Assessment about the measles elimination from cases and outbreaks, 2002-2007 - Assessment about the measles elimination -

2002-2007년 사례 및 유행을 통해서 본 홍역퇴치 수준에 대한 평가 - 홍역퇴치 수준에 대한 평가 -

  • So, Jae Sung (Division of Vaccine Preventable Disease Control and National Immunization Program) ;
  • Go, Un Yeong (Division of Vaccine Preventable Disease Control and National Immunization Program) ;
  • Oh, Hyun Kyung (Division of Vaccine Preventable Disease Control and National Immunization Program) ;
  • Baek, Soo Jin (Division of Infectious Disease Surveillance Centers for Disease Control and Prevention) ;
  • Lee, Jong Koo (Centers for Disease Control and Prevention)
  • 소재성 (질병관리본부 예방접종관리팀) ;
  • 고운영 (질병관리본부 예방접종관리팀) ;
  • 오현경 (질병관리본부 예방접종관리팀) ;
  • 백수진 (질병관리본부 전염병감시팀) ;
  • 이종구 (질병관리본부)
  • Received : 2008.08.07
  • Accepted : 2008.10.08
  • Published : 2009.01.15

Abstract

Purpose : We assessed about the measles elimination in Korea according to analyzing national data on measles cases for 2002-2007. Methods : We estimated the effective reproduction number according to the proportion of imported cases and outbreak size. Results : Eleven cases, thirteen cases, six cases, six cases, 25 cases (60.0% were linked to 1 outbreak of 15 cases), and 180 cases (55.6% were linked 11 outbreaks of 2, 2, 2, 3, 3, 3, 5, 9, 9, 12, 50 cases) were reported in 2002, 2003, 2004, 2005, 2006 and 2007, respectively. In 2002-2007, R is 0.95 by imported case and 0.43 by outbreak sizes. In 2007, multiple chains of transmission occurred in hospital. Most of cases were below 4 ages and unvaccinated. We didn't find most of the infection source. Conclusion : We should prevent outbreak of susceptibility pocket like nosocomial infection, conduct reliable routine surveillance and epidemiological investigation to solve a problem of the measles elimination.

목 적 : 2002-2007년 보고된 홍역 사례 및 유행에 대한 역학적 분석을 통해서 현재 홍역퇴치 수준을 평가하고자 하였다. 방 법 : 홍역퇴치 수준을 평가하기 위해서 인구집단의 질병유행 여부를 평가하는데 가장 보편적인 방법인 한명의 환자에서 평균 몇 명의 환자에게 질병이 전파되는지를 나타내는 감염재생산수(R: the effective reproduction number)를 사용하였다. 결 과 : 2002년부터 2007년 까지 각각 11명, 13명, 6명, 6명, 25명, 180명의 사례가 발생하였다. 2006년도에 15명의 환자가 발생한 1건의 유행이 있었고 2007년도에는 각각 2, 2, 2, 3, 3, 3, 5, 9, 9, 12, 50명의 사례가 발생한 11건의 유행이 있었다. 2002- 2007년도 해외유입 사례의 비율에 의한 R 값은 0.95, 유행의 크기에 대한 비율에 의한 R 값은 0.43 이었다. 2007년도에는 원내감염을 중심으로 한 유행이 발생하였고 대부분의 사례가 4세 이하였고 예방접종력이 없었다. 대부분의 사례의 감염원을 찾을 수 없었다. 결 론 : 홍역퇴치 수준의 문제점을 해결하기 위해서는 원내감염과 같은 감수성 집단의 유행 차단 및 신뢰성 있는 감시체계와 역학조사를 시행하여야 할 것이다.

Keywords

References

  1. National Institutes of Health. Epidemiological character of measles and mumps outbreak in the first half of the 2000. Communicable Disease Monthly Report 2000;11:1
  2. Korean Pediatric Association. Immunization guideline. 5th ed. Seoul: Gwangmun Co., 2002:90-100
  3. Korea Center for Disease Control and Prevention, Ministry of Health & Welfare. National measles elimination 5 year program a white book. Seoul: Korea Center for Disease Control and Prevention, 2006:3-108
  4. National Institutes of Health. National measles immunity investigation result report. Seoul: National Institutes of Health, 2001:37-8
  5. National Institutes of Health. Guideline for catch-up MR vaccination campaigns. Seoul: National Institutes of Health, 2001:27-31
  6. World Health Organization. Field guidelines for measles elimination. Geneva: World Health Organization, 2004:12
  7. Korea Center for Disease Control and Prevention. School entry requirement and certification program guideline of 2nd measles immunization in 2006. Seoul: Korea Center for Disease Control & Prevention, 2006: 49-51
  8. Ministry of Health and Welfare, Korea Center for Disease Control & Prevention. Vaccine-Preventable Disease Control Guideline (I). Korea Center for Disease Control and Prevention, 2007:3-59
  9. Center for Disease Control and Prevention. Elimination of measles-South Korea, 2001-2006. Center for Disease Control Morbidity and Mortality Weekly Report 2007;56: 304-7
  10. Korea Center for Disease Control and Prevention. Measles surveillance and control guideline. Seoul: Korea Center for Disease Control and Prevention, 2006:27-34
  11. National Institutes of Health, Korea Center for Disease Control and Prevention, Korean Medical Association. Diagnostic & reporting criteria for statutory notifiable communicable disease. Seoul: Korea Center for Disease Control and Prevention, 2005:19
  12. De Serres G, Gay NJ, Farrington CP. Epidemiology of transmissible diseases after elimination. Am J Epidemiol 2000; 151:1039-48
  13. Haight FA, Breuer MA. The borel-tanner distribution. Biometrika 1960;47:143-6
  14. Becker N. On parametric estimation for mortal branching processes. Biometrika 1974;61:393-9
  15. Gay NJ, Serres GD, Farrington CP, Redd SB, Papania MJ. Assessment of the state of measles elimination from reported outbreaks: United States, 1997-1999, J Infect Dis 2004;189 Suppl 1:S36-42
  16. Ramsay ME, Jin L, White J, Litton P, Cohen B, Brown D. The elimination of indigenous measles transmission in England and Wales. J Infect Dis 2003; 187 Suppl 1: S198-207
  17. Lee HD, Bae GR, Lee JY, Kim SJ, Go UY, Yang BG, et al. Epidemiological characteristics of measles outbreak in 2000- 2001, Korea. Korean J Infect Dis 2002;34:94-103
  18. Behrman RE, Kliegman RM, Jenson HB. Nelson textbook of pediatrics, 17th ed. Philadelphia: Elsevier, 2004:1026-32
  19. American Academy of Pediatrics. Measles. In: Pickering LK, Baker CJ, Long SS, McMillan JA, editors. Red book: 2006 Report of the Committee on Infectious Diseases. 27th ed. Elk Grove Village, IL: American Academy of Pediatrics, 2006: 441-52
  20. Marshall TM, Hlatswayo D, Schoub B. Nosocomial outbreaks-a potential threat to the elimination of measles? J Infect Dis 2003;187 Suppl 1:S97-101
  21. Rooney JA, Milton DJ, Hackler RL, Harris JH, Reynolds D, Tanner M, et al. The largest outbreak of measles in the United States during 1999: imported measles and pockets of susceptibility. J Infect Dis 2004;189 Suppl 1:S78-80
  22. King A, Varughese P, Serres GD, Tipples GA, Waters J, Members of the Working Group on Measles Elimination. Measles elimination in Canada. J Infect Dis 2004;189 Suppl 1:S236-42
  23. Papania MJ, Seward JF, Redd SB, Lievano F, Harpaz R, Wharton, ME. Epidemiology of measles in the United States, 1997-2001. J Infect Dis 2004;189 Suppl 1:S61-8
  24. Hong CE. Pediatrics, 8th ed. Seoul: Korean textbook Co., 2004:464-6
  25. Guris D, Harpaz R, Redd SB, Smith NJ, Papania MJ. Measles surveillance in the United States: an overview. J Infect Dis 2004;189 Suppl 1:S177-84