resulted from both inadequate vaccination coverage and secondary failure of vaccination. There was no evidence of any effect of the cold chain system on the vaccine failure.; Summary

English Abstracts

Epidemiologic Investigation on an Outbreak of Salmonellosis in Yeongcheon-si, 2004.: Hyun Sul Lim, Young Sun Min, Hwan Seok Lee; J Prev Med Public Health. 2005;38(4):457-464.

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Abstract PDF: OBJECTIVES
An outbreak of salmonellosis occurred among the students and staff of D primary school in Yeongcheon-si, 2004. This investigation was carried out to prevent any recurrence of this outbreak and to study the infection source and transmission of the salmonellosis. METHODS: The authors conducted a questionnaire survey among 1, 205 students and staff members from D primary school about the ingestion of the school lunch and drinking water, and the manifestation of their symptoms. The author examined rectal swabs, the tap water and microorganism cultures, and we also investigated the dining facility and water supply facility. RESULTS: The diarrheal cases were defined as the confirmed cases or the persons who had diarrhea more than one time with symptoms such as fever, vomiting and tenesmus. The diarrheal attack rate was 28.0%. Ingestion of fried bean curd with egg had a significantly high association with the diarrheal attack rate (p< 0.05), and the relative risk of the fried bean curd with egg was 10.68 (95% CI=3.88-29.41), as was determined by logistic regression analysis. The bacterial counts in the tap water of the food preparation room and toilet (first floor) exceeded the maximum permissible counts. S. Enteritidis bacteria were only cultured from the fried bean curd with egg of all the supplied foods on September 3, 2004. CONCLUSIONS: The major cause of salmonellosis was presumed to be the contaminated bean curd via contaminated tap water due to a water leak of a school water pipe. This contaminated bean curd was under prepared, which allowed the S. Enteritidis to survive and multiply prior to its ingestion.; Summary

Epidemiologic Investigation on an Outbreak of Shigellosis in Seongju-gun, Korea, 2003.: Young Sun Min, Hyun Sul Lim, Kwan Lee, Sang Hyuk Lim, Bog Soon Lee; J Prev Med Public Health. 2005;38(2):189-196.

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Abstract PDF: OBJECTIVES
An outbreak of shigellosis occurred among students and staff of S primary and middle school, Seongju-gun, in 2003. This investigation was carried out to institute an effective counterplan, and study the infection source and transmission of the shigellosis. METHODS: The authors conducted a questionnaire survey among 235 students and staff from S preschool, primary and middle school relating to the ingestion of school lunch and the manifestation of symptoms. Also, the author investigated the drinking water, feeding facility and reconstructed cooking process of the food presumed to be the cause of the shigellosis. The diarrhea cases were defined as confirmed cases and those cases who had had diarrhea more than one time, accompanied with symptoms such as fever, vomiting and tenesmus. RESULTS: From rectal swabs 20 people, between June 28 and July 4, 2003, were confirmed with shigellosis. The diarrhea attack rate was 40.0%. Those who had ingested tomatoes and cubed radish kimchi had significantly higher diarrhea attack rates (p< 0.05), with the relative risk of tomatoes being 2.69 (95% CI: 0.98-7.42). The major cause of shigellosis was presumed to be from contaminated tomatoes due to cooking with rubber gloves containing holes. CONCLUSION: The cooks in charge of school lunches must make doubly sure to not only attend to their sanitation, but also to manage the table wear and items used in providing school lunches. The health care authority should introduce higher-leveled criteria for health care among cooks, so that they cannot cook when the have a case of any infectious disease.; Summary

Changing Patterns of Communicable Diseases in Korea.: Hyun Sul Lim; J Prev Med Public Health. 2005;38(2):117-124.

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Abstract PDF: Before twentieth centuries and during early twentieth centuries, communicable diseases were the major cause of morbidity and mortality in Korea. But reliable data are not available. After 1975, the overall morbidity and mortality from communicable diseases, rapidly declined. Recently many new pathogenic microbes were recognized: L. monocytogenes, Hantaan virus, Y. pseudotuberculosis, P. multocida, L. pneumophilia, Human immunodeficiency virus (HIV), G. seoi, H. capsulatum, C. burnetii, V. cholerae O139, C. parvum, F. tularensis, E. coli 0157: H7, B. burgdorferi, S. Typhimurium DT104, Rotavirus, hepatitis C virus and so on. Since the first HIV infection recognized in 1985, the reported cases of infection and deaths from HIV/AIDS have been steady increased each year. Legionnaire's disease, E. coli O157: H7 colitis, listeriosis and crytosporidiasis have been occurring just sporadically among immunocompromized cases. Many re-emerging communicable diseases were occurred in Korea: leptospirosis, malaria, endemic typhus, cholera, tsutsugamushi disease, salmonellosis, hepatitis A, shigellosis, mumps, measles, acute hemorrhagic conjunctivitis, brucellosis and so on. Leptospirosis and tsutsugamushi diseases have been noticed as major public health problems since 1980s. The malaria that had been8 virtually disappeared for a decade has reappeared from 1993 with striking increase of patients in recent 3-4 years. The distributions of salmonella and shigella serotypes have been changed a lot in recent few decades. Furthermore rapid emergence of antibiotic-resistant bacterial strains induces more difficult and complex problems in control of communicable diseases. We must recognize on the importance of environment and ecosystem conservation and careful prescription of anti-microbial agent in order to prevent communicable diseases.; Summary

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