• Journal of Preventive Medicine and Public Health
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• 제38권4호
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• pp.379-385
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• 2005

The impact of the next influenza pandemic is difficult to predict. It is dependent on how virulent the virus is, how rapidly it spreads from population to population, and the effectiveness of prevention and response efforts. Despite the uncertainty about the magnitude of the next pandemic, estimates of the health and economic impact remain important to aid public health policy decisions and guide pandemic planning for health and emergency sectors. Planning ahead in preparation for an influenza pandemic, with its potentially very high morbidity and mortality rates, is essential for hospital administrators and public health officials. The estimat ion of pandemic impact is based on the previous pandemics- we had experienced at least 3 pandemics in 20th century. But the epidemiologi cal characteristics - ie, start season, the impact of 1st wave, pathogenicity and virulence of the viruses and the primary victims of population were quite different from one another. I reviewed methodology for estimation and modelling of pandemic impact and described some nations's results using them in their national preparedness plans. And then I showed the estimates of pandemic influenza impact in Korea with FluSurge and FluAid. And, I described the results of pandemic modelling with parameters of 1918 pandemic for the shake of education and training of the first-line responder health officials to the epidemics. In preparing influenza pandemics, the simulation and modelling are the keys to reduce the uncertainty of the future and to make proper policies to manage and control the pandemics.

• 설비공학논문집
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• 제23권7호
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• pp.520-527
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• 2011

Recently, Influenza(AI, PI) patients have been increasing rapidly. But, there is a lack of isolation hospitals. In particular, according to increase the rate of patients with airborne infection, in order to prevent the spread of pathogens, design of layout plan and air conditioning system of isolation hospitals becomes more important to maintain patient's room as negative pressure. In this study, the spread of pathogens are analyzed as room differential pressure, moving time of medical staff and patients, and moving way in isolation hospitals by multizone simulation; CONTAM 2.4. Through the analysis, the ways to improve isolation hospital considered at the design step are reached to prevent the spread of pathogens effectively. Also, it verifies that HVAC system for isolation hospital is suitably designed as standard.

• Journal of Preventive Medicine and Public Health
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• 제43권2호
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• pp.99-104
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• 2010

The World Health Organization (WHO) announced the emergence of a novel influenza on April 24, 2009, and they declared pandemic on June 11. In Korea, the proportion of influenza-like illness and the consumption of antiviral agents peaked in early November. The government established the Central Headquarters for Influenza Control and operated the emergency response system. In the quarantine stations, we checked the body temperature and collected quarantine questionnaires from all the arrivals from infected countries. We also isolated the confirmed cases in the national isolation hospitals. However, as the community outbreaks were reported, we changed strategy from containment to mitigation. We changed the antiviral agent prescription guideline so that doctors could prescribe antiviral agents to all patients with acute febrile respiratory illness, without a laboratory diagnosis. Also the 470 designated hospitals were activated to enhance the efficacy of treatment. We vaccinated about 12 million people and manage the adverse event following the immunization management system. In 2010, we will establish additional national isolation wards and support hospitals to establish fever clinics and isolation intensive care unit (ICU) beds. We will also make a computer program for managing the national isolation hospitals and designated hospitals. We will establish isolation rooms and expand the laboratory in quarantine stations and we will construct a bio-safety level 3 laboratory in each province. In addition, we plan to construct a bio-safety level 4 laboratory at a new Korea Centers for Disease Control and Prevention (KCDC) facilities in Ossong.

• Childhood Kidney Diseases
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• 제14권2호
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• pp.218-222
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• 2010

최근의 유행한 신종 H1N1 S-OIV는 전세계적으로 퍼지고 있고, 이에 동반된 호흡기 질환등의 여러 합병증들이 보고되었다. 신증후군은 간염바이러스 등의 감염 후에 발현될 수 있는 것으로 알려져 있으나 S-OIV 감염 후에 발생한 예는 보고된 적이 없는 실정이다. 저자들은 S-OIV 감염으로 확진된 환아에서 발생한 신증후군이 발생하였으나 스테로이드 치료로 쉽게 치료된 경험을 하였기에 이를 보고하는 바이다.

• 대한임상검사과학회지
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• 제42권1호
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• pp.1-15
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• 2010

Swine influenza virus (SIV) or swine-origin influenza virus (S-OIV) is endemic in swine, and classified into influenza A and influenza C but not influenza B. Swine influenza A includes H1N1, H1N2, H3N1, H3N2 and H2N3 subtypes. Infection of SIV occurs in only swine and that of S-OIV is rare in human. What human can be infected with S-OIV is called as zoonotic swine flu. Pandemic 2009 swine influenza H1N1 virus (2009 H1N1) was emerged in Mexico, America and Canada and spread worldwide. The triple-reassortant H1N1 resulting from antigenic drift was contained with HA, NA and PB1 of human or swine influenza virus, PB2 and PA polymerase of avian influenza virus, and M, NP and NS of swine influenza virus, The 2009 H1N1 enables to transmit to human and swine. The symptoms and signs in human infected with 2009 H1N1 virus are fever, cough and sore throat, pneumonia as well as diarrhea and vomiting. Co-infection with other viruses and bacteria such as Streptococcus pneumoniae can occur high mortality in high-risk population. 2009 H1N1 virus was easily differentiated from seasonal flu by real time RT-PCR which contributed rapid and confirmed diagnosis. The 2009 H1N1 virus was treated with NA inhibitors such as oseltamivir (Tamiflu) and zanamivir (Relenza) but not with adamantanes such as amantadine and rimantadine. Evolution of influenza virus has continued in various hosts. Development of a more effective vaccine against influenza prototypes is needed to protect new influenza infection such as H5 and H7 subtypes to infect to multi-organ and cause high pathogenicity.

• 한국학교보건학회지
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• 제24권1호
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• pp.61-70
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• 2011

Purpose: To identify factors associated with children's discriminatory attitudes towards fully recovered children who contracted the 2009 Influenza A (H1N1), in order to provide fundamental information to improve health education for children. Methods: Cross-sectional data were collected from the entire 6th grade classes (N=2,323) of 11 elementary schools randomly selected from 11 school districts in the Seoul Metropolitan Area of South Korea. Questionnaires were used to assess participants' knowledge of and attitudes towards the Influenza A (H1N1) virus. Results: Multiple regression analyses were used to investigate the factors associated with children's discriminatory attitudes toward fully recovered children who had contracted the 2009 Influenza A (H1N1). Multiple regression analysis revealed that perceived risk of contracting and knowledge of 2009 influenza A (H1N1) were significant factors in predicting a child's attitude toward fully recovered Influenza A (H1N1) patients, after controlling for socioeconomic variables. Conclusion: The findings suggests that perceived risk and knowledge play important roles in formulating children's appropriate attitudes towards Novel influenza A (H1N1) patients who are fully recovered from the disease. To promote and maximize children's attitudes in this area, health education needs to be directed at children to reduce excessive concern about contracting the virus and to improve their overall health knowledge.

• Journal of Preventive Medicine and Public Health
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• 제43권2호
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• pp.109-116
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• 2010

Objectives: The pandemic of novel influenza A (H1N1) virus has required decision-makers to act in the face of the substantial uncertainties. In this study, we evaluated the potential impact of the pandemic response strategies in the Republic of Korea using a mathematical model. Methods: We developed a deterministic model of a pandemic (H1N1) 2009 in a structured population using the demographic data from the Korean population and the epidemiological feature of the pandemic (H1N1) 2009. To estimate the parameter values for the deterministic model, we used the available data from the previous studies on pandemic influenza. The pandemic response strategies of the Republic of Korea for novel influenza A (H1N1) virus such as school closure, mass vaccination (70% of population in 30 days), and a policy for anti-viral drug (treatment or prophylaxis) were applied to the deterministic model. Results: The effect of two-week school closure on the attack rate was low regardless of the timing of the intervention. The earlier vaccination showed the effect of greater delays in reaching the peak of outbreaks. When it was no vaccination, vaccination at initiation of outbreak, vaccination 90 days after the initiation of outbreak and vaccination at the epidemic peak point, the total number of clinical cases for 400 days were 20.8 million, 4.4 million, 4.7 million and 12.6 million, respectively. The pandemic response strategies of the Republic of Korea delayed the peak of outbreaks (about 40 days) and decreased the number of cumulative clinical cases (8 million). Conclusions: Rapid vaccination was the most important factor to control the spread of pandemic influenza, and the response strategies of the Republic of Korea were shown to delay the spread of pandemic influenza in this deterministic model.

• 대한한방내과학회지
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• 제30권3호
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• pp.558-570
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• 2009

Background : Since March 2009, when the first patient of novel influenza A (H1N1) was reported, many deaths have occurred in North and Central America. The start of the 2009 influenza pandemic was declared by WHO Director-General Dr. Margaret Chan on 11 June 2009, and the level of influenza pandemic alert raised from phase 5 to phase 6. There was no vaccine yet developed, and many experts worried that the novel H1N1 virus could kill as many or more as did the influenza pandemic in 1918-1919. Objective : To evaluate the possibility of treatment for 2009 novel influenza A (H1N1) using herbal remedies and other non-conventional therapies. Methods : We researched the clinical studies for novel H1N1 influenza virus-related herbal medicine or non-conventional medicine treatment using internet search engines including PubMed and CNKI. In addition, we reviewed many reports and clinical practice guidelines (CPG) for influenza A (H1N1). Results : Two case series were selected after reviewing 701 papers, and two CPG published by the Chinese government and Jilin province identified. They reported that the clinical symptoms were no more significant than seasonal influenza, and the condition of patients more than 45 years old was milder than those less than 45 years old. There are no patients with gastric problems, and oseltamivir has been used at the same time in all patients. Conclusion : The efficacy and effectiveness of herbal medicine and other non-conventional treatments for the novel influenza A (H1N1) is questionable, and more studies are needed to draw a firm conclusion. However, in the severe acute respiratory syndrome (SARS) experience in 2002/2003, it was demonstrated that herbal medicine can relieve all symptoms of SARS patients, promote absorption of lung inflammation, improve the degree of blood oxygen saturation, regulate immunological functions, reduce the required dosage of glucocorticoid and other medicines, and reduce case fatality rate. In light of the current situation that there is no vaccine or conventional treatment yet available, the study of herbal medicine and other non-conventional therapies are also necessary for appropriate evaluation.

• 대한한의학원전학회지
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• 제22권4호
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• pp.221-239
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• 2009

Background: The recent outbreak of the novel strain of influenza A (H1N1) virus has raised a global concern of the future risk of pandemic. Traditional Korean Medicine(TKM) has been combatting against contagious diseases and developed its own particular and efficient way in treating those diseases. Objectives: Provide a distinctive and effective TKM method in understanding the principles of treatment, prevention, and contraindications against influenza A through case histories. Method: We revised case histories of eminent doctors of Ming and Qing dynasties according to their clinical manifestations similar to those of influenza A. We also verified prescriptions of the "Dong-uibogam(東醫寶鑑)" through examining clinical practices of China today. Results: 1. The subtypes of Warm disease; Wind Warmth and Pestilence has the most similar clinical manifestation in comparison to Influenza A. Specifying these terms is important in recognizing and classifying various diseases under the name of Warm disease. 2. TKM considered not only external factors but also individual factors like general condition, diet, emotion, constitutional types, etc in the treatment of febrile diseases. 3. TKM developed a new way in the treatment of contagious diseases. considering the characteristics of each pathogen. TKM described the Warm pathogen being light as a feather, which enters through the nose, principally affecting the Lung. Therefore, they emphasized treatment with Pungent Sweet Cooling Moistening[辛甘凉潤] method. 4. As the conservation of fluid and humor is the primordial concern in the treatment of Warm disease, they restricted release of the exterior with pungent-warm and purgation method. The purgation methods was used exclusively to decrease fever and preserve fluid and humor. 5. The only differentiating characteristics of Influenza A with seasonal influenza are vomiting and diarrhea. Case research revealed the possibility of these manifestations to be a mechanism of restoration. 6. TKM provides alimento prevention method like Mint Pear Porridge, mung bean, and etc also combination of herbal medicine. Also emphasized in the conservation of essence for the prevention of contagious diseases. Conclusions: TKM developed its unique way in understanding the pathogenesis, diagnosis, treatment, and prevention of contagious diseases and formed its independent scheme of Warm Disease. This knowledge in febrile contagious disease is relevant today in providing diverse treatment and prevention for influenza A.

• Tuberculosis and Respiratory Diseases
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• 제69권1호
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• pp.24-30
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• 2010

Background: A novel 2009 influenza A (H1N1) virus emerged and disseminated to all over the world. There are few reports on the clinical characteristics of patients with complications. We describe the clinical features of pneumonia in adult patients hospitalized, who have novel influenza infection. Methods: There were 43 adult patients enrolled into the study with pneumonia of 528 hospitalized patients confirmed influenza A (H1N1) virus infection by real-time reverse transcriptase polymerase chain reaction testing, between 24 August 2009 and 31 January 2010. The clinical data of patients with pneumonia were collected retrospectively. Results: There were 22 of 43 (51.2%) influenza patients with pneumonia that had higher risk factors for complications. Compared to 28 patients with influenza A (H1N1) viral pneumonia and 15 patients, who had isolated bacteria from cultures, those with mixed viral and bacterial pneumonia were significantly more likely to have unilobar consolidations on chest radiographs (53.3 vs. 10.7%, p<0.01) and higher scores of pneumonia severity index (PSI; 90 [66~100] vs. 53 [28~90], p=0.04). Six patients required mechanical ventilation support in an Intensive Care Unit and were more likely to have dyspnea (83.3 vs. 29.3%, p=0.02) and low levels of $PaO_2$ (48.3 [37.0~70.5] vs 64.0 [60.0~74.5] mm Hg, p=0.02) and high levels of pneumonia severity index (PSI) score (108.0 [74.5~142.8] vs. 56.0 [40.5~91.0], p=0.03). Conclusion: The majority of pneumonia patients infected with novel influenza improved. Chest radiographic findings of unilobar consolidations suggest that mixed pneumonia is more likely. Initial dyspnea, hypoxemia, and high levels of PSI score are associated with undergoing mechanical ventilation support.