• Food Industry And Nutrition
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• v.11 no.3
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• pp.6-11
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• 2006

바이러스성 식중독은 장염을 일으키는 원인 병원체 중 노로바이러스에 의해 흔히 발생하며 이외에도 아스트로바이러스나 로타바이러스에 의한 집단 설사 사례가 국내에서 보고된 바 있다. 노로바이러스는 식중독과 관련하여 특히 오염된 식수와 굴 등 어패류의 생식을 통한 감염 사례가 많이 보고되어 있으나 사람 간 전파도 흔히 일어나는 전염력이 매우 높은 바이러스이다. 국내에서는 1999년 이후 보고가 되고 있으며 최근 집단 급식과 관련된 대형 식중독 사례들이 보고되면서 학교급식이 사회적인 이슈로 대두되고 있다. 2000년 이후 질병관리본부는 바이러스성 설사의 국내 발생현황을 파악하기 위하여 전국의 17개 시도보건환경 연구원과 노로바이러스를 포함한 4종의 바이러스성 장염원인 병원체에 대한 전국적인 실험실 감시체계를 운영한 결과 바이러스성 병원체가 확인된 사례의 약 18%에서 노로바이러스가 검출되었고, 집단설사 사례에서는 대부분 노로바이러스가 원인병원체로 확인되었다. 또한 노로바이러스의 조기 검출을 위해 질병관리본부는 2004년 중 노로바이러스 유전자 검출 kit를 자체적으로 제작하여 이를 전국의 시도 보건환경연구원을 연계한 감시체계에서 적극 활용함으로써 노로바이러스 집단설사사례의 조기 검출이 가능하게 되었고 지역내 노로바이러스 검출율을 높이는데 기여하였다. 국립보건연구원은 2003년과 2006년에 발생한 대규모 노로바이러스 식중독 사례 이외에도 산발적으로 지속적으로 발생하는 사례들을 조기에 탐지하고 국내에서 검출되는 설사바이러스 유전형 분포양상과 새로운 유전자형이나 변이주를 조기에 검출하고자 전국적인 노로바이러스 실험실 감시망을 강화하여 운영하고 있으며, 집단설사 발생시 각 사례의 연관성을 신속하게 분석할 수 있는 실시간 분자역학적 유전자 분석체계를 단계적으로 도입하고 있다. 실험실 감시체계 운영과 함께 집단 식중독 유발 병원체의 효율적인 관리를 위해 질병관리본부는 노로바이러스를 포함한 설사 유발 병원체를 신고대상 병원체로 지정(2006.06.12)하여 병원체 검출시 보고하도록 하고 관련 지침을 마련하였다. 노로바이러스가 지정전염병 병원체로 추가로 지정됨에 따라 집단 사례 및 실험실 감시사업을 통해 검출되는 병원체에 대한 보고가 강화되고 전파 방지와 2차 감염 사례 감소에도 기여할 수 있을 것으로 사료되며 전국의 실험실 감시망을 연결하는 국가 차원의 노로바이러스 실시간 분자역학적 분석체계 도입을 통해 노로바이러스 2차 감염을 줄이고 대규모 집단발병 및 유행의 조기 차단 효과를 가져올 수 있을 것이다.

• Clinical and Experimental Pediatrics
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• v.46 no.5
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• pp.454-458
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• 2003

Purpose : Rotavirus is the main cause of infantile diarrheal disease worldwide. The purpose of this study is to assess the difference between clinical manifestations and feeding or delivery methods in healthy full-term neonates and those with nosocomially-acquired rotaviral infection. Methods : The study was conducted on 348 babies who were delivered in Dongguk University Kyongju Hospital from Jan 1 to June 30 in 2001. Stool specimens were collected from clinically symptomatic neonates. We studied the rate of positive stool rotazyme ELISA tests and positive symptoms. We compared the frequency of clinical manifestations according to the feeding methods [breast feeding(BF) or formula feeding(FF)] and the delivery methods[normal vaginal delivery(NVD) or Cesarean section(C/sec)]. Results : Rotavirus was detected in 152 of 348 babies. The rate of positive rotazyme ELISA test was 43.7% in healthy full-term symptomatic neonates. The most common symptom of rotaviral enteritis was mild fever; the others were watery diarrhea, abdominal distension, vomiting, delayed weight gain, irritability, poor oral intake and dehydration. Compared with FF neonates, BF neonates have lower frequency of symptoms, especially watery diarrhea, delayed weight gain and poor oral intake. The symptomatic frequency was higher in FF and NVD neonates than BF and C/sec. Conclusion : The symptoms of rotaviral enteritis were less frequent in BF or C/sec delivered neonates. BF appeared to alleviate the rotaviral enteritis but further studies are needed. The cause of the lower frequency of symptoms in C/sec delivered neonates was unknown.

• Neonatal Medicine
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• v.16 no.1
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• pp.55-63
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• 2009

Purpose: This study was conducted to investigate the incidence and clinical manifestations of rotaviral infections in the neonatal intensive care unit (NICU). We also investigated whether neonates referred from other hospitals cause outbreaks of rotaviral infections in the NICU. Methods: Neonates diagnosed wit rotaviral infections in the NICU at Korea University Ansan Hospital between January 2002 and December 2006 were evaluated retrospectively. Results: Of 1,501 neonates admitted to the NICU, the number of rotaviral infections was 94 (6.3%) and the prevalence was 4.9 cases per 1,000-hospital days. Of 223 neonates referred from other hospitals to our NICU, 24 (10.8%) were confirmed to have rotaviral infections at the time of referral. Common symptoms of rotaviral infections were jaundice diarrhea or loose stools, vomiting, fever, apnea, irritability, seizures, and moaning sounds. Necrotizing enterocolitis of stage II or more was diagnosed in 3 premature neonates, accounting for 3.2% of total infected neonates and 6.8% of premature infected patients. There were no statistically significant differences in the prevalence of symptoms between term and preterm neonates, except for jaundice that is more frequent in premature infants. In time series analysis, the admission of neonates who were born at other hospitals and diagnosed with rotaviral infections were associated 1 month later by increased cases of neonates with rotaviral infections who were born at our hospital, whereas new cases of rotaviral infections among inborn neonates were decreased 2 and 4 months later (P<0.05). Conclusion: Rotaviral infections in NICU were not rare and showed vague symptoms. Three cases (3.2%) were diagnosed with stage II or more necrotizing enterocolitis. The referred neonates with rotaviral infections may induce outbreaks in the NICU, therefore awareness and strict surveillance for rotaviral infections should be performed at the time of referral.

• Clinical and Experimental Pediatrics
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• v.48 no.9
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• pp.991-997
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• 2005

Purpose : Cow's milk protein-induced enterocolitis(CMPIE) is a symptom complex of vomiting and/or diarrhea caused by delayed hypersensitivity and may result in serious complications. This study was undertaken to identify high risk factors to facilitate the early recognition of CMPIE. Methods : We reviewed the data of 101 patients, aged 15 to 45 days, admitted due to vomiting and/or diarrhea between 2003 and 2004. After excluding 13 patients absolutely breast-fed and 2 patients transferred from other hospitals with the impression of CMPIE, the 86 study subjects were divided into three groups based on the underlying etiologies; CMPIE, infectious and non-infectious group. Results : CMPIE was diagnosed in 11 patients(12.8%). On admission, failure to gain weight(P=0.003), hypoalbuminemia(P=0.003), peripheral leukocytosis(P=0.015), and metabolic acidosis(P=0.014) were more significant in the CMPIE group than in the others. Multiple logistic regression analysis showed that the independent predictors of high risks for CMPIE were failure to gain weight <10 g/day(OR, 10.25[95% CI, 1.62-65.06]) and serum hypoalbuminemia <3.5 g/dL(OR, 9.18[95% CI, 1.69-49.74]). Cow's milk challenges were performed in the 11 CMPIE patients; vomiting(81.8%), abnormal stool test(80.0%), peripheral leukocyte count and absolute neutrophil count(ANC) increase(100.0%) (P<0.05), and enteropathy(100.0%). Conclusion : CMPIE is not a rare clinical disease in early infancy. The high risk factors of CMPIE were identified as follow : failure to gain weight below 10 g/day, hypoalbuminemia on admission and a rapid decrease during admission. Cow's milk challenge test with endoscopic duodenal biopsy was helpful to confirm CMPIE.

• Pediatric Infection and Vaccine
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• v.27 no.2
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• pp.90-101
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• 2020

Purpose: The multiplex reverse transcriptase-polymerase chain reaction (RT-PCR) test developed recently can help detect enteric pathogens of acute gastroenteritis (AGE). This study aimed to investigate the epidemiology of pathogens in children with AGE using the multiplex RT-PCR. Methods: From May 2015 to June 2018, multiplex RT-PCR tests were performed to identify pathogens in the feces of pediatric patients diagnosed with AGE at a secondary hospital in Seoul, Korea. Results: Of the 1,366 stool samples examined for viral pathogens, 483 (35.3%) tested positive for ≥1 pathogen. Group A rotavirus (RV) was detected in 106 cases (7.8%). The positivity rate increased annually from 3.0% (8/263) to 16.7% (48/288) and surged in 2018 (P<0.001). Norovirus (NoV) GII was the most common viral pathogen (263/1,366, 19.3%), and the positivity rate did not increase during the 3 years. Of the 304 stool samples tested for bacterial pathogens, Campylobacter spp. was the most common bacterial pathogen (32/304, 10.5%), followed by Clostridium difficile (22/304, 7.2%) and Salmonella spp. (17/304, 5.6%). The positivity rate of these bacterial pathogens did not change significantly during the study period. Conclusions: NoV GII is the main pathogen in childhood AGE since the introduction of RV vaccine, yet the number of rotavirus-infected patients increased during our study, especially in 2018. Therefore, further research is needed including the possibility of emergence of novel RV strains. Campylobacter spp. is the predominant cause of bacterial AGE in children. For proper treatment, the clinical characteristics of the bacteria should be taken into consideration, and continuous monitoring is necessary.

• Journal of Veterinary Clinics
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• v.23 no.3
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• pp.223-229
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• 2006

Recently canine parvovirus(CPV) enteritis had been controlled successfully by the use of low-passage high titer modified live CPV vaccines. However, outbreaks of CPV enteritis have been continued in Korea. In this study, we carried out epidemiological investigation on the recent outbreaks of CPV enteritis of dogs and determined the potential prognostic factors affecting the survival of dogs. The total of 140 dogs diagnosed for CPV enteritis were statistically analysed. The majority of dogs were from 6 to 18 weeks of age and were not vaccinated or incompletely vaccinated. There were significant difference in the survival rate between male and female dogs with CPV enteritis and among the age groups(p<0.05). Moreover, there was significant difference in the survival rate of dogs between HI titer <80 group and HI titer 160 group(p<0.05). The majority of dogs had a history of diarrhea, vomiting, lethargy and dehydration. It was considered that recent outbreak of CPV enteritis in Korea caused by the failure of vaccination and/or by the inadequate antibody responses to CPV vaccines. Prophylactic measures should include isolation of young dogs from the dog population until the vaccination can be expected to provide protection.

• Clinical and Experimental Pediatrics
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• v.52 no.1
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• pp.56-60
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• 2009

Purpose : This study aimed to test whether rotavirus-associated necrotizing enterocolitis (RV+NEC) produced different clinical findings or outcomes from those of non-rotavirus necrotizing enterocolitis (RV-NEC). Methods : Eight patients from the RV+NEC group and 22 patients from the RV-NEC group diagnosed with modified Bell stage II or higher NEC were selected for this study. Fecal specimens from all infants were tested for rotavirus infection using a monoclonal antibody-based enzyme immunoassay (EIA). Clinical, radiographic, and clinical outcome data were analyzed retrospectively. Results : RV+NEC infants had a significantly higher birth weight and were born at a significantly higher gestational age ($33.5{\pm}3.3$ weeks vs. $29.3{\pm}4.4$ weeks; P=0.01). There were no differences in the occurrence of thrombocytopenia, mural gas, and pneumoperitoneum between the 2 groups. However, portal vein gas was more common in the RV+NEC group (88% vs. 9%; P<0.01). Neither the incidence of Bell stage III (or higher) NEC nor surgical intervention differed between the two groups. The number of complications and mortality rates were also similar. Conclusion : Rotavirus-associated NEC occurs in infants with a higher birth weight and those born at a greater gestational age. However, the severity of the condition and the resulting outcomes did not differ from those for infants affected by non-rotavirus NEC.

• The Journal of Korean Society of Virology
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• v.26 no.1
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• pp.23-30
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• 1996

대략 36,000 base pairs (bp)의 두 가닥짜리 DNA를 지놈으로 가진 사람 아데노바이러스 (Ad)는 DNA 상동성(相同性) 및 생물학적/생화학적 성격이 특이한 49개의 혈청형이 알려져 있는데, 이들 대부분의 Ad가 영유아군 및 면역능이 저하된 성인에서 치사적 결과를 초래할 수 있다. Ad의 세포향성(向性)(tropism)은 매우 다양하여 종류에 따라 상기도 감염, 각결막염, 영유아 장염등을 유발하는데 최근 Ad의 다양한 병원성에 대한 원인을 분자생물학적 수준에서 규명하려는 노력의 일환으로 지역에 따라 주되게 출현하는 Ad형 규명이 활발히 이루어지고 있다. Ad 동정/확인은 표면을 이루고 있는 group 공통항원인 hexon 단백질을 탐지하는 효소면역 측정법 (EIA)에 의하며, Ad형별은 Ad fiber의 세포독성 중화시험에의 한다. 그러나, 세포독성 중화시험이 엄청난 노동력 및 시간을 요구하면서도 민감도/특이도가 만족스럽지 못하여 이를 개선하기 위하여 검체 또는 세포배양에서 Ad DNA를 추출하여 제한효소 절단형태를 비교하는 방법이 개발되었는데 이는 세포배양에 잘 자라지 않는 바이러스주의 형별뿐만 아니라 지역 분리주들의 지놈 변형주를 관찰하는 분자생물학적/분자역학적 연구에도 도움이 되고 있다. 국내에는 Ad와 관련된 소아장염의 빈도가 rotavirus에 의한 것 다음으로 빈번한데도 Ad40/41외에 주되게 출현하는 장내 Ad형들이 전혀 규명된 바 없고, 한국형 Ad들의 지놈형태가 전혀 보고된 바가 없다. 또한 세계적으로 Ad형별 조사지역이 늘어감에 따라 유아장염과 연관된 Ad 역시 Ad40, 41이 외의 형들이 Ad40, 41을 능가하는 것으로 보고되고 있는 지역도 있으나 국내에서는 Ad40, 41이외의 형들은 그 역학적 중요도가 전혀 알려져 있지 않다. 이로서 본 연구의 목적은 Ad주들에 특이 중화항체를 이용한 세포독성 중화시험과 Ad DNA 절단법을 적용하여 한국형 장내 Ad주들의 형별을 처음으로 시도함과 동시에 1989-1991사이 출현한 Ad들의 유전적 변형을 관찰하려는 것이었다. 두 방법 모두 사용하였을 때 주되게 출현하는 장내 Ad형들은 Ad4l, Ad2, Ad7, Ad5, 및 Ad40이었다. Ad40/41-양성 검체를 제외한 Ad hexon-EIA양성들의 77.5%를 형별 할 수 있었던 Ad DNA의 제한효소 절단방법은 형들간의 교차중화로 특이성이 낮았던 중화방법 (47.5%)보다 매우 효율적이어서 두 가지 방법을 함께 적응하였을 때는 40주중의 81.5%인 35주를 형별 할 수 있었다. 또한Ad DNA 제한 효소 절단방법은 Ad7 변이주 (Ad7b)도 탐지 할 수 있었다.

• Neonatal Medicine
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• v.15 no.1
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• pp.61-66
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• 2008

Purpose : The purpose of this study was to describe the epidemiologic features of febrile illnesses in newborns and to predict the risk of serious infections in this population. Methods : A retrospective study was conducted on 123 full-term infants <30 days of age with an axillary temperature >38$^{\circ}C$ who were hospitalized between 2000 and 2006. Neonates with prenatal risk factors, congenital anomalies, antibiotic administration prior to admission to the hospital, or suspected hospital-acquired infections were excluded. We evaluated the symptoms, physical examination findings, laboratory data, and clinical course between the high- and low-risk groups for serious infections. Results : The high-risk group included 30 infants with the following diagnoses in order of frequency: aseptic meningitis, urinary tract infection, bacterial meningitis, infectious enteritis, sepsis concomitant with disseminated intravascular coagulopathy, bacteremia, pneumonia, cellulitis, and omphalitis. Leukocytosis and thrombocytopenia were statistically different between the two groups. Factors, such as moaning signs, seizures, body temperature, and pulse rate were statistically significant. Conclusion : Unlike previous studies, we included newborns with clinical bacterial infections and aseptic meningitis as the high-risk group. Leukocytosis, thrombocytopenia, moaning signs, seizures, and changes in vital signs were considered useful predictors for identifying febrile neonates at high-risk for serious infections in spite of a difference in the definition of serious infection.

• Korean Journal of Veterinary Research
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• v.32 no.4
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• pp.605-608
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• 1992

This paper dealt with the clinical and pathological observations on the experimental rabbit viral hepatitis. Rabbits with 2-14 months of ages were intramuscularly inoculated with virus suspension. The results were summarized as follows. Ninety percents of experimental rabbits inoculated with virus died within 96 hours postinoculation. Common clinical signs were inappetence, increase in body temperature, depression, mild diarrhea and in three cases, bloody foam from nostrils was recognized. At necropsy, in most of the experimental cases, there were hyperemia or haemorrhages in many organs and pale liver. Intestinal catarrh and retention of turbid urine in urinary bladder were seen in some cases. Histopathologically, liver necrosis was found in all the cases died of this disease. However, there was a difference in the severity of hepatic necrosis. Haemorrhages were Iecognized in lungs, heart, liver, spleen, kidneys and thymus, in order. Liver necrosis was marked even in the cases with no haemorrhage. Perivascular cuffing in brain and catarrhal enteritis in small intestine were seen in many cases. From these results, consistent and primary lesion in this viral disease is hepatitis in susceptible rabbits. It was concluded that rabbit hepatitis virus might have the properties of hepatotropism and consequently induce peripheral necrosis in the liver leading to acute viremia with haemorrhages.