• Clinical and Experimental Pediatrics
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• 제57권4호
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• pp.164-170
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• 2014

Influenza causes acute respiratory infections and various complications. Children in the high-risk group have higher complication and hospitalization rates than high-risk elderly individuals. Influenza prevention in children is important, as they can be a source infection spread in their communities. Influenza vaccination is strongly recommended for high-risk children with chronic underlying circulatory and respiratory disease, immature infants, and children receiving long-term immunosuppressant treatment or aspirin. However, vaccination rates in these children are low because of concerns regarding the exacerbation of underlying diseases and vaccine efficacy. To address these concerns, many clinical studies on children with underlying respiratory diseases have been conducted since the 1970s. Most of these reported no differences in immunogenicity or adverse reactions between healthy children and those with underlying respiratory diseases and no adverse effects of the influenza vaccine on the disease course. Further to these studies, the inactivated split-virus influenza vaccine is recommended for children with underlying respiratory disease, in many countries. However, the live-attenuated influenza vaccine (LAIV) is not recommended for children younger than 5 years with asthma or recurrent wheezing. Influenza vaccination is contraindicated in patients with severe allergies to egg, chicken, or feathers, because egg-cultivated influenza vaccines may contain ovalbumin. There has been no recent report of serious adverse events after influenza vaccination in children with egg allergy. However, many experts recommend the trivalent influenza vaccine for patients with severe egg allergy, with close observation for 30 minutes after vaccination. LAIV is still not recommended for patients with asthma or egg allergy.

• 한국임상약학회지
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• 제13권1호
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• pp.5-12
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• 2003

Influenza virus is a major cause of respiratory infection in the epidemic season. Especially, the elderly with underlying health problems are at increased risk for complications of influenza. The objective of this study was to investigate that influenza vaccination can reduce the hospital admission rate related to the respiratory diseases. This study was a retrospective study of two age groups, who are the healthy children aged 6 months to 9 years (n=237) and the adults aged over 20 years with respiratory disease (n=327). The vaccinated groups were compared to the controls that were matched in sex and age. The children were vaccinated in winter season of 1995-96 and the adults were vaccinated in 1996-97. The efficacy of influenza vaccine was evaluated with the number of outpatient visits in children group, the admission rate and the mean admission days in both children and adult group. As results, there were not significant differences between the vaccinated and the control group of children. In the elderly over 61 years, however, the influenza vaccination can reduce the admission rate $(8.9\%\;vs.\;25.6\%,\;p<0.05)$ and the mean admission days (1.3 vs. 3.8 days, p<0.05) compared to the control. In conclusion, influenza vaccination can effectively reduce the events related to respiratory infection in the elderly than the children. The elderly should be recommended for influenza vaccination.

• Pediatric Infection and Vaccine
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• 제27권1호
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• pp.53-61
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• 2020

목적: 부모의 소아 자녀에 대한 인플루엔자 및 인플루엔자 백신 관련한 인식도 차이 및 변화를 홍보물 교육 유무에 따라 비교 분석하였다. 방법: 2015년 서울, 경기 북부 5개 지역 거주자 중 생후 6개월부터 59개월까지의 자녀가 있는 보호자 1,034명을 대상으로, 설문지 조사를 시행하였다. 설문내용은 인플루엔자 및 인플루엔자 백신에 대한 인식 및 변화 및 인플루엔자 예방접종 의향 및 이유 등을 포함하였다. 부모는 3군으로 나누어 교육 유무(A군: 교육받지 않음, B군: 교육받음)에 따른 인식도 차이와 교육 전후(C군)의 인식도 변화를 분석하였다. 결과: A군과 B군 간 교육에 따른 인식도 차이 중 의미 있는 항목은 '자녀가 고위험군임을 인식함', '독감 예방접종은 효과적', '독감 예방접종은 비쌈' 등이었다. C군에서 교육 전후에 따른 인식도 변화 중 의미 있는 항목은 '자녀가 고위험군임을 인식함', '독감 예방접종은 안전함', '독감 예방접종은 비쌈', '독감 예방접종을 부정적으로 인식함' 등이었다. 결론: 인플루엔자와 인플루엔자 예방접종에 대한 부모의 인식은 홍보물 교육 이후 긍정적인 효과를 보였다.

• 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.

• Pediatric Infection and Vaccine
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• 제16권1호
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• pp.13-23
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• 2009

Acute otitis media (AOM) and pneumonia are among the most common infectious diseases of children. Both are mucosal infections and share many common features such as etiological agents, pathogenesis and immunity. Influenza plays an important role in the pathogenesis of AOM and pneumonia. A vaccine against influenza may have substantial impact on these diseases during the influenza season. In clinical trials, influenza vaccine has reduced the incidence of AOM and pneumonia complicating influenza in children. However, the efficacy of vaccines has been controversial in children less than 2 years of age. Similarly, vaccines against Streptococcus pneumoniae and Haemophilus influenzae type b (Hib), both common causes of AOM and pneumonia, have the potential to reduce the impact of disease. Clinical trials showed that the currently licensed 7-valent pneumococcal conjugate vaccine (PCV), administered during infancy, had an efficacy of 6-7% for the prevention of AOM, however, visits to the clinic for AOM were reduced by up to 20-30% after routine use in the U.S. Both Hib and PCVs have a proven effectiveness of >20% for prevention of radiologically confirmed pneumonia in children. The recently introduced pnuemococcal vaccine conjugated with protein D is expected to reduce AOM and pneumonia caused by non-typable H. influenzae, in addition to its effects on pneumococcal diseases. Considering their high incidence in children, recent achievements in the prevention of AOM and pneumonia with vaccines may have a significant economic and social impact.

• Clinical and Experimental Pediatrics
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• 제60권8호
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• pp.254-260
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• 2017

Purpose: Seasonal influenza can be prevented by vaccination. Disease prevention in children aged <60 months is of particular importance because of the associated familial and societal burden. Considering that caretakers make the decision to vaccinate their children, the identification of drivers and barriers to vaccination is essential to increase influenza vaccination coverage. Methods: A total of 639 parents participated in the pre- and posteducational survey and 450 parents participated in the study via telephone interviews. The participating parents were asked to rank their agreement with each statement of the survey questionnaire on a scale from 1 (strongly disagree) to 5 (strongly agree), and the scores between pre- and postintervention were compared. Results: Before the educational intervention, 105 out of 639 participants reported not to agree to vaccinate their children against influenza. After the intervention, 46 out of the 105 parents changed their opinions about childhood vaccination. The physicians' recommendation received the highest agreement score and was the most important driver to vaccination, whereas the cost of vaccination was the strongest factor for not vaccinating children. In general, the participants significantly changed the agreement scores between pre- and postintervention. However, the unfavorable opinions about vaccination and the convenience of receiving the influenza vaccine did not change significantly. Conclusion: The results of this study indicate that a specific educational intervention involving caregivers is very effective in increasing the influenza vaccination coverage of children aged less than 60 months.

• 대한소아신경학회지
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• 제26권4호
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• pp.221-226
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• 2018

목적: 열성 경련은 생후 첫 5년간 흔히 발생하는 경련성 질환으로 바이러스 감염과 관련이 있다. 인플루엔자 감염은 열성경련을 포함한 다양한 신경학적 증상과 연관이 있다. 이 연구에서는 열성 경련에 대한 인플루엔자 감염의 임상적인 영향을 평가하고자 하였다. 방법: 총 388명의 소아 중 인플루엔자가 동반된 열성경련 환아 75명, 인플루엔자가 동반되지 않은 열성경련 환아는 313명의 두 그룹으로 나누었다. 이 환자들의 의무기록을 후향적으로 분석하여, 발작 유형, 발작 빈도, 발작 기간, 열성경련의 가족력 및 간질의 발병과 임상적 특징을 비교하였다. 결과: 전체 388명의 열성 경련 환자 중 75명(19.3%)가 인플루엔자 감염이 동반되었다. 인플루엔자 감염이 동반된 열성경련 환자가 인플루엔자 감염이 동반되지 않는 환자보다 평균적으로 나이가 많았으며 ($34.9{\pm}22.3$개월 vs $24.4{\pm}14.2$개월, P<0.001), 이전에 열성경련의 병력이 있는 경우가 더 흔하였다(40/75 (53.3%) vs 92/313 (29.4%), P<0.01). 또한 60개월을 기준으로 환자 군을 나누어 보았을 때 60개월이상 열성경련 소아에서 인플루엔자 감염 비율이 60개월 미만인 소아보다 유의하게 높았다(11/22 (50%) vs 64/366 (17.5) %, P=0.001). 결론: 인플루엔자 감염은 연장아의 열성경련과 연관된 것으로 보이며, 열성경련의 병력이 있는 환자에서 재발과 관련이 있다. 인플루엔자 감염이 동반된 연장아의 열성 경련 환자에서 추후 뇌전증 발병이나 항경련제의 복용 여부에 대한 장기적 추적 관찰이 필요하다.

• Pediatric Infection and Vaccine
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• 제27권3호
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• pp.171-179
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• 2020

목적: 제주 지역에서 2017-2018 절기와 2018-2019 절기에 소아 연령에서 인플루엔자의 역학에 대해 알아보고자 하였다. 이에 더하여 국내 인플루엔자 표본감시체계와 비교하여 그 대표성을 확인해보고자 하였다. 방법: 2017-2018, 2018-2019 각각의 절기에 제주대학교 병원에 방문하여 인플루엔자 검사를 시행 받은 13세 미만의 소아를 대상으로 하였다. 의무기록을 통하여 대상 환자들의 인구학적 자료, 인플루엔자 검사 결과를 후향적으로 분석하였다. 결과: 총 5,219명의 인플루엔자 의사환자가 연구 대상자로 포함되었다. 전체적으로 연구 대상자의 평균 나이는 2.85±2.79세 였고, 두 절기 모두 인플루엔자 의사환자는 1세 연령 그룹이 가장 많았다. 인플루엔자 감염이 확인된 소아는 총 902 (17.3%) 명이었다. 2017-2018 절기에는인플루엔자 A형의양성률은 10.4% (236/2,279), 인플루엔자 B형의양성률은 9.1% (208/2,279) 이었다. 2018-2019 절기에는 인플루엔자 A형의 양성률은 10.3% (303/2,940), 인플루엔자 B형의 양성률은 5.3% (155/2,940) 이었다. 인플루엔자 환자의 평균 연령은 2017-2018 절기에는 4.09세, 2018-2019 절기에는 5.05세로 통계적으로 유의한 차이를 보였다 (P<0.05). 인플루엔자의 주별 분포는 국내 임상감시시스템의 인플루엔자 의사환자와 유사한 형태로 나타났다.결론: 제주 지역에서 2017-2018 절기와 2018-2019 절기 사이에 인플루엔자 유행 양상과 연령 분포의 뚜렷한 차이를 보였다.국내 다른 지역과의 역학적 특성과 비교하여 제주 지역 고유의 인플루엔자 역학에 대한 지속적인 연구가 필요하다.

• Clinical and Experimental Pediatrics
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• 제54권8호
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• pp.329-334
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• 2011

Purpose: The purpose of this article is to describe the clinical and epidemiologic features and outcomes among children hospitalized with pandemic influenza A/H1N1 2009 infection. Methods: We retrospectively reviewed the charts of hospitalized pediatric patients (<18 years) diagnosed with pandemic influenza A/H1N1 2009 infection by reverse-transcriptase polymerase chain reaction at a tertiary hospital in Seoul, Korea, between September 2009 and February 2010. Results: A total of 72 children were hospitalized with pandemic influenza A/H1N1 2009 infection (median age, 6.0 years; range, 2 months to 18 years). A total of 40% had at least 1 underlying medical condition, including asthma (17%), malignancies (19%), and heart diseases (17%). Of the 72 patients, 54 (76%) children admitted with H1N1 infection showed radiographic alterations compatible with pneumonia. There was no significant difference in pre-existing conditions between pandemic influenza A/H1N1 infected patients with or without pneumonia. Children with pandemic influenza A/H1N1 pneumonia were more likely to have a lower lymphocyte ratio (P=0.02), higher platelet count (P=0.02), and higher level of serum glucose (P=0.003), and more commonly presented with dyspnea than did those without pneumonia (P=0.04). Conclusions: No significant differences in age, sex, or presence of preexisting conditions were found between children hospitalized with pandemic influenza A/H1N1 H1N1 influenza infection with pneumonia and those without pneumonia. Higher leukocyte count, higher glucose level, and a lower lymphocyte ratio were associated with the development of pandemic A/H1N1 2009 influenza pneumonia.

• 보건교육건강증진학회지
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• 제27권1호
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• pp.9-19
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• 2010

Objectives: This study is to identify the factors which affect children's preventive behavior for novel influenza A(H1N1) and to provide basic data to health education for children. Methods: The subject of this study were 551 children who were attending on the 4~6th grade in elementary school in Seoul. The data were collected using a self-reporting questionnaire for 5 days from October 12 through 16, 2009. Data were all digitized and analyzed using SPSS 17.0K. Results: As for relationship between preventive behavior and the other variables, correlations were observed with sensibility, self efficacy, respond efficacy and behavior intention, and it was statistically significant(p<.001). According to the result of analyzing factors affecting preventive behavior for Novel Influenza A(H1N1), it was affected by variables such as perceived threat, perceived efficacy, behavior intention. Behavior intention was the most influencing variable and has shown influence in order of self efficacy, sensibility, severity and respond efficacy as follows. Conclusion: The results showed effects on preventive behavior of perceived threat, perceived efficacy and behavior intention. It may be beneficial to improve empowerment for students to prevent influenza A(H1N1) by focusing on perceived threat, perceived efficacy, behavior intention.