- Seroprevalence of Measles Antibody and its Attributable Factors in Elementary Students of Routine 2-dose Schedule Era with Vaccination Record.
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Geun Ryang Bae, Hyun Sul Lim, Un Yeong Goh, Byung Guk Yang, Young Taek Kim, Jong Koo Lee
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J Prev Med Public Health. 2005;38(4):431-436.
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We investigated the seroprevalence of the measles antibody and its attributable factors for the students who underwent routine 2-dose Schedule Era. METHODS: The subjects were 996 students of the national measles seroepidemiologic study in December 2000 who had vaccination records. We conducted a questionnaire survey and we performed serologic testing for the measles specific IgG by using an enzyme linked immunosorbent assay. RESULTS: The coverage for the first dose of the MMR vaccination at 12-15 months of age was 95.1% and the coverage for the second dose of MMR at 4-6 years of age was 35.0%. The proportion of subjects undergoing 2- doses of MMR decreased as the age of the subjects increased. The seropositive rate of the measles antibody was significantly high in the second dose vaccinees (93.5% in the second dose group, 84.7% in the non-second dose group, p< 0.001) and it was 72.0% in the 0-dose group, 85.4% in the 1-dose group and 93.7% in the 2-dose group (p< 0.001). Two point eight percent of the subjects had a past history of measles infection. On the multiple logistic regression analysis, the first and second dose (odds ratio, 8.54; 95% CI.=3.05-23.91), the first dose (odds ratio, 3.06; 95% CI.=1.20-7.81) and the outbreak in the year 2000 (odds ratio, 1.89; 95% CI.=1.24-2.88) were the significant factors for the eropositivity. CONCLUSIONS: Maintaining high coverage with a 2-dose vaccination program would be the decisive factor to prevent an outbreak of measles and to eliminate measles in Korea.
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- Cause of Enterohemorrhagic Escherichia coli Infection in Ulju County, Korea.
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Geun Ryang Bae, Sang Won Lee, Byung Guk Yang, Bok Kwon Lee, Jae Gu Park, Byeong Hun Hwang, Hyun Sul Lim
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Korean J Prev Med. 2003;36(1):77-84.
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Two related cases of Hemolytic-Uremic Syndrome (HUS) were reported to the Korea National Institute of Health in May, 2001. Shiga toxin 2 genes were detected in both stool samples. We suspected an enterohemorrhagic Escherichia coli (EHEC) infection as the cause of the HUS, and conducted an investigation to find the source of the infection and its route of transmission. METHODS: We performed case investigations on these two related HUS cases, and obtained interviews and rectal swabs form the family members and other close contacts. Additionally, we performed rectal swabs on the cattle raised by the household of the index patient. RESULTS: We found a 20 month old index patient and a 6 year-old cousin had developed HUS, where there had been a 2 day history of contact with the index, and bacteriological examinations for these two patients revealed, indistinguishably, the same E. coli O171. The grandmother of the index patient was found to be asymptomatic, but E. coli O26 was isolated. We also found a probable case in the mother of the cousin. She reported a history of contact with the index, and developed bloody diarrhea of 3 days duration. The test results for the cattle revealed E. coli O26 in one cow, and E. coli O26 and O55 in another. E. coli O26, which was isolated in both cows and the grandmother of the index, were indistinguishably the same. CONCLUSIONS: We found that the E. coli O26 in the grandmother had originated from the cows, and that the E. coli O171 found in the index patient had been transmitted to the cousin through person-to-person contact.
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- Investigation of Health Hazards in the Underground Storage Facilities of Ginger Roots.
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Hyun Sul Lim, Geun Ryang Bae
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Korean J Prev Med. 2002;35(1):72-75.
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To evaluate the health hazards in the underground storage facilities of ginger roots. METHODS: The authors reviewed the emergency rescue records from the Seosan fire department over the period Jan 1, 1996 to Aug 31, 1999. The atmospheres in 3 different underground storage locations were analyzed for O2, CO2, CO, H2S and NH4. RESULTS: From the emergency records, we were able to identify 20 individuals that had been exposed to occupational hazards in the underground storage facilities. Among these 20 cases, 13 were due to asphyxiation (resulting in 7 deaths) and 7 were due to falls. In the first atmospheric tests, performed on Feb 25, 1998, the O2 level inside the underground storage facility, located about 5~6 meters below the surface, was 20.6% and the CO2 level was about 1,000 ppm. CO, H2S and NH4 were not detected. In the second tests on Jul 6, 1999, measurements of the O2 level at 3 meters below the surface in two different storage locations were 15.3 and 15.1%. And the O2 levels inside the storage facilities were 12.2 and 12.1%. The CO2 level was above 5,000 ppm (beyond upper limits of measurement). CO, H2S and NH4 were not detected. CONCLUSIONS: We conclude that asphyxiation in the underground storage facilities for ginger roots was not due to the presence of toxic gases such as CO, H2S and NH4, but rather the exclusion of oxygen by carbon dioxide was responsible for causing casualties. For the development of a hazard free working environment, safety education as well as improvements in storage methods are needed.
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- Epidemiologic Investigation of an Outbreak of Shigella sonnei among Students in Bonghwa, 1999.
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Hyun Sul Lim, Geun Ryang Bae
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Korean J Prev Med. 2000;33(1):10-16.
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This study was carried out to investigate the sources of infection and modes of transmission of an outbreak of shigellosis that occurred among students of B middle and high school in Bonghwa, Korea from May 1 to 21, 1999. METHODS: We conducted questionnaires to 468 students, 38 staffs and 9 food handlers twice times (May 6, May 21) for follow up and secondary attack rate. Personal details and history of illness and exposure to particular foods were sought. And we conducted rectal swab for culture to 243 students, 33 staffs and 9 food handlers. Bacteriological examinations of water in the school were done. Cases were identified as subjects who had diarrhea (two or more loose stools in a 24-hour periods) on or after May 1. RESULTS: A total of 307 cases (attack rate: 59.6%) of 515 subjects were identified, including 50 confirmed (46 students and 4 staffs) by S. sonnei. All 9 food handlers denied illness and were had rectal swab for culture at May 6 that were negative for S. sonnei. 146 of 307 reported fever, 156 had tenesmus, 44 reported vomiting, and only 5 of 307 reported blood in the stool. The median duration of diarrhea was 4 days (range: 1-18 days). The mean incubation period until onset of diarrhea was 63 hours (range: 16-144 hours) and the secondary attack rate was 2.8% (43 cases of 1,561 family members). Risk for illness was higher among students who had eaten watered kimchi at March 30 than among those who did not [301(72.7%) of 417 versus 5(9.6%) of 52; RR=7.51; 95% CI=3.26-17.31]. CONCLUSION: The source of infection was estimated to be contaminated watered kimchi by one or two food handler who is presumed to be carrier.
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- Epidemiologic Investigation of an Outbreak of Shigellosis in Kyongju, Korea.
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Hyun Sul Lim, Cheol Jung, Geun Ryang Bae, Yeong Joo Hur, Sang Won Lee, Eun Kyeong Jeong
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Korean J Prev Med. 2000;33(1):1-9.
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This study was carried out to investigate the sources of infection and modes of transmission of an outbreak of shigellosis that occurred among pupils of "M" primary school and residents near the school in Kyongju from Sept. 24 to Oct. 24, 1998. METHODS: The subjects who completed a questionnaire and a rectal swab for microbiologic examinations were 1,534 persons (781 males, 753 females), including 469 pupils of "M" primary school (268 males, 201 females). Bacteriological examinations of underground water and simple piped water were done. RESULTS: The attack rate of diarrhea was 28.7% in the subjects from Sept. 24 to Oct. 24, 1998. There was no difference in attack rate of diarrhea by gender, but it was significantly higher in the pupils of "M" primary school than others (p<0.01). The attack rate of diarrhea by resident areas was no different to the pupils of "M" primary school, but was significantly higher in the residents of Mohwa 2 Ri except pupils that "M" primary school is located in (p<0.01). The distribution of date of onset revealed the exposure date to be Sept, 22 and 23 in consideration of incubation periods and common source outbreak followed propagative spread in the epidemic curve. The major characteristics of diarrhea were watery (89.1%) in nature, 1~3 days (72.5%) in duration, 2~3 times (63.9%) in frequency. The clinical symptoms among the diarrheal cases included abdominal pain (74.1%), fever (56.4%), headache (55.9%), chill (40.4%) and tenesmus (31.4%). CONCLUSIONS: The source of infection was estimated to be contaminated underground water and simple piped water caused by leakage from the cess pool. It is highly necessary that the management of drinking water and cess pools should be done thoroughly.
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- Epidemiologic Survey on Outbreak of Dermatosis Associated with Ants, Pachycondyla chinensis.
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Geun Ryang Bae, Hyun Sul Lim, Byung Jin Kim
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Korean J Prev Med. 1999;32(3):421-426.
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An outbreak of dermatosis occurred at a city gas manufacturing factory in Pohang in Aug, 1998. The authors conducted a study to find the cause and prevent the dermatosis. METHODS: We conducted a questionnaire survey of 73 workers in the factory twice, once on Aug. 14th and then Sept. 11th, 1998. Also, a dermatologist examined their skin lesions. We suspected ants as the cause, so we collected them for identification. RESULTS: Twelve cases of dermatosis were identified with an attack rate of 16.4%. The attack rates were not different by age, educational level or tenures. The attack rates were 66.6% among production workers, 2.0% among clerical workers, 16.7% among tank trailer drivers and 0% among guards. The attack rate among production workers was significantly higher than that of the others (p<0.01). There were no histories of the same dermatosis for the past one year. Histories of other skin diseases and allergies were very rare in both cases with skin diseases and control. Multiple, pruritic, rice-grained to bean sized erythematous macules or papules with a central biting point could be found after initial severe itching occurred. Three cases showed signs of dermatosis with an allergic nature. The onset of dermatosis was between July 30 and Aug 12 and the durations varied from 5 days to over a month. The most frequent sites of skin lesions were the chest and abdomen (66.6%), and they were also observed on the neck (33.3%), arms (33.3%), shoulders (16.7%) and back (16.7%). Over 10 ants with their wings were collected in the work place and identified as Pachycondyla chinensis, subfamily Ponerinae. CONCLUSIONS: We thought that the outbreak of dermatosis was brought about by the ants flying into the work place through the open windows. Further studies on the factors contributing to the prosperity of the ants in this area are needed.
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